Integrative Health and Wellness
We envision a future where person-centered approaches to whole health and wellness, spanning the spectrum of life’s choices, are available to all.
David Lovell’s experience with integrative medicine techniques, such as guided imagery and meditation, as he was experiencing end-stage lung cancer helped him spend his last two months more peacefully while connecting with the people he loved. Others in the Lovell family have learned to manage chronic conditions by adopting an integrative perspective in their health and wellness care. These personal experiences led to the Foundation’s support of the nascent field of Integrative Medicine, beginning in 1994. Over time, our focus broadened to become “Integrative Health and Wellness” as, along with allopathic medicine, much of what supports health and wellness, includes nutrition, mindfulness, body work, acupuncture, and therapeutic exercise.
The Bravewell Collaborative
In November 2001, Lura and Ann [Lovell] joined with a dynamic group of like-minded philanthropists who then collaborated to strategically leverage partnerships within the medical system. The goals were to transform the culture and practice of healthcare through initiatives to change physician education, document existing efforts, empower champions, develop and support growth of replicable models or networks of integrative care, and effect cultural change through public education. The Bravewell Collaborative was formally established in early 2002 and over the 13 years of its existence, upwards of 20 individuals and family foundations committed to this work, together investing close to $30,000,000 in pursuit of this vision. The Lovell Foundation committed just over $1,200,000 with Ann and Lura serving as board members and Ann serving on the executive committee as Treasurer.
The Collaborative’s strategies for systemic change, some of which emerged from two pro bono studies done for Bravewell by McKinsey and Co., were responsible in moving the field from relative non-acceptance to more than one-third of the US medical schools embracing integrative medicine. Bravewell’s PBS special, The New Medicine, was selected to air nationally and was awarded the Freddie International Health and Medical Media award. Bravewell also partnered with the Institute of Medicine to sponsor the Summit on Integrative Medicine and the Health of the Public, which among other things validated the strong scientific base that exists for such practices. Other amazing impacts include:
• A consortium of more than 80 medical schools that now teach, research, and practice integrative medicine.
• The world’s largest international integrative medicine research conference.
• Four publications on integrative medicine.
• A fellows’ program at the University of Arizona and a leadership program at Duke University.
• The first practice-based research network in integrative medicine, PRIMIER.
Expanding the Impact of Comprehensive Pain Care for Medically Underserved
The Foundation began looking for ways to make an impact on accessibility just as more attention was finally being paid to the opioid crisis. The national spotlight on this issue created an opportunity to support ways to expand payment for alternative methods for pain management, especially for underserved populations.
Whole Health in the States (WHITS), developed at the Oregon Collaborative for Integrative Medicine and now an initiative of the Academic Consortium for Integrative Medicine and Health, developed a pilot including Arizona, California, Colorado, Illinois, Oregon, Vermont, and Washington D.C. to explore the ability to provide better access to evidence-based, non-pharmacological treatments for chronic pain for the medically underserved, including the Medicaid population. Working at the state level, WHITS convenes and supports local champions to find local solutions through legislation, administrative policy change, education, and advocacy. The goal is to create blueprints for change, to disseminate solutions, and shorten the process for other states to improve access to whole health for all.
• In Arizona, El Rio Community Health Center’s comprehensive pain program is now co-located instead of being a satellite program dispersed across the city. The WHITS initiative was a driving force in supporting El Rio in this decision.
• In Vermont, the University of Vermont’s Comprehensive Pain Program participated in active discussions with Vermont’s accountable care organization, OneCare, to pilot their program with Medicaid patients. University of Vermont’s team has stated that participating in WHITS has accelerated their work and has opened “door after door” and expedited their goals.
Indigenous Healing
The Center for Mind Body Medicine (CMBM) created, in partnership with Native leaders, Empowering All Relatives to Heal (EARTH): Trauma Healing and Resilience in US Native Communities. CMBM has begun to implement its comprehensive training in trauma relief and resiliency building for 420 native nation healthcare providers, educators, counselors, and community and youth leaders representing 20 Nations across North, Central and South America. CMBM’s initiative has recently been added to the program registry with the California Evidence Based Clearinghouse. In another collaboration success, the EARTH initiative funding from the Lovell Foundation was matched by a $600,000 grant from the Novo Foundation and recently, another $300,000 from Wayfarer Foundation.
End-of-Life Care Planning—a Path to More Integrated Care
The Foundation funded the production and outreach of a documentary created by local Arizona Public Media entitled Passing On. The documentary focused on the importance of preparing for end of life, and, in some cases, choosing to forego unwanted medical care. The associated outreach efforts included partnering with local organizations for screenings in southern Arizona, generating large turnouts. The film was picked up nationally by PBS and received the Governor’s Award at the 2016 Rocky Mountain Emmys. Based on that success, the Foundation looked for and found synergy among several local organizations, peer funders, and national coalitions targeting this issue. The result was a collaboration with the Community Foundation for Southern Arizona to fund, over time, 18 unique Grantee Partners and dozens of like-minded organizations and individuals to form the Nation’s largest community-based end-of-life care coalition, the Arizona End of Life Care Partnership (AzEOLCP), anchored at the United Way of Tucson and Southern Arizona (https://lovellfoundation.org/story/end-of-life-care/).
The End-of-Life Care Partnership’s mission is to “enhance the way we live by fundamentally changing the way we talk about death.” The Foundation invested nearly $9,000,000 over seven years for planning, programming, and administration. The Partnership grew from a group of just a dozen advocates around a table in 2016 to now include more than 230 organizations and 350 stakeholders across the nonprofit, healthcare, education, and business sectors.
The impacts on the greater Tucson community are far-reaching and too numerous to report here, however, below are examples of some of the system level changes documented after the six-year grant period.
• The University of Arizona Health Sciences schools of medicine, nursing, pharmacy, and public health came together to create the Interprofessional End-of-Life Care Training Partnership for health sciences students to implement and evaluate a serious illness and end-of-life curriculum through the CARES (End-of-Life Cases and Resources) Toolkit that is fully embedded into each of the school’s formal curriculum.
• Between 2016 and 2021, due to the work of the AzEOLCP and others, there was a substantial increase in the use of advance care planning services and hospice services across the state, with a marked decrease in the average length of hospital stay in the last two years of life in Pima County (greater Tucson).
• El Rio Health, the largest federally qualified health center in Arizona, providing care to one in eight Pima County residents, 69% identifying as people of color, saw a 50%completion rate in employee advance care plans.
• Arizona Hospital and Health Care Association (AzHHA), a champion of the statewide movement to promote advance care planning through their initiative, Thoughtful Life Conversations, has helped establish legislation giving patients more control of their healthcare decisions prior to hospitalization.
• After years of work by AzHHA to change the legislation regarding the state oversight of the advance directive repository, Contexture, which serves as Arizona’s and Colorado’s health information exchange, is fulfilling this mandate by creating a first-of-its-kind, Arizona Healthcare Directives Registry (AzHDR) that can be used in real time by patients, first responders, doctors, emergency departments, specialists, and other caregivers, both formal and informal, to access an individual’s advance directives and medical orders. Funding from the Foundation supported the infrastructure and transfer of documents, whereas funding from the state Medicaid office supported education and marketing.
Contexture also finalized a new provider agreement that will allow for the inclusion of community service and faith organizations to participate as subscribers in the AzHDR and assist clients with uploading their advance directive documents. Pima Council on Aging became the first community-based partner to participate.
• The Arizona End of Life Care Partnership was a vehicle to educate and bring organizations such as Catholic Community Service’s St Jeanne Jugan Ministry to the table, reaching a large segment of the Latinx community in Tucson. This initiative quickly expanded to workshops for priests, deacons, and lay leaders, incorporating a video of the Bishop encouraging parishioners to participate in end-of-life planning. Today St Jugan Ministry staff is seen as the experts in end-of-life care and planning for the greater Catholic community in Tucson.
We invite you as supporters of Integrative Health and Wellness to explore these and other efforts highlighted on our site to see if they might fit into your own personal or organizational philanthropic goals.
“Integrative medicine is an approach to care that puts the patient at the center and addresses the full range of physical, emotional, mental, social, spiritual and environmental influences that affect a person’s health.”
The Bravewell Collaborative