CO-FUNDING

The Best of Both Worlds:
Forging a Model Public-
Private Partnership

The financial crisis that followed the end of the tech bubble in 2000-01 led the Hartford Foundation to the difficult realization that it could no longer continue to fund the Paul B. Beeson Career Development Awards in Aging Research.

The Beeson Awards had proven to be a highly successful program that had attracted scores of brilliant physician-scientists to the aging field over the previous decade. Determined not to allow the program to fail, Dr. Rieder and Hartford staff forged an unlikely alliance, to say the least.

Within the federal government’s National Institutes of Health (NIH), there was no model for creating a public-private career development award. And within the academic ranks of the then-privately funded Beeson Awards, there was some skepticism and concern that bringing in the federal government as a partner would threaten the integrity of the program.

The groundbreaking partnership took two years of hard work to put together. A decade later, the public-private alliance that saved the Beeson Awards is not only thriving, but has served as a model for two similar endeavors: MSTAR (Medical Student Training in Aging Research) (Training and Mentoring Medical Students in Aging Research) and GEMSSTAR (Grants for Early Medical and Surgical Specialists Transitioning to Aging Research) programs (When You Wish Upon a STAR).

“Both the public and private partners brought their own unique resources and abilities to make the program happen,” says Odette van der Willik, deputy executive director and director of grant programs for the American Federation for Aging Research (AFAR), which now jointly administers the program with the NIA, one of 27 institutes and centers within the NIH. “Our goals were really the same: to train more physician-scientists in aging and geriatric medicine.”

By all accounts, forging the public-private partnership required considerable creativity and perseverance. The Beeson Scholars program had been launched in 1994 with support from the Hartford Foundation, the Commonwealth Fund, and a third anonymous funder, later identified as The Atlantic Philanthropies. The idea for the career development award originated in the early 1990s with the late Margaret E. Mahoney, who was president of the Commonwealth Fund at the time.

Fact: 50 percent of Beeson Scholars from the 2004 through 2011 cohorts who responded to a 2012 AFAR survey already hold leadership positions, such as center director, division chief, director of fellowship programs, or they serve on advisory committees. That percentage will certainly rise as those mid-career Scholars in the most recent cohorts advance further along their career trajectories.

The concept was to create a prestigious award—which turned out to be the largest non-governmental scholarship program dedicated to university faculty development, $450,000 over three years—that would attract the best physician-scientists to conduct research in geriatrics, and hopefully, devote their careers to the field. The logic, over time, assumed that top medical students would want to work with these researchers, bringing even more talent to the field.

For the next decade, the program—named for Paul B. Beeson, MD, a renowned physician, researcher, and teacher who, before his death in 2006, attended Beeson Scholars meetings and advised many scholars—delivered on that promise, as other private funders would join for a few years and then move on. One of those was the Starr Foundation.

“It was clear to us at Starr that the aging population required the medical world to look at geriatrics and gerontology more seriously,” says Florence A. Davis, president of the Starr Foundation. “At that time, we were expanding our medical research program, and this just made a lot of sense to us.”

The severe economic downturn that followed the tech bubble-burst in 2000-01 left the Hartford Foundation without funds available to back the program independently.

(Left) Scholars share research posters at the 2013 Beeson Annual Meeting in Santa Ana Pueblo, New Mexico.
(Right) Edward H. Koo, MD, Chair of the Program Advisory Committee and Professor of Neurosciences at UC San Diego Department of Neurosciences. The Beeson Scholarship enabled Dr. Koo to further his research on Alzheimer’s Disease.

Dr. Rieder estimates that over the course of a year, she approached more than a dozen foundations in an effort to convince them to join Hartford in supporting the program. Finding no takers, she came up with the idea of reaching out to the NIA to explore the possibility of creating a sustainable public-private collaboration. It took another year of difficult negotiations before the partnership was struck.

“I really wanted to have this program continue because it was having a huge impact,” Dr. Rieder says. “And there was no way that we had the resources to continue it on our own.”

Robin A. Barr, DPhil, director of the NIA’s division of extramural activities who was training officer at the time, says the NIA’s existing career award program did not offer sufficient compensation to attract more physicians into aging research. So the idea of pooling government and foundation money to come up with a larger, more attractive career development award was appealing, even if it did require blazing new trails at the NIH.

What really impressed him, he says, was “…the organization that went beyond just the awards. Hartford was paying for an annual meeting of the Beeson awardees, which really was—and still remains—a very effective device in terms of sharing their results with each other, developing collaborations, and working with mentors. Basically, that annual meeting alone is a real building block for their careers, beyond the career development award itself.”

It took a shared commitment and willingness to compromise to get the partnership off the ground. Leading experts in the field of geriatrics participated in the Beeson Scholars program review process, and there was concern among some on the academic side that federal rules and regulations would turn the process into a bureaucratic mess or lose sight of the program’s focus on leadership development.

“I think a lot of credit has to be given to NIA leadership in being creative,” AFAR’s Ms. van der Willik says.

The NIA removed the main stumbling block when the agency essentially agreed to accept many of the Beeson review committee members onto the new federal review committee, a move that Beeson project leaders believed would preserve the integrity of the program.

As Dr. Barr worked on getting the new model approved, he says, “At times, I felt that NIH was writing policy around this initiative because there was a gap—they hadn’t done it before. It required our efforts at NIA to make NIH bend sufficiently to allow this to happen. But the thing is that the NIH is one of the more flexible agencies in government. We are always saying the rules are there to serve the research community, they’re not there to obstruct the research community, so let’s find a way through it in order to make it work. I had a lot of support from colleagues because of that general prevailing attitude at NIH.”

In 2004, the new partnership to fund and administer the Beeson Scholars program was established between the NIA, AFAR, the Hartford Foundation, The Starr Foundation, and The Atlantic Philanthropies. It arose from economic uncertainty to a stronger and more stable program that draws on the best of both worlds—the NIH’s rigorous peer-review process and imprimatur attracts a more diverse pool of applicants, which along with the networking and mentorship aspects, were a hallmark of the private program.

It wasn’t cobbling together a brand-new team and trying to figure out who was going to play shortstop. It was pretty clear they had already ironed out the problems and that we were going to be joining a very functional project. Sometimes, it’s like herding cats. This was not one of those cases.” Florence A. Davis, Esq.
President
The Starr Foundation

“It’s a true public-private partnership,” says Stephanie Lederman, EdM, executive director of AFAR, who adds that the unpaid mentors provided by the institutions receiving stipends constitute “another kind of partnership.”

One of the keys to the program’s success is its ability to deliver measurable results. Over a 19-year span, 186 scholars from more than 50 institutions have received Beeson awards. Many are now in leadership roles at top research institutions, and the collective impact of the Beesons on the aging field is undisputed. Thanks to the public-private partnership, funding is assured at least through 2017.

As the Beeson program marks its 20th anniversary, John E. Craig, MPA, executive vice president and chief operating officer of The Commonwealth Fund—an integral partner at
the beginning and throughout the first decade—remarks, “It really is quite an impressive story. There are real challenges in collaboration. So this is quite phenomenal. With all the partners involved, there’s amazing unanimity on what it’s all about.”

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