J MOSS FOUNDATION
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Mission Statement
Our mission is to increase access to Lifestyle Modification Programs, enable organizations to be agents of change in their communities, and connect those with prediabetes to the resources that address their social needs. Together we fight racial and health inequity and enable those at-risk to thrive, not just survive.
About This Cause
ABOUT US The Skinny Gene Project (SGP) is a 501(c)(3) non-profit organization dedicated to preventing the intergenerational epidemic of type 2 diabetes throughout the US. By developing a collaborated network of payers and diabetes prevention program providers, we educate those who are at-risk, empower them by providing an evidence-based lifestyle modification with accountability and support to prevent the progression of prediabetes into full-blown type 2 diabetes. As a non-profit diabetes prevention network, our mission is to increase access to lifestyle modification programs, enable organizations to be agents of change in their communities, and connect those with prediabetes to the resources that address their social needs. Together we fight racial and health inequity and enable those at-risk to thrive, not just survive. We have the rare distinction of being a Fully Recognized National Diabetes Prevention Program (National DPP), CDC Training Entity, and a CDC Umbrella Entity. This makes us the only known organization working with the CDC to address all three barriers to scaling the National DPP – programming, staffing, and organizational support. OUR PARTICIPATION AS AN UMBRELLA ENTITY In 2020, the Skinny Gene Project became one of only seven CDC Umbrella Entities (UE) in the country. Four of these entities are CDC-funded pilot programs, making SGP's autonomous, community-based Umbrella truly unique. Marlayna Bollinger, Founder and Executive Director of the SGP, realized that most community-based organizations lack the required infrastructure to successfully launch and sustain a National DPP. Over the last three years, the SGP identified common obstacles organizations face with National DPP and began offering solutions to address these needs. Although some services are offered à la carte, the core solution is a hub-and-spoke model that provides a suite of services to organizations. This "DPP in a Box") includes a centralized coordination center for referrals, participant eligibility and insurance verification, cybersecurity, claims and billing, etc. In 2020, the CDC announced the launch of their UE program, to which the SGP was strongly urged to apply. Becoming an official CDC UE was a quintessential step for the SGP. The new program validates the need for our hub-and-spoke model, provides the guidelines to integrate our model into the National DPP framework, and allows us to share our Medicare DPP credentialing with our Umbrella subsidiaries. The new pass-through rule enables our organization to extend our credentials and contracts to entities of our choosing, thereby allowing them to immediately become a Fully Recognized National DPP organization eligible to serve and bill for Medicare beneficiaries. Becoming a UE aligns with our mission, increases the number of National DPP programs in the community, and moves us one step closer to access for all. OUR EVOLUTION The SGP Umbrella is the natural progression of Bollinger's 18-year journey as a diabetes prevention advocate and the non-profit's evolution over the last 12 years. What started as a mere passion for diabetes prevention has evolved into a vision to create racial and health equity, so vulnerable communities are enabled and emboldened to heal themselves from chronic disease. Bollinger's passion for diabetes prevention is rooted in her family's history of losing her father's entire lineage (i.e., nuclear family) due to lack of access to quality health care. Losing her Aunt Gloria in 2001 to type 2 diabetes was the catalyst that later sparked Bollinger's passion for prevention. In 2002, Bollinger's work as an advocate for diabetes prevention began. She led several community and physician awareness campaigns to increase screenings and diagnosis of prediabetes in vulnerable communities. Her first major initiative was the Wellmobile in 2004, which brought daily HbA1c testing and prediabetes awareness to the streets of Chicago for one year. Bollinger's time spent interacting with the community enabled her to see, first-hand, how lack of information and low health literacy widens the health disparities gap in high-risk communities. Bollinger recognized that the solution to the diabetes epidemic requires a multidisciplinary approach that would bring together stakeholders to narrow the health disparities gap and address the discrepancy of access to interventions, not just access to information. In 2008, Bollinger founded the J. Moss Foundation to honor her father (Dr. Jesse Moss Jr.) and joined his fight for patients' right to quality health care. Whereas the name J. Moss Foundation is a nod to Bollinger's dedication to increasing physician engagement in diabetes prevention, its dba Skinny Gene Project is now widely-known as being the community-based organization at the forefront of efforts to scale the National DPP in Southern CA. The SGP was the first organization in San Diego County to become a National DPP Provider and launched its first cohort in 2014. We have the rare distinction of being the first organization in San Diego County and the third in California to receive Full Recognition from the Centers for Disease Control and Prevention (CDC) – an accreditation given to organizations whose program outcomes confirm the delay or prevention of type 2 diabetes. We have continued to achieve Full Recognition every year (6 awards) since. Over the past six years, we laid the framework that enabled our growth from 20 to over 400 participants served (directly) in our SGP National DPP annually. This achievement is well above the national average for community-based, National DPP Providers, which serve 30 participants a year. Furthermore, the SGP accomplished this feat without substantial grant funding or large donors, an operating budget for National DPP of less than $250,000, and three administrative staff. Lack of dedicated funding to support the SGP National DPP and delays in insurance reimbursement (e.g., Medicare coverage began in 2018) limited the number of participants the SGP directly serves each year. Still, it also forced Bollinger to focus on building a non-grant funded, sustainable model for the program. OUR SUSTAINABILITY To create a sustainable model able to scale the National DPP, the SGP took a more upstream approach. In addition to providing the evidence-based program, the SGP offered technical support to organizations to launch their National DPP (e.g., Dignity Health). We became one of twelve CDC Training Entities to increase the number of lifestyle coaches able to provide the National DPP. We have trained over 150 coaches (85% POC) throughout CA and held virtual trainings in China and Iceland. The SGP was also one of the first community-based programs to directly contract with insurance plans for the National DPP. In addition to billing fee-for-service Medicare, we have several contracts and referral partners with Medicare Advantage (e.g., Inland Empire Health Plan) and Medi-Cal (e.g., Community Health Group) plans. We also have indirect commercial contracts via Solera Health. Understanding that referrals are crucial to National DPP sustainability, SGP partnered with Unite Us to create a case management system and multidirectional referral network. The platform allows us to make community-to-community and clinical-to-community linkages that increase National DPP referrals, address participants' social needs, and allow a referring provider to track their patient's success in the National DPP. Our unique collaboration with Unite Us has been the subject matter of white papers for the CDC, a case study from the USC Gehr Family Center for Health Systems Science and Innovation, and other research projects. The CDC's research has shown that the sustainability plan for most community-based Medicare DPPs should include sharing resources, as the infrastructure required to provide the program can be too cost-prohibitive for one organization to shoulder alone. Bollinger believes our sustainability is directly tied to our collaborative network's success, which is why the SGP provides the infrastructure, technical assistance, and credentials for our subsidiaries to thrive. OUR ADVOCACY At state and local levels, Bollinger continues to be a staunch advocate for diabetes prevention. She is a member of the Advisory Committee for the CA Department of Public Health's Chronic Disease Control Branch's Diabetes Awareness and Outreach Campaign. She was a Co-Facilitator for the Coalition for Diabetes Prevention, which authored the trailer bill recommendations for the rollout and coverage of the Medi-Cal DPP. Later, Bollinger advocated and succeed in keeping Medi-Cal DPP in the 2020-2021 CA State Budget, when the benefit was in jeopardy of being eliminated. Currently, a person's zip code (not genetic code) is the best predictor of their health. By equipping stakeholders with the technology to connect health and social services to National DPP providers, thereby providing a whole-community approach to individualized care, Bollinger is determined to ensure every person in every zip code has the opportunity to prevent type 2 diabetes.