Evolution of TCWF's Grantmaking
Gary L. Yates (Yates): The Foundation was created when Health Net converted from a nonprofit health plan to a for-profit company. After Health Net received regulatory approval from the California Department of Corporations to convert, it set aside assets to establish a foundation. Roger Greaves — who at that time was president, chairman and CEO of Health Net — worked on the Foundation’s original proposal for the Foundation to the Department of Corporations. The vision for the Foundation from the beginning was on health promotion, wellness education and disease prevention to improve the health of underserved Californians. Tom David (David): Roger Greaves was something of a pioneer in the area of prevention especially among HMOs. From the perspective of our emphasis on health promotion, wellness education and disease prevention, we’ve stayed true to the vision of our founder. Portfolio: How have the Foundation’s grantmaking areas changed over the years? Yates: In the Foundation’s 10-year history, there have been three sets of priority areas. In 1992, we had a responsive grants program with priority areas in Promoting Healthy Communities, Maternal and Child Health, Adolescent Health Promotion and Disease Prevention, School-linked Services, Integrating Wellness Into Delivery Systems and Work-Related Health Promotion and Disease Prevention. That year we also launched the Violence Prevention Initiative (VPI). David: I appreciate that even in those early years, the Foundation recognized the importance of having a fund for responsive grantmaking. In 1995, we began implementing a plan for strategic grantmaking that ushered in our second set of priority areas in Community Health, Population Health Improvement, Teenage Pregnancy Prevention, Violence Prevention, and Work and Health. While each of these priority areas had an initiative program, they also each had a small amount of grant dollars that could be used for responsive grantmaking — that is to say, funding those needs that the applicants themselves had identified. Yates: At that time, we also established the Special Projects Fund to address opportunities that fall outside the scope of the priority areas but fit with the Foundation’s mission. David: In 1995, the strategic plan for the next five years set allocations of 70 percent of our grantmaking dollars for initiatives, 15 percent to general grants and 15 percent to the Special Projects Fund. Yates: The third phase started in July 2001 when we launched our current grantmaking program with priority areas in Diversity in the Health Professions, Environmental Health, Healthy Aging, Mental Health, Teenage Pregnancy Prevention, Violence Prevention, Women’s Health, Work and Health plus the Special Projects Fund. Two of the priority areas — Violence Prevention and Teenage Pregnancy Prevention — still have initiatives as part of the funding areas, but the others are primarily responsive in nature. David: For the time being, no more than 50 percent of funding will be allocated to initiative-style grantmaking. The remaining 50 percent is for responsive grants, with an emphasis on providing core operating support. Portfolio: What prompted that shift of focus from initiative-style to responsive grantmaking that could cover core operating expenses? Yates: We heard a recurring message from our Grantees — they face tremendous difficulties meeting the basic expenses required to provide their core health services. Many expressed frustration that the majority of foundation grants are only available as initiative or new project funding, which leaves the organizations still straining to cover operating costs. We realized that by locking up so much of our funding in five- or 10-year initiatives, we were contributing to this problem and keeping a lot of other organizations out in the process.
Yates: Our intent is not to convey that all initiative grantmaking is negative. To the contrary, we will continue providing proactive funding, including two initiative programs, but we want to balance that with funding for core operating support. We have found that it can be very strategic to provide core operating support — in a timely fashion and for a specific purpose. David: A good example of this is the cluster of grants we made for core operating support to community clinic associations to support their member clinics as they made the transition to managed care. A lot of people were writing the clinics off, saying they’d never be able to compete in a changing marketplace. At the end of 18 months of funding, they had made great strides and many had successfully transitioned to a managed care model. We didn’t parachute in experts or come in saying “here’s what you need to do,” but instead, identified strong leaders and gave them the funding they needed to strengthen their work.
Portfolio: In looking back at your experiences over the past 10 years, have you found that there are some grantmaking areas that seem to take longer to make an impact? Yates: Effecting change in public policy often takes longer. That’s why I think it’s important that evaluations capture process or interim steps. For example, has the organization or community developed its capacity to engage in policy advocacy? Are community advocates seeing or meeting with policymakers? These are important steps—and significant policy changes rarely occur without them. David: When addressing complicated issues like changing public health policies or even mobilizing communities around a health problem, I think it’s important to keep in mind that these efforts require long-term commitment from funders and Grantees. Yates: Absolutely. A good example of this is our Violence Prevention Initiative. Prior to 1992, no state handgun control legislation had ever made it out of committee. At the five-year mark, some capacity was built among the organizations and communities engaged in this advocacy work, but legislation hadn’t been passed yet — although it did make it to the Governor’s desk. In year seven of the Initiative, a number of significant bills were signed into law with the result that California now has some of the strongest gun control regulations in the nation. David: If we hadn’t continued to fund our Grantees’ advocacy efforts over a significant period of time, it is highly unlikely that those policy achievements would have occurred. Yates: With that said, an example comes to mind of a policy change that happened quickly. In 1994, Proposition 188 was on the ballot, and had it passed, it would have weakened local tobacco control ordinances. Prop 188 was backed by the tobacco companies who were very clever — giving it the name “The California Uniform Tobacco Control Act,” which made it sound like a measure put forth by health advocates. We made a grant to the Public Media Center to educate voters about the proposition through a public education campaign, which took no position on the measure but merely stated the facts. David: I think it’s a matter of being ready when the window of opportunity opens. Portfolio: Thank you for this opportunity to learn about the evolution of the Foundation’s grantmaking. Yates: That’s a key word — “evolution” — we are always evolving. We’ve made our share of mistakes, but I think we’ve been good about learning from them and the Foundation and Grantees are better off for it. |
Spring 2002
| INSIDE:
Celebrating 10 Years of Health Focused Grantmaking TCWF founder Roger F. Greaves honored TCWF announces new board officers |
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