Now more than ever, healthcare organizations are seeing the importance of evolution from hospital care to healthcare to health in order to meet the needs of the community.
Simply, healthcare’s emerging mission is less about building hospitals to treat illness and injury and more about elevating the health status of individuals and communities.
As the organization shifts to a more community, value-based module, the foundation will need to shift as well. Since the healthcare foundation’s mission is to help support the parent organization and to meet the needs of its constituents, foundations are increasingly pivoting to adjust their case for philanthropic support to align with this new community-based priority.
For years, the fear has been donors will not support non-traditional community impact initiatives. At the surface, it would appear that historical data would support this theory. The 2019 Association for Healthcare Philanthropy Report on Giving identifies the top three healthcare areas supported by philanthropy were construction and renovation (20.5%); patient care program support (19.6%) and capital equipment (14.6%). Community-aligned initiatives represent a much smaller portion– community support/advocacy receiving 4.2% of the philanthropic dollars. However, the reality is this is likely more about asking than interest: most organizations are not asking donors to support community impact initiatives, but philanthropists – from foundations to individuals – appear to care about these issues and welcome a shift.
When a prospective donor is presented with a capital project during a feasibility study, the overwhelming comments are not about the square footage but are more focused on the impact. People ask important questions like “What difference will the new building make to patient care? Why is the building needed? What is currently missing in the existing space?”
Philanthropists are becoming less motivated by shiny, new buildings and more motivated by innovative and potentially replicable projects that can accelerate results.
Philanthropists look for a return on investment and want to see the impact of their gift. Since positive health outcomes are seen from a higher ratio of social health dollars verses traditional health spending, community impact aligns with philanthropist interest in an innovative, higher ROI (Bradley et al., 2016). And younger philanthropists are becoming more entrepreneurial, continuously searching for new ways to solve problems and believing traditional methods have not adequately addressed current problems.
Fidelity Charitable’s 2020 Giving Report also validates the community impact alignment with philanthropists. It reports 60% of Fidelity Charitable donors designate their gifts to the highest need, realizing trusted organizations require flexibility to address mission-critical priorities. The report also shares that donors support more than twice the number of charities today than they did ten years ago–focusing more on causes than organizations and that 41% of donors change their giving behavior based on nonprofit effectiveness. Donors want to see impact.
Community Collaborative Philanthropy
Prior to the pandemic, there was already a growing trend by individual donors and foundations to support initiatives that expand beyond the hospital walls and beyond the reach of a single organization. Robert Wood Johnson Foundation is one leader of this charge believing “achieving a national Culture of Health will take unprecedented collaboration” and encouraging grantees to include healthcare organizations, universities, government agencies, banks, etc. Payer philanthropists, such as the Humana Foundation, not only encourages collaboration but mandates the relationship in their application process.
The Association of Fundraising Professionals identified partnerships as one of eight fundraising trends for 2020. On the hospital operations side, a 2016 American Hospital Association annual survey revealed 74% have entered into at least one type of community partnership to address social determinants of health. If not yet formed, opportunities for philanthropy alignment will soon follow to help fund these complex initiatives.
COVID-19 has demonstrated the power joining forces can have on constituents needing services as well as on the philanthropists who can help. In Atlanta, Georgia, the Community Foundation for Greater Atlanta and the United Way of Greater Atlanta joined together to expand the philanthropic reach and to more effectively identify the greatest needs within the community. Within the first two months, the joint venture raised $25M and distributed $17.3M to high-risk audiences in order to address the 46% of families in metro Atlanta who do not have $400 on hand for emergencies.
Philanthropists see the value for organizations to partner with others for increased resources, expertise and outreach. However, it should be acknowledged nonprofit partnerships do create organizational challenges, such as which organization will legally accept the gifts and how donors will be acknowledged and stewarded in the future. While organizations will need to address these somewhat complex topics, donors will continually expect and support the movement.
The Right Community Impact Fundraising Case
Not all community impact projects are created equal. Community impact projects as with traditional capital projects still need to align, not only with the organization’s priorities but also with donor interest. Chosen community initiatives need to excite, be unique and have the ability to enhance the current status of care within and beyond the hospital walls. Each case should have the buy in of the leadership and perspective donors, have a community champion and a personal story to share. Activity to choose the case should engage pertinent community partners and discuss division of strategy and philanthropy. Times have changed and so have the development and selection of cases for support.
COVID-19 Case Clarity
“Never let a good crisis go to waste.” – Winston Churchill
The Advisory Board Company’s Philanthropy’s Path to 2020 report, identifies three key barriers for donor comprehension for community impact initiatives:
1) a bridge too far removed: existence too far outside familiar scope
2) far removed: inability to connect with direct impact
3) intangible: difficulty to articulate case
Whether donor comprehension was a barrier for supporting community impact before COVID-19 or not, the pandemic has clearly made the case for health beyond the walls of the health care organization much more tangible. Not only are the COVID-19 stories about hospital patients on respirators but the headlines have highlighted the impact and intersections of social determinants of health including health differences in racial disparities, densely populated verses rural areas, and how access to broadband is now a variable for medical access through tele-health platforms. The crisis has shown how education, trust, and policy can impact community behavior. Social distancing has also shown the negative impact social isolation can have on senior citizens and overall mental health.
Lifting the words of Hamilton: Let’s not throw away our shot. Hospitals and communities know something different is needed, and philanthropists are eager to help create something better and unimaginable by many.
Now is the time not only for healthcare institutions to reimagine itself, but it is also the time for nonprofit foundations to do the same.
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