The author, a high-ranking official in Colorado’s health department and a family physician in his previous work life, is president and CEO of the Colorado Trust. This statewide health foundation is based in Denver. GrantWatch Blog invited Ned Calonge to reflect on his experiences in the foundation and state government sectors.

It’s been a little over a year since I left the Colorado Department of Public Health and Environment, where I was the medical director, to accept the position of president and CEO of the Colorado Trust. While it’s clear I still have a great deal to learn about philanthropy and the foundation and nonprofit sector, it has been interesting to me to reflect on the similarities and differences of the two approaches to addressing the health of our communities.

One of the welcome differences is being free to be circumspect in sharing observations, opinions, and even data. Unfortunately, in my view, even the best, most transparent government officials feel the need to control or “spin” information, though it’s true that some are worse than others. Public image, politics, advocacy, and special interests all play key roles in what government employees are allowed to say, how and what information is released, and how findings are emphasized and acted on.

Foundations, on the other hand, have the ability to undertake studies and evaluations, produce reports, release information, and promote information use much more freely. Our commitment and our accountability are to our missions, to the truth, and to the best interests of the communities we serve. Of course, our reports must be valid, balanced, and respectful of the differing views and ideologies of others, but we can collect, analyze, and disseminate actionable information and make recommendations without having to worry about image, politics, and what special interests might think.

Another freedom relates to the core work of foundations, that of making grants and supporting projects that may lie outside the political arena. One state health official I know used to say, “there is plenty of money in state government, it’s just distributed poorly.” With the current economy and in light of Colorado’s harsh tax-limitation laws, I might disagree with the adequacy of the amount of state funding, but there is truth in the statement. At least one measure of success for a state legislator is getting funding for his or her own bill, project, or program. This legislative decision making, with accountability to different constituencies, is one cornerstone of our democratic process. In my experience, however, it often can result in low-value investments and the distribution and use of state tax dollars not being well-aligned with the most critical needs and issues of the communities served.

A high-functioning foundation, on the other hand, may work directly with the communities it serves and can design funding strategies that are best suited to local needs. I find this difference the most rewarding part of philanthropy.

On the other hand, in a private foundation, my ability to directly influence specific health policies is limited. Working in state government provides a leader with the ability to propose, craft, support, and ultimately implement new policies that have direct and lasting effects on the health of our state’s residents.

While this process is not simple or easy and requires the hard work and commitment of many different people—not the least of whom are the legislators who create state policy—state employees are much more hands-on in terms of creating and changing laws, rules, and regulations. While this process is under the authority and direction of the governor’s administration, the opportunity to directly affect policy can be very rewarding.

Finally, I have been pleased to realize that both sectors place a high value on using evidence to guide their work. The desire to be data-driven and evidence-based has long been a personal core value, and while evidence is only one factor considered in policy making (and is often discounted if it does not support the particular agenda of a given legislator), it is at least considered. Finding that health foundation leaders place great value on using evidence in crafting grant strategies has been a welcome, though not unexpected, learning this past year.

The bonus, however, is that alongside evidence-based strategies, foundations also have the ability to fund innovation. State governments typically do not risk the potential ineffectiveness of innovative, not-yet-proven strategies. Nor would government be inclined to acknowledge and disseminate information about what doesn’t work. That foundations are not only willing to fund innovation, but also are willing to report the results—whether effective or not—indicates an important commitment to using and generating evidence in our work and supports an agenda and a process that requires ongoing evaluation, reflection, and strategic learning as essential elements.

The ultimate goal of legislators and foundations in terms of health policy is a shared one: to make things better. For a former bureaucrat, the approaches, abilities, and tools differ in the foundation world, but the opportunity for these two sectors to work together toward this common goal in ways that make the sum more than the individual parts is a welcome aspect of my new position and one I look forward to continuing to embrace.