The president and CEO and the vice president of policy and communications at the Connecticut Health Foundation describe its new approach and the successes of its grantees.
Foundations often employ the twin strategies of grant making and commissioning and advancing objective policy research, but rarely do the twain meet.
Since its inception in 1999, the Connecticut Health Foundation has commissioned research to identify and advance policy solutions to health issues in Connecticut and has enjoyed success in making known the potential health implications of policy changes. At the same time, we have awarded grants to advocacy groups that are working on the same issues as we are, but with fewer resources.
What if we bolstered their capacity to commission their own high-quality research? And what if we also empowered these groups to select research topics that advanced our shared goals? After all, they know more about the priorities of the people most affected by health policies, and, as a result, could make more effective messengers.
These questions led to the Integrating Health Policy Research and Advocacy Initiative, an experiment in grant making. Through a request for proposals (RFP), we invited applicants to propose policy research projects that both supported our foundation’s strategic objectives and met the applicants’ own needs.
Based on our own experience with shepherding policy research through a process resulting in the creation of a policy brief, we structured an eighteen-month grant period to allow grantees adequate time to commission the research and develop accompanying materials in the form of briefs or reports. We expected grantees to use these materials to educate other advocates and policy makers during the final six months of the grant period coinciding with Connecticut’s 2012 legislative session. We made it clear that without an effective advocacy strategy from the applicants, the information they developed would go unnoticed and not be put to its best use.
We awarded four grantees $50,000 each to work on distinct projects, and thus began the most difficult part—letting go. Because the foundation is known for its high-quality, credible, objective research, we experienced some anxiety, quite frankly, that the four deliverables might not meet our high standards. Ultimately, we recognized that creating complementary policy partnerships demanded freedom for all the grantees, within our parameters.
Put another way, change is our primary objective, not ownership. And we let that mandate guide us.
We also learned that:
* Whatever is lost in relinquishing control is made up for in the power of partnership. In funding and working with our grantees, we enhanced each institution’s abilities, including our own, to achieve its strategic objectives.
* For that partnership to work, clear and frequent communication is mandatory. We started off with well-defined parameters in the RFP and grant agreements, but we didn’t stop there. Regular conversations allowed us to keep each group’s work in line with our strategic objectives and helped all of us avoid straying off course because of the pervasive sense of urgency when people are working to advocate for policy changes.
* New funding approaches break down internal silos. This initiative required program, policy, and communications team members at the foundation to work together on tasks from planning through implementation. We also used this cross-functional strategy to benefit the foundation as we guided the grantees’ work.
Here’s how they applied their research for change:
* The Center for Children’s Advocacy, which provides legal representation for vulnerable children, worked with a researcher from Pace University School of Education. Together, they retrospectively analyzed the school records of adolescents represented by the center. The report, Blind Spot: Unidentified Risks to Children’s Mental Health, quantifies the downstream consequences when no one responds to early red flags raised by school systems about a young person’s mental health. As this report recommended, the Connecticut Department of Social Services is now working with the center to understand how, under Medicaid’s Early Periodic Screening Diagnosis and Treatment (EPSDT) benefit, we can identify developmental and mental health problems early, in the pediatric primary care setting.
* The Connecticut Association of Directors of Health elected to use its own staff to conduct its research. The policy brief, “Housing and Planning for a Healthy Public: Land Use, Design, and Development to Promote Health Equity,” examines the links between housing quality, affordability of housing, neighborhood conditions, and health outcomes. It makes policy recommendations for formalizing public health and housing partnerships at the municipal level. More than 200 people attended a launch event for the report featuring a national speaker, Robert Ogilvie of ChangeLab Solutions.
* The Connecticut Association of School Based Health Centers worked with researchers from the University of Connecticut’s School of Nursing and the Institute for Community Research. Their issue brief, “Connecticut School Based Health Centers Engage Adolescent African-American and Latino Males in Mental Health Services,” showed that when Connecticut’s young men of color visited school based health centers for mental health care, they returned many more times—thirteen visits on average—than if they sought care at a different community setting. After the tragedy at Sandy Hook Elementary School, the brief may help position school-based health centers to receive funding to provide mental health services even at a time of otherwise lean state budgets.
* The Legal Assistance Resource Center of Connecticut worked with researchers from the Center for Health Law and Economics at the University of Massachusetts Medical School. The resulting research brief, “Evaluating the State Basic Health Program in Connecticut,” explores whether the state should pursue the Affordable Care Act’s Basic Health Program option to improve continuity of coverage and provide a rich benefits package to adults with incomes from 133 to 200 percent of the federal poverty level. The brief paved the way for legislation enacted in 2012 that created a workgroup and provided additional funds for further actuarial analysis.
Can a foundation fund advocacy grantees to direct policy projects that advance the strategic objectives of both the foundation and the grantees? Yes, if we are true partners in the project. While this grant program has concluded, it created a funding model that the Connecticut Health Foundation will be able to use on an ongoing basis.