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Equity + Health Connection
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Courage, tenacity and hard work are the keys to transformative change, a group of top philanthropic leaders told the Equity + Health Fellows last month in a wide-ranging discussion about how to advance equity in the Richmond Region.
The Fellows had a rare opportunity over two days to interact with four women and men who are spearheading innovative approaches to achieving equity in their communities. Following an evening panel discussion, the foundation leaders spent time in small group conversations with Fellows the next morning.
The four foundation leaders are:
The E+H Fellows are charged with making recommendations on how RMHF can best pursue an equitable and healthy Richmond Region. West-Scantlebury urged them to challenge the Foundation to take on a broader role that builds on its history as a grantmaker. A focus on equity will require hard work and new approaches, she added.
“To be a change agent is a whole other ballgame,” she said. “Grants are tools, but if you see the foundation as a partner in this change process, then you use all these tools to make the change. When you’re trying to get to equity, you have to lead that charge.”
Karl Stauber summarized a four-step strategy for pursuing equity.
“Our strategic approach is this: Change the conversation. Change who’s in the conversation. Change behaviors. Then change outcomes,” he said. “Equity is what distinguishes you from other health conversion foundations, but you’ve got to figure out how to go from the talk to the walk.”
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The four leaders shared their individual experiences with organizational change. Redwood said Consumer Health Foundation previously gave grants to organizations working on a wide variety of social determinants of health.
“I didn’t perceive this to be the most strategic use of our resources,” she said. “So we asked, ‘How could we get more strategic and get deeper?’”
CHF placed racial equity at the center of its mission. It developed a tool using a racial equity lens to guide its direct grantmaking and impact investing. For example, grant applicants are asked to provide information about the diversity of their staff and boards.
The foundation also builds capacity for addressing racial equity through train-the-trainer programs that help grantee partners create racial equity plans and embrace more diverse recruitment practices. This same approach is used by Consumer Health Foundation itself to ensure diversity on its board.
Shumaker walked Fellows through her foundation’s strategic planning process, which involved research to shape grantmaking, public education and advocacy. Like Redwood, Shumaker was looking for ways to magnify the voice of a mid-size foundation with limited resources.
“Our $5 million a year in grants was not going to move the needle,” she said.
Her organization carefully timed the release of a major study on the impact of Medicaid expansion in order to maximize coverage of the issue.
At the end of the discussion, Richmond Memorial Health Foundation President & CEO Mark Constantine told the Fellows, “I hope you find the courage to challenge us to be better than we are.”
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E+H Fellow Tracy Causey said he left the event inspired to do exactly that.
“I’m a small part of this program,” he said, “but I think the courage we have together will have a great impact on our success.”
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Spring Ahead
Grant Cycle Focuses on Strategic Questions
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Richmond Memorial Health Foundation’s Spring 2017 Grantmaking Cycle is designed to give nonprofit leaders in the Richmond Region the resources to consider strategic questions confronting their organizations. RMHF Trustees approved the grants with the intention that this support will enable our partners to advance their missions and focus on priorities that foster a more equitable and healthy region.
The applications received are a reminder that our community is well served by leaders who are committed to investing their time and talent in the planning necessary to maintain the effectiveness and relevance of their organizations. Rapid changes are happening in health care and our region every day. It is exciting to see the innovative responses and increased collaboration taking place as our partners work to ensure access to health care for uninsured and underserved individuals and families.
In keeping with the Strategic Framework adopted last year, Trustees gave priority in this grant cycle to organizations in the oral and behavioral health fields, as well as those serving new populations, such as immigrants and refugees, who face significant barriers to basic health care.
The following grants were approved by Trustees at their May meeting:
- Daily Planet: $25,000 to address strategic questions surrounding capacity needed to provide oral health care to Hispanic patients and pregnant women.
- Sacred Heart Center: $25,000 to develop a strategic plan for improving outreach and communication in its role as a community hub providing services for the growing immigrant population that include hosting a medical clinic and food bank, and offering parenting classes that support good health.
- St. Joseph’s Villa: $25,000 to improve recruitment and retention of mental health professionals in order to ensure quality and consistency of service, and to sustain a pipeline of future employees through collaborations with education partners.
- Virginia Supportive Housing: $25,000 for development of a multi-year sustainability plan guiding training, capacity and systems to support a Medicaid reimbursement model for services.
- Voices for Virginia’s Children: $25,000 to strengthen the organization’s communications capacity in order to increase public awareness statewide and ensure effective advocacy for children’s behavioral health services.
- YWCA Richmond: $25,000 to develop a master plan guiding the organization’s capacity needs in response to expanding programs and growth in the number of clients and staff. Services include trauma-focused counseling, trained advocates who provide support for domestic and sexual violence survivors seeking medical treatment at local hospitals, emergency shelter, a 24/7 hotline, prevention and education programming, advocacy, and case management.
- Goochland Free Clinic and Family Services: $20,000 to guide staff communications and development strategies aimed at ensuring a smooth transition from a group of separate locations to one common facility.
- Health Brigade: $20,000 for a facilitated exploration of how to best serve the older adult LGBTQ population in the Richmond Region. The assessment will look at gaps in services, how to address those gaps and the identification of potential collaborations that can improve health outcomes for this population.
- Armstrong Priorities Freshman Academy: $15,000 to support a behavioral specialist in a pilot program that could serve as a model for classroom management in other high schools.
- Family Lifeline: $15,000 to explore diversification of program-generated income, an issue identified in the organization’s strategic business planning process.
- Gateway Homes: $15,000 to improve efficiencies in reimbursements for behavioral health services and to ensure that procedures remain up to date in response to changes in Medicaid policies.
- Central Virginia Health Services: $14,000 to train behavioral health staff in order to ensure a consistent and effective approach to behavior management for all patients.
- Virginia Dental Association Foundation: $10,000 for development of a strategic communications strategy to strengthen education on the need for dental care and oral health, and to improve collaboration with program partners in order to build capacity.
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William R. Nelson, MD, MPH
This month, the Chairman of RMHF's Program & Evaluation Committee shares his insights into his work as a Trustee and leader in the Foundation's grantmaking initiatives, including the E+H Fellowships and HEArts.
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You have had a wonderful career in health care. What accomplishment is most meaningful to you?
Working with a talented group of people in Chesterfield, we created an incredible public health team. Not only did we address issues in our District with creative initiatives, the Chesterfield team was instrumental in forming a number of regional efforts. We had the support of the Chesterfield, Powhatan and Colonial Heights governments, and I truly believe we fashioned a department that was innovative and exceptionally competent.
What does your position as RMHF Trustee mean to you as a resident of the Richmond region, as a doctor and public health professional?
If a doctor has a patient who's pretty healthy but is threatening that health with some bad choices or neglect of a problem, the doc would talk to the patient about it. If the patient is smoking, a smoking cessation program is in order. If the patient is neglecting an illness, getting that patient on an appropriate treatment regime is the goal. Thinking like a doctor, view RVA as a younger patient: in pretty good health, at the beginning of a wonderful life. But if some fundamental issues aren't addressed, that potential will be squandered. I believe RMHF should have a role in addressing those issues.
Over the years, I've worked hard at addressing a lot of health issues, but now I see what the patient needs is to have the underlying conditions of poor health addressed: poverty, poor education, loss of community and a certain amount of ingrained racism. We don't like to talk about that, but it's time we did.
What specific goals do you have over the next year as chairman of the RMHF Program & Evaluation Committee?
It's important to keep on track with our current initiatives. If we don't make progress on the underlying issues, we are just not going to be the healthy community we all want to be. The Visiting Artists and the Health Equity Fellows are laying a great groundwork for getting the Health Conversation started. At the same time, our health system is in flux. We need to monitor developments in Washington D.C., and the state level, and be prepared to step in and help the safety net if the number of uninsured and medically poor increases. I don't have a crystal ball on this, but the responsible thing to do would be to have a contingency plan for this.
What do you hope the E+H Fellows will contribute to the Foundation and its mission?
First, they will bring fresh eyes and insight to a long standing problem. Secondly, I hope they are just a beginning. Of course, we should have more Fellows in the future, but I think they will have an impact on how their community and their sponsoring organizations view health. They can be the first wave of a powerful transformative process.
What excites you most about the HEArts Visiting Artist program?
We talk a lot about health. We talk a lot about diseases. We talk a lot about the terrible things that happen to people. HEArts will do something different. It will allow us to imagine what good health could be. We will be able to visualize and understand what a healthy community might look and feel like. Most importantly, I think the work that these artists do will be a catalyst for starting the conversation about real health.
RMHF and other foundations and organizations constantly struggle with community engagement. What are your thoughts on how to get people to feel ownership and take action on issues that affect them and their communities?
Every doctor knows how important it is for patients to take action when their health is in danger. My doctor is always on my case about going to the gym and exercising -- she's right -- but I find it so hard to get there. Numbers and facts didn't really convince me, but when we had our first grandchild, I started to see the issue of longevity differently. As a community, we're not any different.
A lot of the cures for what ails us as a community are clear, but we either aren't sufficiently motivated or don't know how to use them. I'm convinced that, as a community, we need to start a conversation on health and community that will lead to viewing them differently.
If we can do that, I think there will be great benefits to our community -- economic, spiritual and general well-being.
What advice would you have for individuals thinking about serving as foundation trustees on issues that are meaningful to them?
Don't be afraid to dig in, do research and listen to new ideas. I give my fellow Trustees a lot of credit for doing this. They've worked hard to understand the issues, and they're unafraid to consider new approaches. While they are good stewards of the resources, they are bold in their intellectual curiosity and in their hopes for improving the lives of all RVA residents.
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Lisette Johnson, Becky Lee and Alyssa Murray are members of the team at the YWCA of Richmond.
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Access to health care can be particularly daunting for survivors of domestic and sexual violence. New clients of the YWCA Richmond include pregnant women receiving no prenatal care. Others live in fear of losing custody of their children because of health issues. Too many have not seen – or been allowed to see – a doctor in years.
When these survivors do seek medical services, they can feel overwhelmed by paperwork and demands for medical records that were lost in the escape from violent circumstances.
“There is a perception that the systems in place are helping, but those systems contain more barriers for disadvantaged folks than that community realizes. This is due in large part to a survivor’s socioeconomic status. Therefore the systems created to provide care are actually contributing to the problem by being flawed in design,” said Lisette Johnson, the YWCA Health Care Navigator.
Johnson joined the YWCA in January, and she is already a trusted friend and resource for the agency’s staff and clients. She helps to connect survivors to primary care physicians, dentists and specialists, and she educates both clients and providers about the long-term impacts of trauma.
At times, Johnson accompanies survivors to medical appointments, but her ultimate goal is to give them the knowledge and resources to navigate the health care system on their own.
“We know we can’t fix everything. We teach them how to take control,” said Chief Program Officer Becky Lee. “It’s empowering to them when we’re saying that.”
The YWCA used a grant from Richmond Memorial Health Foundation to add the Health Care Navigator position to its staff. Johnson was already a prominent advocate for domestic violence prevention, both professionally and as a volunteer. That background, along with an innate persistence and problem-solving ability, enabled her to quickly begin building a network of providers and resources for survivors.
“With Lisette here, we’re helping individuals, but also creating a new path,” said Alyssa Murray, Director of Grants and Data Management. “The system is designed to be difficult to navigate access to care, and we’re creating a new path to access those services.”
The Health Care Navigator builds on the YWCA’s mission to empower women, children and their families to live their best lives – a mission steeped in a commitment to gender and racial equity. YWCA leaders are proud of the progress they are making, but aware that there is a great deal of work to do to reach their goal.
“The more we talk about equity, and the more we talk about creating an equitable society, the more threatened inequitable structures are and the more pushback we get,” said Lee. “There is a very clear energy in favor of equity, and there are people who understand it intellectually, but the implementation of equity is where we get hung up. The implementation changes everything.”
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We are asking all 18 Equity + Health Fellows to share their insights as they work together to consider how RMHF can best pursue an equitable and healthy Richmond Region. Our guest writer this month is Patricia Mills, Director of Health Equity for the Richmond City Health District. In her essay, Mills writes about the Fellows' commitment to forward thinking as they work together to increase opportunities for everyone in the Richmond Region.
"It’s easy to repeat the past, and to do what has always been done, but we have no wish to color within the lines . . . that’s easy," Mills writes. "The guest speakers, diverse cohort, sharing of data and knowledge, give us the authority to go outside of the lines. That means we can get messy and innovative while thinking beyond what has always been. Too often, people want to feel good without actually doing good, but we want to do good and leave an indelible footprint about health equity with the RMHF that can elevate the work done in our region."
To read Mills' full essay, click here.
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Kendra Jones' official title at RMHF is Operations Manager/Accountant, but she also is the guiding force behind the HEArts program. We invited her to share her thoughts about this new adventure and to tell us about her personal experiences with art.
How do you see these artists helping to define equity and the identity of this region? How do you think this can contribute to a better region for everyone?
Mark [Constantine] shared one of his favorite quotes with us that we now have displayed in our suite’s reception area. It is by Audre Lorde, who said, “There is no …single-issue struggle because we do not live single-issue lives.” I find this quote to be so true because we have been working on equity as a Foundation and learning what it is and is not, and some of us are still unclear. Equity touches on myriad topics, including race, sex, economic status and social justice. When we talk about health, it incorporates various social determinants.
So equity and health are not single-issue struggles that you can tie up nicely with a bow. Creative expression is not singular and one dimensional either. Art can highlight ideas in ways that we cannot understand until we see it, hear it, feel it, touch it, breathe it or experience it and then perhaps understand it. That is my hope with HEArts. The goal is to help us understand our region’s struggles, hear the voices of those affected by disparities, and get a better understanding of how to address the issues.
Members of the arts community have been tremendous supporters of HEArts. How do you see HEArts fitting into the larger arts community in the region?
We have been very fortunate to have full support from Ellyn Parker of Richmond’s Public Art Commission and Scott Garka of CultureWorks. They were instrumental in helping us promote the HEArts opportunity to the creative community. We invited Ellyn and Scott back to talk with our external evaluators for HEArts and detail what the art scene in our community looks like now and what it will look like in the future. Certain foundations like the Ford Foundation come to mind when thinking about support for creative expression and how it can be used to promote change. My dream is for Richmond Memorial Health Foundation to be included on that list.
What is the most exciting aspects of HEArts to you personally?
One of the coolest aspects of HEArts is meeting members of our creative community and discovering new friends of the Foundation -- partnerships we hope to strengthen and grow. I met with some of our Visiting Artists last month, and the encounters left me energized. I usually deal with numbers and would say I am not a people person. However, when it comes to creatives, I love them! I am finding that they are my people. I am so excited to see what comes from this new venture, and the fact that I am directly involved in it and get to see it play out is the icing on the cake.
Tell us about your own artistic interests and how you came to have an interest in art.
Just last night [May 22], initial counts say 22 people, including young ones, lost their lives at a concert in Manchester, England. Oftentimes it is hard to express how circumstances and events affect our life, but creative expression is an outlet for the deep emotion we feel. Whatever creativity flows from those moments becomes an awakening -- or like Oprah used to say, “an Aha moment” -- helping us, and others, understand how we feel about those events.
Creative expression became an outlet for my emotions when I was a teenager dealing with a difficult time. I have a fascination with and love of words. So I started writing. I wrote when I was sad, when I was angry, felt defeated. But then I started writing when I was happy, felt joy, was elated. I just wrote. I wrote poetry and short stories, and I keep journals. Writing became an outlet for me. It has been therapeutic. And going back and reading my writings helps me understand the emotions I felt at different moments in my life.
Reading my works draws me back into the moments described. Some are bittersweet, some make me just smile and laugh. And I love it because all of my writings make up me. They are me.
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East End's Center
for Well-being
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Thanks to Bon Secours and the Robins Foundation, the East End has a new center offering cooking classes, nutrition education, adolescent behavioral health services and wellness therapies for hypertension, diabetes and cardiac conditions.
The name of the Bon Secours Sarah Garland Jones Center for Healthy Living was unveiled last month in a ceremony at the East End location.
The center is named after one of Bon Secours' founders.
Jones was the first African American woman licensed to practice medicine in Virginia, in 1893.
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Kelly Chopus, CEO of the Robins Foundation, and Cynthia Newbille, Advisor to the RMHF President on Special Projects, joined the celebration for the new center on May 16.
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