Dear AITF Members:

Hopefully this message finds you in good health and safety.  We are all facing a unique set of challenges.  We know that anchor institutions will be essential to strengthening communities into the future.  We also know that many of you, while manageing a complex new reality for your institutions, are rising to the occasion and responding to the pandemic in various ways.

Anchor institutions and community partners are developing and contributing to COVID-19 funds, donating supplies, mobilizing volunteers, supporting community-based organizations and small businesses, supporting vulnerable residents in your communities, conducting vital research, developing medical equipment, providing space, increasing testing capacity and many other noteworthy endeavors.  Many of you have also been raising awareness about critical issues, such as equity.

We previously announced that we were beginning to capture examples of ways in which anchor institutions of varying types have been engaging in communities and addressing the combined public health and economic crisis that faces us.  We are pleased to present the  first edition of this inventory  of different ways in which anchor institutions are stepping into action to confront the daunting conditions created by this pandemic. 

We are going to continue to collect examples, as we know the nature of work will evolve.  If you would like us to include some of your efforts in the next edition, please respond to this message or email  sliu@margainc.com . 

Overall, AITF is adapting to the current context, and expecting to be a resource for anchor institution-community partnerships.  Researching examples of COVID-19 activities is one way.  We have also begun to organize special discussions in subgroups to provide a space for sharing ideas and lessons and collectively thinking about the future.  As we are addressing the immediacy of the pandemic’s impact.  We know that we will be required to think through longer range strategies.  As inequities are being tragically revealed and exacerbated during these times, it will be essential to address the root causes that lead deep racial and other disparities.

We will explore other types of programming, including webinars and papers with more in depth case examples.  Please let us know your thoughts on ways in which AITF can be a resource for you.

With respect to our November conference, we continue to monitor the uncertain conditions around us.  We will have a more definitive decision on how we will move forward regarding the conference in the late spring/early summer.

Please find below some articles and other resources from the field.  As many of you have been doing such important work in communities, some of you have been writing quite a bit as well.  Included among the many articles are various opinion pieces by members and AITF leaders.  Please share with us any articles on your work or blogs or op-eds you have composed, so we can share them with everyone.

There is such rich content across AITF members and anchor institutions across the globe stimulated by this extraordinary call to action.  Thanks for your important contributions to your communities and our field at such a pivotal moment.  We wish you, your families, and communities health, safety, good fortune, and the strength to continue guiding the challenge ahead.

Best,
David

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Here are some relevant articles and resources from the field.  
April 20, 2020
David A. Perlstein, President and CEO of SBH Health System in The Bronx, New York has pointed out that despite of the serious financial difficulties faced by SBH, it still delivered high quality care, almost eliminating all hospital-acquired Infections, and kept its outcomes driven and patient centered strategy. Mr. Perlstein also called for sustainable programs aimed at addressing the major social disparities which permeate poorer communities.

During the crisis, the power of anchor institutions could be leveraged as a reliable, built-in market to create community wealth and local opportunity, and therefore anchor institutions could help re-localize industry by purchasing locally. In Cleveland, Evergreen Cooperatives has brought home multiple businesses and millions of dollars through enterprises including Evergreen Cooperative Laundry, which processes about 20 million pounds of laundry annually, and most of it is for anchor institution the Cleveland Clinic.

The COVID-19 crisis will surely change all societal institutions. A better post-COVID-19 world requires democratic civic universities that are dedicated to producing knowledge and educating ethical, empathetic students for just and sustainable democratic societies, argued by Ira Harkavy, Sjur Bergan, Tony Gallagher and Hilligje van’t Land. 

Being an engaged Anchor, University of Pennsylvania announced initiatives totaling $4 million to provide emergency financial assistance to Penn employees, third-party contract workers, small businesses and nonprofit organizations impacted by the COVID-19 crisis, in addition to $1 million in employee assistance by Penn Medicine, totaling $5 million in emergency assistance. Craig R. Carnaroli, Executive Vice President of University of Pennsylvania, pointed out that “While Penn itself is adversely affected financially by the pandemic, we also know that the globally renowned reputation for the highest quality teaching and research also is contingent on the health and vibrancy of our community.”

Nancy Cantor and Peter Englot argue that as we know quite a lot about the pandemic’s disparate impacts by race, we should use the accumulated knowledge of our institutions that anchor our communities, and of our citizenry, to actually do something about it together. The actions could be taken include integrating public schools, using outcomes-based equity metrics to fund public institutions and connecting all students, guarding against displacement of new capital investment, investing in prison education and re-entry training, asking anchor institutions to step up and invest locally, and etc.

Colleges and universities were touted as “anchor institutions,” a term indicating their long-term investment in the communities they served. With the COVID-19 pandemic, however, these same towns now face very real economic peril. Students have been sent back to their homes to reduce the spread of the virus. Gone with them is the purchasing power they had poured into the local economy.  

Futuro Health, a California-based nonprofit established by Kaiser Permanente and SEIU-United Healthcare Workers West (SEIU-UHW) to address the nation’s allied health worker shortage, announced it has expanded its education offerings to prepare frontline health care workers for an expected surge in COVID-19 cases, committing $1 million to launch a new pandemic-readiness program. The  Free Pandemic Readiness online training course  for LVN/LPNs became available April 6 beginning in California, with plans to expand beyond the state.

Universities in South Africa have committed themselves to completing the 2020 academic year and are working with three possible scenarios in the uncertain terrain presented by the unfolding COVID-19 pandemic. A number of universities, such as the universities of the Free State, Rhodes and Cape Town, have conducted surveys to establish their students’ ability not only to access the internet or buy data, but their access to devices through which to do so.

At the same time people are worried about the coronavirus, cities are also worried about the Census. Particularly cities with colleges, since thousands of students have likely gone home after classes across the state have gone online-only to help combat the virus’s spread. But the more people that the U.S. Census Bureau officially counts in a city’s population, the more federal funds the city is eligible for during the following decade.

A new joint project of the University Social Responsibility Network (USRN), a geographically diverse coalition of 16 universities, documents major expansion in the scale and impact of social responsibility programs. In specific, the expansion refers to a substantial increase in the number and proportion of professors doing community-engaged teaching and research; a dramatic increase in the extent of integration of USR in the full range of disciplines; and the growth of and robust activity in both national and international coalitions of universities devoted to elevating civic engagement and social responsibility.

The challenges we face are daunting, but hospitals, health systems, and other anchor institutions can take immediate concrete steps to help stabilize families and communities while continuing to build productive partnerships in health and housing. The Center for Community Investment has summarized actions that anchor institutions can take to INFORM, EDUCATE, ADVOCATE, LISTEN, and INVEST in order to support those who face housing challenges.

Higher education institutions are helping K-12 cope with coronavirus via different ways. Teachers in a few high-needs New York City schools making the sudden shift to online learning during coronavirus closures are receiving some key guidance from Fordham University’s Graduate School of Education. In Kentucky, the Berea College’s Berea Kids Eat program, which is part of its Grow Appalachia initiative, partnered with campus food services to begin feeding local K-12 students who are home while their schools are closed due to the coronavirus.

In the 2020s, public policy should recognize that bits are books, bits are blackboards, and bits are basic tools of medical practice. In other words, broadband networks that run to schools or libraries or health-care facilities are not built to carry only scholastic or literary or medical information. Community anchor institutions can serve as a launching pad for community-based broadband access and, in places where broadband has already been deployed, more broadband competition.

Academic Journal Articles:
Abstract : Not surprisingly, universities and hospitals (“Eds and Meds”) are the focus of most of the literature on anchor institutions as they are often the largest nonprofit entities in a community and can potentially advance their core missions through engagement with their communities. Much less attention has been paid to the role of anchor businesses, such as Michelin, in building a “culture of health” in their communities, meaning that. Overall, it is found that: there are 2,599 anchor businesses in small- and mid-sized communities in the United States. They can be found in almost one quarter (22.6 percent) of all small and mid-size communities; communities with anchor businesses are, on average, less economically distressed than communities without an anchor business; anchor businesses are most commonly from the manufacturing and wholesale and retail trade industries.

Reference : McHugh, M., Ye, J., Maechling, C. R., & Holl, J. L. (2020). Anchor Businesses in the United States.

Abstract : After the financial crisis of 2007/8, the city of Preston in Lancashire, UK, lost half of its government grants and nearly a billion pounds (US$1.3 billon) in private investments. In what has become known as the Preston Model , the city responded by creating a community wealth project. In partnership with the Centre for Local Economic Strategies, the project centred on several large anchor institutions (e.g. the local hospital) shifting their procurement practices from external to more local sources. Simultaneously, the project developed worker cooperatives to address gaps in local supply capacity and support a local cooperative economy. Preston continues to explore alternative ways of bringing wealth to the community, such as a windfarm for local energy generation and redirection of pension investments to the regional economy.

Reference : Cannon, M., & Thorpe, J. (2020). Preston Model: Community Wealth Generation and a Local Cooperative Economy.

Abstract : Non-profit hospitals are important anchors in Appalachian communities, in part because of the concentration of health care dollars within these institutions. Community benefit efforts of these hospitals, therefore, have the potential to fill gaps in public health and social service provision in underserved areas with documented health disparities and access barriers. To date, however, we do not fully understand how community benefit practices vary by hospital setting. Employing hierarchical linear modeling using a multilevel mixed-effects approach, this study analyzes data from the years 2010 to 2016 to assess community benefit practices and spending between hospitals in Appalachia and non-Appalachian counties. Findings indicate that hospitals within Appalachian counties, and rural hospitals in this region, in particular, spent less on community benefit than hospitals, not in this region. Given the potential for community benefit to impact health outcomes and access to care, this disparity is important to state and local public health efforts and suggests the need for additional support for hospitals to engage their communities around critical health needs.

Reference : Cronin, C. E., Franz, B., & Gran, B. K. Hospital Community Benefit in Rural Appalachia: One More Gap.  Rural Sociology .

Abstract
Background:  U.S. nonprofit hospital community benefit recently underwent significant regulatory revisions. New requirements have led to greater transparency and accountability and this scoping review considers what has been learned about community benefit from 2010 to 2019.  Results:  Literature appeared around several topic areas: governance; CHNA and CHIP process, content, and impact; community programs and their evaluation; spending patterns and spending influences; population health; and policy recommendations.  Discussion:  There are several areas of community benefit in need of further study. Longitudinal studies on needs assessments and spending patterns would help inform whether organizations have changed and improved operations over time. Governance, program evaluation, and collaboration are some of the consequential areas about which relatively little is known. Gaps in knowledge also exist related to the operational realities that drive community benefit activities. Shaping organizational action and public policy would benefit from additional research in these and other areas.


Reference : Rozier, M. D. (2020). Nonprofit Hospital Community Benefit in the US: A Scoping Review From 2010 to 2019.  Frontiers in Public Health ,  8 , 72.