How Philanthropists Can Help Meet the Challenges of Healthcare Reform

(Grace Linhard is executive director and vice president of the Western Connecticut Health Network Foundation, which includes Danbury Hospital and New Milford Hospital.)

As a development executive for a growing hospital network, I hear many questions about national healthcare reform from philanthropists who are unsure how the Affordable Care Act (ACA) will affect not-for-profit hospitals. With state health insurance exchanges set to open on October 1, it's too early to predict all the healthcare needs and gaps that will emerge as reforms are implemented. But many of the new challenges hospitals will face as a result of the law and other changes in the healthcare landscape are already clear -- especially in the areas of emergency care, care coordination, and primary care.

One emerging trend that surprises donors is the growing importance of emergency departments in healthcare delivery. Because one goal of the Affordable Care Act is to reduce costly visits to emergency departments for routine cases, it is sometimes assumed that emergency facilities will be less likely to require private support.

In fact, according to a RAND Corporation report, emergency departments, which are responsible for more than half of all hospital admissions, are and will remain key entry points to the healthcare system, "either facilitating or preventing hospital admissions." That is unlikely to change any time soon. A surge of patients who are now eligible for Medicaid under the ACA are likely to turn to emergency departments for primary health care, one California study finds. What's more, nearly one-quarter of the hospital emergency facilities in urban and suburban areas have closed in the last two decades, and that fact, along with hospital consolidations, adds to the pressure on existing facilities.

Weekend Link Roundup (September 28-29, 2013)

Our weekly roundup of new and noteworthy posts from and about the nonprofit sector....

Civil Society

How are market forces, public policies, and digital technologies changing nonprofit organizations, philanthropy, and associational life at the heart of civil society? That's one of the questions the Project on Philanthropy, Policy, and Technology at Stanford's Center on Philanthropy and Civil Society set out to answer last year through a series of monthly charettes. Now, the fruits of those conversations (and a lot of good, hard thinking) have been captured in a series of reports issued by the Digital Civil Society Lab at Stanford PACS. Written by Lucy Bernholz, Chiara Cordelli, and Rob Reich, the reports -- The Emergence of Digital Civil Society (42 pgaes, PDF); Social Economy Policy Forecast 2013: Project on Philanthropy, Policy, and Technology (38 pages, PDF); Good Fences: The Importance of Institutional Boundaries in the New Social Economy (18 pages, PDF); and The Shifting Ground Beneath Us: Framing Nonprofit Policy for the Next Century (30 pages, PDF) -- are thought-provoking, deeply researched, and a pleasure to read. They're also available as free downloads from the Stanford PACS site.

Responding to Dan Pallotta's hugely popular TED Talk -- and echoing some of the conclusions arrived at by Bernholz, Reich, and Cordelli in their Recode Good work -- Ashoka's Valeria Budinich suggests that one of the most important points made by Pallotta in his talk (and first book) is a point everyone chooses to ignore: Philanthropy's moral foundations -- and the resulting legal and policy framework in which it operates -- have remained largely unchanged since the 1700s.

Climate Change

The most exhaustively researched climate report in history is out -- and, as environmental journalist Richard Schiffman explains in The Atlantic, its findings are grim.

For those as troubled by the findings of the report as Schiffman is, the UN Foundation's Kathy Calvin has some words of encouragement.

Philanthropy and the Millennium Development Goals

(Bradford K. Smith is president of the Foundation Center.)

New York has been abuzz this week with the reconvening of the United Nations General Assembly and the annual meeting of the Clinton Global Initiative, and in the streets, cafes and restaurants you can hear people from all over the world taking about "the MDGs." Those who circulate in the acronym-laden universe of international development know that "MDGs" are the Millennium Development Goals -- the ambitious blueprint developed by the United Nations in the year 2000 to make serious progress on the pressing challenges of global poverty, health, education, and environment.

By one measure, "MDGs" is hardly a buzz phrase among America's philanthropic foundations. I just did a quick keyword search of three years' worth of 990-PF tax returns for close to 90,000 foundations and found just seven in which the term "millennium development goals" appeared. Then I tried an "only foundations" Google search on Glasspockets and got 3.65 million results!

But what people usually want to know about foundations is how much money they have spent on a cause or issue. It says a lot that only once in the years since the Millennium Development Goals were established has the Foundation Center been asked to map foundation funding to the eight goals. So this being a week where the MDGs are being discussed everywhere, we decided to pull some very quick data for 2011.

Goal	Amount	No. of Grants	No. of Fdns.
Eradicate extreme poverty	$770,761,183	1,663	318
Achieve universal primary ed	42,756,909	294	80
Promote gender equality	223,768,315	312	56
Reduce child mortality	456,276,756	337	54
Improve maternal health	211,008,135	215	38
Combat HIV/AIDS, malaria, other diseases	1,572,823,543	426	48
Ensure environmental sustainability	534,927,086	1,747	224
Develop partnership for global dev	278,124,929	363	109

 

Mobilizing for Good

(Todd Woodward is vice president of brand, public relations, and corporate social responsibility at Amway.)

At my office at Amway World Headquarters, I am surrounded by photographs of children from all over the world who've been helped by the Amway One by One Campaign for Children -- a young child receiving a life-saving series of immunizations for the first time, a sick child in a playroom built just for patients like him in a hospital in rural Russia, and others in different yet similar situations. What they have in common is that they received critically needed services and support thanks to Amway, its business owners, and employees who live, work, and play in communities around the globe, from the West Michigan town where our company was founded more than fifty years ago to a small fishing port in rural China.

What Amway does best is mobilize people toward a goal. In our business model, an Amway business owner is rewarded for selling products and for mentoring others eager to earn income doing the same; by working together to achieve sales targets, the group also wins bonuses. Isn't philanthropy a lot like that? What starts as a commitment to give and a philosophy that we have something of value to offer others -- money, time, or expertise -- simply grows into a movement.

The Amway One by One Campaign for Children started ten years ago when we realized that most of the markets where we'd been doing business for years had individually embraced children's causes. Amway business owners and employees around the globe were taking the initiative to make a difference in children's lives -- starting an afterschool program for at-risk middle-schoolers, buying desks for students who had none, or bringing play to hospitals for terminally ill children. Together, we have helped more than ten million children by donating $190 million in funding and 2.7 million volunteer hours.

The Transparent Spend Down

The following post by Charles R. Bronfman, chairman of The Andrea and Charles Bronfman Philanthropies (ACBP), is the first in a new blog series, "Making Change by Spending Down," produced by ACBP in partnership with GrantCraft, a joint service of the Foundation Center and the European Foundation Centre. In the post, Mr. Bronfman explains how he, his late wife, Andrea, and ACBP president Jeffrey Solomon arrived at the decision to spend down the foundation by 2016; why he and Solomon decided to take extra steps to create transparency around the spend-down process; and what they hope the added measure of transparency will accomplish.

We welcome your comments on this and every post in the series and encourage you to discuss and/or share individual posts on Twitter using the #spenddown hashtag. To learn more about the project, visit the GrantCraft Web site.

*****

My parents were my greatest mentors. They taught me the meaning of philanthropy through their active involvement in many causes. Creating initiatives to address social, cultural and community needs now, and facilitating positive change for the future, were and remain my guiding principles.

Those principles became the foundation for The Andrea and Charles Bronfman Philanthropies, which my late wife, Andy, and I established in 1985. All along, we believed in creating programs with long-lasting effect and which could and would make a real difference in the world.

At the beginning of the twenty-first century, after doing our homework about foundations created in perpetuity, Andy; Jeff Solomon, the president of our foundation; and I decided that ACBP should fulfill its mandate. While several other foundations had chosen this course, we decided to keep our decision to ourselves. But as more foundations chose to be time-limited and publicly announced their decision, we decided to go public with ours in 2008.

In an open letter to the philanthropic community three years later, Jeff Solomon and I announced that we would spend down ACBP by 2016.

That's not news anymore. What is, though, is the transparency we vowed to establish around the spend-down process, a conscious effort to share our experiences -- expected and not, good and bad -- on the road to 2016.

Weekend Link Roundup (September 21-22, 2013)

Our weekly roundup of new and noteworthy posts from and about the nonprofit sector....

Corporate Philanthropy

Corporate support can be a key factor in securing your organization's future, but many of you may be lost when it comes to attracting and keeping such support. Not to worry. Guest blogging on Beth Kanter's blog, Simon Manwaring, CEO of We First, shares a seven-step plan designed to help you do just that.

Fundraising

Nonprofits want to be loved, and they especially want to be loved by their donors. How can they make that happen? Start by loving your donors back, writes Jeff Brooks on his Future Fundraising Now blog. "Focus on them. Obsess about them. Seek ways to understand, serve and please them."

Healthcare

On the Collective Impact blog, Christine Kendall, a senior consultant at FSG, argues that, like it or not, the Affordable Care Act, is going "to drastically change healthcare in America as it is rolled out over the next five years." And for organizations in the healthcare space, "[b]eing ahead of the healthcare reform curve means moving from symptoms, diseases, and working in isolation to thinking about health determinants, systems change, and collaboration."

[Infographic] The Future of Social Activism

On Thursday, we reviewed Cause for Change, a new book by Kari Dunn Saratovsky and frequent PhilanTopic contributor Derrick Feldmann that explains, in some detail, how to get so-called millenials -- the social-media-savvy generation born between 1982 and the early 2000s -- to support your nonprofit organization or cause.

This week's infographic from ad agency network TBWA/Worldwide and TakePart, the digital division of Participant Media, provides basic info related to how millenials support the causes they care about (e.g., donate time/money, boycott businesses, e-mail/write their representative or senator) -- and why you should care.

[Review] 'Cause for Change: The Why and How of Nonprofit Millennial Engagement'

Kari Dunn Saratovsky and Derrick Feldmann, the authors of Cause for Change: The Why and How of Nonprofit Millennial Engagement, believe that nonprofit organizations must change the way they go about their business if they hope to connect with the rising millennial generation. But Gen-Xers, baby boomers, and older nonprofit leaders need not run for the hills. Anticipating a certain amount of generational skepticism and pushback, Saratovsky, former vice president of social innovation at the Case Foundation, and Feldmann, CEO of Achieve (and a frequent contributor to PND), do a lot of hand-holding as they guide the non-millennial reader through the process and practical steps needed to develop and implement a long-term engagement strategy for millennials.

According to Saratovsky and Feldmann, the "why" of millennial engagement is simple: nonprofits can't afford not to engage millennials on millennials' own terms if their organizations are to thrive. In part, that's because millennials boast $62.7 billion in discretionary spending power and, perhaps more importantly, are in line to inherit some $41 trillion in wealth from their parents and grandparents. What's more, Saratovsky and Feldmann argue, millennials insist on being actively engaged, as opposed to simply solicited, and are driven by personal relationships based on trust.

The "how" is more complicated. Saratovsky and Feldmann propose a "Millennial Engagement Platform" comprised of four "operational and cultural components" — "leadership inviting" (i.e., inviting and empowering millennials to connect with the organization’s decision makers); transparency; social connectivity; and a solution-inspired environment. To implement the platform effectively, however, an organization first needs to "BUILD" it:

• Be unified as an organization about working with the millennial generation;
• Understand the complexities of the technological and cultural environment in which millennials have grown up;
• Identify those seeking to make a difference through calls to action and peer identification;
• Lead through conversational and relationship-oriented engagement rather than focusing on event attendance figures; and
• Determine and institutionalize how the organization wants millennials to be involved and to what end.

Introducing 'FDO Free'

(George Ford is Product Manager, Online Subscription Services, at the Foundation Center.)

Back in May, the White House issued an executive order and accompanying memorandum which stated that "the default state of new and modernized government information resources shall be open and machine readable." For the nonprofit community, the announcement was intriguing. What would it mean if all that data on foundations and their grants were liberated from hundreds of thousands of IRS Form 990s and, for the first time, made truly open, searchable, and readable by machines?

While it looks like we'll have to wait to find out, here at the Foundation Center we've decided to take a step toward that goal with the release of Foundation Directory Online (FDO) Free, a new search tool that provides free, public access to essential information about nearly 90,000 foundations and more than 250,000 of their 990-PF tax returns. Yes, there are plenty of excellent tools around for retrieving the 990s of grantmaking foundations, including our own 990 Finder. What has been missing, however, is the ability to unlock the rich information available within those forms by searching across them with keywords relevant to your nonprofit's mission and programs. Until now, that was only possible through the Center's premier subscription product, Foundation Directory Online Professional. The launch of FDO Free changes that.

Indeed, FDO Free represents a significant step forward in the Foundation Center's efforts to make more funding data available to a larger portion of the grantseeking public. In addition to the ability to keyword-search across foundation 990-PFs, FDO Free allows you to search the profiles of nearly 90,000 private foundations by name, EIN, or location and to search their last three 990-PFs by name, EIN, location, or keyword.

A Cost-Cutting Technique Many Nonprofits Are Discovering

(Mike Pugh is vice president of marketing at j2 Global Inc., a Los Angeles-based provider of cloud-based communications services, including eFax®, eVoice®, and Campaigner®.)

If the public has a preconception about nonprofits these days, it's that they are engaged in a constant struggle to raise funds. That's half right, of course. But we rarely consider the other, equally difficult struggle: managing costs.

With the decline in government grants and increased competition for private donations, you're probably chasing the same sources of funding as other nonprofits. This post offers no secrets or tricks for beating others to those dollars. Instead, I'd like focus on the other side of your ledger -- keeping your costs down while remaining productive and even boosting your team's productivity.

One great cost-cutting technique that many nonprofits have discovered is the use of "cloud communications" -- lower-cost online alternatives to many of the legacy technologies they're already using (and probably overpaying for). Examples of these next-gen tools include online fax services, virtual phone systems, online videoconferencing, Web-based collaboration, and online customer resource management (CRM).

In fact, these days there's very little your organization can't accomplish online -- or "in the cloud" -- while maintaining a professional image and saving money.

Here are a few ideas for using cloud services that will help your nonprofit get more done with less.

Weekend Link Roundup (September 14-15, 2013)

Our weekly roundup of new and noteworthy posts from and about the nonprofit sector....

Impact/Effectiveness

Lots of good discussion around impact investing, social impact bonds, and social capital this week. In Forbes, Jean Case, president of the Case Foundation, shares some findings from a 2012 listening tour conducted by the foundation with the help of Sonal Shah, former director of social innovation at the White House, and Sean Greene, former chief of investments and innovation at the Small Business Administration. What did they learn? The field, Case writes, is ready for less talk and more action; is looking for clarity around definitions; is hungry for more data around actual financial performance; is looking for a framework that positions impact investing not as an asset class but as a mindset; and would like to see the pipeline of organizations, people, and ideas worth betting on grow. Case and her colleagues also heard a lot of people talk about hope --

hope in a new class of entrepreneurs -- social entrepreneurs -- who are pointing the way to exciting and innovative solutions from the private sector. While most agree it's early days, it turns out impact investing might be the path forward that allows business-savvy investors to use their investment dollars to realize financial return while helping to solve critical problems with new solutions....

Ted Levinson isn't so sure. In an interview with Social Velocity blogger Nell Edgington, Levinson, director of lending at RSF Social Finance, a San Francisco-based leader in the social finance marketplace, tells Edgington that he is both "hopeful and deeply skeptical" about the future of social impact bonds. Hopeful because SIBs are "a clever way" to push the risk of solving some of our most intractable social problems on to investors who are willing to take a long view about the potential upside of those investments. And skeptical because he doubts that a social capital market can ever reach a stage where transactions costs drop enough to make such investments economically viable. "Bringing together the multiple parties...required for such a transaction," he tells Edgington, "just seems unaffordable to me."

Expensive, maybe, but not unaffordable -- if we keep are eye on the prize, argues Steve Goldberg, author of a fine book about social investing (Billions of Drops in Millions of Buckets: Why Philanthropy Doesn't Advance Social Progress), on the Pioneers Post site. While acknowledging that SIBs are (as Martin Brookes and others have argued) "complicated and expensive" to put together, Goldberg says there are good reasons for the added cost. For starters, SIBs "enlist all essential stakeholders in actively collaborating in delivering an integrated set of innovative solutions with fidelity to evidence-based models," and that

requires dedicated and skilled intermediaries to herd all those cats, collect lots of data and use it to manage performance over many years. Unlike philanthropy, outcomes-based finance requires accurate cost estimation, continuous quality control and rigorous evaluation. If investors don't think they’ll get paid back because they're not convinced their money will accomplish the contractual objectives, they won't invest.

But if investors do think a SIB can bring everyone to the table in coordinated support of multi-dimensional solutions that have proven effective against multi-dimensional problems, and if government payers agree to pay a fair return if, when and to the extent that those problems are actually solved and commensurate savings are actually realized, then they just might invest enough money to get the job done. Aggregating sufficient funds under vigilant management to make meaningful headway against pervasive social problems doesn't sound less ethical to me than giving away money that isn't large enough, disciplined enough or enduring enough to make a dent.

For a different take on the role of capital in the social sector, read Clara Miller's contribution ("Capital, Equity, and Looking at Nonprofits as Enterprises") to a four-article series in the Nonprofit Quarterly describing the practice of capital funding (click here for the first and second) articles in the series). In her piece, Miller, president of the F.B. Heron Foundation, writes that while she has "been hearing a lot of loose talk about capital in the nonprofit sector" and that it has "become axiomatic that unleashing untold trillions of dollars from the global capital markets (most of which are evidently panting for nonprofit action) will fix all manner of social ills," in her experience, "revenue, or income, is far more fundamental to enterprise and mission success than capital -- preferably reliable, repeatable net revenue."

[Infographic] A Decade of Million-Dollar Gifts

News that the income gap between the richest 1 percent of Americans and the other 99 percent reached an all-time high in 2012 lends some poignancy to this week's infographic. Based on an analysis of publicly announced million-dollar-plus gifts made between 2000 to 2011, the graphic captures highlights of A Decade of Million-Dollar Gifts, a new report from the folks at the IUPUI Lilly Family School of Philanthropy.

Among other things, the report found that the number of million-dollar gifts peaked at 2,355 in 2008 and reached its lowest level -- 1,092 -- in 2003; that the combined value of million-dollar gifts peaked at nearly $61 billion in 2006 (thanks in large part to Warren Buffett's gift of approximately $33 billion to the Bill and Melinda Gates Foundation); and that, following a three-year decline, the combined dollar value of such gifts reached its lowest point of the decade, roughly $10 billion, in 2010.

The report also identified three patterns in the number and dollar amount of gifts:

• most types of recipient organizations saw the highest level in the number and dollar amount of million-dollar-plus gifts either at the beginning of the period (in 2000 or 2001) or in the middle years (2007 or 2008);
• giving to most types of recipient organizations experienced a decline from 2001 to 2003, and again from 2008 to 2010, years that bracket the decade's two recessions; and
• giving to most types of recipient organizations rose modestly in 2011, although it was still lower, in inflation-adjusted dollar terms, of the levels seen in 2007.

The 'More Asking – Less Writing' Approach to Grantseeking

(Marilyn Hoyt has been active in the philanthropic sector as a funder, teacher, grantwriter, and consultant for more than thirty years. A co-author of the Foundation Center book After the Grant, she also serves as a trustee of the Association of Fundraising Professionals-New York Chapter and is program co-chair for Fundraising Day in New York. A version of this post appears on the Philanthropy Front and Center - Washington, D.C. blog.)

When I moved from being a grantmaker to a fundraiser, my first thought was "Where am I going to find funders for our work?" Today, after raising over $200 million and working as a consultant, I find it's still the most common first question in fundraising.

As soon as we start researching potential funders, though, the question should be, "How are we going to find time to approach all of these folks?" It's a key question, and how you answer it will determine your success in raising resources to advance your organization's mission and work. Obviously, you can't approach them all. You need to develop a time-efficient method for prioritizing those most likely to fund your work in the near term, and then see what stands between you and securing funds from some of the others.

Funds are not raised by writing; they're raised by asking. Which means you want to increase the time you spend on tasks related directly to asking and reduce the time you spend on writing proposals. To that end, I always tell clients to identify the most fundable parts of their work and learn how to write generic base proposals -- essentially, templates -- that can be revised as needed for individual funders. Just a few of these will go a long way to reducing the time you spend writing proposals and will increase the amount of time available to focus on refining your potential funder list and building relationships with your current funders.

Dear Abby’s Advice to a Funder

(Allison Shirk is a freelance grantwriter based in the Northwest. In her last article, she offered some tips for making your volunteer board members feel appreciated.)

***

Dear Abby:

It's been a while since I wrote. I've been busy going through grant proposals -- lots and lots of proposals. In fact, that's why I'm writing. We love nonprofits, our grantees especially. Without them, we couldn't succeed. But there are so many of them, and they all want funding -- even organizations that work in areas that have nothing to do with our programs and initiatives. I do my best to give every application the attention it deserves, but, really, things are getting out of hand. What's a funder to do?

As a grantwriter, I'm pretty sure my clients aren't the only organizations frustrated by the grant application process. Funders are, too. Over the last decade, many social and environmental problems have gotten worse; the number of nonprofits looking for funding has grown; and the stock and bond markets have subjected most portfolio managers to a ride they'd probably like to forget. I don't suppose many funders, harried or otherwise, turn to Dear Abby for advice. But if they did, here's what she might she say....

Weekend Link Roundup (Sept. 7-8, 2013)

Our weekly roundup of new and noteworthy posts from and about the nonprofit sector....

Communications/Marketing

On the Communications Network blog, Kate Emanuel, senior vice president of nonprofit and government relations at the Ad Council, offers some straightforward advice for organizations looking to create and/or leverage an online community:

1. Think hard about whether you need an online community.
2. Choose the right platform.
3. Once you build it, be sure to promote it.
4. Make your community work for you.

Disaster Relief

On LinkedIn, Charles Best, founder and CEO of DonorsChoose.org, shares a list of things every community needs after a disaster.

Education

Writing in the New York Times, Rob Reich, a professor of political science at Stanford University, argues that the "policies that govern private giving to public schools [are] perverse" and deepen the "inequalities they are...responsible for diminishing." How can we improve the situation? First, writes Reich, wealthy school foundations should honor the equality-promoting standards released by the National Commission on Civic Investment in Public Education. Second, donors and school foundations should support progressive tax reform. And third, Congress should differentiate or eliminate charitable status for local education foundations. What do you think?