CT Health’s History as an Advocacy Funder

July 6, 2016

by Elizabeth Krause, VP of policy and communications

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At Connecticut Health Foundation’s (CT Health) most recent board meeting, our board of directors heard from a panel of four of of our advocacy grantees.  In today’s post, I share an abbreviated version of the primer I wrote for the board to tee up the panel and summarize our history as an advocacy funder.

Definition and Scope of Advocacy

We simply define policy advocacy as educating and informing policy leaders (and those who influence them) on decisions that will affect the health and health care of Connecticut residents.  Clearly, we prioritize alignment with health equity and our strategic objectives.  We consider fiscal, legislative, regulatory, and administrative policy issues.

As a private foundation, the IRS prohibits us from engaging in lobbying, as well as from supporting earmarks for grantee lobbying.  We can, however, support grantees who lobby as long our funding comes in the form of general operating support.

The Alliance for Justice has published a fantastic playbook on what foundations can and cannot do with their grantees when it comes to advocacy.  The good news is that, from policy analysis to influencer education to media advocacy, we can do much more than we cannot do.

Our Arc Over our 17 Year History

Since our earliest days, CT Health has proactively sought to inform policy decisions with credible data and analysis.  Some of our policy briefs from our first five years covered the topics of Connecticut’s constitutional spending cap, co-pays in Medicaid, Medicare Part D, and policies to reduce racial and ethnic health disparities

Over time, we have grown our recognition of advocacy as an essential counterpart to policy analysis.  During our first years, we helped to seed the Medicaid Strategy Group and the Connecticut Oral Health Initiative – both still in existence and both key partners in advocating for effective Medicaid and oral health policies.

Around 2006, we commissioned policy research on Medicaid reimbursement for medical interpretation for people with limited English proficiency.  A multi stakeholder coalition came together to advance the recommendations and we provided the coalition with some modest funding.  This was a turning point for investing in policy analysis and advocacy in more concerted pairings.

Around 2011, we saw success with an request for proposals that challenged grantees to integrate policy research and advocacy.  This funding opportunity made grant dollars available to non-profit organizations that do not typically have the resources to commission rigorous policy analysis to advance their policy agendas.  While typical research grants end with a manuscript, the expectation of an active advocacy phase was designed into the grant period.

Our recognition of the essentiality and effectiveness of investing in advocacy has become particularly manifest in the years of the current strategic plan.  We have funded approximately $2.6 million in advocacy related grants in that time and several hundred thousand dollars in program initiative funds for consultants and publications tied to our policy agenda.  Our current approaches include:

  • Making a long term investment in seeding Health Equity Solutions
  • Encouraging organizations led by people of color to engage in advocacy in order to diversify the face of health advocacy in Connecticut
  • Funding “non-teeth” organizations to take up oral health advocacy
  • Funding a full time oral health advocacy fellow
  • Providing general operating support grants to advocacy organizations
  • Redesigning our leadership program to be advocacy focused
  • Aligning advocates around campaigns related to the Affordable Care Act and Medicaid defense

The dynamic nature of advocacy gives us reason to engage with our grantees and partners beyond the traditional foundation-grantee relationship.  We strategize together, provide each other with real time information, align messages, coordinate campaigns, problem solve, and utilize the unique relationships and perspectives that each partner brings to the table.

Maintaining advocacy as a core strategy also helps ensure a close working relationship between our internal policy, program, and communications staff since each department is an essential contributor to this work.

Trends in the Field of Health Philanthropy

Just as CT Health has increased its comfort with and investment in advocacy, so too has the sector.  A decade ago, funding advocacy was still largely considered a risky proposition in health philanthropy.  With one look at the current programming of Grantmakers in Health, our national affinity group, the shift in the sector becomes evident.  CT Health would like to think it has been ahead of the curve within the health funder community and the health funder community is still ahead of the curve within the wider philanthropic community.

A challenge facing advocacy organizations, however, is that they are heavily reliant on foundation dollars.  While more foundations are funding advocacy, there is a need for yet more foundations to get on board.

From the Archive:  Advocacy Thought Leadership from CT Health

Krause, E. & Armijo, C. Public Policy and the Health Equity Agenda. Grantmakers in Health Views From the Field. January 20, 2014.

Baker, P. & Krause, E. A Connecticut Foundation Experiments with a Different Way of Funding Health Policy Research. Health Affairs GrantWatch Blog. Posted February 12, 2013.

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