Today’s post is by Kien Lee, PhD, principal associate/VP, and Sinead Younge, PhD, managing associate, at Community Science
“We feel like our mission is to contribute to policy in a data-driven way…., we have the data to answer some additional questions about what is going on in the program, but we don’t have the state resources to use the data in all of the ways that we would like to, so the extra funding from the CHF made that possible when we proposed to them that we examine this particular question.”– CT Health Grantee
Community Science has been evaluating the Connecticut Health Foundation’s work to promote a healthy state since 2007. Last year, the foundation asked us to evaluate its progress in advocating for health equity as part of its new strategic plan. We interviewed 41 people from grantee organizations with active grants at the time as well as staff, board members, health fellows, and other nonprofit leaders. Some of you asked if we would share the results. We and CT Health heard you. In this post, we share highlights from the evaluation with a more detailed slide deck below.
Key Evaluation Findings
Our evaluation found that CT Health has unequivocally played a leadership role in promoting and infusing health equity into policies, procedures, and practices in state initiatives and in organizations. It has played a critical role in brokering relationships, increasing knowledge about the healthcare system and social determinants of health, and strengthening nonprofit capacity.
Specifically, CT Health, through its grantmaking, communications strategy, and policy work in 2014, has contributed to:
- Reaching 6,144 people, educating 5,883 people, and enrolling over 4,379 individuals via Access Health CT;
- Enabling grantees to lay the groundwork for integrated care coordination, for example, by developing and implementing screening protocols that identify a patient’s multiple needs in order to provide comprehensive services;
- Establishing Health Equity Solutions, the first healthcare advocacy organization of its kind;
- Brokering relationships that facilitated several grantees’ and fellows’ involvement in governing and decision-making bodies and in shaping legislative and other important decisions; and
- Holding systems accountable to health equity through the infusion of the concept into state systems, development and integration of mental health policies and programs, oral healthcare practices by statewide maternal and child health programs, and primary care models.
Two observations are worth noting at the end of the evaluation:
First, grantees frequently referred to their use of data, which may be a reflection of CT Health’s values about the importance of data-informed strategies and decisions. Community Science has been evaluating foundation’s efforts for almost 20 years and in our experience, grantees will develop habits that their funders themselves practice. If a foundation appreciates and uses data, its grantees will notice that and be inspired to do the same. So, while we don’t have evidence that directly links grantees’ use of data to CT Health’s own practices, we believe that the foundation had some influence in cultivating the shared culture of data-informed decision-making illustrated in the grantees’ reports.
Second, grantees were genuinely appreciative of CT Health’s support and the availability and willingness of the foundation’s leadership and staff in connecting them to opportunities where they can have a voice and influence strategies, actions, and decisions. Again, in our experience, we have frequently found that some grantees tend to use the evaluation as a platform for their dissatisfaction with funders. This was not the case here. We believe that the deep knowledge of the foundation’s leadership and staff about health care and health disparities in general and specifically, about the state’s health care system was perceived as a huge asset by both grantees and leaders in the state.
“The foundation has shaped the whole state of Connecticut’s exchange, so if not for the foundation, the first open enrollment would not have gone as well and the SIM grant would not be as successful.” — Stakeholder
Recommendations
There is always room for improvement. While there were many accomplishments in 2014, the hard work of promoting health equity in Connecticut cannot stop. Grantees discussed the need to improve the availability and adequacy of data and integration of data systems in order to continue to foster a data-informed decision-making culture. They also requested clearer instructions about CT Health’s expectations with regards to outcomes and reporting and more information about its future direction. The foundation, in our assessment, could also take advantage of the momentum it has started to build among its grantees to push for health equity in the state, and convene grantees regularly to foster collaboration, knowledge exchange, and sense of community – all towards the end of having collective impact.