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Navigating Change and Accelerating Promising Practices

By Sarah Strunk on September 26th, 2018

In 2017, I had a unique opportunity to partner with staff from several health legacy foundations* that compose the Health Legacy Collaborative Learning Circle (HLCLC).

HLCLC created opportunities for learning across four similar foundations around the country to 1) test and expand assumptions about promising approaches for addressing common population health challenges; 2) explore organizational best practices related to programming and operations; and 3) understand the roles and impacts that health legacy foundations have in their communities.

Earlier this year, I wrote about the collaborative. In that blog, I described how the HLCLC promoted and practiced facilitative leadership with a cohort of colleagues from a sector in which processes are often shrouded in mystery despite efforts to promote transparency. Now, with a few months of additional hindsight, I’ve learned additional lessons.

As a consultant, I facilitated a collaborative learning journey that included site visits to HLCLC partners’ communities and regular reflection sessions among the participants. The site visits helped HLCLC partners test assumptions, see the impact of their peers’ work, and refine their thinking about successful models and approaches to community health initiatives. In some cases, they also shattered myths and misperceptions about the nature of health improvement efforts in places like rural counties, border towns, and inner cities.

Programs, initiatives, and partnerships served as valuable learning labs during the site visits. Foundation staff, partners, and grantees explored approaches to 1) building community connections and capacity; 2) promoting schools as hubs for health; 3) investing in residents as community connectors; 4) fostering resourcefulness; 5) addressing mental health; 6) stimulating a broad vision of health; and 7) focusing on health equity. I also facilitated reflection sessions that lead to synthesis and sharing of insights. These are summarized in Navigating Change and Accelerating Promising Practices: Lessons Learned from the Health Legacy Collaborative Learning Circle (HLCLC).

The lessons weren’t particularly groundbreaking, or even unique to HLCLC members. In fact, they included many that their grantees, such as nonprofit leaders and grassroots advocates, have known for years: Collaboration is hard to measure. Take time to learn and share with peers. Stretch your definition of community expertise. Be willing to invest in the slow, sometimes invisible efforts that lay the groundwork for sustainable impact. Effective evaluation balances evidence and innovation. Equity starts from within. And more.

So it’s not surprising that, according to HLCLC participants, the value of the collaborative wasn’t just in the learning itself; rather, it was also the opportunity for in-depth conversations, leading to new understanding and sometimes even changes in mindsets and practices, with a trusted group of peers. “Foundations can be isolating places. Having shared experiences, especially if your foundation is the only one in town, is valuable,” reflected Michael Kelly, Vice President of Programs at the Paso Del Norte Health Foundation in El Paso, TX. Annie Martinie, Senior Program Officer at the Danville Regional Foundation, concurred. “This work is hard to understand if you’re not in it every day. It’s nice to have a tribe that does the same work but has a different perspective. I’ve been able to think more critically about why we do certain things and how we may be able to improve our practices,” she said.

While change takes time and the impact of HLCLC may not be realized for years to come, improvements are already taking root in HLCLC partner communities. One foundation is exploring how to engage grantees more collaboratively in evaluation. Another is introducing new strategies for addressing children’s health in under-resourced areas through school-based health clinics. Several have adopted new ways of communicating with their boards. And nearly all are more immersed in health equity work like exploring how institutional racism plays out in their own organizations. The PATH Foundation, based in Warrenton, VA, is even looking beyond its expansive rural service area to consider how lessons can be applied throughout the state. “Now we’re discussing how the HLCLC’s methods and approaches can inform new work on impact investing with a group of health-focused foundations,” observed Kirsten Dueck, Senior Program Officer.

Overall, this collaborative learning experience provided opportunities for both seasoned and new grantmaking professionals, and their foundations, to reflect on their impact from multiple perspectives. Jaime Love, former Program Officer at Interact for Health in Cincinnati, OH, agrees: “The experience was great. It made me really proud to think about all that we have accomplished. It was also a reminder that everyone has a wealth of knowledge. You just have to tap into it.”


*Health legacy foundations (also known as conversation foundations) are created from the assets from the sale, lease, merger, or other configuration of the assets of nonprofit hospitals, health systems, health plans, and specialty care facilities, often creating billions of dollars in new charitable wealth. The results of these conversions can be significant. In 2010, health legacy foundations awarded a total of $1.1 billion in grants, with an average of $3.7 million paid out per foundation.

(Niggel and Brandon, Health Affairs, January 2017).

Sarah Strunk

Strategic Advisor

Healthy communities networker, integrator and distance runner on the go.