Lessons Learned

Lessons Learned

Place-Based on Shifting Sands: When Responsive Funding is Strategic Funding

The Foundation’s giving area was strictly limited to the primary service area of the Advocate Ravenswood Medical Center, defined by the boundaries of 17 zip code areas.

Place-based funding can fuel ambitious goals. Early on, trustees debated whether to take what is commonly called a strategic approach to philanthropy – invest in something specific to create measurable change – or to be a responsive philanthropist partner and allocate funding to effective organizations so that they can address emerging community needs.

Trustees selected responsive philanthropy, and it proved to be a wise choice. For while the geographic boundaries remained static, the demographics within shifted tremendously. Any attempt to “prove” a solution or “attain” a statistical goal would have been foiled by significant and unanticipated changes in racial, ethnic and economic profiles.

The Foundation conducted a participatory Community Health Needs Assessment in 2006 and discovered that lower-income families, primarily families of color, were moving away from the north lakefront because of increased housing costs.

Demographic shifts accelerated during the lifespan of the Foundation. North lakefront neighborhoods like Rogers Park, Uptown and Edgewater gained predominantly middle-class white residents while losing lower-income Black, Asian and Hispanic residents. Concurrently, northwest side Jefferson Park, Dunning and Portage Park, gained Black, Asian and Hispanic residents – and lost white residents.

As a responsive funder, Ravenswood was able to adjust grantmaking to address the demographic dynamics and accompanying issues.

Lessons Learned

Long-term, Consistent Funding Yields Results

The limited geographic focus allowed the Foundation to remain in long-term relationships with grantee organizations. Because the Foundation was not trying to meet a city-wide need, it did not have to stop funding certain organizations in order to make room for others.

For the small or mid-sized organizations without large fundraising departments, this consistent financial support was especially important. The Foundation’s funding commitment alleviated anxiety and enabled organizations to focus on their work. Larger organizations were able to grow or expand programming in ways that might not have been possible without ongoing support.

The financial stability afforded by Ravenswood’s grantmaking is perhaps just the beginning of the story. The early support and ongoing commitment allowed the Foundation’s grantees to strengthen their programs, therefore ensuring the delivery of high quality services.

Feedback from grantees suggests that there was a connection between the Foundation’s long-term financial support, grantees delivering effective programs, and improved health outcomes for client populations.

Lessons Learned

Welcome Innovation

Some grantee organizations developed or replicated programs to address a need in their community. Programming was also enhanced by deepening engagement with partner agencies and by testing out new or innovative approaches. Ravenswood was open to funding promising new approaches, even those that might be outside of some foundations’ comfort zones.

In 2007, before widespread transgender awareness, Chicago Women’s Health Care Center developed a trans-inclusive gynecological program for male-identified clients with Ravenswood funding: “It allowed us to become a pioneer in this area. We have been able to build upon this, and in 2014-15 we expanded the capacity of providers to further expand our trans health services.”

Another organization, Chicago Adventure Therapy, created new model to expand leadership opportunities for the youth they served: “Ravenswood funding meant more time to be able to work with young people and working in deeper more long-term ways like programming through partner agencies. Now we have started a smaller year-round program with young people becoming coaches. We have produced the youngest paddle sport coach in the country. The youth have mentored each other.

Lessons Learned

Be the “Vote of Confidence”

For many organizations, Ravenswood Health Care Foundation was one of the earliest funders to invest in new programs. Ravenswood funding often helped organizations leverage other funding sources for these programs, including foundations and individual donors. Citing Ravenswood as a seed funder made other local and national funders comfortable and excited to support their work.

“I think it encouraged other foundations to support us, since Ravenswood had been there from the start. Ravenswood was huge in terms of getting other private funding. The program is now 100% covered by other Foundations.”

Lessons Learned

Be the “Listen, Learn & Respond”

Annual summer Gatherings became an informal capacity building mechanism; they were spaces to exchange ideas and share common challenges. Attendance was entirely optional for grantee organizations, though many attended at least in part for the opportunity to meet directly with Foundation trustees.

“Compared to other foundation convenings, I would rank the RHCF discussions much richer and more meaningful. It wasn’t show and tell. It was really homing in on really important questions that impact the health of Chicago. And to have the trustees interspersed among the grantees had a different feel for me. We could give true recommendations to the Foundation about how they could invest in us and reap the reward.”

Each Gathering centered around a topic, from Effective Evaluation to Implementing Healthcare Reform. In 2013, multiple organizations voiced concern about the imminent changes in public funding streams due to the Affordable Care Act. The Foundation responded by enlisting expert consultation to meet with self-selected organizations one-on-one to determine if and how each could access a new billing system.

Lessons Learned

Be the “Invest in Frontline Providers”

In 2015, the Ravenswood Health Care Foundation initiated a Special Opportunities Grant Fund specifically to support training and professional development for clinical mental health providers at grantee organizations. Professional development funds were scarce throughout the nonprofit provider sector; by supporting skills and knowledge development, Ravenswood would create a cadre of practitioners with advanced training.

The Special Opportunities Grant Fund was intended to ensure that the impact of the Ravenswood Health Care Foundation continued beyond 2017. This uncommon funding stream, provided in 2015, 2016 and 2017, was tremendously popular among grantee organizations.

Perhaps the most notable element of the Special Opportunities grants has been the way in which the knowledge gained through the trainings did not stay confined to the single staff person who took the training. Rather, staff returned and shared their knowledge, resulting in stronger programs and changed practices across their organizations.

Lessons Learned

No Surprise Endings

Concerned that a sudden ending would negatively impact grantee organizations, Foundation trustees created a Sunset Committee in 2012 to develop a plan for the Foundation’s closure. One of the first decisions was to suspend board term limits, citing the potential difficulty of bringing on new trustees unfamiliar with Foundation for shortened terms.

The summer Gathering of 2013 served as a forum to seek grantee input on the process for ending grantmaking. Overwhelmingly, grantees advised against surprises. While annual funding was never guaranteed, knowing a year or two out whether funding was even a possibility would be helpful.

With this guidance, the Foundation formally notified grantees that funding would cease after 2017. Trustees elected to maintain level funding for the Lakeview and Amundsen High School Health Centers (the largest single grantees) through the remainder of the life of the Foundation to eliminate any uncertainty. And only organizations funded in the previous five years would be eligible to apply for 2014 funding.

Trustees set aside $15,000 in 2014 for mini-grants in support of organizational sustainability. The executive director allocated small grants to grantee organizations for specific activities related to future viability, including: fundraising consultation, strategic planning and board development.

To further facilitate grantmaking in 2015, 2016 and 2017, the Sunset Committee recommended a funding strategy based on four categories (or “buckets”) that had emerged as priorities throughout the life of the Foundation:

Specialized Language and Cultural Accessibility included the unique organizations that served vulnerable immigrant and refugee populations in their language (Mandarin, Amharic, Khmer, Vietnamese, Korean, Spanish, Polish, Thai, Hindi, Urdu, Gujarati, Arabic, Nepali, etc.) and with knowledge of and sensitivity toward cultural differences; their grant sizes would not be limited as they were considered a top priority.

Boosters referred to those organizations that could use a “boost” of support from the Foundation’s executive director in addition to grant support; a boost could be an introduction to another potential funder, feedback on fundraising proposals, or brainstorming.

Community Treasures were large, highly respected and stable organizations that Ravenswood wanted to continue to fund but at a lesser amount; their grants would be limited to $10,000 per year.

Relationship to former Ravenswood Medical Center included a handful of organizations that originated at Ravenswood and continued to thrive; their grants would remain at previous/current levels.

Lessons Learned

Reflection & Results

In 2018, the Ravenswood Health Care Foundation engaged the Pratt Richards Group to interview grantees, ascertain how they were doing, and get their feedback on the Foundation’s grantmaking practices. All of the grantee quotes featured in this report surfaced during those interviews.

Pratt Richards Group learned that most of the organizations had secured replacement funding or found other ways to support the work that the Foundation had previously supported. In some cases, grantees were able to grow a privately funded program into one that had become financially self-sustaining:

“We’ve kept the position after the funding finished – we’ve just done it through increased patient care. That person’s funding has been retained because we have increased our number of patient encounters which generates revenue through third party billing.”

While many organizations expressed confidence about the future, some noted that replacing Ravenswood’s funding was going to be a challenge. Organizations in this category, however, either had concrete ideas about where they might secure additional funds or identified the situation as opportunities for growth:

“It’s always a challenge to lose funding. That is the honest answer, but thankfully we have a diverse portfolio of funders and revenue streams, so this doesn’t put us in jeopardy.”

“Now we have a track record and results – and so now we have to figure out how we tell our story. It has made us rethink being more focused and strategic in fundraising and grant funding.”

Interviewees expressed that RHCF was a true collaborator in their work, many of them – unprompted – using the word “partner” to define this relationship. This dynamic, somewhat rare in philanthropy, appeared to be the product of staff and board tenor coupled with remarkable transparency.

Almost without exception, interviewees praised the executive director’s operating style which was described as accessible, smart, warm, frank and engaged. This style allowed grantees to generalize from their experience with her to the character of the Foundation as a whole: “It’s one of the friendliest foundations we have worked with”

The Foundation’s application and reporting processes were appreciated for being clear and manageable, and grantees also revealed a high degree of honest, straightforward interaction – a practice unfortunately uncommon in philanthropy. Grantees recounted stories of difficult but necessary conversations, second chances, constructive feedback and concrete advice, and committed side-by-side work.

The Ravenswood Health Care Foundation will be missed for more than its dollars, as grantees believe they are losing a true partner in their work.

The Foundation was so much more than lists of grants. By partnering with nonprofit organizations and building trusting relationships, the Ravenswood Health Care Foundation created a space for health leaders to learn from and coordinate with one another.

In 2010, the Foundation commemorated a decade of service by publishing a Ten Year Report. In 2018, as the Foundation concluded its grantmaking and ceased operations, it documented lessons learned and the voices of grantee organizations in a final report, Leaving a Legacy.