Health equity means everyone has a fair and just opportunity to be as healthy and well as possible. This requires engaging communities and partners to reduce health disparities by removing obstacles to health such as poverty, discrimination and their consequences.
Three years ago, the Trustees of Richmond Memorial Health Foundation (RMHF) approved the Strategic Framework for RMHF’s work reflecting our commitment to foster an equitable and healthy Richmond region. The Framework maintained RMHF’s longstanding commitment to focus on access to health care through investments to traditional health safety net organizations, and introduced new strategies to (1) advance health equity, (2) address the social determinants of health, (3) invest in arts and creative expression, and (4) integrate impact investing in our work.
Earlier this year, the Trustees and staff took a close look at the Strategic Framework and assessed RMHF’s work over the past three years. As part of this process, Trustees and staff worked with leadership from Virginia Center for Inclusive Communities (VCIC) to explore issues related to implicit bias, privilege, and the racialized structure and culture of the Commonwealth. Our staff worked with Sukari Pinnock and Becky Choi to deepen our shared understanding of health equity and consider how our internal practices can better align with and support RMHF’s mission. Trustees and staff alike assessed the shifting landscape, paying particular attention to Medicaid expansion, the fast changing demographics in the Richmond region, and the increasing public conversation about rising housing instability.
We looked closely at the recommendations of our first and second classes of Equity + Health Fellows and took seriously our commitment to integrate those recommendations into RMHF’s work. We listened to and learned from partners about what was working and what could be refined in how we approach our work. Finally, the Trustees were clear that all of RMHF’s investments must be aligned with and support its commitment to foster health equity.
At their most recent Board meeting, the Trustees unanimously adopted the Strategic Framework for 2020 through 2022. The Trustees reaffirmed RMHF’s mission and values. They affirmed RMHF’s aim to advance health equity and reduce health disparities, with an eye towards cultivating a health equity movement in our region that brings together diverse partners across neighborhoods, institutions, and sectors.
We embraced a definition of health equity that acknowledges the Richmond region’s history of segregation, disinvestment, and structural racism. When we talk about health equity, we mean that “everyone has a fair and just opportunity to be as healthy and well as possible. This requires engaging communities and partners to reduce health disparities by removing obstacles to health such as poverty, discrimination, and their consequences.”
Our Strategic Framework represents no significant shift in direction or focus. Like our previous Framework, the Framework for 2020-2022 has four components:
- Access to Health Care: RMHF team members Lisa Bender and Albert Walker will co-direct this portfolio. We will continue to provide general operating support to RMHF’s nine longstanding health safety net partners and release Open Calls for Oral Health and Behavioral Health. The Open Call for Oral Health will be released on November 6th with funding awards to be announced by March 2020. The Open Call for Behavioral Health will be released in early January 2020 with funding awards to be announced by late May 2020. Beginning in the first quarter of 2020, we will also award capacity-building grants, with a focus on supporting organizations led by people of color and grassroots organizations working to promote access to health care to underserved populations in our region.
- Equity + Health: RMHF team member, Albert Walker, will design and direct this portfolio. During the past three years, RMHF’s Equity + Health Fellowship programs and HEArts investments were the core components of this category. Moving ahead, the Equity + Health portfolio will be focused on implementing and accelerating the recommendations of our Equity + Health Fellows. We will focus investments on community engagement, as well as on leadership development and capacity building for neighborhood and resident-led efforts. Grant opportunities in this portfolio will be released in January 2020, and we anticipate making grants throughout the year on a rolling basis to support this work.
- Health Equity, Arts, & the Built Environment: RMHF team members, Kendra Jones and Michael Smith, will lead work in this new portfolio. Kendra will continue to direct RMHF’s HEArts investments that demonstrate the power of art and creative expression to promote health equity. Over the next two years, RMHF’s investments in HEArts will give priority to work that integrates meaningful community engagement, provides opportunities for leadership development, and lifts up community voices to advocate for solutions to the persistent inequities in health and housing. The HEArts request for proposals will be released in early January 2020 with funding awards to be announced by late May 2020.
In the Built Environment portfolio, Michael will focus RMHF’s grantmaking on issues related to (a) discrimination in housing, and (b) mobility and economic opportunity, as well as issues related to (c) extreme heat and humidity which disproportionately and negatively impact low-wealth communities and communities of color. The Built Environment request for proposals will be released in early January 2020 with funding awards to be announced by late May 2020. RMHF will also allocate resources in this portfolio to support responsive grantmaking opportunities.
- Impact Investing: With the support of Debby Kasemeyer from Northern Trust, Mark Constantine and Courtney Worrell will direct this portfolio which includes both debt and equity investments in CDFIs, as well as limited grantmaking. We are also exploring opportunities to make program-related investments that advance health equity. RMHF’s impact investments are by invitation only.
Dr. Cynthia Newbille and Dr. Fred Karnas will continue to provide leadership on special projects at RMHF, provide support on cross-portfolio initiatives, and serve as resources to community partners.
With the full support of our Trustees, we are making some changes in our practices.
- Our partners spoke about the value of general operating support grants. Recognizing the critical importance of unrestricted capital to support mission-aligned organizations, we will increase our use of grants to provide general operating support.
- Our partners strongly encouraged RMHF to provide multi-year funding. We are pleased to report that – beginning immediately – RMHF will incorporate multi-year funding opportunities in our three portfolios: Access to Health Care, Equity + Health, and Health Equity, Arts, & the Built Environment.
- In response to the recommendations of both cohorts of our Equity + Health Fellows, we will significantly increase RMHF’s investments to support policy and advocacy work. Within the Access to Health Care portfolio, we will commit at least 25 percent of our dollars targeting Oral and Behavioral Health to support policy and advocacy efforts. Within the Built Environment portfolio, we will allocate at least 50 percent for policy and advocacy efforts. While we did not set a particular policy and advocacy allocation for RMHF’s HEArts investments, we strongly encourage proposals for HEArts investments that integrate policy and advocacy efforts.
- In response to the recommendations of both cohorts of our Equity + Health Fellows, we will increase our investments to support community engagement, leadership development, and capacity building for neighborhood and resident-led efforts. We will target dollars specifically to support grassroots organizations and organizations led by people of color, and we are exploring more flexible funding strategies to support these organizations.
- We will continue to offer racial equity trainings to grantee partners and will open these opportunities up for more members of our community to participate.
- While many partners affirmed RMHF’s increased focus on trainings and cohort meetings, others expressed concerns that we were asking too much of our grantees. We are sensitive to the demands placed on our partners and are open to suggestions about how we can best support shared learning and relationship building among people and organizations engaged in common causes. We want to support our partners in ways that are meaningful, responsive, and appropriate, without placing undue burdens on busy people.
- We will explore ways to streamline our end-of-year reporting requirements to facilitate learning between RMHF and its partners.
We are excited about the work ahead and deeply honored to work with and learn from extraordinary partners who work tirelessly to bring health, opportunity, and hope to all the people of our region.