Community health partnerships
We seek to improve community health by encouraging cross-sector collaboration and the integration of community health strategies into health care, especially the primary-care safety net.
Focus Area Overview
Unemployment, loss of insurance coverage and increases in chronic disease and mortality have converged with government spending cuts and shortages of primary-care physicians and clinics to produce wide gaps in access to and quality of health care among all groups in the United States. For low-income, minority communities this situation is particularly acute: Evidence shows that this population has historically received substandard care and is exposed to conditions that are harmful to health.
We believe that improving the nation’s health, especially for vulnerable populations, requires more than increased health care. It requires a focus on the social determinants of health – things like air quality and access to healthy food. Factors as varied as crime and the absence of parks may contribute to injuries and illness in different communities.
Health care providers and systems are beginning to recognize the need to address the underlying social and physical conditions that affect the health of their patients. At the same time, there are increased demands on community health centers and the primary-care safety net.
We invest in two main areas:
- Building a better primary-care safety net.
- Innovative approaches to improve community health.
Building a better primary-care safety net
This work builds on community health centers’ leadership in addressing the upstream determinants of health and aims to strengthen these critical organizations.
Work under way
In response to the economic crisis, in 2009 we offered grants to sustain and build the operational capacity of charitable health clinics, public health clinics and those designated as federally qualified health-center look-alikes. (Learn how the U.S. Department of Health and Human Services defines health centers.)
Two-year grants were awarded in 2009 and 2010, providing support for 30 organizations. As a result, these nonprofits have been better able to meet increased demand for health care services by vulnerable populations.
We have also funded a demonstration project designed to highlight multisector collaborations among community health centers and local partners to reduce health disparities. Our four-year safety net enhancement initiative provided planning grants to a dozen public health agencies and community nonprofit organizations in 11 states to design innovative health care delivery models in 2010. Subsequently, grants totaling $6 million were given to eight of those organziations for the development of their proposed models.
The multisector approach has created partnerships among organizations as diverse as a women’s health organization and a law enforcement-led antirecidivism program.
We believe public health, safety net organizations, local health systems and nonhealth community partners must all play a role in improving community health. We hope that this demonstration project – and an accompanying evaluation process – will provide models for systems change.
Community health hub investment initiative
Today, in partnership with our Social Investment Practice, we work to couple grantmaking with below-market-rate loans, loan guarantees and other alternative-financing tools to support both the growth and sustainability of community health centers. The Social Investment Practice typically makes funding available to Community Development Finance Institutions or other partners that, in turn, make loans for capital projects to federally qualified health centers.
As part of the community health hub investment effort, we seek to leverage other health-advancing solutions in the communities these health centers serve. These include features such as technology to promote and preserve good health, access to healthy food and supportive services.
In 2012, $10 million was provided to regional and national community development financial institutions. These lenders include IFF, which has targeted health centers in Wisconsin and Indiana, and the Reinvestment Fund, which has partnered with IFF on a demonstration project funding four health centers.
We support promising new practices that serve vulnerable populations by advancing prevention, improving access and integrating primary community and clinical care.
We look for efforts that foster connections between the clinical health care and community health, integrating patient care with activity to recognize and “treat” the social and environmental factors that contribute to poor health.
Examples include a first-ever report highlighting the work of community health centers in promoting health and working to eliminate conditions that adversely affect the communities they serve and medical-legal partnerships that address patients’ nonmedical needs.
Who should apply?
- U.S. 501(c)(3) organizations with audited financial statements that are not classified as private foundations. Audits must be independently prepared following Generally Accepted Accounting Principles or Government Auditing Standards. Financial statements prepared on a cash, modified cash, compilation or review basis do not qualify.
- Government entities.
Who should not apply?
- Organizations that discriminate on the basis of race, color, religion, gender, national origin, citizenship status, age, disability, sexual orientation or veteran status.
- Organizations that require membership in certain religions or advance a particular religious faith. (Faith-based organizations may be eligible if they welcome and serve all members of the community regardless of religious belief.)
- Programs operated to benefit for-profit organizations.
We have a two-step application process that begins with an inquiry, submitted via an online application system.
Part 1, the preliminary application, contains a data-entry component and several attachments, including a narrative.
If the activity you describe fits one or more of our strategic priorities and our budget, we then request additional information. This will constitute Part 2 of the application process.
We accept and review inquiries about innovative approaches to improve community health on an ongoing basis.
Applicants awarded multiyear grants should be prepared to secure matching support after the first year. That match may take the form of additional funding or in-kind services or other resources. The match should be equivalent to half the Kresge contribution for the second and, if applicable, third year of the grant.