This report updates the progress and early outcomes for four supportive housing projects funded by the Missouri Foundation for Health as part of its Show Me Healthy Housing program. The report updates the initial evaluation report from 2016. It details the implementation of supportive housing for all sites and interim outcomes on housing stability, income, health status, healthcare utilization and costs for projects that have served tenants for at-least 12 months. Most sites struggled with securing funding for long-term rental subsidies and case management, but the report finds positive outcomes for housing stability and reductions in ER usage and costs.
Source: Urban Institute
At Funders Together, we make it a goal to share the work of funders across the country so you can learn what's working and adapt these strategies to your own community. One way we do that is through our Featured Members. Some are featured because of their innovative grantmaking. Others are featured because they are making connections and bringing new people into the conversation about ending and preventing homelessness. Still others are featured because they are challenging the very systems that allow homelessness to persist. In each case, our Featured Members are an integral part of the solution to homelessness.
The HealthSpark Foundation is a private, independent foundation providing support to organizations that serve the unmet health and/or human service needs of residents living in and organizations serving Montgomery County, Pennsylvania. We spoke with Russell Johnson, President and CEO of HealthSpark Foundation, about the Foundation's systems change approach to population health and, ultimately, preventing and ending homelessness.
1. Thank you so much for taking the time to talk to us today. Could you explain a little bit about what HealthSpark Foundation does and in what capacity it is involved in homelessness issues?
To understand what HealthSpark Foundation is, we need to go back to where we started. We were founded in 2002 as the North Penn Community Health Foundation with a $39 million endowment, generating approximately $1 million for grants on an annual basis. Early on, the foundation invested in nonprofit capacity building, but mostly served as a responsive health and human service focused grantmaker. Our work soon highlighted that capacity building grants were scarce, that few foundations offered this type of grant and that the need was large. In 2012 the board adopted a new strategic plan that focused on opportunities to address the challenges of poverty through investments in changing systems – including continued support for nonprofit capacity building initiatives.
Our investments supported nonprofit organizations seeking to introduce and/or enhance their data collecting tools and analysis; helping recruit, train and maintain skilled staff; and using data to guide and focus the allocation of resources to achieve desired goals and community impact. We promoted the use of evidence-based case management tools help produce quality outcomes. Staff training and implementation of these tools represented significant areas of our grant making. There is value in independent research of outcomes, so investing there was, and continues to be, a priority for the foundation.
We helped to start and continue to serve on the leadership council of a public/private partnership initiative called Your Way Home Montgomery County (YWH). YWH was established as the county's coordinated housing crisis response system for residents experiencing homelessness. HealthSpark Foundation took the lead in supporting research of best practices. Once a framework for systems change was developed, HealthSpark also invested in targeted capacity building for providers and scaling the impact of YWH with support to create a website, implement a marketing and communications strategy, establish a development team to raise money from other foundations, conduct a formative evaluation of our early work and support the costs of several pilot projects designed to test out new models of service delivery.
Prior to YWH, our community’s approach to addressing homelessness was designed and influenced by HUD rules and guidelines. Yet HUD lacked an understanding of the resources and challenges in our community. HealthSpark’s leadership convinced the county to reorient its relationship with HUD, shifting from a model focused on compliance to operations designed to leverage local knowledge and resources that remained informed by HUD guidelines. Through YWH, our community designed a plan that made sense to local stakeholders and preserved HUD’s investments in our work. The organizational structure of YWH provides a single umbrella for county government, philanthropy, providers and other community stakeholders to come together and work as one aligned system addressing the needs of those experiencing homelessness.
2. HealthSpark Foundation recently underwent a rebranding. Can you explain why this was important for your work and the foundation’s mission?
Originally, as the North Penn Community Health Foundation, our board wanted to maintain a connection and legacy to the source of our endowment: the local community nonprofit hospital. The board wanted to preserve and invest only in the local community, commonly referred to as North Penn. However, as we started to focus more on capacity building and systems change, the board realized that providers served a broader community and their revenues were driven by county government contracts. The board came to understand that our disciplined focus on a small geographic area was inhibiting our ability to achieve scale and the desired community impact.
Our efforts to expand our impact to all municipalities within Montgomery County was hampered by the geographic portion of our name. Many mistakenly thought we worked only in the North Penn community, while others thought we worked throughout northeastern Pennsylvania. Moreover, some nonprofits and foundations thought we raised money, as would be typical of a “community foundation.” We are, in fact, a private foundation that does not engage in fundraising so this too created confusion and distracted from our intent and mission.
In January 2016, we officially launched our new name and identity: HealthSpark Foundation – investing in healthy communities. Our new logo is a dandelion, a medicinal plant, with one seed going off into the wind, which reflects our efforts to “seed great ideas.” Our investment in our new identify/brand has been worthwhile, opening new opportunities to partner and learn.
3. The HealthSpark Foundation takes a “systems change” approach to your grantmaking. Can you explain why you feel this is the right strategy and if/how that has impacted the outcomes of your grantmaking?
Our work with nonprofits and feedback from consumers has taught us that many of the service delivery systems are segregated and inefficient. Federal and state funding sources have historically contributed to this segmented approach to financing programs and services. However, there is a growing interest in our county to leverage block grant opportunities and to dismantle redundant and cumbersome intake and service delivery models that have historically segregated services. This new interest and commitment views the consumer as a whole person rather than someone with a specified need who fits into a funded program. Opportunities for public/private partnerships and collaborative efforts have been enhanced and new, more cost-effective programs and services are evolving that are producing better results for both consumers and the community.
As these collaborative conversations were taking place, HealthSpark Foundation identified an investment opportunity to help the provider community learn about and use evidence-based case management tools. The YWH leadership identified these tools and the public/private partnership implemented regular trainings and established a learning collaborative to help build and sustain the capacity to use them. HealthSpark created and supports this learning collaborative where providers refine their skills and talk about various issues and challenges they are experiencing.
Investments in research, capacity building, learning collaboratives and more have been worthwhile, but our systems change approach has not been easy to implement. Through the collective support and efforts of the public/private partnership, we are slowly convincing providers, landlords, employers, other community service providers and foundations that this approach is making a significant difference in the lives of people experiencing homelessness. Providers, other foundations and consumers have joined to tell their stories. For example, the YWH website and annual community meeting highlights stories of consumers who have benefitted from rapid re-housing. Landlords are also talking about the value of the supportive partnerships forged by YWH’s housing stability coaches and housing locators. These professionals are helping to mitigate disruptive tenant behaviors and encourage positive communications and constructive relationships between tenants and landlords. Funders have joined together creating a pooled fund that housing stability coaches can use to assist consumers in overcoming financial barriers to secure housing. The YWH coordinated entry program, now in its third year, is reducing waiting lists for shelter services by assessing consumer vulnerability and diverting some seeking shelter services to more appropriate resources that preserve existing housing.
4. Homelessness is a symptom of a larger issue and the intersectionality between homelessness and other issue areas is crucial. How would you encourage other foundations who don’t see themselves as primarily involved in homelessness to focus more on it?
Population health is a relatively new concept. But this approach has proven to be exceptionally helpful as we build partnerships and continue our work. We use this framework to engage other funders who may define their role and mission in ways that don’t reference “homelessness.” We look for funders interested in promoting the well-being and success of communities through economic development, education, access to health and other human services, food and nutrition, job training and employment, child care and more. When all these “systems” work well, the overall health of the population is healthier and stable. We have been successful in building awareness that investments in these areas can help homeless individuals and families achieve success – again the theme of integrating systems and resources to overcome the barriers that living in poverty impose on homeless people. HealthSpark welcomes opportunities to explore various partnerships that might help leverage our individual efforts and together achieve a collective impact greater than the sum of its parts. This message now resonates with more than a dozen philanthropic partners that support YWH.
5. Advocacy can seem a bit untouchable or unobtainable to many funders. What role does advocacy play at the HealthSpark Foundation? Do you have any insight on successful strategy or challenges to be aware of when participating in advocacy?
We know and understand advocacy can take various forms. As a private foundation, we have some limitations imposed by the IRS. Nonetheless, our board supports many advocacy and educational efforts targeted to building awareness around best practices. We often contribute time to share our stories with others in Pennsylvania and occasionally at national gatherings. We educate our funder colleagues, elected officials, providers and sometimes even consumers on what is working in Montgomery County, Pennsylvania. We also advocate by sponsoring research and publishing the results, disseminating articles and hosting site visits.
6. Funders Together is starting to look more at employment and economic security as an important part of ending homelessness. What, if anything, has your foundation done to address this intersection?
We are just beginning to learn about Employment First and other employment strategies. We recognize that access to an adequate household income enhances housing stability. We have invested in a comprehensive benefit enrollment service and recently introduced the SOAR program to our community.
We recently provided grant support to establish a Catalyst Kitchen program in our community. This program is currently being piloted to help a small cohort of individuals without existing job skills or recent employment histories to quickly learn basic culinary arts skills and then to enter the workplace. The food service industry is robust and growing in Montgomery County and through this investment we are hopeful that some homeless families will build careers in this industry.
Through the YWH leadership council, we are also partnering with the county’s Department of Commerce and the state’s Department of Human Services to explore how we can work together to support the efforts of people with significant barriers to enter the workforce more quickly and remain employed. The Employment First program may become a focus for this work, but for now HealthSpark intends to focus on building awareness of opportunities through researching best practices, hosting site visits and sending key leaders to conferences to enhance their own learning.
9. How can groups like Funders Together support the work of foundations like yours?
We joined Funders Together to End Homelessness to connect with other funders, further our knowledge and ultimately increase our impact. While members for only a few short months, FTEH has helped us to create new relationships and connected us with other funding innovators. We also have appreciated the recognition of our own work while inspiring us to continue learning and building a sustainable system that seeks to make the experience of homelessness brief, rare and non-recurring.
One specific opportunity that we have found incredibly important and enlightening was the 2016 Funders Institute’s focus on racial inequity in homelessness. The HealthSpark Foundation board has long embraced the concepts of diversity, equity and inclusion (DEI). Recently, three of our board members participated in a regional learning collaborative hosted by Philanthropy Network of Greater Philadelphia convened to inspire foundation leaders to engage in this type of work. This group acknowledged HealthSpark Foundation’s DEI leadership in our region. HealthSpark staff has also engaged with other funders to learn and share strategies for board and staff development and DEI work with grantees and other community partners. Our staff has been encouraged to serve on other community organization task forces and boards as well.
We encourage discussions and exploratory conversations about the use of data to help identify learning and investment opportunities. We are urging our YWH colleagues to publicly disclose client demographic data. A second strategy is to engage the provider community to critically explore whether existing programs and services are welcoming and appropriately supportive of the diverse needs of consumers. We are hopeful that this information will spark DEI conversations among funders and the provider community to explore enhancing provider leadership and capacity and seeking new DEI strategies to improve access to and service for a more diverse population of consumers.
HealthSpark Foundation would welcome conversations with other funders working in smaller communities. We value learning about the accomplishments of all communities, and particularly value learning how smaller communities with populations of less than one million residents can work together to leverage and learn from one another.
Interested in past featured member profiles? Check out our archive here.