April 8 2018

What follows is a letter from the leadership of The California Endowment Board of Directors to the broader community that provides an update about our process of strategic planning.  While the timing is coincidental, the communication is released at the moment of the holiday to honor the legacy of civil rights icon Cesar Chavez.  This quote of Cesar Chavez certainly captures the central theme and narrative of our Building Healthy Communities journey:

                              “Once social change begins, it cannot be reversed.  You cannot un-educate the person who has learned to read.  You cannot humiliate the person who feels pride.  You cannot oppress the people who are not afraid anymore.”

The issues of community power, voice, and agency matter in health.  In honor of Cesar Chavez, we release this message to community with the power of his words in mind.

Friends, Colleagues, and Partners of Building Healthy Communities:

The Board of Directors at The California Endowment is now engaged in the strategic planning of our work beyond 2020, including the future of Building Healthy Communities (BHC).  BHC was planned as a ten-year effort, running from 2010 through calendar year 2020.

This letter summarizes the Board’s process for evaluating the progress and success of BHC, gathering input from community partners and evaluation consultants, and determining a path for the work of the BHC beyond 2020.

The Board is Pleased with BHC’s Impact.  We have spent the last 18-24 months gathering input and data about BHC, learning about its impact, and listening to our community partners’ perspectives about the last eight years of work.  We are thrilled about the progress to date.

From an impact perspective, we have witnessed and/or documented the following key, high-level impacts of the work:

  • Significant contribution to California’s success in implementing the ACA, expanding access to Medi-Cal, and expanding access and coverage for undocumented Californians;
  • Significant improvements in helping California move from a “punishment” frame toward more of an “investments in prevention” frame – school discipline reform, Local Control Funding Formula, and Prop 47 implementation serve as key examples;
  • More than 500 documented local “wins” have occurred across the 14 BHC sites, all unfolding under the banner of local and community land use and neighborhood policy and practice changes to improve health;
  • Statewide youth engagement and leadership support in advocating for health-supportive policy and system changes; and
  • Contributing to a new narrative of health across our state—or, in shorthand, “Health Happens Here.” The community experience and the best emerging science tell us that in order to improve our nation’s health one must leave the confines of the health delivery system and view “community” as the center of our efforts.

We Have Learned a Great Deal.   As a private foundation committed to addressing health disparities, inequity, and the social determinants of health, we have learned a tremendous amount about the role or roles that private foundations can play in advancing a health equity agenda.  We also had our fair share of blunders and short-sightedness along the journey, and you responded with candor, clarity, and constructive feedback.  The lessons are manifold, but the central, primary lesson for us was about the critical importance of building community voice and power – which some refer to as “agency,” and the value of true and meaningful inclusion in generating lasting policy and systemic change for health.

The Value of Engaging Our Young People.  Perhaps the most pleasant development of the BHC journey has been the value and productivity of engaging young people, and support for “lifting up” of their voice.  Youth leaders and their adult allies are the “secret sauce” of BHC. Youth engagement builds agency, strengthens collaboration, drives new and positive narratives for systemic change, engages artists and expert storytellers to articulate the need for change, and illuminates the path towards a bold vision for a healthier, more inclusive California. We have learned that these elements of social change are critical to address the adversity and trauma that so many of our young people and their families have been subjected to during the course of their lives — structural racism and oppression, anti-immigrant and LGBT stigmatization, gender injustice, community violence, and hopelessness.

What We Stand for in the Decade Ahead.  With this context in mind, the Board has approved a core set of principles and assumptions, grounded in the experience and lessons of BHC, in guiding our foundation’s work and strategy to achieve healthier communities beyond 2020.

  1. Building “Agency” and the value of Inclusion will remain central themes in our work going forward; we will continue to support communities in their efforts to transform systems, policies, and conditions that drive community wellness.
  2. The statewide “North Star Goals” of BHC will continue to guide our work beyond 2020: a) health coverage and access to prevention for all (“Health Happens with Prevention”); b) school climates of wellness and prevention (“Health Happens in Schools”); c) Neighborhood policies and practices that support health (“Health Happens in Neighborhoods”).
  3. The Theory of Change and Drivers of Change will continue to represent the HOW of our work: people power, the importance of place, and community voices rising to generate a new narrative of health.
  4. We must do more to support the integration and alignment of local, regional, and state-level strategies for greater impact.
  5. The meaningful engagement of community leaders, youth leaders, and advocates for health will remain critical in providing us with guidance and feedback about California’s road to health equity.

The Process of Board Planning.  Key milestones and inputs to inform Board decision-making:

  • Each of our board members has spent dedicated time learning about and visiting our BHC sites and policy work.
  • The Board has spent time reviewing commissioned evaluation and learning reports on BHC: these reports are featured and summarized on the TCE/BHC website. Click here to find out what we are learning.
  • A set of more than 140 interviews with BHC grantee-partners about the results and lessons of BHC was conducted by the Center for the Study of Social Policy. Click here to read that report.
  • Between the fall of 2017 and this past month, a series of panel discussions and learning conversations with experts (including BHC grantees) on key topics were conducted, with robust Board discussion following each learning session.
  • A series of what we call “Bird’s Eye Interviews” were conducted with California civic leaders and thinkers, providing an “outsider’s” perspective on the roles TCE should play in the years ahead in advancing health equity.
  • TCE staff members are providing input into the planning process as well.
  • The TCE Board will dedicate our May 2018 and August 2018 meetings to the review and discussion of the above-mentioned reports and inputs, and begin laying the groundwork for our work beyond 2020.
  • An announcement about the future of BHC beyond 2020 is expected before the close of this calendar year. This will provide for a two-year transition period from BHC, as we currently know it, to what will take place beginning in 2021.

In sum, our Board is very proud of the work and leadership of our partners and grantee leaders in BHC.  As we look toward the decade following 2020, our Board considers our future work as a “re-modeling” on the platform of BHC, based upon the progress and lessons of the work since 2010.  What you will NOT see us do is to “drop the curtain” on BHC by coming up with an entirely new and different strategy – we will build on from the best and promising work of the last 8-10 years.  The changes involved, however, could range from modest to significant – with the above-mentioned principles and assumptions in mind to guide the work.

We welcome and appreciate your continued partnership and support, and particularly would value any additional comments, suggestions, or insights that you would offer to help us make our beyond 2020 work even more impactful.  Please submit to partnerfeedback@calendow.org

Peace and blessings to you all.

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