Evolution is gradual. So, it’s often hard to recognize the importance of seemingly small changes until they add up to something big and obvious.
But two events this legislative session have made it clear that some of the state’s six health foundations are evolving, stepping beyond their traditional funding roles into more direct advocacy.
Speaking up
Two of them – The Sunflower Foundation: Health Care for Kansans and The Health Care Foundation of Greater Kansas City – played guiding roles in a grassroots lobbying campaign that Gov. Mark Parkinson and others credited with helping to break the legislative stalemate on a statewide smoking ban.
And the Health Care Foundation of Greater Kansas City joined two other Kansas City-area philanthropies – the REACH Healthcare Foundation and the Wyandotte Health Foundation – to recently release a “position statement” urging legislators to “consider revenue options” to balance the state budget rather than make additional cuts in social services.
“Our foundations are not advocating for or against any specific legislation,” the foundations said in the statement posted to their Websites on April 6. “However, as some legislators maintain that budget cuts are the only option, we feel compelled to speak up about the damage this one-sided approach will have on the lives of Kansans.”
Brenda Sharpe, chief executive for REACH, said the severity of the state’s budget problems and indications that many legislators, particularly House Republicans, remained opposed to tax increases demanded that the foundations participate in a way they hadn’t before.
“It is sticking our necks out a little bit,” she acknowledged. But she said, “Given our mission, we felt like it was our responsibility to speak up at this time.”
Established in 2003 with 20 percent of the proceeds from the sale of Health Midwest to the Hospital Corporation of America, REACH uses its approximately $112 million in assets to help poor and underserved people in three Kansas and three Missouri counties gain access to health care services. The remaining proceeds from the sale of Health Midwest were used to establish the Health Care Foundation of Greater Kansas City, which has assets of approximately $350 million. The Wyandotte Health Foundation was established in 1997 with money generated by the sale of Bethany Medical Center.
“Rigid ideology”
Kim Moore, president of the United Methodist Health Ministry Fund, also stepped into the budget debate. But he did it by writing a guest column in the Hutchinson News. He said the $1.3 billion in budget cuts made in the last two fiscal years were undermining the foundation’s work to expand oral health services to needy Kansans. He said the cuts also were forcing unnecessary reductions in Medicaid programs that provide medical care to poor and disabled Kansans as well as seniors in long-term care facilities.
“The current budget crisis should not be used as an excuse for opportunistic undermining of critically needed services due to a rigid ideology of less government and lower taxes,” Moore wrote.
Sharpe said that no legislators in REACH’s service area reacted negatively to the position statement. She said the fact that organizations from foundations to local chambers of commerce and service providers were all calling on lawmakers to take a balanced approach to addressing the state’s budget problems appeared to be “turning the tide” against a cut-only approach.
Some health foundation initiatives
“I’m hearing more and more legislators saying quietly that they understand the realities and that they’re willing to consider all of the options that are available to them,” Sharpe said.
But Senate Majority Leader Derek Schmidt, an Independence Republican whose district includes the one county outside the Kansas City metro area that REACH serves, said foundations have a fine line to walk in balancing their desire to affect policy and also remain above the political fray.
“It’s a delicate balance that only they can judge,” Schmidt said. “There are very few organizations in Kansas that can be viewed as reliable sources of information that have no political or ideological taint. They should be careful not to squander that.”
Moore said the heads of the state’s health foundations understand the need to maintain that balance. He said the views he expresses on behalf of United Methodist Health Ministry Fund are in keeping with its guiding principles.
“I wouldn’t want to speak for anybody else, but I think the perception is that we are a compassionate organization that tries to make decisions based on evidence,” he said. “I don’t think that puts us on one part of the political spectrum or the other.”
Grassroots advocacy
When Parkinson, a former state Republican chairman turned Democratic governor, signed the legislation implementing a statewide smoking ban, he gave part of the credit to the foundation-backed lobbying campaign aimed at specific members of the Kansas House.
He said when he started working with the foundation leaders he perceived them as “latte-sippin’, NPR-listenin’, foreign-film-watchin’, policy wonks.” But he said while they might have been those things, “They also got down and dirty and helped make this thing happen.”
Billie Hall, chief executive of Sunflower, said the $600,000 Clean Air Kansas Campaign, which was also funded by the Health Care Foundation of Greater Kansas City, was a first for the Topeka-based foundation.
“It was the first time we engaged as directly with a public issue campaign with a specific goal of achieving a legislative outcome,” she said.
Hall said one of the tactics that helped secure votes was recording 5,000 constituent messages www.cleanairkansas/voices/ and delivering them to legislators thought to be swing votes on the bill. That innovation and others won the clean-air campaign a 2010 Pollie Award from the American Association of Political Consultants.
Hall is pleased about what the award conveys about the skill with which the campaign was waged. But she said the foundation wouldn’t have funded it if the scientific evidence about the health dangers of second-hand smoke hadn’t been clear and public opinion polls hadn’t revealed that a large majority of Kansans favored a ban.
“Every foundation needs to find the best way for them to engage in public policy,” Hall said. “Some are much more comfortable with public information and education. Others are comfortable with more direct advocacy.”
Rep. Brenda Landwehr, the Republican chair of the House Health and Human Services Committee and a smoking-ban opponent, said she wasn’t comfortable with tax-exempt foundations urging legislators to consider tax increases or funding lobbying campaigns.
“They’re prioritizing lobbying for a bill over services for their clients. I have a problem with that,” Landwehr said.
Sunflower was established in 2000 as part of a $75 million settlement between the state and Blue Cross Blue Shield of Kansas over the disposition of the insurance company’s charitable assets. Today, the foundation has assets of approximately $105 million.
A different approach
The state’s largest health philanthropy, the Kansas Health Foundation, which has about $400 million in assets, is among those more comfortable funding activities that educate the public or inform policymakers. In 1995, it established the Kansas Health Institute, which operates the KHI News Service, to do research and provide legislators and other policymakers with objective, independent and nonpartisan analysis on health issues. The goal then and now, said Steve Coen, chief executive of the foundation, is ensuring that local and state officials have the accurate and timely information they need to make informed decisions.
“We strongly believe that if objective and credible health information is made available and communicated to decision-makers in the state, better-informed choices will be made that can improve the health of Kansans.” Coen said.
In 2007, KHF committed $30 million to create and sustain the Kansas Leadership Center. The center developed a unique curriculum to help people exercise leadership in their communities, workplaces and other policy-making settings to improve the health of Kansans.
Both the Kansas Health Foundation and United Methodist Health Ministry Fund were established with proceeds from the 1985 sale of Wichita’s nonprofit Wesley Medical Center to the for-profit HCA. The Hutchinson-headquartered health ministry fund is the smaller of the two foundations, with assets of approximately $51 million.