Finding FQHC Funding: Foundation Grantseeking for Community Health Centers

With at least $3.6 billion at stake in FY2015, federally qualified health centers (FQHCs) need to be prepared to secure competitive grant dollars funded by the Patient Protection and Affordable Care Act (ACA). As FQHCs begin to strategically assess collaborative relationships, stakeholders and networks across sectors, now may be time to amplify their non-federal grant seeking to achieve this goal.

According to the Foundation Center's Key Facts on U.S. Foundations, the dominant giving focus in 2011 was health, totaling $6.8 billion and comprising over one quarter of foundation giving that year. The center's preliminary data for 2013 indicates that strong stock market performance boosted the assets of many foundations. Overall giving by the nation's private and community foundations reached $54.7 billion in 2013, exceeding previous record levels. A spring 2014 Chronicle of Philanthropy survey of the nation's largest foundations reflected this positive outlook, citing a "skyrocketing" stock market that was fueling new grant programs dealing with society's most complex challenges, including efforts to "make Obamacare work for everyone."

Grantmakers in Health (GIH) recently published a report informing foundations of the opportunities presented by federal health reform to improve access to care and strengthen the financial security of the uninsured. GIH recommended several foundation investment priorities for 2014 and 2015, including:

• Medicaid Expansion
• Enrollment Policies Facilitating Access to Coverage
• Outreach, Education and Mobilization
• Technical Assistance to States
• Feedback Loop (Convening front line advocates and state officials)
• Information Technology Infrastructure
• "Second Wave" Eligibility and Enrollment Simplification

The Uniform Data System (UDS) reported that FQHCs secured almost $600 million in foundation and private grants and contracts in 2013, representing about 11 percent of grants and contracts income. Several foundations are directly supporting community health centers and other safety net providers, including:

• National Funders — The Robert Wood Johnson Foundation funded the National Association of Community Health Centers to provide leadership for enrolling individuals in Medicaid and ACA-subsidized coverage and the Kresge Foundation's Community Health Partnerships initiative, which seeks to build a better primary-care safety net and supports innovative approaches to improving community health.
• State Health Foundations — While state government budgets have tightened, several state health foundations have stepped forward to facilitate care access and improved care for underserved populations. For example, the California Endowment has invested $18 million to expand and build community health centers in low-income neighborhoods, while the California Healthcare Foundation partnered with the Center for Care Innovations to improve analytic capacity of community health centers to mine electronic health records data for improved patient care.
• Health Plan Foundations — Entities like the Independence Blue Cross Foundation are also heavily involved in "strengthening the safety net" through direct funding of FQHCs, look-alikes, free clinics and safety net hospitals.
• Corporate Foundations — The for-profit sector is beginning to recognize that community health and workforce vitality is directly linked to accessible, affordable health care. To illustrate this new corporate priority area, the GE Foundation sought to expand primary care for underserved populations in the 22 cities in which it operates by creating the multi-year, $50 million Developing Health^TM (DH US) initiative in partnership with community health centers.