Policy Change

Over the past few years, foundations of all kinds have been paying increasing attention to ways their resources can have greater impact by effecting policy and systems change. This trend has led foundations to reassess how they do their work and who their likely partners are. As a result, a body of knowledge within philanthropy is being created about how to successfully draw on foundation resources to change policy. As a large health foundation focused on changing health systems, The California Endowment has been gathering experience over the last ten years about what works when we seek to affect policy change. Following is a short summary of some of the critical aspects we have found that must be incorporated into this work.

Define the system and the policies you want to change

Many people use the terms "policy change" and "legislative change" interchangeably. When embarking on this work, it is vitally important first to understand the policies that directly and indirectly affect the system (that is, health, arts, education) you are trying to change. In some instances, the system you want to change may be tied directly to legislation, and in order to change the system you will need to change laws. In other cases, the system may be related to administrative regulations, enforcement guidelines, or other ways of implementing public policy. Not all systems change requires new legislation or the support of an elected official.

In addition, not all systems are public or require changing public policy to achieve reform. In the health sector, for example, private systems, like some hospital chains and health plans, may change corporate policy in ways that can significantly improve the quality of or expand access to care. In such cases, the decision makers, your access to them, and the levers for change are quite different than
if a public policy change is needed, say, in the Medicare system which is government-run.

Support the grassroots and the treetops, and help them connect

To effectively change policies and systems, a foundation's effort must target decision makers and policy makers, either directly or through grantees. However, your efforts should not be limited to these leaders operating at the "treetops." Grassroots leaders, who can mobilize constituencies for change within their communities, are equally essential to making change. More important still is connecting the grassroots and the treetops. Grassroots organizations do not have access to treetops decision makers. Treetops pol-icy makers too often make decisions without input from the communities who are most affected by their policies. Foundations can play a singular role in providing the "glue" that binds together the grassroots and treetops. Non-grantmaking activities, like gath-erings organized by a neutral convenor, are particularly well-suited to this work, and foundations can be especially effective in this convening role and in bridging the divide. In addition, making grants not typically undertaken by most foundations — such as grants to support strategic communications, issue-marketing, and applied research — can also be critical to “binding” these two kinds of leaders together.

Provide core support for advocacy organizations

Advocacy organizations are critical components in a policy-change strategy. They have the experience and expertise to track issues and to assess the ever-changing nature of the policy environment in which the issues are debated and discussed. Supporting the work of these organizations ensures that a “platform” for change can be built, one that supports the development of reliable data, clearly formed issues, credible spokespeople, and ongoing strategy. Without such a platform, resources cannot be mobilized and organized to capitalize on unexpected windows of opportunity for policy change. The California Endowment, for example, has been working in collaboration with other foundations and advocacy organizations for years to achieve universal health insurance cover-age for all children in the state. This year, California Governor Arnold Schwarzenegger unexpectedly decided to back bold health reform, including kid's coverage. The advocacy organizations working on this policy agenda have been able to mobilize immedi-ately to support the Governor's efforts and to engage in a lively debate over the best possible ways to achieve this policy goal.

Civil and consumer rights organizations, legal services agencies, and applied research institutes are examples of the advocacy orga-nizations that make up a healthy policy environment. However, most have difficulty obtaining the kind of unrestricted operating support they need to maintain the long-term work of policy development that is required to make enduring systems change. Founda-tions are uniquely suited to provide this kind of support.

Rethink the organizational needs of a foundation seeking to make systems change

Before embarking on an agenda of policy change, it is important that a foundation's executive leadership and board of directors understand how the foundation itself needs to change in order to effectively execute its plans. Sometimes, for instance, the traditional duties of a program officer may change significantly. Non-grantmaking activities may be as important as grantmaking ones and these require an entirely different background and set of skills from those typically sought in candidates for program officer positions. In addition, so-called administrative departments of a foundation, like communications and evaluation, may play larger roles in the programmatic life of the foundation. Similarly, foundations, like The Endowment, may find that they need to create a separate policy department to monitor the policy environment and to interact regularly with advocates.

As the foundations who choose systems-change work do more and more of it, they may need to restructure their institutions to achieve maximum impact: they may need to begin working more like operating foundations, and it may be beneficial to regard their policy-change work more as “campaigns” than as grantmaking programs.

Gwen Walden is director of the Center for Healthy Communities at the California Endowment. She is author of “When a Grant Is Not a Grant” in State of Philanthropy 2006, published by the National Committee for Responsive Philanthropy, and participated in a forum organized by the LA Arts Funders held in January, 2007.