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Subject:	A colleague recommends John Muir/Mt. Diablo Community Health Fund Updates
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Message from the Chair & President/CEO, March 2009

As the Number of Uninsured Grows, We Focus Tightly on Health Care Service Delivery

By the last quarter of 2008, it became clear that our economy wasn't going to rebound quickly. We are fortunate that our grantmaking and operating resources are not derived from an invested endowment, but rather from John Muir Health. Nevertheless, the deteriorating economic environment has made it necessary for the Board and staff of the Community Health Fund to take a second look at grantmaking plans underway and projected operating expenses in an effort to become an ever more efficient and cost-effective operation.

We have always been both transparent and prudent in setting our operating costs in relation to dollars granted, but in 2009 we will become more so. In 2008 our operating expenses totaled $258,621 and grants approved totaled $1,933,092, resulting in a spending ratio of $1 for operating to every $7 granted. The budget for 2009 totals $271,105 for operating and $2,358,071 available for granting, thus improving the spending ratio to $1 for operating to every $8 granted.

We will be just as efficient in distributing our grantmaking dollars. The $2.3 million available for granting in 2009 is derived from a combination of: 1) new funds from John Muir Health, 2) 2008 year-end unspent grant funds, and 3) interest earned on funds awaiting disbursement. To determine how best to use these funds, the Board first assessed currently funded health partnerships. They decided to make a firm commitment to continue supporting the implementation of three endeavors that are already delivering health care to the expanding number of people most in need:

• Osteoporosis outreach, screening & treatment targeting aging Latinos
• Integrating behavioral health with primary care in La Clinica's Monument and Pittsburg clinics
• Enhancing health care and support services for aging Latinos

These three health partnerships are unique collaboratives that started before the economic downturn. Though they have already shown they can deliver what they promised, the partnerships need continued support to fully achieve their goals, which made them the Board's top priority for receiving continued funding.

The Board also decided to continue its support for a collaboration developing an action plan to address health care disparities affecting African Americans in Bay Point and Pittsburg, a growing and documented need that can no longer be ignored. In addition, we awarded the first new grant for 2009 to La Clínica de La Raza to help them implement a plan in the works since late last year: renovation of a newly purchased building that will become the permanent and greatly expanded home for the Monument Clinic in Concord.

Because we expect these endeavors will require most of the $2.3 million available for 2009, the Board decided to put on hold consideration of any new health partnerships until at least mid-year. Two other health partnerships funded in 2008 fit into this wait-and-see approach. The Antioch Children's Health Alliance completed its plan of action and secured other funding enabling them to implement that plan; we wish them well. The Contra Costa Health Access Campaign, led by the Community Clinic Consortium, completed its action plan, which identified important advocacy and health coverage enrollment goals. We are delaying acting on this plan for one simple reason: the economic downturn is expanding the ranks of the medically underserved, causing us to more tightly focus on funding the direct delivery of health care services.

Before the economy plunged, we had an ambitious plan for gradually increasing grantmaking over the next several years and funding complementary efforts that deliver health care, advocate for better health care policies, and increase enrollment in health coverage programs. Given the current situation, however, we must make pragmatic choices leading to outcomes that can quickly deliver health care to people in need; this explains our commitment to the major health improvement efforts already underway. While it is difficult to turn away inquiries and potential opportunities, we believe it would be worse for the community if we were to abandon our support for current health partnerships that are delivering health care services, but need more time to develop and implement sustainability strategies.

We regret that the economic situation has forced us to scale down our plans, but we remain deeply committed to our mission of funding programs that improve the health of medically uninsured and underserved populations in Central and Eastern Contra Costa County. We will use this website to keep the community and organizations seeking grants informed about changes in our grantmaking strategies.