From The Field A U G U S T 2 3 , 2 0 1 0 Board Service: From in Perpetuity to Term Limits TOM FEENEY Board Member, The Health Foundation of Greater Indianapolis, Inc. T wenty-five years ago in 1985, The Health Foundation ties, however, have changed as health concerns evolved. Our of Greater Indianapolis was created with proceeds current funding priorities are HIV/AIDS, school-based health, from the sale of MetroHealth, one of the first and childhood obesity. statewide, staff-model Health Maintenance Organizations Although other organizations may shy away from a board (HMOs). As an independent, not-for-profit grantmaker, the that is voted to lead in perpetuity, historian Beth Greene foundation has been, and is still, dedicated to preserving and (1995) describes the foundation board as “members who enhancing the physical, mental, and social health of the represent a cross-section of the population, people with experi- Greater Indianapolis community. Originally named the ence on the firing line in providing health services to the Metropolitan Health Council, our first mission statement disadvantaged.” Our charter board members gave the board laid out a commitment to community health that has not more than just experience; we gave the board continuity and changed in 25 years: stability, first during the transition and IRS appeal process, and then in the face of a changing health environment in The Health Council encourages certain health-related projects Indianapolis. and programs which would promote effective, efficient and While our board members held their positions without innovative service to the community, particularly to the challenge, they were anything but complacent. The medically disadvantaged. foundation supported programs that would otherwise go unfunded, and it provided much more than just dollars. We In the early days, as one of the nation’s first conversions shared expertise; built partnerships to address health issues and from a staff-model HMO to a private foundation, we were in disparities; and encouraged innovative solutions that improve new territory. For example, it took the Internal Revenue the health of people in Greater Indianapolis, especially the Service (IRS) three years to approve our 501(c)(3) status. disadvantaged. Another challenge was learning how to manage a foundation without the large professional staff, office space, and equip- Some early examples include: ment that we had become accustomed to as the 600-employee • In 1993 the foundation partnered with the Indianapolis MetoHealth Plan. Foundation, United Way of Central Indiana, CLASS, and The challenges did not stop our charter board of directors Indianapolis Public Schools to fund Bridges to Success to from developing our organizational documents and identifying provide health clinics in six city schools. health funding priorities and an investment policy. We enjoyed the challenge of being Our charter board members gave the board more than just experience; we responsible for making deci- gave the board continuity and stability, first during the transition and IRS sions and learning all aspects of running a successful small appeal process, and then in the face of a changing health environment in foundation office. We did Indianapolis. not feel, however, that it was appropriate to add new board members during the transition process, so instead we voted to • The next year, the foundation and the Indiana State establish lifetime terms. Department of Health cofounded the Indiana AIDS Fund, To ensure that we were serving our constituency best, we which would go on to become the largest private funder of developed our first funding priorities of maternal and child HIV/AIDS programs in Indiana. The original goal of the health, adolescent health, and HIV/AIDS. The funding priori- organization was to raise $900,000 in five years. The Indiana AIDS Fund has raised and granted over $5.42 mil- original board back in the 80s when we were established. The lion in 15 years, far surpassing that original goal. “new board” agreed to a new funding priority – childhood • In the late 1990s, recognizing the fragmented nature of obesity – in 2005 after funding a community dialogue that school-based health, the foundation brought together the involved more than 70 health care providers, fitness instruc- United Way of Central Indiana, local hospitals, and several tors, dieticians, and nutritionists. FitCity Indianapolis was school districts to explore collaborative models that would launched in 2005 as a communitywide marketing organization accelerate the expansion of school-based health services. that connects residents of Indianapolis with the resources and After funding the initial research and planning, the information they need to make healthier choices regarding foundation provided a grant in August 2000 to launch a food and exercise. program – Learning Well, Inc. – that now operates more As part of our ongoing efforts to orient and train new board than 80 clinics that provide health care at no cost to members, we recently went through a yearlong strategic students, parents, or schools, many of whom otherwise planning process, evaluating our financial status and funding would not have access to quality health care. Along the way, we gained a reputation as the “little foundation that could.” Our charter board members have a combined history with the foundation of more than 150 years. That experience has priorities and setting a vision for the next 25 years. Part of the been crucial in determining how the foundation can protect strategic visioning was a result of the economic recession. Like our endowment and still serve the community through grant- other foundations, the foundation’s endowment lost ground making. Through sound leadership and financial strategy, the and our ability to make grants at the level we had in the past foundation doubled the size of its original endowment to was compromised. approximately $25 million in five years. Board members, new and charter, worked together to address While we often agreed to disagree, we also were able to the stereotypes and status quo of health grantmaking, even form a consensus to fund these kinds of innovative partner- challenging ourselves to consider granting ourselves out of ships in order to address health issues and disparities and business. Ultimately, we decided to continue the original improve the health of people in Greater Indianapolis, mission set forth 25 years ago – to serve the community’s most especially those who are disadvantaged. In total, the vulnerable citizens by funding health-related projects and foundation contributed more than $32.7 million to health- organizations not easily supported by other means. related projects that were not easily funded by other means. While we may no longer be a board in perpetuity, we Along the way, we gained a reputation as the “little founda- continue to be a foundation that desires to serve a community tion that could.” With our focused funding, our board for a lifetime. In one more year, all of the charter members of structure worked well for nearly 20 years. As the board aged, the foundation board will have fulfilled their term limits and however, some decided to retire from the foundation and a will leave the active board. As an original board member, few developed health issues of their own. I am confident the new members will combine experience, In 2002 the board amended the bylaws to eliminate the intuition, community spirit, and cooperation in a manner that lifetime status and began the process of recruiting new board my fellow board members would find commendable. members to serve three-year terms. The 12 remaining original board members volunteered to serve a one-, two-, or three- year initial term before retiring from the board. This transition plan was developed to help the board maintain its connection to its own roots in community health while also building board leadership. While new board members did not always have the direct health experience of the charter members, they brought new skill sets such as legal, accounting, medical, and education. They challenged us to explore new investment opportunities to maintain the gains of our early endowment. In 2005 the SOURCES foundation purchased and renovated a historic building in Greene, Beth Van Vorst, A Look Back: Examining the Past, and downtown Indianapolis. Now known as the Academy, our Celebrating the Present of The Health Foundation of Greater building is not only home to the foundation, it houses other Indianapolis, Inc. (Indianapolis, IN: The Health Foundation of small businesses, professional services, and other nonprofits. Greater Indianapolis, Inc., 1995). These rent payments are another source of income that con- tributes to our ability to continue grantmaking. New board members brought more than new skills to the Views from the Field is offered by GIH as a forum foundation; they brought a vitality that is reminiscent of the for health grantmakers to share insights and experiences. If you are interested in participating, please contact Faith Mitchell at 202.452.8331 or fmitchell@gih.org.