Impact of EHF's Strategic Plan 2018-2023

Impact of Episcopal Health Foundation's

Strategic Plan, 2018–2023

Key Findings: Episcopal Health Foundation has become a leader in improving health, not just health care in Texas with a commitment to health equity. The foundation has worked to change the conversation and shift the collective mindset → to focus on overall community health, in addition to health care services, foster innovations →, and significantly shape the health agenda → for Texas.

Strategic Plan 2018–2030 Overview

In 2018, just five years after founding, EHF set an ambitious goal: help health care providers shift away from health care alone to a new focus on health that includes addressing the non-medical, root causes of poor health in communities.

Goals	Strengthen systems of health by catalyzing health systems to be accessible, equitable, and deliver health not just health care.	Activate communities by strengthening organizations and congregations to build health-promoting communities	Build a foundation for a healthy life by investing in early childhood brain development
Outcomes	1: Resource allocation and systems reform 2: Comprehensive care	3: Community and congregation shape healthy communities	4: Early childhood brain development (ECBD)*
Strategies	Support change in healthcare financing \| Work upstream \| Support comprehensive clinics \| Strengthen rural health \| Expand health coverage & benefits	Raise community voices \| Support congregations in action	Build brain development: Providers \| Build brain development: Community Organizations

*EHF has been using the term Early Childhood Brain Development (ECBD) to describe one desired outcome of Early Relational Health (ERH). Over the years of funding this work, our language now more accurately reflects what many organizations practice. EHF is now positioned to better articulate the promotion of ECBD through the lens of ERH to benefit maternal and child health.

Stewardship

The vision resulted in significant changes to how EHF approached its investments. It moved away from supporting downstream action, toward upstream community prevention efforts that addressed systemic drivers of health, focused on long-term investments, and leveraged its research and engagement capacities to maximize impact.

Between 2018–2023:

$195M

invested

519

grants

172

unique grantees

Investment by Outcome

EHF made investments—financial and non-financial—in every one of the original 57 counties of the Diocese

Type of Investments	Count of Investments	Number of Individuals Attending	Number of Organizations Represented
Convening	118	2,902	1,408
Strategies	177	3,527	1,067
Total	295	6,429	2,475

Cumulative Investments (financial and non-financial)

Hover over each county to view the number (financial + non-financial) of investments:

Shifting Mindsets to Overall Health

Building Capacity

As a leader in health, EHF helped build the capacity of grantees to serve more people, offer comprehensive care, shift services upstream, and/or prepare for value-based care.

EHF funding for comprehensive care clinics increased access to primary care sites and women’s health/family planning services in our 57-county service area and shifted mental health services to integrated behavioral health. Additionally, now, nearly every safety net clinic in the EDOT has developed the capacity to screen and refer for non-medical drivers of health (NMDOH).

Grantee Spotlights:

Through one large EHF grant, Foundation Communities in Austin expanded their reach into new communities – including 4 rural counties – and established a new partnership with Central Health hospital district. Taken together, these service expansions significantly increase access to care to families that need it. FC expanded reach of enrollment through partnerships with Central Health and Community Resource Centers in Burnet, Blanco, Williamson, and Llano Counties.

St. Paul’s Children’s Services in Tyler convened and led a multi-sectoral Food Security Council, which is working to reduce hunger across Smith County. This unique effort continues to lead several initiatives including an electronic self-referral platform being utilized by the East Texas Food Bank and local healthcare providers to connect more families to healthy foods.

Community Centered Health Homes Initiative

EHF’s Community-Centered Health Homes (CCHH) Initiative, the foundation’s first major initiative, invested more than $10 million in 12 clinics over five years to build the capacity to engage in community prevention work, build authentic partnerships with organizations in their community, and take action to improve community conditions that affect health in their community.

8 of 12 clinics’ efforts resulted in:

12

environmental improvements

6

policy/systems changes

8

NMDOH programs in underserved communities

As a result of their participation in the Initiative, leaders at six of these community clinics have shifted their mindset about the role community clinics can play in promoting health. They have made a deep commitment to engaging in population health work and demonstrate an ongoing capacity and interest to maintain this work beyond EHF’s funding.

Grantee Spotlight: AccessHealth

Clinics Pathway Approach

EHF’s Clinics Pathway Approach (CPA) Initiative helps clinics redeploy resources to provide comprehensive services, address patients’ non-medical drivers of health, use population health approaches, and engage in community prevention, for better health outcomes at the patient and community levels.

Grantee Spotlight: Vibrance Health

Through participation in the CPA initiative, Vibrance Health‘s organizational infrastructure is significantly more robust to support their population health efforts. The many organizational enhancements are improving the patient experience, reducing the appointment no-show rate, improving inventory management, reducing expenses, and building capacity to track data and milestones. Vibrance has also increased patients served by 50%, expanded to a new county and added new programming.

Congregational Engagement

EHF’s Congregational Engagement work has engaged 150 congregations, 22 of which have risen to working at ‘transformative’ levels, where they are engaged in strong community partnerships to improve their communities.

TRANSFORMATION SPECTRUM

Transactional

“Doing For”
Short-term relief
Charity-oriented outreach

Transitional

Building relationships
Changing mindsets
Community participation

Transformational

“Doing with”
Strong community partnership
Sustainable

Congregation Spotlight: St. Luke's Episcopal Church, Livingston

St. Luke’s Episcopal Church in Livingston felt called to address mental health needs in their community. After extensive trainings, made possible by EHF, St. Luke’s has established a Mental Health Initiative which offers support group for people on probation in a three-county area.

Fostering Innovation

Texas Accountable Communities for Health Initiative (TACHI)

TACHI supports sites as they move to center health equity and multi-sector partnerships by providing flexible grant-funding, site-specific technical assistance, site-directed learning opportunities, and refinement and evaluation of the ACH model within the context of Texas. TACHI aims to position collaboratives to advance community-led, financially sustainable strategies that address non-medical drivers of health that improve health outcomes. Read more about the support for TACHI sites here.

TACHI Site Spotlight: Greater Longview Optimal Wellness Collaborative (GLOW)

As a participant of the TACHI initiative, participants of the Greater Longview Optimal Wellness collaborative (GLOW) are utilizing the state’s platform for coordination among emergency responders (Pulsera) in a novel way to demonstrate its capabilities to identify high utilizers in the ER and assign a navigator to navigate those individuals to more appropriate, less costly care.

Early Childhood Brain Development*

EHF’s investments have seeded new directions in early childhood development work.

Grantee Spotlight: Texans Care for Children

An EHF grant to Texans Care for Children (TCfC), a statewide non-profit organization, to conduct research on early brain development made clear that there was a gap in rigorous research in this area. This led TCfC to develop a research division, which is helping them to influence early childhood development work in the state. For example, as a result of their research, the state has made recommendation to increase developmental screening rates and Texans Care for Children has gained state recognition of as a reliable source of rigorous information.

Shaping the Health Agenda for Texas

Managed Care Organizations (MCO) NMDOH Learning Collaborative

With support from the Episcopal Health Foundation and the Robert Wood Johnson Foundation, the Center for Health Care Strategies (CHCS), in collaboration with the Texas Association of Community Health Plans (TACHP), convened the MCO NMDOH Learning Collaborative. The collaborative was designed to help Texas Medicaid health insurance plans develop and implement strategies to address the non-medical, root causes of poor health for patients across the state. After several years of regular meetings, Texas released its first ever action plan to address NMDOH.

Passage of HB 1575

Signed into law in 2023, HB 1575 requires Texas Medicaid to develop a standardized, strengthened screening tool to help determine the non-medical health needs of pregnant Texans and their babies. The new law also allows community health workers and doulas to be reimbursed by Medicaid for their work to address those important needs through the state’s Case Management for Children and Pregnant Women program.

EHF-funded research helped provide evidence showing the significant influence of non-medical drivers of health on high-risk pregnancies in Texas. For example, a report by actuarial firm Milliman found that high-risk pregnancies are about twice as likely to have had a non-medical health need recorded on a health care claim as non-high-risk pregnancies. Researchers estimated that the health care cost in Texas for high-risk pregnancies was more than $770 million a year. The report was cited in committee hearings and in the official analysis of the bill.

Key Lessons

1

EHF’s deep relational approach has raised visibility and the reputation of the foundation.

2

EHF is a thought leader, finding alignment and generating action in key health policy areas.

3

Shifting systems and health outcomes takes time.

Our efforts over the past 6 years have made clear that how we work—by leveraging all our resources in research, convening, and advocacy in tandem with grant funding—is how we will get to health, not just healthcare.

Feedback from Grantees and Partners

Research

“EHF sponsored studies and reports are providing critical Texas-based data that we use to advocate for policy change and is essential to legislative outcomes.”

Connections

“EHF is a different kind of beast in how they work with us. They take a big picture approach in developing a mutual relationship and guidance.”

Advocacy

“EHF’s support for HB1575 helped us progress more quickly than we could have on our own. . .”

Convenings

“There’s so much work and research going on. It is hard to identify and quantify all of the work that has been generated out of the MCO SDOH Collaborative.”

Multi-year Grants

“Having multi-years grants gives us a chance to plan for the longer term, pivot, try new things, and build longer research projects.”

Flexibility

“Not everything we do yields the expected results, but they often identify how to move differently.”

Support, Not Direction

“EHF let us build our collaboration on our own, identify our own needs, and have been flexible about deliverables.”

Raising Visibility

“EHF funding has often laid the groundwork for additional funders to join an effort.”

Changing the Conversation