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South Florida Insights Series

February 2018

Interview with Steve Marcus, Ed.D.

Today we are pleased to interview Steve Marcus, Ed.D., President and Chief Executive Officer of Health Foundation of South Florida. Steve is an innovative non-profit community leader, having established multiple partnerships focusing on community development and economic prosperity programs for the underserved. Steve's 360 view of philanthropy has been shaped as both a fundraiser and a grantor, including previously serving as the Executive Vice President of the Mount Sinai Medical Center Foundation on Miami Beach.

Having guided the HFSF over the past 18 years, Steve holds a unique understanding of South Florida’s humanitarian organizations and a personal resolve to develop lasting solutions.

Grantors are often asked to provide yearly funding for important programs, yet often funding can become a dependency instead of a lasting solution. In this interview, we will learn how Health Foundation of South Florida (HFSF) and many other innovative foundations are adapting to encourage sustainable solutions to health and social challenges.

Q: Steve, you have been in the philanthropic sector all of your adult life. What influenced you to follow this career?

Two reasons really. On the personal side, my mother taught middle school kids all of her life and made an amazing difference in their lives. She understood that many of her students came from underserved households and lacked basic life skills: balancing a checkbook, reading a lease, understanding insurance, and much more. These skills would serve them throughout their lives. She became committed to changing the service model, not just teaching facts to kids. This example helped shape my outlook on sustainable change.

From the business perspective, I have always held an innate interest in systems and measurement. I enjoy doing good, but appreciate it even more, when I can quantify results. In fundraising, measurement is built-in because you must produce a result and if you do not, it quickly becomes obvious. Fundraising is the combination of doing good, with being measurable and accountable.

During my graduate school years at Ball State, I found myself gravitating to internships for fundraising projects. Then my very first professional position was as a campaign fundraiser for a consulting company in Chicago, my hometown. At HFSF I’ve found the ideal opportunity to combine my love of philanthropy with my interest in assuring accountability of outcomes.

Q: So what are the most significant changes you’ve seen for non-profits in the last few years and how is it impacting HFSF?

Future service programs will be more and more influenced by the social determinants which lie behind the problems we are initially trying to solve. We can no longer deal only with the visible symptoms, we must identify the factors leading to the problem to begin with!

As a result, HFSF has begun partnering with organizations that approach service from a broader, strategic perspective. We must dig beneath the surface and facilitate stronger and sustainable outcomes. The objective is to create collaboration with valued partners and leverage strengths to achieve more.

Q: So this must be shaping your grantmaking policies and practices quite a bit.

In healthcare, programs have traditionally been all about the hospital, the doctor, medicines and clinics. In other words, treatment. But there are endless opportunities to change the environment and help prevent illness and injury. So the important question becomes: does it make more sense to attack the contributing factors that lead to illness and injury in the first place?

Poverty is, of course, a key environmental factor that has been proven to lead to poor healthcare outcomes. An individual who cannot afford healthy food, who has no insurance, and who lacks access to healthcare and education is less likely to remain healthy.

Access to affordable housing is another proven factor inextricably linked to poor health. Those living in low-quality housing are more likely to have respiratory problems because of lack of ventilation, AC or heating, mold and dust. Sanitary conditions could also be ripe for the spread of illness. By helping improve housing, we can help improve health outcomes.

Q: So how have these macro-level forces changed your current priorities?

One example is HFSF’s collaboration with a nationwide movement referred to as Anchor Institutions . These are enterprises such as universities and hospitals that are rooted in their local communities by mission, invested capital, or relationships to customers, employees, and vendors.

Anchor Institutions have a huge stake in the welfare of their neighborhood residents.

Anchor Institutions focus on how to attract and keep good employees, develop a talent pool, and strive to make the neighborhood around the institution healthier. For a hospital, this may mean empowering neighborhood residents to succeed through vocational training, jobs, and improved access to healthcare through insurance. A win/win for both the neighborhood and the hospital!

HFSF has been working with a national group called The Democracy Collaborative to assess the feasibility of engaging our local anchors in strategies that would build economic prosperity and health. To advance this work, we are establishing a South Florida Anchor Network which will serve as the platform for anchors and other community partners to discuss strategy. Locally, University of Miami, Florida International University, Memorial Health Systems, Holy Cross Hospital, and Miami Dade College, along with others have been engaged in initial planning conversations.

Why does this make sense for HFSF? Because when you provide low-income individuals with jobs, there is an increased chance they will experience improved health. Our goal is to support systems and policies that encourage local procurement, local hiring, minority training, and other positive factors, rather than just focusing on treating illness after the fact.

Q: So how are you changing your grant policies and processes?

We can no longer think of grantmaking in the traditional sense, in terms of a mere transactional relationship.

Our primary question now becomes: how does our grant provide a smaller organization with the ability to make a greater impact than in the past? Our practical objective is to help organizations create the systems and partnerships necessary to solve the problems they address.

From a Policy perspective, grant outcomes must resolve to do more than just expand a current service. We want to go beyond awarding grants for short-term alleviation of symptoms, and instead develop bridges, systems and strategies that create more sustainable improvement in health.

From a Systems perspective, how will services be different than the way they are currently being delivered? Is there a way to make the deliverables include outcomes that have measurable effectiveness, efficiency, cost reduction, or cost savings? How do we create opportunities to change the models - and do more with the grant funds beyond just repeating and repeating the current service model? Our objective is to help organizations develop improved best practices on how to achieve greater impact.

Q: This sounds rather complex. Can you give us an example?

We know that hospitals are very competitive and most of them provide birthing services. We also know there are strong, evidence-based studies that breast feeding leads to healthier babies. HFSF recently partnered with a national group to implement a new hospital template that encourages mothers to breast feed. The national organization was funded by HFSF to implement this breast feeding protocol, and to certify the hospital as a “Baby-Friendly Hospital” thus also creating a competitive benefit to the hospital. A small part of the funding also went to participating hospitals. The ultimate beneficiaries were the mothers and babies, yet it was an HFSF-funded systems change within the hospital that that aimed to increase breastfeeding rates .

Q: Will this impact your grant application processes?

Our grant application Practices are changing dramatically. We used to have two grant cycles a year and an application deadline for a pre-proposal. Then the grant applicant was given the green light to submit a full proposal, usually 8 to 10 weeks later. During this period grantees had very little contact with the foundation. You’d get a site visit, some discussion, and then you presented your proposal.

We understand that this is not the best way to accomplish our new goals. It doesn’t allow for interaction, including collaborating on the design of what the grant applicant is proposing. HFSF intends to have program officers provide feedback while the program is being developed, and increase the likelihood of funding and program success.

And if as a result of this process there is an early turndown, it won't necessarily be a permanent turndown because there will be a more open applications cycle and the ability to continue to adapt the program in collaboration with HFSF.

Q: Speaking of grant-applicants, are there some unique attributes that you personally value?

I believe many great organizations are built on the vision and hard work of one leader, perhaps even the founder of the organization. But at times this creates an over-reliance on the founder rather than the development of systems, depth and functionality that makes the organization competitive. I believe a good leader is able to identify talent to execute his or her vision and support staff development. I like to see evidence that they are thinking ahead about staff development, recruitment and succession planning.

I also like to see a reasonable budget and process in place for professional development of staff. An organization that doesn’t invest in its workforce is likely to be more inefficient and to suffer more turnover. Why should we invest in an organization, if that organization won’t invest in itself?

Most importantly, does the organization expose its board members to the people that they serve? Education should not be happening only at an organization’s board meeting. If you are serving kids in need, how about providing opportunities for board members to meet these kids in their own environment? Board members should have opportunities to hear feedback first-hand, and have a chance to engage personally with those being served by the organization. It’s up to the non-profit’s staff to create these opportunities, and the board members to demand them.

Q: Final thoughts?

I believe greatly in equity. The grantor cannot be up in the sky somewhere, looking down upon the applicant. The Foundation is seeking to share its expertise with community partners and work together on finding solutions that will have lasting impact in our community.”

The ultimate goal is to increase the impact we are facilitating, not merely by providing more money through the same old models, but instead to have the model do more to begin with! Our job as a grantor is to help those on the front lines - those providing the services and raising the money - to create lasting success. And ultimately this new model accomplishes this by assuring that we are a catalyst for change – and an investor in new innovative methods to create impact.

We at Health Foundation of South Florida are in a transformational process to implement a new strategic approach to help our community continue to grow and thrive.

We expect great results!

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