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The California Health Care Foundation is dedicated to improving the health care system so that all Californians get the care they need. CHCF works toward this goal through deep partnerships with grantees in the field, without which the work of the foundation would not be possible. We value our relationships with partners and see communication and trust as essential to success.
With this in mind, CHCF partnered with independent consulting firm Goodwin Simon Strategic Research to elicit frank feedback from grantees through an anonymous survey. In 2024, Goodwin Simon sent questions to 543 CHCF grantees, and 269 responded. Among them were nonprofit (60%) and for-profit (20%) organizations, individual consultants (16%), and public and state agencies (4%). The vast majority had received grants within the previous two years.
What We Heard
We were heartened to learn that 96% of respondents said they were very or somewhat satisfied with their overall experience with CHCF.
“As a female leader of color, I felt that my program officer understood, appreciated, and supported me and my organization,” said one current grantee at a nonprofit organization. “To say that you treat everyone the same is not equity. To acknowledge that different groups have historically experienced more barriers, and therefore require different supports to succeed, is equity.”
More than 90% of people surveyed said CHCF staff members were a valuable resource as authentic partners and collaborators, offered useful guidance, improved projects, and fostered transparency in their relationships.
“CHCF’s program officers are highly skilled, thoughtful, and engaged as partners,” said a former grantee at a for-profit organization. “CHCF uniquely positions itself to help grantees solve policy and infrastructure challenges.”
Opportunities for Improvement
While most of the feedback from survey respondents was positive, we are mindful that even an anonymous survey might not offset the inherent power imbalance between funders and grantees. We therefore paid special attention to critical feedback and suggestions for improvement. Key issues were raised that prompted us to make these three changes:
Streamlining the Publication Process
While respondents said they appreciate our commitment to producing high quality publications, they believe the process should be streamlined.
CHCF is known for funding and producing well-researched publications. Our reputation was built on the quality and utility of these products. More than half of survey respondents had produced a report or other external-facing content as part of their grant. These reports were either CHCF branded or were published by the grantee.
CHCF-branded publications undergo a thorough review process that involves multiple rounds of feedback from subject-matter experts and can take months to complete. While most respondents had positive reflections about the CHCF publication process, some experienced challenges. Of the respondents who published content as a grant deliverable, 29% said they strongly or somewhat agreed that the editing process was burdensome, and 16% said the editing process was somewhat or very unclear.
While remaining true to our commitment to producing informative and accurate publications, we have responded by improving editorial processes for CHCF-branded publications. These changes include:
- Simplifying and clarifying guidelines for grantees about what to expect from us and what we expect from them
- Requesting detailed outlines when a publishing project commences
- Involving the CHCF communications team early in the process
- Expanding the range and mix of publication lengths and formats to align with readers’ evolving needs
- Implementing a post-project survey to assess which processes went smoothly and which could be improved
Establishing Clearer Channels of Communication
While most respondents thought lead program staff promptly answered questions (88%), set realistic expectations (89%), and offered useful guidance (97%), some grantees cited challenges with their program officers, including slow communication, difficulty scheduling meetings, and insufficient thought partnership. Some said their program officers tended to micromanage and be less trusting or were unclear and inconsistent in their communications. This was more common for respondents with multiple CHCF grants managed by different program officers.
To address these issues, the CHCF Learning & Impact team assessed the survey responses in detail, reflected on them with program staff, and reviewed literature on relationships between grantees and philanthropic foundations.
We have developed best practice guidelines for program staff to support the establishment of mutually beneficial and respectful relationships. Recommendations include taking the time to develop trust, collaborating to set realistic expectations, being transparent about CHCF’s role, and respecting all parties’ schedules by responding promptly to inquiries. This guidance will be shared periodically with program staff to keep these practices top of mind.
Funding the True Costs
For many years, CHCF capped the rate of indirect costs (IDC) for nonprofit grantees’ general and administrative expenses not directly attributable to a funded project at 15%. A growing number of grantee partners have told us this rate is insufficient to cover current indirect costs.
We responded by engaging a consultancy, BDO, to analyze grantees’ financial data and help us update our IDC policy (PDF) to reflect the true costs borne by CHCF grantees, conform with best philanthropic practices, and align with CHCF’s values of equity and transparency. As of July 2024, CHCF no longer imposes a cap on IDC for most nonprofit grantees. (For-profit entities are not eligible for IDC.)
Thank You, Grantee Partners!
We are grateful for the honesty and openness of our grantee partners. The feedback helps CHCF improve our relationships with grantees. We plan to continue to listen and learn from our partners and to conduct periodic grantee surveys.
We know that our collective efforts move at “the speed of trust,” as Stephen M.R. Covey, the authority on trust famously called it. We are committed to building that valuable resource. Without successful partnerships with grantees in the field, CHCF’s work would not be possible.
CHCF encourages feedback from grantees about ways the foundation can improve our collective efforts.
