Former Senior Vice President of Impact
Learn more about Dogwood Health Trust here
As a health funder, why is Dogwood Health interested in tax credits? How does it advance your mission?
Before I talk about our work at Dogwood, it may be helpful to add a bit about my background in this work. I have been working in philanthropy for 15 and doing work related to the EITC for some years in Washington State. At Dogwood, we are deeply focused on improving health in Western North Carolina and always looking for new ways to approach health equity. As health funders, we know that housing, education and the workforce are huge drivers of health; and, there are natural intersections for partners doing some or all of this work. This is true across the country including in North Carolina. Given my experience in Washington, I was a big champion of building a health improvement strategy that included access to tax credits.
In North Carolina, our work on tax credits built on pilots we ran to test strategies for increasing health insurance enrollment. We worked with Pisgah Legal to answer the questions “How do we make improvements in enrollments for health care? ” and “What are the best practices on enrollment?” . In North Carolina, we were able to build a 14-county coalition of partners to focus primarily enrollment for folks who had never had insurance and show them how to get them enrolled in healthcare. The partnership was super successful. So, I was familiar with tax credits work and their potential impact.
Based on the success of the pilot, we began thinking about how doing other screenings could also help. We initially began with legal and eviction assistance. At the same time, I was hearing about the EITC but not much work was being done in this area even though there was a lot of research about the connection between tax credits and health. We started doing work on tax credits and our efforts were incredibly successful.
What things did you consider and discuss when deciding on whether to move forward
with this body of work? What was persuasive to your board, staff, and supporters?
We had been talking about expanding our portfolio to include work related to tax credits. There is a huge return on investment (ROI) for this type of work. Because philanthropy can’t get money directly to people even though we believe that getting more money into people’s pockets is crucial, supporting work around tax credits is a way to do it indirectly. The passage of the American Rescue Plan Act (ARPA) provided us with a new opportunity. It also made our ROI go from 3 to 1 to 7 to 1 and gave us an opportunity to include work on the Child Tax Credit (CTC).
There wasn’t any real pushback from our board, staff, and supporters. Our board took a look at the data and research and got it right away. We explained to our staff and supporters the close connection that tax credits have to our other work around snap benefits, housing, health and wellness. They got it right away too. Everyone agree that the ROI was clear and we should move forward. That said, because this would be our first multiyear grant, there were complexities related to setting up the grant and making sure it was the right size.
What specific work have you or will be funding in the tax credits space?
And, what specific strategies offer the most potential for impact when doing work related to tax credits?
Pisgah Legal suggested we work on tax credits because it was really low hanging fruit. Over 6 months, we developed a program to cover 18 counties using a hub and spoke model. Our partners in the community, On Track, began doing tax prep. We put targeted funding toward working with people who do not traditionally file taxes because we wanted to direct resources towards connecting with people who are the hardest to find. We focus 50% of our energy on strategies meant to reach those who have not filed in the past which helps us to really have a strategy that is able to reach people who often slip through the cracks.
We invest in identifying and working with trusted partners and institutions (that are connected to children) who can make warm connections/handoffs (ex: EC centers, Boys & Girls Clubs, After school programs, churches, libraries, etc). We also fund Federally Qualified Health Centers because we know that many of the people who we want to reach use those centers. And, we build in incentives for referrals.
We support efforts to raise awareness. A big portion of the budget is focused on traditional print, billboards and bus advertisements. We also invest in internet & social media advertising so relevant messages that resonate with community members can be developed and shared widely. We really try to go beyond our own followers. There is a whole new wave of social media advertising (Hulu and Netflicks ads) that we want to tap into for this work.
Finally, we also make our PR firm available to grantees who ask for assistance in this area. Our grantees really appreciate this option being available to them.
What advice would you have for health funders (or others) who are thinking about investing in this work?
Some of my advice for health funders include:
- Think of the ROI– There aren’t many strategies that offer the level of ROI as work related to tax credits.
- Find Overlap in your Venn Diagram– For health funders, this isn’t a big stretch. It is very aligned with the work we seek to do around improving health outcomes. Look for intersections in your current work. For example, screening for tax credit eligibility was an easy add-on for our partners who are already doing other screenings with community members.
- Talk to Your Partners– Your partners will make the argument for you. They will also make the connections quickly. It is their main line of work. We partnered with groups like Pisgah Legal for strategic advice, On Track (located in almost all counties in NC) for tax prep services, the United Way (who does work across the country for older adults) and Grantmakers in Health. Our partners all added value in various ways.
- Build Trust With Your Partners- People need in-person connections to make the process work. We need other trusted partners who can do warm handoffs and connect people to key tax prep services. That said, building trust with partners to make sure that the community organizations are looking out of the best interest of the client is essential.
- Don’t Wait to Start Exploring It– Start thinking about it using a Bright Spot model. It will lay itself out.
- Don’t Be Dissuaded By the Fear of the Unknown– Unintended consequences are unavoidable but we were always able to figure things out.
- Make a Meaningful Investment– Capacity is a huge issue. Many of our partners are having a tough time hiring because nonprofit organizations don’t pay people doing work on the ground enough. We need to do a better job of making investments that actually meet the needs of our partners doing the work connected to our priorities if we truly want to improve the impact of our investments.
- Remember the Big Picture– Getting cash into people’s pockets is a huge benefit that helps to meet daily needs, reduce stress and provide the resources needed to improve health outcomes.