It’s hard to think that we will be able to look to our state and federal governments to lead the way to healthier communities. “Big” government is viewed by many as inefficient, wasteful and incapable of managing complex systems (regardless of the success of the Medicare program, for example). Proponents of “small” government seem to think the private sector will come up with better solutions. But since the private sector is focused primarily on profit, any proposed solutions will leave a void that will need to be filled.
MeHAF board members frequently talk with staff about how to best support change in today’s environment. Questions of sustainability plague both grant funders and grantees. How can we ensure that small organizations will be able to carry on the longer-term tasks that are required to effect meaningful change after their funding has ended? In order to better understand the proposals developed by grantees, members of the MeHAF Grants Committee have joined staff to conduct site visits for many of our projects.
Recently, I had the chance to participate in three site visits in two MeHAF programs: the Healthy Community program and Access to Quality Care program, and the visits changed my view of how to promote change. It was enlightening to see diverse organizations collaborating in a way that previously had not easily occurred. The organizations were actively seeking input from the community for direction and decision making. This was not a situation where town leaders or professionals were directing a “top down” organization, or a few individuals were doing all the difficult lifting, but one where MeHAF grantees and partners actually shared the subject of the work with members of the target population, and sought input and decision making authority from community members. The excitement and enthusiasm in the room was palpable!
This is not an easy task for grantees to accomplish. Giving up control and turf can be difficult, and the unknown or unpredictable direction that decisions may take may be cause for caution. Getting disparate organizations to look beyond their usual partners may result in hesitant or uncertain steps. And finally, at the end of the initial process, the actual results that are obtained may be slight, at least in the short run. However, if we can encourage true collaboration between diverse organizations and the populations they serve, then maybe our local communities can be effective forces to achieve sustainably healthy communities without relying on “big” or “small” government to lead the way.
Dr. Ted Sussman is a MeHAF Trustee and Chair of the foundation's Grants Committee.
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