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Published Date:
Mar 3, 2023
Community Health
Behavioral Health
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When Community Health Care Missions Fail
I arrived at Dallas Love Field by private aircraft in the Fall of 1984. I was there interviewing for a job in venture capital. I am quite sure today that, at the time, I had never seen how the super-success class moved around. There was no comparison between the faux-leather in my Chevrolet Malibu and the imported leather I didn’t want to leave behind as we taxied into the flight base operation. I was there to meet a Texas icon, who I would later realize to be among the most influential mentors in my life. It was not hard to be impressed. The Highland Park penthouse. The grand portrait of him looming over me. Not surprisingly, a little brass plaque indicated it was painted by James Anthony Wills the artist who had painted President Richard Nixon that same year. The Bible on his desk was a subtle reminder this man had his priorities in the right place. The appreciation plaques from dozens of his philanthropic causes lined his bookshelf.
I arrived at Dallas Love Field by private aircraft in the Fall of 1984. I was there interviewing for a job in venture capital. I am quite sure today that, at the time, I had never seen how the super-success class moved around. There was no comparison between the faux-leather in my Chevrolet Malibu and the imported leather I didn’t want to leave behind as we taxied into the flight base operation. I was there to meet a Texas icon, who I would later realize to be among the most influential mentors in my life.
It was not hard to be impressed. The Highland Park penthouse. The grand portrait of him looming over me. Not surprisingly, a little brass plaque indicated it was painted by James Anthony Wills the artist who had painted President Richard Nixon that same year. The Bible on his desk was a subtle reminder this man had his priorities in the right place. The appreciation plaques from dozens of his philanthropic causes lined his bookshelf.
As we talked that morning his assistant Janet, who would later become my assistant, politely dropped the Wall Street Journal on his desk. There, on the front page was his portrait in the famous WSJ stippled art style featuring him as the morning’s top story. I was on-edge.
I was about to learn a valuable lesson about strategic vision
He opened the meeting with a simple question. Ed, he asked, “what’s the difference between a man with a strategic vision and a visionary”? I stumbled around a few minutes as he patiently allowed me time to consider my oratory and when nothing meaningful in my answer arrived, he began to speak.
He said, “A man with a strategic vision, or call it a mission or whatever you like, is like a man in an unkept suit with only an imagination - unless he has a plan to execute it”. “But if he has one”, he continued, “he earns the title and respect as a visionary!” Life, as it turns out, is full of imaginary missions that under-perform. I’m not sure why he hired me but I’m grateful he set me on a new direction with my life with a few plaques of my own.
When Community Care Missions Fail
About 50% of behavioral health is delivered by non-profit community health providers in the United States. There are more if you consider missions, churches and residential sober living centers who don’t provide health care, but support the transition of care or a bridge to what’s next. Each of these actors plays an important role in the community, of course. But, in my experience few have strategic plans or struggle with executing the mission of their founders. By the same definition in the words of my mentor, most are not particularly considered “visionaries”. As a result, too many non-profits are short-handed, under-funded and unable to provide outcomes that stick. They themselves become stuck imagining a good outcome must be just around the corner.
Likewise a “mission” is not a missionary, the later of course being someone who is executing the mission by making a difference building a community. I‘ve seen organizations founded decades ago stuck at maximum capacity unable to grow. Those persons need and deserve funding for their charitable good works placed in action with measurable outcomes. And, there is plenty of room for the visionaries and missionaries with institutional philanthropy today.
Creating an Impact Economy. Visionary Community Care needs and deserve funding.
Institutional philanthropy—different types of foundations, family offices, donor- advised funds and other organized routes to giving and impact investing by those with significant resources—sits at the nexus of wealth and purpose. We recognize that financial capital has an absolutely key role to play in enabling change to occur at scale, for two reasons. First, financial capital has played a critical role in creating the very inequity we see in the system today. Second, if provided with the right incentives and guardrails, financial capital will facilitate economic systems oriented toward positive social transformations.
To date, efforts to create an impact economy have been piecemeal. But, not due to a shortage of available capital. The organizations, networks, and movement-building processes struggle to create a meaningful transition to a new equilibrium in large part because too few recipients are willing to play their part in investing in the infrastructure required to scale the growth of alternatives to the mainstream.
A main call to action among philanthropic organizations is to use their capital in a way that more directly supports the development of an impact economy with non-profits who are the visionaries and missionaries; and to align their investments and actions overall with the underlying values inherent in an impact economy.
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