Combining the expertise and passion of social services leaders from different organizations into a learning cohort aimed at systemwide change is a powerful formula — or, as one organizer has said, a little bit like “rocket fuel.”  

Through an emerging program known as HealthConnect Fellows, 18 selected individuals who work in children’s health organizations in Central Iowa are connecting in a network focused on improving their advocacy efforts and enabling them to better collaborate to advance children’s health. 

The grant program is also a pilot for a more flexible approach to funding for community projects that its lead funder, Mid-Iowa Health Foundation, believes could serve as a model for a capacity-building tool for other philanthropic organizations. 

Mid-Iowa Health Foundation launched the program in October 2017 by funding individuals from six organizations with two-year fellowship grants of $50,000 to each organization. The grants were intended to provide the fellows with the flexibility to carve out some time to focus on particular projects that build on and advance their work in addressing social determinants that affect children’s health. 

“[It’s] understanding that the people in the community are the best ones to tell us what needs to change,” said Suzanne Mineck, president of Mid-Iowa Health Foundation. “And the people in the community are the best ones to step up to transform the systems that are currently harming, or at least not equitably dispersing access to health, for our kids.”  

As defined by the Kaiser Family Foundation, social determinants of health include factors such as socioeconomic status, education, neighborhood and physical environment that can create disparities in health and access to quality health care. It’s a recognition that someone’s ZIP code can be one of the biggest determiners of how healthy they will be. 

Among the fellows’ projects:  

– Expanding kids’ access to healthier foods. 

– Better connecting homeless children with resources and improving interactions with educators. 

– Improving the quality of health care for low-income children through Medicaid and CHIP. 

– Developing curriculum and advocating for improvements to Latino kids’ mental health. 

– Increasing kids’ daily physical activity through built environment changes.

The fellowship program is an investment in developing the leaders who will bring about change, as well as an experiment in giving up a large degree of the command and control that a funder would typically hold over a grant recipient to produce tangible results, Mineck said.  

Participating fellows have met frequently over the past two years for a combination of one-on-one mentoring, cohort sessions focusing on viewing the issues through different lenses, and group training aimed at improving their advocacy skills. The fellows received specific training on how to frame their advocacy messages on children’s health to policymakers from the research and training firm Topos Partnership.   

The initial fellows were invited to select additional participants for the program that they believed could help them further advance their projects. Those 12 additional fellows joined the program in October 2019. 

“Even though they’re all working in this broader [area of] children’s health systems, they all come with very distinct experiences, issues and networks that they represent,” Mineck said. “So the ability to have a different lens to view work has been extremely valuable, and I think that’s probably one of the things we didn’t anticipate.”  

Advocates can often hit a “wall” — such as not getting a bill or a policy enacted — which carries a profound weight because they often can feel they’ve failed the children that they represent, she said.   

Rick Kozin, who joined the program as a mentor shortly after retiring as Polk County public health director two years ago, works one-on-one to help the fellows consider aspects of their projects more strategically. 

“Having some time and space to think strategically with someone who is experienced, but neutral, is really helpful,” said Denise Swartz, senior program officer with Mid-Iowa Health Foundation and a facilitator in the program. 

The fellows also find an incredible degree of synergy from each other, she said. 

“The cohort experiences are amazing, and they accelerate. I mean, boom — it’s just like rocket fuel when they’re together,” Swartz said. 

The fellowship/grant program provides a potential new model for philanthropic organizations to consider. 

“There is inherently a power differential between those that have philanthropic funds to invest and those that need them to advance their missions,” Swartz said. “So there are a lot of conversations that are going on in the field of philanthropy right now about how do you be authentic in that; how do you invite getting closer to the issues? 

“If we say we’re going to be flexible and we say we’re going to be nimble and we say we’re going to be opportunistic, but we’re still asking for an interim grant report on this date and you must be halfway to this objective, well, then we’re not really doing that.” 

From the perspective of a foundation, corporate funder or community foundation, the approach takes a certain degree of humility, she added. 

“You have to really be prepared to say, ‘Well, we hadn’t even thought of that,’ and ‘Let us figure out how we can find a way to help you navigate around that,’ ” Swartz said. “And almost always, that answer lies in the peer coaching.”  

The invitation to each fellow comes with an expectation to keep trying, knowing there aren’t definite answers to these issues, Mineck said. 

“We expect that they are going to hit walls, and we’re expecting that they don’t know right now what that wall will be, or how they’re going to pivot around that wall. Our invitation is only that they keep open to how they’re going to move forward to get that goal,” she said. 

“Not only has it been transformational for Mid-Iowa Health Foundation, it’s also given our partners and fellows this invitation to think about a lot of their work in a different frame. … We hope we can share our experiences with other funders in the power of taking a different approach in grant-making.” 

Perspective of an initial HealthConnect fellow

In her initial two years as a HealthConnect Fellow, Chaney Yeast has worked toward a goal of developing a coordinated voice for children’s mental health needs in Iowa. 

Yeast (pronounced like taste) has been director of government relations for Blank Children’s Hospital since January 2015. She also leads the Medical-Legal Project at Blank Children’s, an initiative with Iowa Legal Aid to connect low-income families with medically related legal services. 

Working with the Topos Partnership on messaging strategies was instrumental in helping to guide the direction of numerous agencies that are working on various facets of children’s mental health programs, Yeast said. 

“One of the important connections that we were able to make was with Topos to really help guide our messaging strategies and talking points based on what public policy research says will help move the issue forward, because in Iowa we’ve been talking about creating the children’s mental health system for 20-plus years,” she said. “So for me, it was really putting that research and knowledge into action.” 

Being able to collaborate with two other fellows in the program who work with children’s health initiatives — Lisa Cushatt and Mary Nelle Trefz — was particularly valuable, Yeast said. Cushatt is program manager of Central Iowa ACES 360, a program that addresses childhood trauma. Trefz, a health policy associate with the Child & Family Policy Center, is focusing her fellowship project on improving how Medicaid delivers services for children. 

A strategy that has proved effective is requesting joint meetings in which the three of them would make their advocacy pitch together, as they did in speaking to Gov. Kim Reynolds about the importance of children’s mental health and the connections between prenatal health and Medicaid support to Future Ready Iowa’s success. 

“I think if we really make a conscious effort to tie [the advocacy message] to other initiatives that policymakers are working on, knowing what’s important to them as individuals, really helps move our message as well,” Yeast said. 

Looking ahead, Yeast hopes to use the same collaborative approach with other HealthConnect fellows to push for adequate funding of the Children’s Mental Health System that’s been created. 

 “I think it’s really finding what the common messaging is across our different advocacy organizations that everyone feels comfortable and confident in using, so that we have very specific messaging around why children’s mental health is different than adult mental health,” she said.

A perspective from an incoming HealthConnect fellow

Mike Armstrong hopes that participating as a HealthConnect Fellow will enable his organization to help bring about systemic changes for health at a more rapid pace in Greater Des Moines. 

Armstrong  is director of planning and communications for the Street Collective, a transportation advocacy group in Des Moines that began as the Des Moines Bicycle Collective. 

“I am very excited that we were pulled into this community [of children’s health advocates] that we’re a little less connected with,” Armstrong said. “At every meeting I’m learning a lot about the similarities between these different fields.” 

Participating in the fellowship — and the fellowship grant that goes along with it — will enable the Street Collective to bring more time and resources to some of its current priorities, among them accelerating the pace of the city’s sidewalk improvement plan. 

The Des Moines City Council recently approved a plan for $60 million in sidewalk improvements, but those projects are spread out over the next several decades. The Street Collective hopes to speed up the projects, particularly the ones connecting more schools and parks to neighborhoods to enable kids to be more active, Armstrong said. 

Other priorities include involvement in updating bicycle ordinances and taking a look at construction policies for sidewalk access during construction, particularly for the downtown and East Village areas that have been heavily affected by numerous building projects. 

The Street Collective is currently working on a partnership with AARP and Public Allies, a national nonprofit, to bring in two AmeriCorps interns for the first time. “We’re really excited about that opportunity,” Armstrong said. 

“These are conversations we absolutely need to have,” he said. “This really gives us an opportunity to put more feet on the ground and have those conversations to much better serve our community.”

The healthConnect Fellows

Maria Alcivar Zuniga, Al Exito 

Aubrey Alvarez, Eat Greater Des Moines

Malai Amfahr, United Way of Story County

Mike Armstrong, Street Collective

Angie Arthur, Polk County Continuum of Care 

Lisa Cushatt, Iowa ACEs 360 

Andrea Dencklau, Youth Policy Institute of Iowa 

Erin Drinnin, United Way of Central Iowa

Daniel Hoffman-Zinnel, Proteus Inc. 

Dawn Martinez Oropeza, El Exito 

Becky Miles-Polka, the Campaign for Grade-Level Reading

Emily Price, Healthy Birth Day Inc. 

Olivia Samples, Iowa Coalition for Collective Change

Nathan Simpson, Primary Health Care Inc. 

Mary Nelle Trefz, Child & Family Policy Center 

Lina Tucker Reinders, Iowa Public Health Association 

Annie Wood, EveryStep

Chaney Yeast, Blank Children’s Hospital