Chris’s essay in the Mercury News…

In case you missed it (or want to read it again, like the way some of us watch The Breakfast Club over and over), this was published in the Mercury News on March 22:

As you may know, the President’s first budget draft eliminates funding for the National Endowment for the Arts, and for the Corporation for National Service. His first take on a health care bill – the one designed to replace the Affordable Care Act – slashes Medi-Cal expansion and would leave millions without coverage.

I feel strongly about this. See, not long ago I chaired the board at San Jose Jazz, and today I work closely with Silicon Valley Creates. I know well the good they do, and what will be lost if they go away.

Longer ago I ran City Year San Jose/Silicon Valley, the premiere AmeriCorps program in the South Bay. I know well the good it does. I also know what will be lost if it goes away.

And for thirteen years I’ve run the foundation at Santa Clara Valley Medical Center. I’ve gotten my health care at SCVMC that whole time…just like thousands of individuals and families who need primary care or the unique, specialty care our public hospital provides. One in four residents of Santa Clara County have recently used or rely on SCVMC, just like me.

Yes, we very well know the good it does.

You of course remember the “ice bucket challenge” of 2014, a clever idea that went viral and raised tons of well-deserved money for ALS research. Dump ice on your head, film it, post it, and donate to ALS…fun! More than fun in fact: The ice bucket challenge introduced a whole new group of people to the idea that giving to a cause is helpful and even feels good and makes you happy. Again, fun!

Well I think it’s high time for a less-fun, but equally important idea to go viral: Donate now to the nonprofits you love who are under attack. Not everyone is comfortable writing to congress or marching in the streets (which is still vital), but donating to the charities that will be impacted by these proposed cuts is another great way to channel your anger toward something positive.

You ARE angry, aren’t you? This isn’t even political, really: You don’t need to be a liberal or democrat to appreciate jazz, or a museum or the ballet. I served on San Jose Jazz’s board with conservatives and progressives alike. Through City Year, I met Bill Clinton and John McCain and Carly Fiorina, all of whom appreciated the ideals of national service.

And I’ve met Republicans and Democrats whose lives were saved by our county’s trauma team.

I can’t guess about San Jose Jazz or City Year, but here’s something certain: SCVMC isn’t going anywhere. Your public hospital has been here since 1876 and has weathered all kinds of storms. Its leaders and doctors and nurses are a brilliant team, and our county leadership is determined and resolved. This new storm, however, will bring challenges. And simply put, it makes me angry.

Now is absolutely the time for a new wave of viral philanthropy. If you’re angry about any effort to stop federal funding for arts programs that make our communities vibrant and exciting, donate to your local arts council. If you’re steamed about destroying the Corporation for National Service and the democracy it builds in our nation’s young people, give to your local favorite AmeriCorps program.

And if you’re upset about low-income families losing coverage while the wealthy see a reduction in cost, or about the very idea that some deserve quality health care while others perhaps don’t…well, there’s a public hospital foundation that could really use your help.

Please.

You don’t even need to dump ice on your head.

The State of the County 2017

Last night the President of the Santa Clara County Board of Supervisors Dave Cortese gave his State of the County Address to a standing-room-only crowd. He spoke for sixty minutes, far longer than his previous SOC address.

…because in 2017, I think you’d agree, there’s more to discuss.

President Dave Cortese (second from  left) with a crew of us who fought for Measure A last year: Ben Field, Betty Duong, Tom Steyer, Congresswoman Zoe Lofgren, me, Supervisor Cindy Chavez and Derecka Mehrens. 

A reminder: The County owns and operates Santa Clara Valley Medical Center and the Health & Hospital System of which it is part–the busiest healthcare deliverer in Silicon Valley and making up roughly half of the 19,000 employees of Santa Clara County (not including some 25,000 home care workers, according to President Cortese, whom he also praised).

But no matter where in the County one works, Dave’s message resonates and in my view, informs how we must think and act: 2017, Dave proclaimed, will be the Year of Compassion.

I was sitting in a section of the Board Chambers last night reserved for we who helped pass Measure A, the County’s historic supportive housing bond. Along with my colleagues Kevin Zwick and Derecka Mehrens, we applauded throughout Cortese’s speech and took pride every time he referenced the bond measure to upend the housing crisis. And the reason we did, he reiterated again and again, was that ours is a compassionate community.

At times he openly defied recent federal threats to our region’s marginalized and underserved, referencing the recent County lawsuit to defend sanctuary policies. It says a lot about our County that this was the strongest applause line of the night: All the work we’ve done, all the people we’ve helped, all the distance we’ve come… We are not going to turn back and abrogate our responsibilities now.

His message of dogged determination and the need for deliberate compassion certainly resonated with me. See what you think; here is Dave Cortese’s State of the County Address (and it’s been edited somewhat; don’t be afraid). Read it and let me know what speaks to you.

A great victory…and the future it informs.

yes-on-aThere is an adage that goes “success has a thousand parents; failure is an orphan”. This, obviously, speaks to people and organizations who seek credit for a good thing happening. Sometimes that’s unjustified and unfair.

But what about when a great success really does come about because so many stood up and stepped up? That’s powerful and profound, and that’s exactly what happened in Santa Clara County this summer and fall…and the victory came together the night of November 8, 2016, when Measure A was approved by the voters.

…not that we knew it at the time.

We needed 66.67% to win, and it took nearly two weeks to certify that we won with 67.67%. Obviously, we won by a very, VERY narrow margin of a single percentage point.

A reminder, in case you’re late to this party: Measure A provides $950,000,000 to build supportive housing, low-income housing and to help first-time home-buyers.  The lion’s share, paid for with a property tax increase, will kick Silicon Valley’s homelessness crisis to the curb. That crisis is arguably the worst in the nation, and county voters demonstrated on Election Day that they have heart, they want to help, and they embrace the common good. Considering the results at the top of the ticket, this victory and the compassion it reveals is extremely important.

What’s also electrifying is the number of non-profit organizations that got involved, many for the first time. To do that, their leadership needed to confront and reject a myth that 501c3 tax-exempt charities cannot “do politics”. I’ve written about this myth before, and this summer and fall after jumping in head-first to this effort, I worked to educate and urge my colleagues in the “public benefit sector” that contributing time, talent and treasure to Measure A was

  • Perfectly legal;
  • A moral obligation;
  • A path to your own success, and;
  • The only way we were going to win.

Let’s explore these four areas a little…and at the end, I’ll explain why.

Perfectly Legal. That is, if you follow the rules. No big deal; we do it every day. It’s legal to drive your Corvette 70MPH. But only on some roads. If you’re sober. And you’re a licensed driver. Rules…we learn them and abide by them. In the case of charities and elections, California’s rules are quite clear: Your charity cannot officially support a candidate, but you can support a non-partisan initiative or measure so long as it relates to your mission (why homelessness and health care are related should be evident, but if it’s not don’t worry: It will be by the end of this essay).

The general rule is 20%–that is, a nonprofit charity can donate 20% of their annual budget to a ballot initiative in California, and spend right around that much staff time advocating. There are reporting requirements that get a little complex, but not nearly as complex as, say, your annual audit!  Again, it’s a matter of learning the rules and following them. If you’re lucky and can afford it, a nonprofit or election lawyer is smart to engage…or better yet, talk one into joining your board!

Here is a great place to start to learn the details of campaign/lobbying rules…and remember, rules change all the time, so don’t just rely on one source of information.

A Moral Obligation. Those who work for/run nonprofits do so to get rich and buy jet airplanes. Kidding! We are fiercely dedicated to the idea of reconfiguring parts of the world for the betterment of others. We love animals and want them safe. We detest prejudice and injustice. We want to slow climate change so it doesn’t destroy Florida.  Or, in the case of Measure A, we feel that everyone deserves a place to live and that homelessness is worth fighting.

None of that makes us saints or even unusual. People who run hotels and who sell falafel for a living also care about these things…if they didn’t, Measure A wouldn’t have passed. But here’s the difference: If you work for a homeless shelter or a food bank, you understand the issue WAY better than the average person. If you and your agency sit on the sidelines while the community discusses supportive housing, the issue and level of discourse is short-changed. Your voice is necessary. Your opinion piece in the newspaper is vital. Your agency’s money is a bit greener. Your endorsement counts…more than that of others. Not getting involved is simply not okay.

A Path to Your Own Success. Homelessness, for example, is sad and awful. That’s why people are compelled to help. Also, homelessness is expensive. I knew the number was big, having spent time with so many providers, but even I was shocked when I learned that Santa Clara Valley Medical Center (the hospital my agency supports) spent nine hundred million dollars over a four-year period providing care for people who are homeless. Add in other county (tax-payer provided) interventions like law enforcement and social services, and you’ll find we spend over five hundred million in just one year, not counting the program budgets of the dozens of nonprofits on the front lines.

And the real tragedy? People are, generally speaking, NOT getting better. How could they? Managing people’s chronic health conditions while they’re living in a creek bed? Helping people with mental health conditions while they’re living under a freeway overpass? What the ping pong balls do we expect? This is why the housing first model makes logical sense, and why so many nonprofits ultimately came aboard the Measure A Campaign: Working hard to serve people whose lives aren’t measurably improved by your service is soul-crushing—among people like doctors, nurses and social workers whose hearts and souls are huge.

Fundamentally, the heroes of Santa Clara Valley Medical Center—along with my colleagues who run nonprofits like HomeFirst, The Health Trust, Destination Home, Momentum for Mental Health, Catholic Charities…they care about people. When asked why a hospital foundation was all-in on a homelessness measure, I would often site those great agencies and say “I want their work to work better.”

The Only Way We’re Going to Win. Like it or not, campaigns are expensive. Cheap compared to the homelessness crisis, but still. We faced the longest ballot in California history, and local measures are way, way down near the bottom. To earn the attention and vote of enough Santa Clara County residents this year, we figured we’d need to raise a million and a half bucks. At least.

But here’s the problem, which is really the central message of this rambling treatise: Lots of nonprofits didn’t even know they could get involved! What an untapped resource (I reasoned), and opportunity to exceed those fundraising goals. By the time I jumped in, our badass County Supervisor Cindy Chavez had already convinced several charities to give big, and the VMC Foundation immediately endorsed and gave (gulp) $100,000. This was not funny-money; this was operational reserve. This was a risk.

cookieNow, we’d done that before and more than once, so I also saw that my obligation was to help educate other 501c3’s that they needed to ante up. Boy, did they ever! By November the Measure A Campaign had raised a whopping $2.3 million. There has never been a time in Silicon Valley where more nonprofits joined housing developers, wealthy progressives and other stakeholders to amass such a war chest. All that money was turned into direct mail to voters, radio, TV, YouTube, and (not making this up) 15,000 cookies given out on college campuses…anything really, to rise above the Clinton/Trump noise and Be Heard. We also hired seasoned campaign professionals – the best we could find.

The nonprofit community stepped up in other important ways. Many of us are members of the San Jose Silicon Valley Chamber of Commerce, and together, we convinced them to withdraw their initial opposition to Measure A. We wrote letters to editors, penned opinion pieces for every newspaper in the valley, and spoke at every community gathering we could find. Closer to November 8, we got on the phones and never stopped dialing. We pounded the pavement with literature. We went bananas on social media. If not bananas, then

gingiegingerbread.

Election Night, November 8, 2016. The shock of Donald Trump’s victory muted what would have otherwise been a great celebration: Measure A passed—by a hair. This is revealing on a number of fronts. First, we needed every agency, every donor, every dollar to win. Had any of our handful of six-figure contributors sat on the sidelines, we likely would have lost. And because giving means commitment, agencies that contributed were also there with volunteers walking and phoning. It took every one of them to get us across that goal line.

Second, this victory speaks to who we are in Silicon Valley. With civility and compassion in short supply nationally, we dig deep and find it here. We’ve done it before, many times, for similar reasons: If Washington won’t help us solve problems, we’ll solve them ourselves. For example, with the election of George W. Bush in 2000, Santa Clara County leaders realized no one was going to help us provide care to underserved kids. Thus, the Children’s Health Initiative was created by county officials, labor leaders and funders who responded to the problem and built an innovative solution to it. Years later, it would be replicated by most counties in the state. Years still later, Governor Brown made it the law of the land. As a result, every child in California has access to health coverage.

That’s a major triumph, right? That’s why my third and final point is that we must keep the band together. Pundits and newspapers described Measure A as “game-changing”, a “hail Mary pass”, “staggeringly ambitious” and “unprecedented.” Every nonprofit who joined the coalition should feel proud and electrified, because all of us, together, made it happen. I’ve already described how every ounce of energy and every dime donated was necessary to win, so now let’s ask the obvious question: What’s next?

Keeping a coalition together is never easy, but the “other” major event of November 8 reveals that we simply must. If Trump’s promise to repeal the Affordable Care Act is actuated, if persecution of specific religious groups is encouraged, if trickle-down economics widens evenangela further the economic canyon swallowing more and more in our community…well, you get it. We’ve got our work cut out for us.

So, even loosely, we nonprofits have to stay united to further the progressive policies on which we agree. We have become a multi-celled customizable action tank for addressing needs. As the greatest needs emerge, and as solutions are proposed, and to the degree those solutions require a massive coalition of idealistic leaders, we must be ready and be together. If you’ve read this far, you may very well be one of those idealistic leaders. We’ve proven we can do amazing things. You are awesome. We are awesome. Let’s meet for coffee soon. I’ll buy.

Healthcare philanthropy should help everyone, not just VIPs

carson

At some hospitals, donors practically get their own butler. At VMC, the goal is to provide the same great care to all.

One major reason I joined the VMC Foundation 12 years ago is that Valley Medical Center cares for anyone, regardless of status. It remains the cornerstone of my commitment.

Furthermore, the quality of care doesn’t vary according to any sort of “wallet biopsy”. The woman living in a shelter gets the same world-class care as the woman living in a Monte Sereno mansion.

You might think this is a matter of basic human dignity, but in fact, this is not the way it goes everywhere. Some hospitals – more than you might suspect – do play favorites, and do so as a matter of policy and practice. “Concierge service” or other VIP treatment of wealthy patients is not uncommon…and I’ve lost count of the number of seminars/conference sessions/webinars I’ve attended that encourage we medical charities to push for this.

As last week’s NY Times’ op-ed points out, this makes obvious sense on one level: Treat your wealthy patients better, and philanthropy flows. But, as the article also reveals, this can also lead to worse care…not just for the non-wealthy patients, but for the wealthy ones too!

It’s also unfair.

And it’s the last thing you’ll find going on at Valley Medical Center.

Read the full article here, and ask yourself: What are the values you’d prefer your medical care team believe in?

Happy 30th Birthday Valley Health Plan!

Chris Wilder Flu Shot 2013

Long story short: When I first started here at the VMC Foundation, the job afforded no health coverage. Which was ironic, don’t you think?

My wife’s company did, and I was already on her plan. I don’t remember what it was, or any of my doctors’ names. That’s because the few times I ever went to see one I felt like a number (at best) or an imposition (at worst). Nobody ever got to know me, or talked to me about my overall health. Many of us have experienced the “five minute doctor visit”…and until 2006 I thought that was normal.

That was the year the VMC Foundation became a true “employer” and had to decide what kind of company we were going to be. If we were going to hire staff, we needed to offer benefits—and they’d better be good, since that’s a core value that the VMC Foundation and Valley Medical Center holds dear. We were finally ready to talk to Valley Health Plan about doing something they’d never done before: Offering coverage to a private non-profit. We were the first, and suddenly, my health care was with VHP and Valley Medical Center!

What. A. Difference.

My doctor, Chris Snow, asked me questions, and not just about me, but my whole family. Some of them went like this: “Why are you taking cholesterol medicine when you’re vegan, and when everyone on both sides of your family live into their 90’s or longer?” Other questions, like “How much time to you spend sitting at your desk?” or “What would it take to schedule some more cardio?” demanded that I truly think seriously about the answers – because by then, I had come to like and trust Dr. Snow and I wanted him to be proud of me.

Not long after, Chris Snow moved on…but not his caring manner. He left that for Dr. Bob Horowitz who inherited me next. Just like Snow, Dr. Horowitz took the time to learn about me and me about him. Rarely, he would refer me to others throughout the VHP system and always, I met world-class providers and Nurse Practitioners and X-Ray Techs and – well, everyone really. Even when I showed up at 3am with the weirdest emergency I’d ever had, I was met with compassion and technical brilliance. I still have ten fingers as proof.

Over the years, as the VMC Foundation grew from a tiny nonprofit to one more robust, Valley Health Plan has also grown. What a thrill it was when they were selected to be part of the Covered California health exchange! Suddenly, our “little” VHP was one of just a handful of choices that anyone could choose through our state’s exchange. For me, it was no choice at all; when was the last time you got to interact personally with the CEO of your health plan? For me, and “super-local” VHP, it happens frequently.

Here’s a bonus: Whenever I get medication or visit my doctor, I’m not asked for a co-pay. This isn’t always the case, but at Valley Health Plan, it certainly is the norm. Other perks include acupuncture, the widest array of specialists for whatever might ail me, MyHealth Online, and because I work here, running into my doctor in the hallway all the time. Okay, that last part has its downsides, but the occasional “getting those 10,000 steps in, Chris?” do have an effect.

And the result? I’m a healthier person for my VHP membership. I know it, and I appreciate it. Happy birthday, VHP. I’m writing this on my 48th, and I expect you and I will both have a lot more birthdays to share.

Women & Children’s Center at VMC receives $5.75 million towards launching campaign to raise $25 million

FIRST 5 Santa Clara County, SAP, Sharks Foundation and the Rademakers Family announce major gifts.June 24 montage

Making a historic down payment on the future of women and children’s healthcare in Silicon Valley, SAP, the Sharks Foundation, the Rademakers Family, and FIRST 5 Santa Clara County have committed $5.75 million in seed funding to create a Women and Children’s Center (WCC) at Santa Clara Valley Medical Center (SCVMC), which will be the first of its kind in San Jose.

“This Center will strengthen Santa Clara County’s historic commitment to providing quality care to women and children,” said Ken Yeager, Chair of the Santa Clara County Board of Supervisors Health and Hospital Committee. “I appreciate the generosity of these donors. Their gift lays the groundwork for this essential service as we plan for the future of VMC.”

“Caring for women and children is at the core of what we do,” said Paul Lorenz, SCVMC Chief Executive Officer, during a news conference at SCVMC today. “This is a huge first step in raising the $25 million needed to make the Center a reality in 2016.”

The Women and Children’s Center at SCVMC will make use of an existing hospital building, consolidating pediatric, birthing and postnatal services into a single facility. Funded by a public-private partnership, the building will undergo significant renovation and upgrades to convert from general adult uses to specific women and children’s services.

A $4 million gift from FIRST 5 Santa Clara County will be invested in the labor and delivery department and the neonatal intensive care unit to be located on the third floor of the future WCC.

“This upgraded facility represents all the values we cherish at FIRST 5, which focus on making sure children five and younger have a better chance to lead healthy, happy, and productive lives,” said Jolene Smith, CEO of FIRST 5. “We’re excited because we’ll be able to integrate many of our programs and services throughout the WCC.”

With their $750,000 gift, SAP and the Sharks Foundation are making the single biggest donation to a non-profit since the foundation was started in 1994. As part of the SAP sponsorship agreement, SAP directs about $375,000 annually to the Sharks Foundation. The donation will sponsor the pediatric unit, located on the fifth floor of the WCC.

“The Sharks Foundation is thrilled to partner with SAP to fund the pediatric floor at the new Women’s and Children’s Center at Santa Clara Valley Medical Center,” said Jeff Cafuir, Manager of the Sharks Foundation. “We are extremely pleased to be involved with such a unique project that is going to make a significant and positive impact on the lives of so many here in Santa Clara County.”

“SAP is excited to support the development of the Women and Children’s Center as it reflects our belief that we strengthen our communities when we are making smart investments in projects aimed at improving the health outcomes for women and children,” said Jenny Dearborn, Senior Vice President at SAP.

After a tour of the WCC site at Santa Clara Valley Medical Center, John and Ann Rademakers were so impressed they decided to donate $1 million to make it a reality. “We immigrated from the Netherlands decades ago and raised our children here. We have received so much from our community that we feel this is a meaningful way to give back and support the well-being of all our children.”

VMC is partnering with Silicon Valley Creates (SVC), the region’s arts and creativity network, to bring together artists and cultural partners to completely redesign the family experience with a touch of magic that complements VMC’s premier medical services.

“We believe in the healing powers of the arts and there will be no better place to put this idea to work than at the new Women and Children’s Center,” said Connie Martinez, SVC Chief Executive Officer.

The founding sponsors of the WCC have recognized why the WCC is urgently needed as San Jose is the largest city in the United States without a free-standing children’s hospital. That deficiency has been on the minds of healthcare leaders and local advocates for decades.

They emphasized, while the initial donations are a great start, much work needs to be done to raise the remaining $20 million necessary to finish the WCC.

To learn more about the Women and Children Center at VMC Campaign, click here.

“There’s a lot of baloney in that sandwich…”

Chris Wilder headshotWhat are we accomplishing? How do we know we’re using our donor’s dollars in the best ways? How do we measure our successes? Are we really solving problems?

 These are not just good questions for any public benefit corporation (like the VMC Foundation) to ask; they are the questions that Charity Navigator will now be asking of nonprofits around the world in a move they call CN3.0. Paul Brest, former CEO of the William and Flora Hewlett Foundation, calls it “the most important work being done in the nonprofit sector.” High praise, indeed.

But Charity Navigator’s new direction – to capture the results and outcomes of a charity’s work – is also drawing fire. Many agencies wonder how to measure outcomes when their mission is to serve immediate, day-to-day needs. Are you “solving problems” if you feed a hungry family, knowing they will be hungry again tomorrow? How do you capture satisfaction of a client when that client is a 5-year-old child on an operating table in a war zone?

In a fantastic NPR story this morning, Charity Navigator CEO Ken Berger said this about some nonprofits’ concern over their new rating system: “There’s a lot of baloney in that sandwich.”

That’s a great line. I’m totally going to use that.

Worth noting is that the for-profit sector has no similar accountability expectation. Companies like General Motors or General Foods are measured by shareholder value and little else. Whether a video game maker is improving children’s health, or the degree to which Starbucks is strengthening gender equality overseas take a back seat to “are they making money?”

Seriously though, I wonder the degree to which Ken Berger began re-thinking this rating question after he (and millions of us) watched Dan Pallotta’s TED talk called “The Way we Think About Charity is Dead Wrong”. If you haven’t seen it, please do. Like, right now. I’ll wait.

There. Pretty compelling, right? So it makes me wonder about the VMC Foundation. What problems are we actually solving? How do we meaningfully measure our results?

This would be easy if we did just two or three things…but we do more. The VMC Foundation:

  • Boosts medical center morale by throwing parties and running softball leagues
  • Manages complex grant agreements to provide everything from newborn care technology to reduction in readmission rates for patients with chronic conditions
  • Advertises the world-class care available in our spinal cord and brain injury rehab center
  • Gives away thousands of new bikes every year to kids who otherwise may never have one
  • Outfits VMC’s clinics with beautiful artwork, creating healing environments
  • Participates in hospital committees, interview panels, and conducts staff appreciations
  • Runs financials for the hospital gift shop, launched a farmers’ market, runs medical conferences…

…I really could go on and on. We’re proud of all this, but how would we begin to evaluate our overall effectiveness and whether we’re “solving problems?” We probably shouldn’t take credit for work done by VMC’s doctors and nurses, even if we brought in a big grant that pays for what they do. If our medical center’s patient satisfaction scores go up, what role did we play? What if they go down; are we then to blame?

But we also cannot just evaluate ourselves on how much money we raise or the number of programs we run. Are we moving the needle on people choosing to get care at VMC? Are we keeping staff proud of their work and reducing turnover or absenteeism? What about our overall work to improve public health (evaluating what doesn’t happen is always a challenge; how many people didn’t get the flu because they got a flu shot because they responded to our campaign)? What, in short, can we take credit for?

Just because these questions are hard doesn’t mean we shouldn’t ask them. I think Charity Navigator is on to something very important…even if I don’t know how to respond to it yet.

If you do, or have ideas, please share them. This is normally the kind of thing reserved for a 2-day board retreat, but I have a feeling that crowd-sourcing ideas here might be useful. Let’s see if I’m right.

It’s time to re-think charity…for the good of us all.

SitHappy-00022IMGL9901

When I first watched Dan Pallotta’s TED talk, I wound up yelling back at my computer screen: “That’s IT! That’s what I’ve been trying to say!”

Of course Pallotta, the founder of the AIDS Ride, said it far better than I could. His talk, “The way we think about charity is dead wrong”, lit a fire under me and many of my colleagues in the public benefit sector. He discusses why salary ranges are all wrong, why marketing and advertising is undervalued, and why the mission and potential of a charity (like the VMC Foundation) is more important than that of a video game company…yet the double-standard of for-profit vs. non-profit keeps societal problems from getting solved.

He also points out something getting new traction: The amount a charity spends on “overhead” – meaning fundraising and administration – is a poor measure of their worthiness. Now, a letter written by the leaders of three leading charity watchdogs called The Overhead Myth, is making the case in a loud and clear voice.

I would add to this conversation that another area where charities under-participate is in issue advocacy. Many nonprofits believe they are not allowed to get involved in politics, and in some cases that’s true. But in others, like the county Measure A campaign in 2008, the VMC Foundation was the largest donor. Why? Because a victory would mean a new hospital building and seismic compliance for Valley Medical Center. Seriously – how could we NOT have been involved? It was the very definition of “go big or go home” for us. By the way, we won, and the Sobrato Pavilion opens next year as perhaps the finest public hospital building in the nation.

So we learned a lot in 2008, and we applied it again last year in another “Measure A” campaign. This time, the $400,000,000 generated over the next decade will support county services that include fully funding the Children’s Health Initiative—ensuring that every child in our county has health coverage. This is not just good, but GREAT for Valley Medical Center…and more importantly, for our young patients.

Is issue advocacy a risk? You bet it is. We failed in 2010 with a similar ballot measure, and I wish we had that money back! But the private sector risks all the time, and frankly, Silicon Valley rewards aiming high and failing when it’s followed up by trying again. The public benefit sector has too much expertise and mission alignment to be sidelined when issues like hunger, homelessness and health become the subjects of political decisions.

Charities need to be bold, take calculated risks, and be measured not by the smallness of their spending but by the largeness of their dreams.

The art of VMC’s teaching program…

Medical school is NOT what it used to be. Seriously – art museums? Yes, art

Medical students digging deep into art at Stanford's Cantor Art Museum.

Medical students digging deep into art at Stanford’s Cantor Art Museum.

museums! But first, a little background…

Valley Medical Center has been the teaching hospital for Stanford’s School of Medicine for more than 75 years. That’s a lot of doctors whose careers were launched here. How many? One in four who practice medicine in Silicon Valley trained at VMC.

That training environment is not just great for doctors; it’s great for patients. The collaborative spirit and team approach to diagnoses and medicine has demonstrated better patient outcomes. And of course, the best doctors fall in love with VMC’s mission and stick around for the next 40 years or so. Pretty cool.

So speaking of cool, the way VMC teaches our young doctors-in-training is pretty special too. Yeuen Kim, MD, invited me to spend part of my Friday morning with our young doctors and her fellow faculty at Stanford’s Cantor Art Museum. If you’ve never been, you really should go. Like VMC, it’s world-class.

We were there as part of Dr. Kim’s four-week seminar on medicine and the humanities. Art, music, literature and poetry. “We’re measuring empathy, attitudes and visual diagnostic skills to see if humanities help improve those aspects of professionalism and physical diagnosis,” Dr. Kim explained to me.  This concept is funded by a National Institutes of Health Clinical Translational Sciences Award, administered by the Stanford Office of Community Health – a true scientific study of outcomes (see? Art and Science DO mix!)

While gathered around a particular painting with Cantor Museum Curator Patience Young, I got the feeling that Dr. Kim was right on target. “What are you seeing? What is the artist telling us about this girl? How would you describe her facial expression?” For art students, these questions are basic ones, but Curator Young drew great responses from our medical students – few of whom had any knowledge of art history and were hesitant (at first) to respond…but opened up more and more as the morning went on.

By the time we convened around Rodin’s “The Thinker” and “The Kiss”, the conversation was lively and detailed. Hand position, toes and fingers, the back story of the characters. A true thoughtful exploration of these masterworks.

Dr. Kim and her team believe humanities training can help recapture “the dying art of the physical examination, which our students often struggle with.” She explained to me that technological advances have changed the way patients are examined and diagnosed, and training has changed a lot since she finished medical school in the late ’90’s. “We need to teach our future physician leaders to truly connect with the whole person, to see them for who they are. That’s the best way to help them.”

What struck me was the length of time we all spent on each artistic work. This is the very antithesis of how most people these days think of a doctor’s visit and exam: Quick! Get in, get out, on to the next patient! How many can we see in an hour? More productivity!

My personal experience getting care at VMC for the last decade is not this. Sure, our doctors don’t waste time, but there is a sense of care and connection I get that I understand doesn’t mirror some of my friends’ experiences elsewhere. Training our new doctors to slow down, see the whole patient, learn about WHO they are and not just WHAT ails them can make a big difference.

And as of last week, I see where it comes from.

The (healthiest) State of the County Address…

President Ken Yeager, far right, with Supervisor Wasserman, Congresswoman Eshoo and First 5 CEO Jolene Smith

President Ken Yeager, far right, with Supervisor Wasserman, Congresswoman Eshoo and First 5 CEO Jolene Smith

In my 9+ years of service to the VMC Foundation, I’ve never been more excited about a “State of the County” speech than I was today. Board President Ken Yeager succinctly outlined his goals for 2013, which he explained would require close collaboration from everyone present…and that’s a lot of county leaders – the Board Chambers was standing-room only.

 

Why was I so excited? First, because President Yeager has demonstrated for years that he truly cares about and works hard on these issues…so he’ll make it happen. Second, because the VMC Foundation is actively working on half of the goals he presented. Mathematically, that lines up: The Santa Clara County Health & Hospital System is roughly half the County’s budget, and half of President Yeager’s goals involve that “system” directly…and what do you know: the VMC Foundation is engaged in nearly all!

This, in a nutshell, suggests to me that the VMC Foundation has its priorities straight. In addition to raising funds for vital equipment and programs within the walls of the medical center, we’re addressing community health needs.

Here, then, are President Yeager’s health-related goals and a bit about how your VMC Foundation is lending a hand:

Prepare Santa Clara County for Health Care Reform

The VMC Foundation has, for years, been part of the committee to further improve the patient experience. From the moment someone walks in the door (or arrives by ambulance), we have countless opportunities to make them feel welcome and cared for. In part, this is how medical centers will be measured under the Affordable Care Act – and if we fall short, VMC loses money. Yes—this is a big deal. We also fund programs to keep patients from being re-admitted once they go home, another crucial measurement of the ACA.

Ensure every eligible child has medical and dental coverage

You likely know already that Santa Clara County was the first in the United States to offer health coverage for every single child. But that was 11 years ago, and since then county budget cuts have eroded this wonderful program. The VMC Foundation was part of the team (and the largest contributor) that campaigned and passed Measure A in November, which President Yeager confirmed generated enough funding to fully restore medical and dental services to each and every child in our county…what a huge victory!

Reduce the over-consumption of sugar-loaded beverages in our community

Again, you know this because I rarely shut up about it: The VMC Foundation is the fiscal sponsor of the county’s “Re-Think Your Drink” campaign and works to encourage kids and adults to drink more water, not soda.

Create a program to install hydration stations where kids and families gather

An extension of, and example of, “Re-thinking our Drink” in our communities – and an example of how good health originates not in a medical clinic, but where we live, work and play.

Expand HIV and STD testing programs

The VMC Foundation has raised tens of thousands to support the Positive PACE Clinic, part of the Health & Hospital System and the only county agency that provides testing, clinical and support services for residents living with HIV/AIDS. The PACE Clinic also conducts testing, and with the help of the VMC Foundation, led a huge World AIDS Day event last month to bring more awareness to the issues.

Perform developmental screenings of children during pediatric visits

This is a biggie for the VMC Foundation, as we run the Reach Out and Read Program at our Valley Health Center pediatric clinics—serving a quarter of all kids living in Santa Clara County. VMC’s pediatricians provide new books to young children, and as they present the books and the importance of reading to the parents, the doctors carefully assess how the child is reacting to the book. There’s a whole developmental screening model associated with Reach Out and Read, and yearly our team identifies lots of developmental delays that may otherwise have been missed. Great to see this as part of an expanding effort to catch developmental issues as early as possible.

To me, President Yeager’s goals had everything to do with public health in a very progressive sense of the term; not just preventing disease, but Better Health for All – which is the new motto of the Santa Clara County Health & Hospital System. I’d say “let’s get started”, but as you now know, we’re already off and running.