How bi3 is Building On, and Building In, Trust
Bethesda Inc. is both founder of bi3, a dedicated grantmaking initiative to transform health in Greater Cincinnati, and co-sponsor of TriHealth, the leading integrated healthcare delivery system in Southwest Ohio. Since 2010, Bethesda Inc. has invested $50 million to transform and enhance health in Greater Cincinnati. Bethesda Inc. President Jill Miller shares how they practice Trust-Based Philanthropy to fuel success.
Bethesda Inc. began providing multi-year funding more than a decade ago when it launched bi3 – a dedicated grantmaking initiative to transform health in Greater Cincinnati. At the time, the trust-based philanthropy movement had not come into being, but our practice was already aligning with the core principles that drive it. bi3 is a small and mighty team, and over time, has adopted a more trust-based approach that has not only made bi3 a more effective funder, but also fuels our ability to collectively achieve our mission of transforming health for all people in Greater Cincinnati, and beyond.
Here are some ways we’ve incorporated a trust-based approach in our work:
Give Multi-Year, Unrestricted Funding
Ten years ago, we understood that in order to address deep-seated community health issues like infant mortality, we must fund new ideas and approaches to health and healthcare that fuel systems and culture change. Systems change requires years to plan, implement, test, refine, adapt, scale and sustain. Throughout the grant life cycle, we encourage our funded partners to think differently, take risks, challenge the status quo, and not be afraid to adapt and flex proposed outcomes along the way. We discovered that it is by learning and adapting that we can achieve things we did not think were possible when we started.
For example, in 2013, we funded an initiative called StartStrong with the goal of reducing infant mortality by 10 percent in Hamilton County, where Cincinnati is located. While the initiative did not reach this goal, the team learned a great deal and launched a number of initiatives developed in partnership with women, particularly Black women who are at highest risk for extreme preterm birth. bi3’s flexible funding supports the work of Queens Village, a community of Black women focused on changing not just racial disparities in birth outcomes but also the conditions that drive inequity in maternal and infant health. There is still a lot of work ahead, but this work has resulted in a 50% reduction in extreme preterm birth, and most notably Black pre-term birth, the leading cause of infant death.
Do the Homework
When Bethesda Inc. launched bi3 a decade ago, we asked potential funded partners to complete an cumbersome application, which required a significant amount of information, including their website, mission statement, board list, and IRS 990s —all of which are publicly available and easy to find. In recent years, we’ve moved the onus onto our team to find and research this information as part of our due diligence.
In the past, we relied strictly on typical communication vehicles (such as our newsletter and website) to market our Requests for Proposals (RFPs), which limited applicants to those whom we or our committee members knew and/or organizations’ development directors who stumble upon the funding opportunity. We now take more ownership to ensure RFPs are more widely distributed to better reach our most vulnerable communities and neighborhoods. For a recent RFP, we engaged multiple organizations and community voices to help in its design, and leaned on United Way of Greater Cincinnati, Urban League of Greater Cincinnati, and others to help us reach grassroots organizations and organizations led by People of Color which may be unfamiliar to us, but who are known to and trusted by those they serve. We are looking beyond our usual circles to identify organizations doing good work that may have been overlooked in the past.
To increase our understanding and diversity of thought, the small staff of bi3 works closely with BIPOC (Black, Indigenous, and People of Color) community partners and board members, to inform and guide our strategies.
Simplify and Streamline Paperwork
We want to be true partners. We seek to alleviate the power imbalance between funder and grantee and save grantees’ precious time and resources. We encourage community organizations to share their concepts with us before writing a proposal so we can explore the potential for funding. We also utilize letters of intent as a way to evaluate grant requests before asking for more detailed information in full grant proposals. All of this is done to reduce the burden on our partners and be respectful of the time and talent required to apply for grants.
For example, we structured our most recent RFP to streamline the application to just four key questions with the idea that we can follow-up with applicants to get additional information as needed. We focused on the information we needed to make funding decisions. We are also working with grantee partners to identify a few key metrics verses submitting cumbersome reports.
We are proud of the fact that we are moving away from paper reporting toward more personal communication. Rather than asking funded partners to submit monthly or quarterly reports, we schedule time by phone or (in pre- and post-pandemic times) in-person meetings. This allows a genuine conversation about recent successes, learnings and challenges. It positions us to be a true thought partner and encourages grantees to think differently and pivot based on learnings.
We try to minimize the burden of reporting on funded partners by accepting materials written for other funders. For example, our grantee partner Cradle Cincinnati submits regular reports to the state of Ohio and other funders, which they share with us. Like many funders, we have reporting templates that we use for our annual/semi-annual reports, but in some cases, we tailor the templates for specific grants – there’s no ‘one size fits all.’
Be Transparent & Responsive
Because of the entrenched power dynamic between funders and grantees, we work to create a more balanced relationship and center our partners as the content experts. We build trust by constantly reiterating our commitment to the success of the project and by sharing how bi3 has supported other grantees to learn from “failures” or pivot based on learnings. We are willing to flex and adapt as funded partners learn and grow in their work, and transparency is an important part of that process. We share what we see as strong points in the project, and where there might be opportunities for growth. There should be no surprises when we come together to discuss a project.
We acknowledge that trust takes time and that people don’t care how much you know until they know how much you care. Therefore, we are intentional about building more personal connections with funded partners by picking up the phone and actively listening and asking good questions about the ecosystem in which the grantee partner operates. This helps us better understand the players and factors impacting the work and identify opportunities to connect them with resources and others doing similar work.
Offer Support Beyond the Check
We work with our grantees to problem solve and connect them to resources. We share what we’re learning from other grantees and from the research in our funding priorities. We provide coaching and support for everything from proposal development to evaluation and sustainability planning. We always look for opportunities to share and highlight our partners’ work in our newsletter, blog, Learning Series papers, media features and presentations. We aim to lift up our partners’ work to other thought leaders both locally and nationally, often leading to recognition and other funding opportunities.
Solicit & Act on Feedback
This continues to be an area of growth for us. We have not done a formal grantee survey but constantly encourage our grantees to provide us feedback. At the end of every call or meeting we ask, what else can bi3 do to better support you? We include a question on the bottom of our reporting form that asks how we can better support grantee partners in the future. This is a principle we plan to direct more time and attention to in the future.
Build on Trust
To solve our community’s long-term problems, we need to take risks and fuel new approaches. As funders, this means trusting and supporting our grantee partners to do their mission-driven work and getting out of the way. At bi3, we bring in trust in another way, which is recognizing that an initiative’s success can take a variety of forms, including:
Achieving outcomes
Changing practices or ways of doing business
Building new collaborations or relationships
Generating learning
We encourage other funders to join us in finding new ways to lead with trust, and to see impact through a more expansive lens.