How We Work

We don’t just observe and advise. We design and build with our clients and their partners to help them build a multisector table, develop the capacity for sustainable initiatives, and gain financial stability.

Sharing Resources and Knowledge

Cross-cutting Issues

To enable communities to realize their visions for health and wellbeing, multiple issues must be addressed. 

Overall systems issues

Lack of a long-term view in terms of projects, capital, and financial sustainability. Grant and government funders want “shovel-ready” projects, but the infrastructure in communities to create such projects on spec is missing or expensive. The due diligence processes may also be unclear.

Lack of scale underserved communities tend to be small (<10,000 people) with few specialized skills or spare capacity.

Service deficits especially in social determinants of health-linked (SDOH) services, such as food deserts, adequate housing, quality schools, job opportunities, and safety. 

Relationships & interactions

Lack of relationships with leaders/power brokers in government, large local organizations such as hospitals, health insurers, or private businesses.

Shifts in power dynamics: changing the status quo and sharing power with community members may be uncomfortable.

Few ways for disparate groups to interact and build sustainable trusted collaboratives to identify a shared vision and priorities, and reach shared goals. Many communities that have created successful collaboratives, but the “sustainable” piece often remains elusive. 

Funding & capital

Communities lack access to capital—they need access to credit & lenders (banks) and the know-how to create and sustain legal entities that manage/mitigate risks to lenders. They have little access to grants or private funding.

Grants are restrictive and usually time-limited—not a reliable source of ongoing support.

Grant funders tend not to be investors—they look for different things in what they fund than investors do.

Governments can’t directly access private funding—it requires working through intermediaries such as public-private partnerships.

Investors requirements don’t match community offerings—they want clear risk profiles. Communities’ needs don’t easily translate into standardized investment vehicles and addressing community priorities may not provide the financial returns investors seek.

Impact investors require additional, difficult-to-create information—they want specific (nonstandard) investment opportunity characteristics, reporting, and risk profiles. 

Data, information, & skills

Poor data that can’t support analysis of problems, targeted solution provision, nor provide evidence of impact. Examples include siloed healthcare data not integrated with SDOH data; lack of accurate broadband maps.

Lack of information that funders require for their due diligence, risk management, repayment schedules, and other contracts.

Lack of affordable professional expertise and business skills in the community such as contracting, legal, fundraising, risk management, software development, data analytics, business case development, proposal writing, investment, and project management.

Sustainable collaboratives provide the infrastructure to address these issues through community-based and -led initiatives and enable flexible financing strategies that reduce dependance on restrictive grants.

We help our clients

Our process begins with understanding our client’s community context and existing organization. Depending on needs, we can customize work on any or all of three phases of building a sustainable collaborative.

Clarify their vision

  • Facilitate analysis of governance/ partnerships, data/ analysis, capital/ finance, administration, and integration
  • Identify needs & assets

Codesign robust models

  • Codevelop and test conceptual designs
  • Build pathways from concept to scale
  • Supplement and build internal capacity

Facilitate implementation

  • Blueprint future-state
  • Develop operational plan
  • Integrate flexible financing strategies