2020 Annual Report

COMMUNITY ADVISORY COMMITTEE

HealthForward.org

HEALTH FORWARD FOUNDATION @HealthForwardKC

2020 AN NUAL REPORT

2020 ANNUAL REPORT

2020 WAS A YEAR LIKE NO

OTHER.

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2020 Annual Report

The COVID-19 pandemic, glaring health injustices for people of color, the economic downturn, racial unrest, and political polarization have all challenged our health, mental health, and livelihoods.

As I reflect on a year of great adversity, I’m proud to live in a region with so many caring and knowledgeable organizations who work every day to address inequities, provide quality health care, and create healthy environments for everyone in our communities.

At Health Forward, we remained deeply committed to ensuring our grantees, partners, and staff were equipped to stay healthy and provide services during this public health crisis. I’m proud to share this report of our accomplishments in 2020.

QIANA THOMASON President/CEO Health Forward Foundation

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PANDEMIC RESPONSE As COVID-19 prompted stay-at-home orders, we moved our operations to remote, and went to work evaluating funding needs that would naturally arise from the fallout of the pandemic. For our grantmaking, we converted current grants to general operating support, relaxed reporting guidelines, and awarded $ 3.7 million in emergency support to our communities.

This included child care scholarships for essential health care workers from safety net providers. We also advocated for policies to address injustices and we joined in a regional response to help with contact tracing and testing, as well as supporting a recovery fund to meet immediate and long-term health and household assistance needs.

MEDICAID EXPANSION We continued to advocate for Medicaid expansion in Missouri and Kansas and were elated by the August election results demonstrating that voters supported the passage of Amendment 2, which expands Medicaid in Missouri. In 2021, we will focus on protecting the will of Missouri voters to expand and implement Medicaid and continue to work with groups in Kansas to pass Medicaid expansion.

15 TH ANNIVERSARY AND NEW ORGANIZATIONAL DIRECTION In September, we hosted a virtual event to celebrate our 15th anniversary and shared a new direction for Health Forward that aims to achieve greater health equity through economic opportunity for the communities we serve.

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2020 Annual Report

EQUITY Health Forward deepened our commitment to equity by building a foundation of trust, accountability, and intentionality in our daily operations. Some of the steps we took included: • Identifying racial equity and economic inclusion as the greatest opportunities for achieving health equity • Developing a culture and inclusion officer position • Creating an internal culture and inclusion advisory group • Conducting an intercultural proficiency assessment for Health Forward associates • Participating in racial equity workshops • Initiating in-depth equity assessments of our policies, practices, and communications

LOOKING AHEAD Our work in 2021 is focused on an internal process of purpose alignment that explores various strategic paths at the nexus of health, economic wellbeing, and race equity. We expect our grantmaking to evolve, our partnerships to diversify, and our advocacy footprint to broaden.

Our partners and the community are informing our purpose alignment process. The work before us will not be easy. But it will result in more meaningful connections with our partners and a thriving region filled with healthy people in healthy communities.

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INVESTMENT RETURN Note: Approximately 10 percent of Health Forward’s portfolio is invested in private equity where fourthquarter valuations will not be available until the spring of 2021. For this reason, all numbers reported here are preliminary.

Health Forward’s investment portfolio returned 10.1 percent in 2020 or $77 million. This exceeded the portfolio’s benchmark return of 9.6 percent.

2020 was a volatile year for Health Forward’s investments. Unrealized losses during the first quarter totaled $114 million. At that point, our investments were valued at $697 million — only $36 million higher than our contributed capital of $661 million. Investments rebounded 26 percent in the last three quarters of the year with a preliminary, year-end investment value of $842 million — the highest since Health Forward’s inception.

Over a 10-year period, the portfolio earned an average annual return of 7.9 percent which is greater than our asset allocation targeted return of 7.1 percent, but less than the benchmark return of 8.6 percent.

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2020 Annual Report

STATEMENT OF FINANCIAL POSITION * 2 0 2 0

2 01 9

ASSETS Cash, Prepaids, Accounts Receivable

5,440,473

805,465

842,220,303

804,833,445

246,624

273,446

847,907,401

805,912,355

625,069

552,229

13,314,337

17,835,782

0

2,000,000

Current Liabilities

13,939,406

20,388,011

Contributed Capital Historical Value

660,620,188

660,620,188

Increase (Decrease) since Inception

173,347,807

124,904,157

Unrestricted Net Assets

833,967,995

785,524,345

Total Liabilities & Net Assets

847,907,401

805,912,356

Investments at Market Value Net Fixed Assets Total Assets LIABILITIES & NET ASSETS Operating Payables & Accruals Grants Payable Line of Credit

* Preliminary. Final numbers will be available at the end of May 2021.

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CUMULATIVE GRANTS ( IN MILLIONS )

TOTAL AWARDED: 317M SINCE 2005

$

30 26.4

$

25 22.7

26.7

$

22.6

$

$

20

21.1

$

20.3

$

18.0

$

15

20.2

$

19.0

$

17.8

$

19.3

$

19.5

$

20.6

$

20.9

$

14.6

$

10 5

0

6.8

$

2005 2006 2007

2008 2009 2010 2011 2012

EXPENSE SUMMARY

2013 2014 2015 2016 2017 2018

ADMINISTRATION 18 % GRANTS + GRANT SUPPORT 82 %

NET ASSETS Health Forward increased its net assets by $ 48 million in 2020 versus a budgeted increase of $18 million. Despite the pandemic and related investment volatility, 2020 was an excellent financial operating year and Health Forward met all stewardship goals.

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2020 Annual Report

2019 2020

STATEMENT OF CHANGE IN NET ASSETS *

2 0 2 0 2 01 9

REVENUES Net Investment Revenue

77,288,019

105,093,388

25

161,112

Other Revenues

1,715

26,018

Total Revenues

77,289,758

105,280,518

Public Support & Contributions

EXPENSES Grants

22,615,637 20,925,118

Special Initiative Projects

238,478

274,233

Grant Support

939,667

1,114,220

Operating Expenses

5,052,326

4,688,226

Legal – Extraordinary

0

43,219

Prior Period Adjustment

0

222,728

28,846,108

27,267,744

Total Increase (Decrease) in Net Assets 48,443,651

78,012,775

Total Expense

* Preliminary. Final numbers will be available at the end of May 2021.

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Funded 171 organizations Across 250 grants Amounting to $22.6 million HEALTHY COMMUNITIES 44 grants

$

3.4 million

Includes 14 pandemic response grants totaling $414,000

MENTAL HEALTH 45 grants

$

4.5 million

Includes 12 pandemic response grants totaling $455,264

SAFETY NET 28 grants

$

4.5 million

APPLICANT DEFINED GRANTS 79 grants

$

3.1 million

SPECIAL INITIATIVES 54 grants

$

7.1 million

Includes 15 Policy and Civic Engagement Grants totaling $1 million Includes 24 pandemic emergency funding grants totaling $ 3.6 million

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2020 Annual Report

2020 HIGHLIGHTS NEW CEO •H ealth Forward announced Qiana Thomason as its new president/CEO on Jan. 6, 2020.

•Q iana is a life-long Kansas Citian who has dedicated her career to the improvement of health and wellness across the region, with a special focus on communities experiencing significant health injustices.

•P rior to joining Health Forward, Qiana served as vice president, community health and health equity at Blue Cross and Blue Shield of Kansas City.

15TH ANNIVERSARY/ NEW VISION • I n 2020, Health Forward celebrated 15 years of partnerships that elevated the health of all communities in our region.

• I n her keynote address during the virtual event, President/CEO Qiana Thomason announced a new direction for the organization: a focus on achieving health equity through economic inclusion.

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EQUITY JOURNEY •H ealth Forward has long advocated that to achieve healthier communities, we must look to the root cause issues and social factors that are impeding health. This includes acknowledging and addressing the role racism plays in our society and its impact on philanthropic practices and norms.

• I n 2020, Health Forward established an internal team to identify data, measures, and process changes for increasing racial equity and access in grantmaking.

• I n April, Health Forward led an advocacy initiative in partnership with El Centro, the Urban League of Greater Kansas City, and 75 partners across Kansas and Missouri to urge both states to prioritize the collection and public dissemination of COVID-19 testing rates and results, contact tracing, hospitalization, and mortality rates — all disaggregated by race, ethnicity, and ZIP code.

• I n September, Health Forward convened a listening session with 17 leaders of color to learn more about philanthropic funding strengths and challenges for their organizations.

This candid conversation provided a valuable perspective that is informing our current and future work.

•A ll of these experiences are helping Health Forward build the foundation we need to fully integrate race equity practices into our culture.

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2020 Annual Report

MISSOURI MEDICAID EXPANSION • I n May 2020, Medicaid expansion advocates turned in close to 350,000 initiative petition signatures to place expansion on the November ballot.

•H ealth Forward supported “Yes on Amendment 2” campaign efforts, and ensured targeted communications reached the communities we serve.

•O n Aug. 4, Missouri voters expanded Medicaid to close to 230,000 people who previously fell into the coverage gap.

HEALTHY COMMUNITIES LEADERSHIP ACADEMY •2 020 marked the seventh and final year of the Healthy Communities Leadership Academy.

•S ixteen community members composed the 2020 cohort.

•H ealth Forward’s service area now benefits from having 100 health equity advocates trained in adaptive leadership who graduated from the academy.

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CENSUS • Health Forward participated in Governor Parson’s Missouri 2020 Complete Count Committee, numerous community presentations to raise awareness and call for action, and ongoing communication with community partners about census issues.

•W e also led mobilization for the 2020 Census through grants supporting a metro Kansas City complete count committee and contributed to a regional census equity fund partnership with several local philanthropies that provided two dozen grants to trusted community partners engaged in census efforts.

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2020 Annual Report

CENTER FOR EFFECTIVE PHILANTHROPY STAKEHOLDER SURVEY •C ustomized a survey that invited input from key community partners about Health Forward’s communication, priorities, and work.

•C ommunity partners see us as an organization that understands the key issues influencing health; advances a broader understanding of those factors; and understands local communities.

•H ealth Forward’s support of health reform and influencing policy is viewed as a strength.

Moreover, stakeholders see growing that role.

•W hen asked to list issues affecting health in our region, survey respondents named access to limited resources to meet daily needs such as housing, food, and transportation. They also named access to opportunity — including educational, economic, and employment opportunities. Respondents also identified racial equity, racial health injustices, and a broader focus on social determinants of health as priority topics for advocacy.

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LOOKING AHEAD PURPOSE ALIGNMENT •H ealth Forward will spend 2021 developing a new guiding strategy that centers our purpose, refines our focus, and deepens our impact by generating systemic solutions that address the conditions driving health equity.

•A s we continue to assess and refine our purpose, we will listen with humility and thoughtfully consider all input from partners to ensure our strategies reflect community priorities and address the root causes of health injustice.

EQUITY •H ealth Forward will prioritize and implement equity assessment recommendations.

•W e will operationalize and sustain best practices around diversity, equity, inclusion, and belonging •W e will provide race equity training, development, and capacity building for community partners.

COVID -19 RECOVERY •O ur recovery efforts will continue to focus on supporting the stability and resiliency of our partners and communities.

• T his includes equitable testing, tracing, and vaccination.

•W e will continue to support for COVID-19 vaccine communication efforts that effectively engage community partners and Health Forward’s target population.

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2020 Annual Report