Regionalization and Systemization in Philanthropy

By Betsy Chapin Taylor, Accordant Philanthropy

The health care field is changing. Hospitals are partnering with other health care providers and experimenting with new ways to create centers for excellence, as well as better integrate care within the community. By finding non-traditional ways to move care into communities, hospitals become more accountable and patients can experience improved wellness, expanded services and access to even better quality care. These activities can also involve mergers and acquisitions. These changes can affect areas of the organization responsible for advancing philanthropy.

As philanthropy organizations consider reorganization, it is important to articulate common rationale for change:

• Strengthen fulfillment of the organizational mission

• Improve efficiency and effectiveness of fund development

• Consolidate non-donor-facing activities (i.e. data management)

• Share specialized talent and resources

• Leverage human and budget resources

• Capture a broader view of donor engagement

• Share boundary-spanning funding opportunities

• Drive standardization in development practice

• Enhance the donor-centric experience

• Diminish duplication and/or competition in donor engagement

To pursue integration, leaders must consider the legal structure of existing philanthropy entities. Health care organizations currently utilize several legal structures to advance philanthropy work, these include:

• Philanthropy department: Uses health care organization 501(c)(3) status

• Foundation: Separate 501(c)(3) public charity

• Foundation: Affiliated 501(c)(3) supporting organization

Of the structures above, both separate, 501(c)(3), public charities and affiliated, 501(c)(3), supporting organizations are led by a foundation board of directors with a legal governance responsibility, while an internal development department generally engages leadership volunteers through a development council or advisory board.

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