Through the Building Capacity for Health Advocacy RFP in 2019, the Rx Foundation made a three-year grant commitment of $150,000 per year to Alabama Arise, supporting efforts to increase the organization’s capacity and infrastructure for proactive organizing and advocacy for policies to improve the health and well-being of people in Alabama. Alabama has one of the highest poverty rates in the nation (16%) and is one of 12 states that have not expanded Medicaid. We were interested in Alabama Arise’s plans to bolster coordination between the grassroots table and lobbying table in the state, and in the review process it was noted that they are a “powerhouse racial equity group with impressive wins over the years.” The many dimensions of the grants’ impact underscore the value of investing in capacity building.
In 2018, Robyn Hyden became Executive Director of Alabama Arise, and in 2019 she started to build a coalition to champion expansion of Medicaid in the state. But the coalition was small, and she didn’t have sufficient staff to expand it. The Rx Foundation grant enhanced that capacity, and it leveraged $450,000 in grant funds from Community Catalyst Together for Medicaid. That funding in turn leveraged more support – $150,000 from CareQuest and additional funding from local foundations including the Community Foundation of South Alabama. That cumulative funding later helped leverage $250,000 in support from the Robert Wood Johnson Foundation.
The funding dramatically expanded the Cover Alabama initiative – within Alabama Arise – enabling it to have its own dedicated field staff, including a campaign director, an organizer, and a communications associate, among others. It also enabled the coalition to grow from 31 organizations to 118: health advocacy organizations, disease-specific associations, civil rights groups, disability rights groups, religious institutions, and others.
The coalition needed not only to grow but to be well-coordinated. Alabama Arise already had a fledgling grassroots group and a similar grass-tops collective, but their approaches could seem contradictory. The grassroots activists wanted to create public pressure; the grass-tops lobbyists did not want to jeopardize their relationships with elected officials. Trust had to be generated, so that the divide could be bridged for the success of the overall effort.
The staff and coalition had to be expanded – and the trust built – amid the COVID-19 pandemic, which prevented in-person team-building or meetings of any kind. Addressing that challenge was supported by additional coaching and training resources provided by the Rx Foundation. Alabama Arise benefited both from one-on-one coaching and from group (leadership) coaching.
The Rx Foundation also created a learning community of grantees in its Building Capacity for Health Advocacy initiative. That learning community enabled Alabama Arise to share its experiences and insights with peers and to learn from those peers as well.
In response to Cover Alabama, the State extended, on a pilot-project basis, postpartum Medicaid coverage from 60 days to one year – at a cost of $9 million per year. That’s a major achievement, as about 30,000 births in Alabama are covered by Medicaid annually, and many postpartum problems occur after 60 days. Cover Alabama continues to pursue overall Medicaid expansion.
The initial Rx Foundation grant triggered this extraordinary range of impacts and highlights the many benefits that can accrue from supporting an organization’s capacity building. Those benefits can have ripple effects that are ongoing and give lasting impact to a short-term grant.