Philanthropy: The Government’s Tugboat with Community Health Acceleration Partnership

Featuring Wendy McWeeny, Director, Community Health Acceleration Partnership and Tammy Snyder Murphy, First Lady of New Jersey

Wendy: [00:00:04] To do this work. Ray. We can't just have private dollars doing it. The big money is in government, but government can be slow moving sometimes. And so the analogy is always like they're the big boat and they're trying to get into port and they know they got into port and eventually they will get there. But where the tugboat philanthropy can be, that tugboat that really helps direct a little bit here and a little bit there to get government into the right port, which for us is really deeply engaged with community. [00:00:38][33.1]

Tulaine: [00:00:46] You're listening to System Catalysts. Each week you will hear personal stories of change makers who are bringing more inclusive connective system level solutions to our most persistent challenges. I'm to Lane Montgomery. In this episode, Jeff Walker spoke with our guests Wendy McQueeney and Tammy Murphy. You might remember from last week's episode that to achieve large scale systems change, it is important to connect the needs of the community to government policies and programs. But often grassroots organizations and governments don't have enough funding or reach to make this a reality. This is where philanthropy comes in at Community Health Partnership, also known as Chat. They see philanthropy as a tugboat to the large vessel of government. CHEP is helping drive New Jersey's government closer to their goal to make the state the safest place to deliver a baby. And they do so by working in partnership with people and organizations from the communities most impacted by poor maternal health outcomes. In today's episode, we'll learn how with a common goal and the right partners, philanthropy can be the connective tissue between community and the government. [00:02:20][93.6]

Wendy: [00:02:23] I do feel really lucky that I grew up in a household with like a very strong commitment to social justice. [00:02:28][5.1]

Tulaine: [00:02:29] That's Wendy McQueeney. Chaps Director. [00:02:31][1.7]

Wendy: [00:02:32] My grandparents are all from Newark, New Jersey. My dad's business was in Newark, New Jersey. And yet, like many white families, frankly, my family moved out of north to the southern parts of New Jersey. But we're always very cognizant of the fact that eight miles separated us from a world that should not have been as different as it was. And so I always grew up with this feeling of this doesn't make any sense. You know, I'm living in the same state, in the same county. I have relatives in the city. But our outcomes, whether it was education or health, were so vastly different just because of the zip codes that we were born in. [00:03:18][45.8]

Tulaine: [00:03:21] Hoping to do something to address these inequalities. Wendy studied public administration at Princeton. But after getting her master's degree, she found herself instead at a consulting job. One of her clients was Philip morris, an international tobacco company. [00:03:35][14.2]

Wendy: [00:03:37] And was time when you could actually smoke in the Philip morris building? I remember thinking I was thinking my cubicle working and thought something was on fire. It was just my colleague across the way smoking. And so I had this moment of realizing this isn't what I was meant to do. I just recognized that the time for me and really wanted to get back to public service. And my dad, as I said, had a business in Newark, so he knew Chambers. [00:04:03][26.5]

Tulaine: [00:04:07] Ray Chambers is a philanthropist who currently serves as the World Health Organization's ambassador for Global Strategy. [00:04:12][5.8]

Wendy: [00:04:14] And I called him, as sometimes daughters do, in a panic, saying like, Dad, what have I done with my life? Like, I'm at a place where people are smoking around me and what I've learned I'm wasting. And he was really my father. It was an amazing, amazing work ethic. So when he said to me, Drop everything you're doing and leave. I was like, Leave work. Walk out the door, he said, and take the subway to Yankee Stadium. It's like, you're insane. But sure enough, he'd been invited to raise Richard Burr, also was that owner of the Yankees. And so I met my dad and Ray at a Yankees box for opening day. And instead of watching the game, Ray and I spent the entire time talking about Newark and about income inequality and education and urban economic development and some of our favorite scholars. And we had to do far reaching, but landing at a place where I knew I wanted to go work for Ray at the end of it. So, yeah, cinemas suck up letter after saying how much they admired. All very true. How much I admired him, how much I believed in things happening for a reason. I was like, My dad has never told me to leave work. I've never missed a day of work, but I did it and we crossed paths and I feel like there's something here. [00:05:29][74.8]

Tulaine: [00:05:30] Ray decided to hire Wendy to work on his family foundation. Part of Wendy's job involved leveraging money to reach the Millennium Development Goals. These were eight international development goals for the year 2015. Think of them as the prequel of the Sustainable Development Goals. [00:05:46][15.1]

Wendy: [00:05:47] And in the best things that Ray taught me is the importance of people. You know that you can have a great idea, but if you don't have the right leader and a leader who's willing to really collaborate, you weren't going to go anywhere. And it was the importance of leadership. It was the importance of leveraging dollars and using our phone traffic dollars catalytic glue. And then I think the other related systems piece for me, Jeff, was just the power of storytelling. We would go to some of these meetings and at one point I was helping with some of. The fund raising, you know, trying to get other philanthropies, but also sometimes governments interested in this work. And at first, we would go in and we would talk about, which really was a systems based approach to U.N. at the time, which was it wasn't just one vertical approach to poverty. It really was this system, that multivariable approach to trying to halve the number of people living in extreme poverty and the work of the Millennium Villages was to show in real time what it would look like if you funded these interventions. [00:06:50][63.1]

Tulaine: [00:06:56] The Millennium Villages Project goal was proving an approach to rural development. The project supported people living in extreme poverty and ten countries in sub-Saharan Africa. Its focus was on improving access to clean water, education, health care and sanitation. Part of Wendy's job was to mobilize philanthropic dollars to support this project. [00:07:17][20.8]

Wendy: [00:07:18] We went in there talking about, you know, strengthening health systems. People's eyes just glazed over. I mean, not the most exciting thing in the world, most important thing in the world, not most exciting. And that I'll never forget. After the Villages have been funded for a while, you know, maybe six months or so, almost a year. We got a photo from one of the first babies born since the start of you know, these were now villages that have increased seed and fertilizer. So bumper crops had started. Access to water. Malaria bed nets. Right. And it was a photo of a baby. And it was the first baby who had been born in this village who was at wait actually even above wait for the gestational period of that baby, which hadn't been seen in this village for a while. So instead, we started going to these meetings and saying, if you do this work comprehensively, if you resource the needs, all of the needs of these areas with the right leadership, you get that babies and people suddenly started getting what it then, you know, basically was the same thing this systems based approach to work but sometimes you that story in that visual. [00:08:32][73.8]

Jeff: [00:08:33] Those stories are so critical I think that's why you leverage a lot of that experience into community health and into maternal health. Back here in the States, you know, how did you feel about that kind of switched back to the US and domestic? [00:08:47][13.9]

Wendy: [00:08:48] So it's interesting because I was starting to really feel conflicted a little bit about my lack of proximity to these issues. And look, we all have distance, you know, sitting in positions of privilege. I don't want to pretend like I have that much more proximity to, you know, black women in New York at all. But being able to physically got places started to get hard for me. I should note I have four children and I live in a rural area. And just getting to Africa, the number of times I felt like I should a year was getting personally kind of hard. And so at the same time, many of us were starting to see the success we were having in sub-Saharan Africa felt like there were lessons we should be taking back to the U.S., right? I mean, the traditional approach has always been this like global Noor is coming in with all these clever ideas about how it's going to change the global South. And I think luckily enough of us got called out on that and recognized like, no, there's a lot of incredible innovation that's happening here that we need to learn from. And so I started looking also at the maternal health outcomes in our own country. [00:10:10][81.8]

Tulaine: [00:10:11] Even though New Jersey is one of the richest states in the country, it had the fourth worst maternal health outcomes. And black women were seven times more likely to die at childbirth than white women. [00:10:22][10.8]

Wendy: [00:10:23] In many of the communities in York where we are working. Their preterm birth rates were worse than Haiti, Namibia, Ghana, State of California, which has the largest number of births in the country every year. Did a study showing that upper income black women have worse outcomes than low educated, low income white women? I mean, talk about the need for assistance. Seems like this is systemic racism. People have tried for many years to say, oh, black women have higher rates of diabetes or, oh, it's education. No, we're controlling for all of those things. And we're showing that the heart of this is a medical system with deep, deep and not just medical system. Obviously, sadly, world where systemic racism is driving these poor outcomes. [00:11:11][48.0]

Tulaine: [00:11:15] Wendy had learned from her experience in sub-Saharan Africa that community health workers could care for patients more effectively. They had greater proximity to the challenges their people faced and therefore better knew how to find solutions. Hoping to bring this lesson home. Wendy pivoted in 2016 to building community health worker efforts in New Jersey. [00:11:34][19.0]

Wendy: [00:11:36] You need to have the right mix. You need to have the right ingredients. And I think one of the key ingredients is political leadership. And you can create that through advocacy, for sure. But in New Jersey, we were so lucky to have first Lady Tammy Murphy, who had already put it out there as her sort of lead issue, her raison d'etre. And so we found the perfect storm or confluence of good variables from her political leadership. The poor outcomes of red states. So we knew that there would be some philanthropic interest in this as well. But then also crucially, Jeff, I always think and I'm mad at myself for listing at last, but community input and strong community partners is going to be the biggest determinant, too. I mean, I just think that for too long we've had a little bit of a top down approach. And one of the things that we've really prioritized through our work in New Jersey is strengthening community based organizations and partners and that ecosystem so that it's really central to the work that's being done. [00:12:50][74.6]

Tulaine: [00:12:54] Wendy joined the Community Health Acceleration Partnership for Champ right around the time Phil Murphy became New Jersey's governor, bringing along his wife, Tammy Murphy. Champ has supported Tammy strategic plan, as well as efforts to establish a maternal and infant Health Research and Innovation center. They also helped develop a maternal health playbook for other governors to follow, hoping to extend their reach nationally. [00:13:17][23.3]

Tammy: [00:13:20] Infant and maternal health has been something that I have been working on since literally day one of my husband's first term. [00:13:26][6.3]

Tulaine: [00:13:27] That's Tammy. [00:13:27][0.3]

Tammy: [00:13:28] We're working on our sixth year now that we've been working on this scourge. And how did I get here? Pretty simply. Phil and I both saw some statistics about how New Jersey at the time when he first came into office, was 45th in the nation for maternal mortality rates. And given the fact that we not only are the proud parents of four kids, but we also live in a state that has some of the best health care in the world. It was inconceivable to us that this could be a challenge. And so it has been a labor of love and it's been something that's been a real conundrum for me. But I have great interlocutors, and without the partnership of many important organizations and just individuals out in the world, we would not have made any progress at all. [00:14:20][51.4]

Tulaine: [00:14:22] Tammy began tackling this issue by doing what great system catalysts do. Listening to the affected communities and everyone involved in the system. [00:14:30][7.8]

Tammy: [00:14:31] The one thing that I can do in the position I currently hold is I have the ability to convene people. And so for the first year, when I was trying to understand the challenges of correcting this horrible scourge, I went around the state and just literally met with as many people as I could and just listened, whether they were mothers, whether they were medical providers, doulas, midwives, insurance providers, I mean, health systems. It just ran the gamut across the state because I came into this assuming that the challenge was going to center on access to prenatal care. Just didn't occur to me that the real challenge was so entrenched and so generational and has been something that we've been working against for many, many years. But I also started day one, speaking with two departments and agencies within the administration. And I just assumed it should be children and families in Department of Health. Today, we have quarterly convenings with more than 22 departments and agencies within the administration because this is institutional racism. This is going to have to involve an entire systemic review and approach transformational change that would not will not happen unless everybody understands that we all play a critical role here in moving this ball down the field. So it's been really something that I have loved, and I have loved it only because I feel so passionately that we can fix this space. But it's not going to be any single person who does it. [00:16:08][97.1]

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Tulaine: [00:16:58] Since Tammy came into office, New Jersey has gone from being 45th in the nation for maternal mortality rates down to 36. [00:17:04][6.4]

Jeff: [00:17:06] One of the things, though, that people stumble over is reaching up and talking to government. They tend to be great NGOs that know all the answers or foundations willing to fund them or individuals or corporations even. But that government thing scares everybody. How do you advise people to kind of think about including government in a system change model? [00:17:23][17.3]

Tammy: [00:17:24] So I'm going to digress for one second because I want to just give you a little anecdote. My husband served as the US ambassador to Germany and prior to our moving over to Germany. Neither of us had really had any interface at all, at any level of government, beyond what most people do, which is, you know, paying your taxes, getting your driver's license, getting your passport. And so we kind of went in, I don't want to say biased, but probably with the same bias that most Americans have, and that is that government is, you know, this hulking organization that we spend too much money on government. And the people who were there are, you know, punching a clock, 9 to 5. And I will tell you, some of the most professional people I have dealt with have been in the US government. And if only the average person on the street could crack open the State Department or any single agency and really see the people, the quality of the people who are involved, the education level that they have attained, and the fact that these people are there because they want to make our country stronger and better in every possible way. So that's a that's a really long way of telling you that I think that government is an ally. Government is not the enemy. Government is something that can help make our world a better place. And there's a lot of people who are working in, whether it's, you know, state, county, federal, you pick it local administrations, too. They're not doing this because they're going to make a lot of money. They're doing this because they have a passion in some area and want to be able to help people. So if you go in with that assumption that you're dealing with logical people who really want to make the world a better place, make change in a positive fashion, I think you'll find that there's a lot of collaboration that can be done. And for an organization like Chap, you know, the power of philanthropy to scale what government does is unbelievable. So that would be my answer. Don't be shy. [00:19:30][125.8]

Jeff: [00:19:31] LEHMAN Yeah, and it seems to me that we have a lot of philanthropists listening to this and. They can be the seed corn, right? They can be the innovative funds that unlock the ideas that then can be talked about with government, with larger groups to help figuring out how to scale it 100%. [00:19:50][19.1]

Tammy: [00:19:51] That's exactly what CHOP has done since day one, and I could not be more grateful. The fact that we have been able to do many of the things that we have done. It's really because we've been scrappy and we've found great partners, particularly in the private sector, who believe in the work that we're doing and who want to partner with us. Otherwise we wouldn't have done anything here before. [00:20:12][21.0]

Tulaine: [00:20:17] In addition to using resources from the private sector, New Jersey's government has also prioritized maternal health in their budgets and policies. Wendy believes that this combination of philanthropy and government with a community focus is what can spark systemic change. [00:20:31][14.6]

Wendy: [00:20:33] I amazing colleague Frankel always uses this analogy of the tugboat, which I think is so apropos, which is, you know, to do this work, right? We can't just have private dollars doing it right. The big money is government, but government can be slow moving sometimes. And so the analogy is always like they're the big boat and they're trying to get into port and they know they got to go into port and eventually they will get there. But where the tugboat philanthropy can be, that tugboat that really helps direct a little bit here and a little bit there to get government, in this case government dollars into the right port, which for us is really deeply engaged with community. And so with the first lady, Tammy Murphy, there's an incredible work happening at the policy level, legislation that has unlocked tens of millions of dollars to go to things like home visitation programs for pregnant women, centering pregnancy, which is an amazing peer based group where women of similar gestational age are matched with one another. And so how do you take the work that's happening at that kind of higher policy level and make sure that it's getting to community based organizations who are leading that work on the front grounds? Right. So local churches, women's groups, you know, nontraditional partners, sometimes, you know, housing authorities that are sponsoring groups of women to work together around pregnancy, really building capacity in those community based organizations, we felt made a big difference. And I think we see ourselves as philanthropists as that connective tissue almost. Right. Like connecting the policy work up here and then the community work that's on the front lines. [00:22:28][114.8]

Jeff: [00:22:29] But as you did with Ray, you used a little bit of money to unlock a whole lot of money and a whole lot of energy and action, right? Yeah. And so how do you keep it all going? You know, how do you become that catalyst that holds that action together, that allows that leverage? [00:22:45][16.3]

Wendy: [00:22:46] Well, you have to have a lot of friends, good friends. I think we don't want to go this alone. We did two things. I think that helped a lot. First thing is we funded what was called the Nurture New Jersey Strategic plan. And I think when you have a lot of people working together on something, having a shared roadmap and agreed upon goals is crucial because left our own devices. Ray, I have an idea. You have an idea? People come with all the best intentions, be running around to bet. And so if we can coordinate and harness that energy towards a shared plan with very tangible, ideally quantifiable goals, that's the ideal. And so we funded what's called the New Jersey Strategic Plan. [00:23:33][46.7]

Tulaine: [00:23:35] The New Jersey Strategic Plan is Tammy Murphy's initiative. It is a blueprint to reduce New Jersey's maternal mortality by 50% over five years and eliminate racial disparities in birth outcomes. [00:23:47][11.0]

Wendy: [00:23:48] And so with that, we were able to rally other funders. You know, it became this kind of locus for us to all get around and get behind. And I think without that, it would have been a little tricky. Right? So having the nurturing New Jersey road map gave us an opportunity to come together. So we, along with Nicholson, created the New Jersey First Equity Funders Alliance, also with the Brook Foundation, the TAB Foundation, and the Robert Wood Johnson Foundation. And we're just it's a great group. We've had another partner come on, a pharmaceutical company called Organon. And again, I think this group is learning together. We're really listening. What are the needs of the community? [00:24:31][43.2]

Tulaine: [00:24:32] These organizations came together to form the New Jersey Birth Funders Alliance, aiming to advance community based solutions to maternal mortality and birth equity. [00:24:42][9.2]

Wendy: [00:24:43] We recognized that we wanted to have this work locally led, and so we hired an amazing director, Cecile Edwards. She's a woman from New Jersey who has done a lot of community organizing. She's now in charge of and leading the New Jersey Birthed Equity Funders Alliance, along with input from all of us. To me, when we're doing this, learning from the community, it can't just be extractive, you know, We have to then make sure that's being heard by policymakers so that the next set of policies are really in. Formed by the voices and experiences of the women that we're working with in community. [00:25:21][38.8]

Tulaine: [00:25:23] This is why these funders have a community advisory committee, a group of people proximate to those most impacted in New Jersey. [00:25:30][6.5]

Wendy: [00:25:30] And they have a pool of half a million dollars, which they determine how it will be used by organizations it will go to. So it's I think now people are calling this trust based philanthropy. I think that's so much easier to do or efficient to do together. Right. I think all of us, all of the foundations have been able to take a little more risk and do this work, which is really important to gather and giving the kind of trust that should have. And I like to think was there all along, but making it more explicit by creating this fund that community members themselves will determine. [00:26:10][39.5]

Tulaine: [00:26:12] These community led efforts are showing results in 2022. New Jersey was one of only four states in the U.S. that improved preterm birth rates, a key indicator of maternity health for Tami. That kind of progress begins with collaboration. [00:26:27][14.9]

Tammy: [00:26:29] I think there's a lot of people who have ideas, and I would say no matter what you think about your own idea and what you think the solutions are to that idea, my best advice is to go out and listen to her, go out and talk to as many people as possible, because I think what I found is not only were my assumptions in need of resetting on the one hand, but also there are a lot of people out in our space who are doing things, who are trying to be changemakers, who just don't have the platform or have the partners to enable them to succeed. So one thing that's happened with us is we've found incredible ideas, incredible people who are working in the infant maternal space, who really were working in silos and being able to break down those silos, bring people together, share best practices, and just collaborate with other people. That's the most important aspect for me. And it's also very fulfilling because when you find someone who shares the passion, you have double the energy and if you find two people, then you're going to have even more energy. And it's been really great for me, and I think that's the only way forward is we have to work together. [00:27:43][73.7]

Tulaine: [00:27:44] Wendy hopes implementing measures like this will help make philanthropic efforts less necessary in the future. [00:27:50][5.5]

Wendy: [00:27:51] At the end of the day, it's kind of like philanthropy to not be needed, right? Like, you know, in the ideal world, gosh, government has the money it needs and people, the things that aren't rights or thought of as rights, like the right to health care, the right to housing, the right to income. You know, I think there will be a day where maybe we don't need quite as much philanthropic work. But until then, I want us to continue to be that tugboat, you know, continue to be that connective tissue, ensuring that partners are all working together and that our government leaders and our local departments of health have the support they need. And crucially, those public dollars are getting to the strongest community based organizations, bipoc led organizations, and that we're helping to build capacity in those community based organizations so that they can make a difference. [00:28:49][58.4]

Tulaine: [00:28:53] And now our Rapid Fire segment. [00:28:55][1.8]

Jeff: [00:28:59] What's one word to describe your journey as a system catalyst? [00:29:02][2.8]

Wendy: [00:29:03] Intense. [00:29:03][0.0]

Jeff: [00:29:06] What's been one of the most gratifying moments along this journey? [00:29:08][2.2]

Wendy: [00:29:09] Friendships. I love our team so much. They're friends. [00:29:13][3.5]

Jeff: [00:29:14] What about your organization that keeps you up at night? [00:29:16][1.7]

Wendy: [00:29:18] Oh, the sustainability. You know, we are hiring community health workers with COVID dollars that we know are time limited, and we're not helping states do the hard work they have to do to sustain that workforce. And now people in the very communities where we're trying to build trust are losing their jobs. And that keeps me up at night. [00:29:38][19.9]

Jeff: [00:29:39] For listeners who aspire to be a system catalyst, you know, where and how do you think they should start. [00:29:43][4.5]

Wendy: [00:29:45] Community work or government work through osmosis? I'd like to think, glean some experience, but go be in a system and see what that's like first. And then I think you will have an education that will serve you well as you become an orchestrator. [00:30:04][19.2]

If you want to learn more about CHAP, head over to chap.health