With contributions from Kimberly McPherson & Abena Asante.

St. David’s Foundation (SDF) invests in improving the health and well-being of residents in the five-county area around Austin, Texas. SDF has grown significantly during the last decade, enabling it to make larger and more significant investments in the local health infrastructure. During that period, a number of changes to public health insurance also occurred, including passage of the Mental Health Parity and Affordable Care Acts. This growth in Foundation resources and new opportunities in the healthcare landscape prompted SDF to start investing more thoughtfully to ensure that its grants were complementing rather than duplicating the services funded by public insurance.

SDF also realized that there was a need to strengthen grantees’ capacity to take advantage of the expanded insurance options now available to many of their clients. By having the close relationship with grantees made possible in place-based, long-term funding, SDF found that many grantees were providing services covered by Medicaid and other public insurance coverage, but lacked the expertise on how to effectively bill for these services. Equally importantly, many grantees lacked the knowledge necessary to help their clients secure the health coverage they were eligible for and entitled to.

In response, SDF engaged in a number of activities, all designed to fully leverage existing coverage in Medicaid and other insurance options. These included:

  • Requiring grantees to provide their uninsured clients with information about coverage options under the ACA and resources to help with enrollment,
  • Funding ACA insurance navigation resources for the local area,
  • Hosting and facilitating a number of grantee forums to better explain the public benefit landscape,
  • Developing a local conference to highlight the advantages to low income clients and the organizations that serve them of the new benefits within the ACA and MH Parity Act, and
  • Convening and funding in-depth training for a cohort of grantees committed to increasing their capacity to bill Medicaid and other insurance more successfully.

While SDF has not yet engaged in activities to directly change policy, (e.g. advocating for Medicaid expansion or preserving the ACA), it has found ways to increase coverage within the existing policy framework. These activities will hopefully create immediate benefit for individuals and the non-profit organizations that serve them, while giving SDF deeper visibility into the mechanics of publicly funded health coverage.