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| ANATOMY OF THE SKAGIT COUNTY FLUORIDATION CAMPAIGN |
| GRANTMAKERS IN HEALTH THE PATH TO POLICY CHANGE: Practical Steps and Lessons from Health Funders |
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| As part of its continuing mission to serve trustees and staff of health foundations and corporate giving programs, on November 3, 2005, Grantmakers In Health (GIH) convened nearly 80 grantmakers and a diverse group of individuals with expertise in different types of public policy work to discuss the challenges and opportunities for health funders who seek to bring about change in federal, state, and local public policies. The program was designed to address funders’ desire to go beyond the basics of funding public policy work and to learn from peers and others about how to improve the effectiveness of their public policy efforts. It was structured as a series of small-group discussions on key topics including advocacy infrastructure, communications, community organizing, data development and analysis, evaluation, working with foundation boards, and working with policymakers.
Special thanks are due to those who participated in the Issue Dialogue, especially discussion leaders Tom David, Tides Foundation; Elizabeth Heagy, Center for Lobbying in the Public Interest; Susan Hoechstetter, Alliance for Justice; Lorez Meinhold, Colorado Consumer Health Initiative; Andy Mott, Community Learning Project; Delia Reid, Grantmakers In Health, and Steven Wallace, UCLA Center for Health Policy Research. Tracy Garland of the Washington Dental Service Foundation helped frame the discussion and inspire others with the story of her foundation’s work in Skagit County, Washington. Barbara Masters and Amanda Rounsaville of The California Endowment shared a new game, Move Your Issue!, developed by the foundation to train its program staff about strategies that can be used to move an issue through the policy change process. This Issue Brief synthesizes key points from the day’s discussion and highlights some of the stories shared. It builds upon previous GIH publications, including Strategies for Shaping Public Policy (2000) and Funding Health Advocacy (2005), and reflects GIH’s commitment to communicate with health grantmakers about the relevance of public policy to their work, create opportunities for grantmakers to learn more about specific policy issues, provide training and technical assistance to grantmakers, and connect grantmakers with strong interests in health policy to each other. Other aspects of GIH’s public policy work include raising the awareness among policymakers about the work of health philanthropy and building relationships with government agencies. Anne Schwartz, vice president of GIH, planned the program and wrote this report. Todd Kutyla, GIH communications manager, provided editorial assistance. Funding was provided by The California Endowment and the Missouri Foundation for Health. |
| Visualize a field of tulips. If it weren’t for the beautiful mountains to the east, you might think you were in the Netherlands. The Pacific Ocean lies to the west. You are in Skagit County, Washington, located in a rural area north of Seattle. Farming and fishing used to be the mainstay of the economy here but now it is rapidly becoming a bedroom community for those working in manufacturing to the south, and a retirement destination for others.
Anacortes is the largest city in Skagit County, best known as the point of ferry departures to the San Juan Islands. The water in Anacortes has been fluoridated for 40 years, perhaps because the mayor in the early 1960s was a dentist. But in the rest of the county, where 55,000 people live, the water supplied by the Skagit County Public Utility District (PUD) is not fluoridated. For the Washington Dental Service Foundation, the philanthropic arm of a major dental insurance company, beginning a campaign to fluoridate the water in Skagit County was a natural expression of its mission to improve oral health and built solidly on a track record of making investments in systemic change. The campaign in Skagit County began quietly in 2003, when the foundation’s board examined the risks and committed to a political and legal analysis. In this stage, consultants, working under contract, helped the foundation understand the political environment: both thematically, in terms of fear and mistrust of government and concern about individual rights as a deterrent to community action, and practically, in terms of who was in office and where these individuals might stand with respect to fluoridation. legal analysis confirmed that, while the PUD insisted it had no authority to make such decisions, the county commission could take such action. A second step was to use the foundation’s relationships to recruit local leaders. A family physician was identified to be the local face of the campaign; he was recently retired, with longstanding service to the community and political skills honed as past president of the state medical society. The foundation also assembled a local strategy group of concerned citizens from medical, dental, and public health backgrounds as well as those with other types of community service backgrounds. A campaign management staff was hired. Media training was conducted, and the community organizing phase began, as the strategy group went out and met with civic organizations throughout the county and asked them to take action. In time, 26 organizations, including the county medical and dental societies, endorsed the effort. The message of the campaign built on fundamental values: fluoridation is so safe and effective that we have a duty to share it with others, giving the entire community the benefit. During media training, the team learned to stay on message, rather than spending time responding to the views of the antifluoridation activists, and to voice their message with passion. The community organizing phase led to earned media including letters to the editor and op-ed pieces in the Skagit Valley Herald. Some members of the strategy group met with the Herald’s editorial board, the result being an unequivocal endorsement of the fluoridation campaign. The public fight had been engaged. In the summer of 2005, the public fight came to a head with a public study session of the county commission. Thirty-seven groups testified in favor of fluoridation including the medical and dental community, business leaders, the Head Start Parents Council, and others. By the time of the public hearing in August, the antifluoridation camp had mobilized. A fractious situation left county elected officials in an uncertain position. Who would pay? Would action lead to litigation? The story in Skagit County doesn’t have a happy ending...yet. The phase of final resolution and ribbon cutting lie in the future. But it illustrates, as Washington Dental Service Foundation CEO Tracy Garland commented, “that foundation resources can — in the form of staff, contracts, and grants — be used to unleash a powerful political force and to empower effective leadership.” |
| FLUORIDE FOR A HEALTHY SKAGIT: ADVENTURES IN PUBLIC POLICY GRANTMAKING Tracy Garland, CEO, Washington Dental Service Foundation |
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