For the past nine months, I’ve interned with Archstone Foundation and learned about supporting community-based programs to address gaps in care for older adults in California. During this time, I’ve observed a grant cycle, seen how the Foundation supports community organizations for culturally competent whole-person care, and gained context to the philosophy of grantmaking and philanthropy.
While what I’ve learned far exceeds what I can summarize in a blog post, I will focus on two key ideas: the impact of policy change and what it means to invest in a community.
Understanding Policy Shifts
As a student at the USC Leonard Davis School of Gerontology, I abstractly studied policy frameworks that influence services for older adults in America, such as Medicare/Medicaid, the Americans with Disabilities Act, and the Older Americans Act. It was clear policy changes are slow and seem perpetually “catching up” to current needs. With Archstone, I directly witnessed policy changes affecting healthcare and social service providers’ operations, I became aware of how policy could induce operational and strategic shifts in organizations serving older adults. There is a slow-moving pace when looking at policy from above, but zooming in helped me appreciate how policy targets foundational assumptions and pushes affected stakeholders to reconsider service models.
One example is the Data Exchange Framework, a statewide data sharing agreement. I initially perceived it as having well-intentioned endpoints but failed to grasp the value of signatories without tangible implementation. During the first couple months of my internship, I researched the development of an electronic Physician Order for Life Sustaining Treatment (POLST) form registry in California, which altered my perspective on progress. AB 133, signed into law in 2021, allocated funding for a statewide electronic registry, enabling emergency medical providers to access patients' POLST forms anywhere. This understanding, coupled with attending the Coalition for Compassionate Care of California’s 15th Annual Palliative Care Summit, crystalized for me the importance of end-of-life discussions and documentation to provide person-centric care.
Synthesizing these experiences at the Foundation and my prior research clarified my misconceptions and highlighted the Data Exchange Framework’s role in advancing the POLST registry. It underscored that policies require evaluation within the context of existing and emerging legislation. Looking ahead, the implementation of California Advancing and Innovating Medi-Cal (CalAIM) is transforming organizational billing practices by modifying healthcare delivery to include community-based, whole-person care. Observing Archstone Foundation grantees’ and partners’ operational adaptations prompted by CalAIM highlighted the substantial influence of policy shifts.
Evaluating Community Investment
I've also been able to see the impact of philanthropic investment in bridging healthcare gaps. During the summer, I took a break from interning at Archstone Foundation to complete a summer intensive program through Girls Who Invest, a non-profit organization with a goal of diversifying the financial industry by teaching finance principles and placing college-age women and non-binary individuals into investing internships. During this program, I learned to evaluate investments by looking at investment fit (how well an investment aligns with an individual’s objectives) and financial return. When I restarted my internship with Archstone Foundation, I was able to find parallels and differences between investing in assets and investing in a mission.
A key difference is that Archstone Foundation does not expect monetary return from grantees – but instead seeks lasting impact in care delivery and supports organizations to bridge gaps in care for underserved populations. During my summer placement at a software-focused private equity firm, I learned that the firm selectively pursues investments aligned with its expertise and core values and may pass on “good” investments outside of their specialty. I saw a similarity to this when reviewing capacity building grants with Archstone Foundation. The Foundation’s “investments” (or grantees) were evaluated for their alignment with the mission and grant objectives – such as how capacity building funding could lead to increased sustainability in an organization at the grant’s conclusion, its connection to the Foundation's strategy, and the organization’s outcomes for older adults. Archstone Foundation can select grantees based on their fit with these values, and work toward impact instead of financial return.
One of my projects at the Foundation was a retrospective analysis on the result of its support of the Award for Excellence in Program Innovation through the American Public Health Association. As with investment research, I conducted firsthand research by interviewing a few previous awardees, which provided context to patterns I identified across the award’s history. I analyzed the award’s impact on organizations’ ability to serve older adults, which primarily stemmed from national recognition in securing additional funding and providing credibility when engaging with interested stakeholders. These project outcomes also informed future directions for the award program.
Financial return is easy to measure with numbers. When it comes to creating systems-level change and moving toward bridging social services and health care, success is not clear-cut, and each organization has varying capabilities. Pools of Hope, for example, used Archstone Foundation funding to build their internal capacity to bill Medi-Cal for occupational therapy services, allowing more low-income older adults to gain access to this type of care. El Sol Neighborhood Educational Center was also able to expand capacity by billing Medicare and Medi-Cal for community-based mental health care, sustaining their services in the Inland Empire.
Beyond grant funding, Archstone Foundation invests in the aging service ecosystem by fostering introductions and new relationships, providing guidance, and facilitating discussions. Recently, Archstone Foundation and California Health and Policy Strategies partnered to create a CalAIM Statewide Dementia Care Learning Collaborative, which will provide information sharing between community-based organizations for best practices in dementia care and guidance on building each organization’s capacity to partner with Managed Care Plans for these services.
Moving Forward
I’d like to give a huge thank you to all the staff at Archstone Foundation for welcoming me and sharing their perspectives as I continued learning about the Foundation’s work and mission. One of the key transferrable skills I have practiced is being deliberate and prepared, and the importance of understanding an organization’s values to guide curiosity. With Archstone Foundation conducting mission-driven grantmaking, everything I learned came back to the impact on older adults and their caregivers. As I finish my degree and begin working in the field, I will continue to bring these lessons and a community and organizational perspective to shape my insights.
