The Healthcare Anchor Network (HAN) defines three core strategies for anchor institutions and collaboratives to maximize their impact in the community: Impact Workforce, Impact Purchasing, and Place-based Investing. Taken together, these strategies form the core of the anchor mission framework. This framework activates what we believe are the anchor institutions' most powerful assets for equitable economic development: their workforce, supply chain, and investment portfolio. As anchor institutions intentionally shift to more equitable and local hiring, purchasing, and place-based investment strategies, they can generate positive, often transformational, impacts in the form of increased economic opportunity and capital flowing into their communities.
Historically, organizations have operationalized these core strategies within their individual institutions. This section describes the core concepts and rationale behind the three high-impact anchor strategies recommended by HAN, and provides examples for how groups of anchor institutions, in partnership with the community, can scale anchor strategies together. Even at the individual-organization level, all anchor strategies require both a shift in institutional practices and strong community partnerships. Section 3.4: Collaboration with Community provides practical guidance for anchor collaboratives to center community priorities and work effectively and equitably with community partners.
While this playbook does not dive deep into the implementation of each strategy, the core anchor strategies and sample goals are briefly introduced here, and readers are highly encouraged to utilize the numerous case studies and other Resources for the Anchor Mission developed by HAN, including a dedicated toolkit for each anchor strategy, linked at the end of each section.
Core anchor strategies
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Impact Workforce strategies connect residents of local, economically-disadvantaged neighborhoods to quality jobs and career development opportunities, and build financial stability for employees within the anchor institution.
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Impact Purchasing strategies support spending with local, diverse, and other high-impact (e.g., employee-owned) businesses who reflect the socio-demographic diversity of their community, and help to incubate new community enterprises to fill gaps in anchor institutions’ supply chains, thereby driving local economic growth.
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Place-based Investing strategies are an impact investment approach that generates positive social and economic impacts in historically disinvested communities and geographies, while achieving a modest financial return or at least preserving the principal of the investment.
These high impact strategies are reinforced by a set of complementary strategies around policy advocacy, community giving, land and real estate, and skills-based volunteering. These complementary strategies are summarized in Section 2.4 Complementary Anchor Strategies.
Aligning anchor assets with community priorities
The table below offers examples of how anchor collaboratives can activate their institutional assets in alignment with community priorities and in partnership with community groups. For further guidance on building effective community partnerships, see section 3.4 Collaboration with Community.
Community priority → |
Anchor institution priority |
Anchor institution assets → |
Community partner(s)*→ |
Anchor collaborative strategy |
Increase employment and career pathway opportunities. |
Address workforce shortages and retention issues; strengthen diversity, equity, and inclusion. |
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Preserve or increase supply of safe, affordable housing. |
Address issues related to housing access and affordability facing employees, patients, clients, or other key stakeholder groups. |
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Support women-,minority-, employee-owned and other high impact businesses. |
Create a resilient supply chain. |
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Close the racial wealth gap. |
Address workforce retention issues; strengthen diversity, equity, and inclusion; improve community health and well-being. |
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Increase access to fresh, affordable foods. |
Address social determinants of health in its communities caused by the lack of healthy food. |
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Promote physical activity, and access to safe and reliable transportation. |
Address transportation issues and long, unreliable commutes facing workers, patients, clients, or other key stakeholder groups. |
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2.1 Impact Workforce
When done well, Impact Workforce strategies should help accomplish broader workforce objectives to address worker shortages, reduce turnover and recruitment times, and create a better prepared staff that is reflective of their community.
Impact Workforce strategies are defined by three core approaches: outside-in, inside-up, and institutional commitments.
Outside-in
Outside-in strategies prepare residents experiencing barriers to employment for jobs at anchor institutions by offering training and skill development, and providing specific entry points for these candidates. Traditional hiring practices are often designed to whittle down the applicant pool, hindering the consideration of applicants with backgrounds or experience deemed nontraditional by the employer. By partnering with community-based organizations, workforce intermediaries, and education providers to create intentional, outside-in pipelines to hire, anchor institutions can improve the efficiency of their own recruiting and hiring processes, and expand employment opportunities for residents who may face barriers to hire. Examples of outside-in strategies range from providing job training and support services to residents, to cohort training programs focused on high-need positions, to paid “earn and learn” programs and apprenticeships.
Anchor institutions should identify where additional recruitment efforts and training programs are needed to develop a targeted and impactful workforce strategy that aligns with the hiring needs of hospitals and the job seekers in the community. Rather than seeing similar job needs as an area of competition, anchor institutions can collaborate to implement training programs that prepare residents for jobs that are needed by all participating institutions. This can help to shift the mindset from fighting for the same employees and driving up costs for employers, to creating a more sustainable talent pool that all institutions can draw from. In addition, implementing shared training and cohort programs can generate cost efficiencies when the program and staffing costs are split across multiple institutions.
For example, Cleveland-based health systems University Hospitals, Cleveland Clinic, and The MetroHealth System—all members of the local Healthcare Sector Partnership—partner with Towards Employment, a nonprofit workforce development organization, to implement a Career On-Ramp initiative that prepares local residents for entry-level roles in nutrition services, patient transport, and more. Participants receive training in soft skills, professionalism, healthcare work culture, and interview skills, and are guaranteed an interview upon successful completion of the program.
Key partners in developing sustainable talent pipelines:
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community-based organizations
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workforce intermediaries: public or nonprofit organizations that help connect residents to job opportunities and provide wraparound services
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education providers such as community colleges and vocational and technical schools
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job placement agencies or community-based organizations that offer job search and placement services
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workforce investment boards: regional entities that direct public workforce development programs
Community-based organizations and workforce intermediaries can help connect residents to jobs through training and wraparound support such as childcare and transportation assistance, and they often have established ties and relationships with specific populations—such as justice-involved individuals—that anchor institutions may not possess.
One way to leverage these partnerships is to create a shared resource or information clearinghouse to make it easier for local residents to find job openings at participating anchor institutions. Information about job opportunities and career pathways at participating organizations can also be shared through in-person events such as job fairs. For example, members of the St. Louis Anchor Action Network (STLAAN) use an outside-in strategy to reach residents across 22 zip codes in St. Louis city and county that have been impacted by more than a century of systemic economic, racial, and spatial inequities. STLAAN hosts career expos and hiring events, utilizing an online platform designed to connect residents of these geographies to open positions within the participating hospitals and universities. As of 2023, more than 50 residents of the focus zip codes have been hired into positions at anchor institutions as a result of such events.
A comprehensive outside-in strategy should include intentional pathways into entry-level jobs as well as jobs that require certifications or continued education (less than a bachelor’s degree). Many anchor institutions partner with training providers and education institutions to subsidize the costs of education, training, and credentialing for specific roles. For example, University Hospitals in Cleveland, Ohio, partners with New Bridge Cleveland, a community-based training organization, to implement a training program for Sterile Processing Technician roles, available to residents of Cleveland’s Greater University Circle. Training is offered at no cost, and participants are prepared to sit for a certification exam following completion of the program. In New Hampshire, Dartmouth Health partners with Colby-Sawyer College to implement an apprenticeship program for the Pharmacy Technician role, which requires an associate’s degree. Participants earn an hourly training wage and college credits towards an Associate of Science in Health Science, and upon completion of the program, are transitioned into full-time roles at the health system.
Steps for getting started on an outside-in approach:
- Below are factors that the anchor collaborative should contemplate when planning an outside-in strategy that focuses on access, opportunity, and targeted outreach, to ensure that no one is left out of the economic potential of roles at anchor institutions:
- Conduct a landscape analysis to understand the pain points in hiring and retention across the anchor institutions, and identify what could be positively impacted by a coordinated Impact Workforce strategy with intentional pathways to hire, such as paid internship programs and earn-and-learns for high-need roles.
- Measure your workforce baseline. Anchor institutions can examine application and hire rates across demographic groups, starting wages for new hires, retention rates, employee satisfaction, and the time and costs associated with recruitment and training. Further detail on sample metrics is included later in this section.
- Implement a targeted cohort training model for specific high-need positions shared by participating anchor institutions, and foster partnerships with local education institutions and community organizations to cultivate a talent pool that can meet employers’ needs.
Inside-up
Local hiring initiatives do not end at the moment of hire. Inside-up strategies help entry-level and other incumbent employees reach their full potential through accessible learning opportunities, job coaching, wraparound support, and clear pathways for career advancement within the institutions. Collaboratives can collectively employ or share career coaches who help new and current employees across anchor institutions understand and recognize career development opportunities. Anchor institutions might cross-promote opportunities for advancement that arise within their peer organizations, or open internal training opportunities to staff at other anchor institutions.
Building an internal culture that encourages all employees to envision long-term careers with space for advancement is an essential strategy for retention and can help anchor institutions meet organizational goals for diversity, equity, and inclusion. Internal career pathway programs that help employees to advance professionally in the organization include: bridge skill-building programs, apprenticeships or other earn-and-learn programs for current employees, short-term certification training, soft skills training, English and literacy programs, among others. Key to retention is regular communication with entry-level and incumbent employees about training and education opportunities available to them, as well as wraparound services that can help them to address issues such as transportation and childcare.
One of the benefits of the inside-up approach is that it can create a measurable impact on employment and wages in particular neighborhoods by supporting lower-wage employees’ movement into higher-paying roles. These efforts can help to improve the overall health and wealth of the community by increasing economic security and resilience over time. In order to further sustain the investment in their employees and communities, leadership across members of the anchor collaborative should help employees achieve financial stability. Anchor collaboratives can establish financial assistance funds or provide services to help lower-wage employees achieve financial security and avoid taking on debt. Examples include tuition advancement for degree or certificate programs (prepaid financial support for education), or creating cohort training programs for specific positions within anchor institutions.
Steps for getting started on an inside-up approach:
Below are considerations an anchor collaborative should contemplate when creating pathways for career advancement and increased retention:
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Provide new entry-level employees with job coaching and mentoring for professional career development and support navigating various systems that may be unfamiliar.
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Offer tuition advancement or grants to entry-level and incumbent employees for certification and skill-building programs (such as English or literacy classes, college preparation, medical coding, patient care, etc.).
Embedding institutional commitments
Embedding institutional commitments involves advancing systemic change in hiring and workforce systems to eliminate bias in hiring and advancement and build an organizational culture of belonging. Collaborative members should complete a comprehensive assessment of their organization’s internal policies, practices, and culture to determine the extent to which they promote accessibility, racial equity, and inclusion. Actions to shift organizational practice and culture into alignment with the goals of Impact Workforce strategies include:
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Edit job descriptions to remove unnecessary education and experience qualifications.
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Educate hiring managers and supervisors about more inclusive hiring through skills-based hiring.
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Ensure hiring practices and processes are inclusive and transparent (e.g., accessibility of job postings across diverse applicant groups, clear application instructions and user-friendly portals, diverse interview panels, and standardized application processes).
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Engage talent and development and benefits teams within human resources departments to market initiatives that promote employee advancement and parity in benefit utilization among employees.
Anchor institution staff from human resources, talent acquisition, community engagement, and diversity and inclusion teams play vital roles and should proactively collaborate to create organizational accountability (e.g., creating shared performance indicators). Internal buy-in from executive leadership, hiring managers, and supervisors can build a sense of ownership and active participation in inclusive, local hiring initiatives and drive success as these initiatives become integral components of the organization. When executing upon these different components, collaboratives may choose to create and engage working groups that can manage goal setting, strategy development, and collective impact outcomes for each aspect of impact workforce efforts. This is discussed further in section 3.3 Effective Governance.
Assessing Internal Hiring Barriers, The South Florida Anchor Alliance (SFAA)
SFAA sought to understand systemic barriers and implement changes to hiring policies to advance racial and economic equity within anchor institutions. Following an internal review of policies, anchor institutions identified the following barriers: hiring websites were not user-friendly and applications were difficult to complete without assistance, especially for those without internet or computer access, or by individuals who did not speak English as their primary language; obtaining letters of recommendation from previous employers was challenging; and requiring candidates to pay for background checks was an added and unnecessary barrier. In response, one anchor institution is building a new user-friendly hiring platform that addresses these barriers, with the hope of modeling this structure as a best practice for others to adopt.
Anchor collaboratives’ impact workforce efforts have predominantly focused on outside-in strategies—partnering with job training programs and community-based organizations to prepare and recruit residents for quality jobs at anchor institutions. Some collaboratives have embedded inside-up and systems change strategies within their organizations as well.
Sample metrics for Impact Workforce strategies
It is beneficial for anchor collaboratives to establish a starting point and targets for monitoring Impact Workforce strategies (see section 3.6, Quality Data and Impact Measurement for more information on approaches to data collection and measurement). Below, we provide examples of specific and measurable metrics that health systems and anchor collaboratives use to track their impact workforce strategies.
Example baseline metrics:
Requires submission of two data points:
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Total number of employees across anchor institutions by race, ethnicity, and gender.
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Number of those employees earning at or above the MIT Local Living Wage for a 2-Adult (Both Working), 1-Child Household by race, ethnicity, and gender.
Why the Healthcare Anchor Network (HAN) uses the MIT Living WageWhile no single indicator can comprehensively account for the complexity of real world phenomena, the MIT Living Wage is a robust and reliable tool for estimating the local wage rate that a full-time worker requires to cover the costs of their family’s basic needs where they live. The MIT Living Wage calculator was chosen for its geographic availability (estimates are available for all US counties, metropolitan statistical areas, and states), regular and ongoing publish cycle (annually recurring to track over time), conservative household budget items (does not account for entertainment, restaurant meals, vacations, and other leisure activities), and its ability to calibrate for household size.
Example Impact Workforce goal:
Definition(s): Impact Hires are individuals hired from historically under-resourced communities or through community-based hiring programs, into jobs that require less than a bachelor's degree, pay a living wage, and offer benefits including health insurance, paid leave, retirement benefits, stable schedules, and growth opportunities.
Important note about Disaggregation: For each anchor strategy, the goal is for members of the collaborative to report data that is disaggregated by race, ethnicity, gender, and other socio-demographic measures that reflect the collaborative’s commitments to racial and economic equity. Stated best in the Racial Equity Toolkit by the Collective Impact Forum: “Disaggregated data can help you see how different groups are doing relative to your goal and help you tailor efforts to meet the needs of different populations based on your understanding of how structural forces impede on the opportunities of some groups and accelerate it for others.”
Anchor institutions may not have systems that are set up to collect data at this level of granularity. Indeed, the effort to collect disaggregated data is a significant endeavor that is consistent with the collaborative's (and HAN's) intentions around positive systems change. While the collaborative may not be able to collect disaggregated data from its members right away, putting it forward as a goal helps provide a unified point for the group to work toward.
Examples of Impact Workforce strategies by anchor collaboratives
[29] Chetty et al., “The Association Between Income and Life Expectancy in the United States, 2001-2014.” JAMA 315, no. 16 (2016): 1750, accessed February 1, 2024, https://doi.org/10.1001/jama.2016.4226.
[30] University Hospitals: The Evolution of Step Up to UH and Earn-and-Learn Programs (Healthcare Anchor Network), page #3, https://healthcareanchor.network/wp-content/uploads/2023/08/University-Hospitals-Hiring-Training-Case-Study-August-2023.pdf.
[31] Dartmouth Health Workforce Development: Building sustainable talent pipelines in rural communities (Healthcare Anchor Network, n.d.), page #2, https://healthcareanchor.network/wp-content/uploads/2024/01/DARTMOUTH-Case-Study_121423.pdf.
[32] Dominique Samari and Paul Schmitz, Racial Equity Toolkit: A reflection and resource guide for collective impact backbone staff and partners (Collective Impact Forum, 2023), page #16-19, https://collectiveimpactforum.org/resource/racial-equity-toolkit/.
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Inclusive, Local Hiring Toolkit, Healthcare Anchor Network (2016)
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Case studies of HAN members’ Impact Workforce strategies (ongoing)
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Aspen Institute’s Workforce Strategies Initiative identifies, evaluates, and promotes promising and successful practices and policies that help workers attain stability and mobility, including through training, education, and broader systems change.
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National Fund for Workforce Solutions maintains a robust library of tools and resources that can assist employers, workforce practitioners, and community leaders in their efforts to create a more equitable workforce. CareerSTAT, its network of healthcare and workforce leaders, offers peer learning, technical assistance for frontline workforce development, and impact analysis.
2.2 Impact Purchasing
The Impact Purchasing strategy aims to leverage the purchasing power of anchor institutions to create positive social and economic impacts in their local communities. This strategy calls for anchor institutions to prioritize spending with local, diverse, and high-impact (e.g., employee-owned) businesses who better reflect the socio-demographic diversity of their community to help strengthen local economies and address the racial wealth gap.
Impact Purchasing strategies have a place-based multiplier effect that can increase local economic activity beyond a single purchase, thus enabling wealth accumulation in communities. When done at scale through an anchor collaborative, Impact Purchasing allows for supply chain strategies that drive inclusive economic growth that would not be possible with any one institution alone.
Impact Purchasing strategies can complement anchor institutions’ business objectives by identifying and addressing pain points or vulnerabilities in the supply chain, while uncovering and building the capacity of local, diverse, and high-impact businesses to provide better quality products and services, therefore creating a more responsive and resilient vendor base.
Impact Purchasing strategies manifest in three core areas: creating connections, building capacity, and embedding institutional commitments.
Creating connections
Creating connections involves connecting existing local, diverse, and high-impact vendors to contracting opportunities with anchor institutions. Often, traditional procurement practices create barriers for local, diverse, and high-impact vendors—including ones that are cost-competitive and provide high-quality services. Adjusting internal practices to facilitate connections with local vendors not only shifts procurement dollars in a way that fosters local job growth, but it also helps grow these businesses over time.
Anchor collaboratives can create connections by hosting outreach and education events for vendors, embedding local and diversity goals into requests for proposals (RFPs), and “unbundling” contracts to carve out opportunities for new local, diverse, and/or high-impact vendors. For example, the Denver Anchor Network (DAN) leverages its ShopBIPOC platform—with over 500 small businesses in the directory—to facilitate connections between buyers and sellers in an online marketplace. Below, the South Florida Anchor Alliance shares some lessons learned on leveraging a technology platform to create connections.
Lessons on Leveraging Technology to Create Connections, South Florida Anchor Alliance (SFAA)
In May 2023, ten members of the SFAA embraced a technology-driven regional marketplace to better connect with local vendors. The technology solution streamlines vendor registration and uses artificial intelligence to connect vendors with bid opportunities. When developing the regional marketplace, each member signed its own agreement with the technology provider, with some shared provisions across anchors to allow for data sharing with the backbone institution (Health Foundation of South Florida).
Anchor institutions in Florida value the platform's alignment with their goals to provide greater opportunities for their local, small, and minority-owned vendors. Collaboratives interested in a technology solution for vendor matching should consider several factors, including bringing together the technology provider and the IT departments of the institutions early on in the process. Ample time for systems integration and a clear understanding of Application Programming Interface (API) requirements should be discussed early on. SFAA recommends that all partners identify which metrics the platform should be designed to track (e.g., number of vendors, matches made, award data) and understand the limitations, if any. Vendor engagement is key to success, and a communications toolkit has proven effective in empowering anchor institutions to engage with their vendors and encourage the use of the regional marketplace.
Building capacity
Building capacity means increasing the ability of local, diverse, and other high-impact businesses to meet anchor institution supply chain needs—growing the capacity of existing businesses as well as helping to incubate new businesses. A capacity-building approach helps address supply chain gaps, meet specific product needs, and improve the efficiency and resiliency of the supply chain. Capacity-building initiatives often incorporate philanthropic or public funding, bringing additional financial resources. Capacity strategies are most effective when employed in combination with internal policies that encourage connections with local vendors.
Examples may include creating mentor-mentee programs which pair experienced vendors with newer ones; embedding contractual expectations to subcontract to diverse, sustainable, and/or local vendors; and providing in-kind support—including space, expertise, and access to information (e.g., the importance of third party certifications). For example, the Denver Anchor Network (DAN) supports the Feeding Anchors program, which provides capacity-building support to Black, Indigenous, and people of color (BIPOC) caterers and food trucks seeking to expand their business to include anchor institutions. Additionally, the South Florida Anchor Alliance (SFAA) facilitates vendor access to technical assistance providers within the network, including a subset of small business technical assistance providers collaborating to standardize assessment, referral, and linking to small businesses.
Barriers Facing Local Vendors in Philadelphia, Philadelphia Anchor Institutions for Growth and Equity (PAGE)
PAGE learned quickly that insurance, prequalification, and regulatory requirements differ across sectors, which can be difficult for suppliers to navigate. For example, PAGE has helped a business get ready to work with one group of anchor institutions, but the business was unable to work with another type of institution due to variations in requirements. One way PAGE reduces those barriers is through its Hurdle Fund program, which provides catalytic grants to cover third-party costs so businesses can more easily move between supply chains. These costs have helped suppliers overcome barriers related to requirements for insurance, specialized equipment, security infrastructure, and certifications.
Embedding institutional commitment
Embedding institutional commitment involves implementing the internal policies, processes, and organizational culture necessary to sustain Impact Purchasing strategies within anchor institutions. While many Impact Purchasing strategies and programs are started by one or two individuals, in order to have staying power within the organization, institutional policies, procedures, and cultures must align with the goals of the strategy. Examples may include developing or updating internal policies to support Impact Purchasing strategies (e.g., net-term payments, requiring participation from target vendors in RFPs), creating purchasing-evaluation criteria, tracking progress over time, and attaching Impact Purchasing priorities to performance metrics for relevant leadership and staff. For instance, West Side United (WSU) engages with its anchor institutions to monitor spending on Chicago’s West Side through its Local Procurement Dashboard, which tracks both the cumulative spending with West Side vendors since 2018, as well as the average overall spend with these vendors.
Creating a culture of learning and best-practice sharing can increase commitment and momentum around Impact Purchasing strategies. Of all anchor strategies, Impact Purchasing strategies can be especially nuanced by organization and sector. The anchor collaborative creates a supportive environment where members can articulate goals, share data in support of those goals, receive support from peers, and share best practices.
Below are some steps to implement a collaborative Impact Purchasing strategy:
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Create collective goals around Impact Purchasing (e.g., increasing the amount of local, diverse, and high-impact spending) to ensure shared accountability and collaboration in the community.
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Share vendor master lists, prioritizing those vendors who align with Impact Purchasing priorities (local, diverse, high-impact, etc.) so that all anchor institutions are aware of existing businesses in the community. For example, see Denver Anchor Network’s Curated Caterer List.
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Investigate shared purchasing needs in order to combine purchasing power for upcoming supplier contracts to source in alignment with Impact Purchasing goals. By identifying shared needs, institutions focus on incubating businesses that help make their collective supply chains more efficient while simultaneously promoting job creation and wealth building.
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Co-create and resource impact purchasing programs (e.g., mentor-mentee programs, business accelerator programs) to upskill vendors in the community to meet supply chain needs.
Sample metrics for Impact Purchasing strategies
Note on “local” spendingIt is beneficial for anchor collaboratives to establish a starting point and targets for monitoring Impact Purchasing strategies (see section 3.6 Collecting Data and Measuring Impact). Below, we provide examples of specific and measurable metrics that health systems and anchor collaboratives use to track their Impact Purchasing strategies.
Example baseline metrics: Tier 1 Addressable Procurement Spend, disaggregated by ownership for at least the following ownership characteristics: minority-, women-, and employee-owned.
Example Impact Purchasing goal: Within five years, the anchor collaborative will at least double spending with local minority and women-owned business (MWBEs). The collaborative may also set five-year goals and track spending with locally-owned, employee-owned, cooperatively-owned, and nonprofit enterprises.
Definition(s): Tier 1 vendors are direct suppliers to the organization whereas Tier 2 vendors are suppliers to the organization’s direct vendors.
Examples of Impact Purchasing strategies by anchor collaboratives
Greater University Circle Initiative (GUCI) and Evergreen Cooperative
Started in 2005 and convened by the Cleveland Foundation as the backbone, the Greater University Circle Initiative (GUCI) convened anchor institutions to create “jobs, income, and ownership opportunities” for all Greater University Circle residents. Working together, the anchor institutions identified shared needs around laundry operation services, and in 2009, helped to launch the Evergreen Cooperative Laundry in a LEED Gold Certified facility with the goal of building wealth in GUCI neighborhoods and addressing the anchor institutions’ shared supply chain needs. Today, Evergreen Cooperatives has 250 employee-owners, 83 percent of whom are people of color and 55 percent of whom are returning citizens (i.e. people who were previously incarcerated), while offering “20 percent higher pay rates than comparable industries, [and] supportive benefit plans including healthcare, specific voting rights, and profit sharing.” For more on the Evergreen Cooperative, visit evgoh.com.
More recently, other anchor institutions have partnered to replicate this model in their own communities. In 2022, Steans Family Foundation, a Chicago-based philanthropy, bought a 168,000-square-foot building located in Chicago’s West Side to create Fillmore Linen Service, an industrial-scale commercial laundry facility to support Chicago’s local hospitals. It is expected that the facility will provide up to 175 jobs by handling hospital laundry currently sent to out-of-state cleaners. As of 2024, SSM Health and BJC HealthCare (both members of the St. Louis Anchor Action Network) have formed a joint venture to build and operate a regional laundry facility in a historically disinvested community in St. Louis. The 100,000-square-foot facility will clean 35 million pounds of the health systems’ laundry annually, and create eighty new jobs for local residents.
Philadelphia Anchors for Growth and Equity (PAGE)
As an anchor collaborative solely focused on supporting anchor institutions to localize and diversify their supply chains, PAGE has implemented a multi-pronged approach to building an equitable business ecosystem that supports both business owners and anchor institutions to create sustainable partnerships.
PAGE staff launched PAGE R&D to support anchor institutions in assessing procurement spending, advocating for spending shifts, and mapping contract opportunities for local Black and Brown businesses. PAGE R&D serves as a community of practice through which anchor institution members come together to identify and brainstorm how to address internal policy barriers around minority-owned business classifications, and rethink how economic opportunity planning is set up in order to support small business growth.
Two additional PAGE programs support local minority-owned business owners. PAGE Prep coaches minority-owned businesses on contracting with institutions, and recently launched a cohort consulting program to increase operational efficiency of seven participating suppliers. Additionally, PAGE Capital provides financial consulting and grant funding to minority-owned businesses to lower the cost burden of additional insurance, certifications, security infrastructure, and potential barriers to doing business with a large institution.
Since 2021, the PAGE program has participated in at least $50 million in new minority-owned business enterprise contracts. In partnership with ImpactPHL and the American Sustainable business network, the PAGE Capital program has deployed over $237,000 in catalytic grants, unlocking twenty-six contracts with local anchors and over $3.2 million in contract revenue for thirteen minority-owned businesses. PAGE is in the process of compiling a robust data set to further track and report purchasing impact. For more, visit economyleague.org/page.
Additional examples of anchor collaborative impact purchasing strategies:
[33] Ryan Powell, A. Sheehy, and A. Kind, “The Area Deprivation Index Is The Most Scientifically Validated Social Exposome Tool Available For Policies Advancing Health Equity,” Health Affairs Forefront (2023), accessed February 1, 2024, DOI: 10.1377/forefront.20230714.676093.
[34] “Evergreen Cooperative Laundry,” Evergreen Cooperative Laundry, last modified 2023, accessed March 27, 2024, https://www.evgoh.com/evergreen-cooperative-laundry-2/evergreen-cooperative-laundry.
[35] Brian J. Rogal, “Fillmore Center project, touted as jobs engine for struggling North Lawndale, clears city commission,” Chicago Tribune, March 5, 2024, accessed March 28, 2024, https://www.chicagotribune.com/2024/03/05/fillmore-center-north-lawndale/.
[36] Dave Muoio, “St. Louis’ SSM Health, BJC HealthCare Launch Joint Venture to Iron Out the Wrinkles of Laundry Service,” Fierce Healthcare, March 22, 2024, accessed March 26, 2024, https://www.fiercehealthcare.com/providers/st-louis-ssm-health-bjc-health-systems-taking-out-their-own-laundry-new-joint-venture.
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Impact Purchasing Toolkit, Healthcare Anchor Network (2016)
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Case studies of HAN members’ Impact Purchasing strategies (ongoing)
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The Local Multiplier Effect: How Independent Locally Owned Businesses Help Your Community Thrive, American Independent Business Alliance (2012)
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The Future of Health is Local: A Field Guide for Health Sector Leadership, Business Alliance for Living, Local Economies (2016)
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Billion Dollar Roundtable recognizes corporations that have achieved spending of at least $1 billion with minority- and women-owned suppliers, and publishes white papers on best practices in supply chain diversity excellence.
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Health Care Without Harm seeks to implement ecologically sound and healthy alternatives to healthcare practices that pollute the environment and contribute to disease. It offers resources, tools, and best practices around healthcare practices for local food purchasing and environmentally preferable purchasing, among many other areas.
Note on “local” spending
The collaborative will likely be interested in tracking spending with “local” vendors, specifically those in economically disadvantaged areas of their community. Collaboratives may agree on a certain geographic area within which a business would be considered local (e.g., target zip codes, or a broader region), or members may have different definitions. Below are two approaches that collaboratives have used to track local spending:
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Local as defined by each institution: Individual anchor institutions define “local” based on their own institution’s catchment or service area. In this case, anchor institutions’ definitions of local should be footnoted in any data reporting.
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Local by target zip codes (or other defined geographic area): Anchor institutions report spending at the zip code level, or other similar geographic concept (e.g., Area Deprivation Index or census tract). In this case, the collaborative can analyze spending within a specific geographic area, or at the city or county level, depending on whichever tier is relevant for the anchor institutions.
HAN encourages anchor collaboratives to seek out a definition for local spending that 1) considers the limitations that arise from ensuring that all activity determined to be “local” is headquartered in small, targeted geographies, 2) is flexible enough to be useful to all members, and 3) accounts for keeping a larger share of economic activity circulating within the members’ collective footprint and focus areas for a longer period.
HAN’s definition of local accounts for these tensions by ensuring that all economic activity by a given vendor in a focused geography (“neighborhood spend”) is supported by a headquarters location within the larger footprint (“regional spend”). HAN’s definition was developed to incentivize a stronger local multiplier effect while accommodating the practicalities of business location and the geographic footprint of many anchor institutions today. The HAN Data Companion provides guidance on defining local and can serve as a resource for existing and emerging anchor collaboratives.
2.3 Place-based Investing
Place-based Investing (PBI) is an impact investment approach that generates positive social and economic impacts in historically disinvested communities and geographies, while achieving a modest financial return, or at least preserving the principal of the investment. A place-based investing strategy in partnership with community brings affordable and flexible capital to high-impact projects that improve community conditions. It begins to address racial and economic inequities around affordable housing, job opportunities, economic mobility, and opportunities for wealth building.
Shifting a sliver of an anchor institution’s total investment portfolio to place-based investments will not have a material impact on the organization's bottom line, and such investments allow anchor institutions and collaboratives to create positive social and economic impacts in their communities while still producing a positive financial return.
Note: Place-based Investing is used interchangeably with “community investment,” geographically targeted “impact investing,” or “local investing” by some anchor institutions or collaboratives.
What is Place-based Investing?
Place-based Investing is geographically-targeted impact investing, which is often understood on a scale that extends from traditional philanthropy (e.g., grants with no expectation of repayment, or forgivable loans) to traditional investments (whose primary objective is to maximize return and are agnostic of social impact).
In the center of the spectrum, impact investing and responsible investing both consider social and/or environmental factors in investment decisions. Responsible investing refers to directing or diverting funds to or from companies or sectors based on environmental, social, or governance factors—factors which are not considered in traditional investing. Impact investing, especially when taking a place-based approach, allows investors to directly finance projects or organizations in specific communities, with a level of direct impact that responsible investments are not designed to accomplish.
Grants and impact investments both allow for positive measurable impact in communities. Creating healthy communities cannot be done with grants alone or accomplished by a single impact investor. By partnering on a collaborative, Place-based Investing strategy and identifying the right community partners, anchor institutions can create a sustainable source of financing to advance community development priorities. As funds are paid back with modest interest, capital can be recycled back into the community to finance new projects.
Such investments can help improve the underlying factors affecting health and wealth outcomes in communities, including access to safe and affordable housing, economic opportunity, childcare, healthy food, and transportation. The most common type of place-based investments for anchor institutions are fixed-income debt investments: providing debt capital to borrowers that address social, economic, and environmental needs. For example, flexible, low-interest loans to entrepreneurs of color, who have faced a long history of discrimination in traditional banking, can provide the necessary resources to grow their businesses and generate wealth. Furthermore, below market-rate loans to nonprofit housing developers can help increase the supply of affordable housing—a notoriously complex sector to finance, often drawing on several funding sources including traditional banks, government subsidies, and mission-driven investors.
There are distinct benefits of collaboration on a Place-based Investing strategy. Anchor institutions working together, alongside strong community partners who have a solid understanding of capital needs and the community investment ecosystem, produce economies of scale that in turn can maximize efficiency and impact. A collaborative approach that includes community partners—such as local housing authorities, city governments, community development experts, mission-driven banks, and community foundations—can reduce the burden on an individual anchor institution to identify investment opportunities in the community.
When members of the collaborative pool their resources, their individual financial contributions can be stretched farther than what could be accomplished while operating individually. The increased capital that a group of investors brings to an investment deal can be a turning point for attracting additional lenders who may not have contributed otherwise. In addition to the benefits of efficiency, a collaborative approach allows institutional investors with different levels of experience, expertise, and risk profiles to finance at a level that is comfortable for them.
Place-based Investing strategies are made possible by educating and engaging leadership, building a pipeline of investable projects, and embedding institutional commitments.
Educating and engaging leadership
Anchor collaboratives tend to gravitate toward Impact Workforce and Impact Purchasing strategies because they are conceptually more familiar than Place-based Investing. Place-based Investing strategies yield significant benefit to the community for relatively less organizational effort. This strategy does require community buy-in, and there are often political factors at play. However, the most common initial barrier to getting started on a Place-based Investing strategy is comfort with the concept.
Additional time may be required to socialize the Place-based Investing strategy among key leaders across the organization, and with community partners who may be accustomed to a philanthropic relationship to the anchor institutions. Collaboratives will need to devote ample time to learning the local investment ecosystem, its key players, and investment needs in the community in order to understand the benefits that can accrue from the affordable and flexible capital that they bring.
Support from executive leaders at the outset, especially from champions within the finance department, can accelerate adoption of a Place-based Investing strategy. Executive champions should secure support and necessary resources (financing, staff, and time) for place-based investments from key departments within their institution—including treasury, finance, community engagement, and others. In practice, board members are often more supportive than the organization’s leaders might expect, and it is helpful to identify key supporters on the board’s finance committee. When presenting place-based investment opportunities to finance leaders, it is important to note what risk they can expect to assume and how much of a financial and personnel commitment is required, in addition to the social impact returns they can expect to see.
After launching Impact Workforce and Impact Purchasing strategies in 2021, STLAAN began exploring the possibility of a Place-based Investing strategy. It started by educating members of the collaborative about Place-based Investing and sharing best practices, before envisioning what a future Place-based Investing strategy could look like in St. Louis. Fortunately, two members of STLAAN were already active in Place-based Investing and able to share their experiences with peers, helping motivate other institutions to join and guiding a scalable impact investing strategy for the collaborative.
Building a pipeline of investment opportunities
The Center for Community Investment’s Capital Absorption Framework emphasizes a pipeline approach to Place-based Investing. Recognizing that a single project alone will not transform a community, anchor institutions must work with community partners, city officials, local housing agencies, local banks, and community development finance experts to surface projects and facilitate joint action in lockstep with community priorities for investment. Working collectively with partners reduces the staff time required of each institution to source investment opportunities, and creates efficiency and alignment between financial intermediaries, community partners, and impact investors looking to address financing gaps for community projects.
In developing a Place-based Investing strategy, anchor institutions and collaboratives have the option of financing local businesses and nonprofits directly, or indirectly through intermediaries. Community development financial institutions (CDFIs) are mission-driven institutions that provide essential financial services and debt capital in underserved communities. Risk tolerance often informs whether the collaborative pursues a CDFI loan model for their place-based investment portfolio. The benefits of partnering with CDFIs as intermediaries include reduced risk, and ability to leverage their impact investment expertise and existing relationships with community borrowers. This approach shifts risk to the CDFIs, and the collaborative avoids having to hire a portfolio manager, which can be a deciding factor when pursuing a place-based investment strategy.
Partnering with CDFIs does require collaboratives to give up some control over individual investment decisions, and a collaborative who wants to maintain autonomy in this regard may prefer to hire a portfolio manager and operate their own fund. For many, the benefits of working with a CDFI is a worthwhile trade-off, and the scale generated from multiple anchor institutions working together may offset some of the loss of control that comes from individual anchor institutions operating on their own.
Community-based organizations, local housing authorities, and experts within the collaborative’s focus areas (e.g., partners in affordable housing, economic development, food access) are the most knowledgeable about opportunities for investment in the community. Building awareness in the community about the place-based investment objectives of the anchor collaborative can elicit new partnerships, leading to new investments that might not have surfaced otherwise. Furthermore, the most successful investment programs integrate community groups, leaders, and residents into decision-making about which investments to pursue—holding the collaborative accountable for their alignment with community needs.
Anchor institutions who make direct investments (i.e., without a CDFI) should be sure to have a process that includes input from community groups, leaders, and residents. For those working with CDFIs, consider CDFIs that have strong community relationships, a local presence, experience financing areas of interest (e.g., affordable housing, small businesses), and a history of serving the communities that the organization or collaborative wishes to reach.
Boston Medical Center (BMC) and Boston Children’s Hospital were introduced to City Fresh Foods through the Boston Opportunity System—a collaborative between anchor institutions and community organizations focused on increasing economic opportunity in Boston’s historically underinvested neighborhoods. City Fresh Foods is the only minority- and employee-owned, and minority-led food service company in Massachusetts. The well-regarded, community-based enterprise was facing pressures of gentrification and struggling to access the needed capital to support their growing business. BMC and Boston Children’s, alongside other institutional investors, collectively provided a mix of grants and low-interest, long-term loans totaling $1 million to City Fresh Foods, enabling the owners to protect and expand their operations in the community. Both hospitals attribute their identification of this impactful, place-based investment opportunity to their involvement with the Boston Opportunity System.
Embedding institutional commitments
Embedding institutional commitments involves anchor collaboratives and their member institutions defining objectives, governance, and dedicated staff necessary to sustain the place-based investment strategy. Healthcare Anchor Network (HAN) has defined best practice in this area as allocating at least 1 percent of an anchor institution’s long-term reserves to place-based investing. These allocations can be pooled into a fund and managed by the collaborative, or anchor institutions can choose to partner on individual investments.
Immediate actions: High-impact banking As collaboratives build their place-based investing programs, they can also take immediate actions to put their other financial assets to work. Depositing cash into community-based banks, while not considered a place-based investment, requires relatively little effort and can immediately increase the lending capacity in low-income communities. For example, through its community health improvement initiative, BJC HealthCare moved a portion of its savings to two community-based financial institutions—St. Louis Community Credit Union and Midwest BankCentre—who in turn were able to increase lending with local businesses in St. Louis. Hear more from one beneficiary of such a loan, Freddie Lee’s Gourmet Sauces.
The anchor collaborative can adopt a shared investment policy which guides investment activity, outlining key principles and criteria such as: priority geographies and population, desired rate of return, and duration of investments. Impact measurements—such as the number of housing units or jobs created as a result of investments—should also be clarified. An effective governance structure—within each organization or overseen by the backbone—can guide program direction, source investment opportunities, review prospective loans, and make investment decisions. Success in place-based investing programs occurs when relevant departments within each anchor institution—including treasury, finance, community engagement—stay involved and accountable.
Anchor institutions may also align their grantmaking with community development priorities, for example, offering grants that lay the groundwork for later investments in affordable housing or small business development. Such actions are in alignment with the anchor mission, and can help organizations and collaboratives better leverage and align their financial resources in support of equitable economic development and community wealth building.
Below are some steps to get started on a collaborative Place-based Investing strategy:
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Consult with community investment experts to better understand the capital investment needs in the community. Identify CDFIs, CDCs, housing authorities, housing coalitions, community development groups, or networks of community investment experts, and find ways to engage with them.
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Host an educational session or workshop on place-based investing for executive champions within the collaborative to ground the group in key terms, concepts, and the role that anchor institutions can play in the place-based investment ecosystem.
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Ask that each anchor institution assemble a discovery team that includes leaders from treasury and finance, community engagement or community health, and social impact departments. Together with community partners, discovery teams from each anchor institution can work collaboratively to shape a place-based investment strategy.
Sample metrics for Place-based Investing strategies:
It is beneficial for anchor collaboratives to establish a starting point and targets for monitoring Place-based Investing strategies (see section 3.6, Collecting Data and Measuring Impact). Below, we provide examples of specific and measurable indicators that anchor collaboratives can consider when tracking their place-based investments.
Example baseline metrics: Submitted by each anchor institution and reported in the aggregate for the collaborative.1) Total investable assets or long-term reserves; 2) percent or dollar amount allocated and deployed as place-based investments.
Sample goal: Each member of the anchor collaborative will allocate one percent of their total investable assets to place-based investments, and agree to deploy investments in under-resourced communities within five years for projects that improve community conditions in areas such as: affordable housing, community and economic development, food access, childcare, transportation, and arts and culture.
Definition(s):
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Investable assets: The institutions’ total long-term reserves or unrestricted investment funds/pools. Pensions and other restricted assets should be excluded from this total.
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Place-based investments are defined as geographically-targeted impact investments with a social and financial return. Grants do not count as place-based investments, as there is no expectation of repayment.
Core metrics for any place-based investment program also measure where dollars are going and to whom. Anchor collaboratives are encouraged to track dollars invested within a defined geography and by project type in key community development areas: affordable housing, community economic development (e.g., small business loans), nutrition and food access, climate resilience, transportation, child/youth development, and arts and culture. The collaborative should also aim to collect socio-demographic information of borrowers within the portfolio. These metrics can keep the collaborative on track toward its goal of increasing the flow of capital to underinvested communities, to projects that help meet that community’s specific demand for essential infrastructure and services.
Finally, anchor institutions, collaboratives, and financial intermediates should regularly track specific investment project details, including stories from community borrowers. Such details elevate the capital needs in the community and communicate the benefit of the Place-Based investment strategy to civic leaders, elected officials, anchor institution employees and leadership, and other key stakeholders.
Example of collaborative Place-based Investing
West Side United (WSU) is a collaborative between four hospitals in Chicago, and is a pioneering collaborative for place-based investing. WSU anchor institutions, along with Illinois Medical District (IMD), Northern Trust Bank, and the American Medical Association (AMA), collectively invest across four community development financial institutions (CDFIs) who in turn finance community-based projects on Chicago’s West Side. Since 2018, WSU has collectively invested $15.5 million, including “recycled capital,” in community-supported West Side projects through more than 600 loans. Recycled capital is capital generated as proceeds or profit from a prior round of financing for a CDFI, which is then used to reinvest into the same CDFI for the disbursement of more loans into the community.
These investments have contributed to the creation and preservation of 901 housing units; the creation of fifty-two supportive housing beds; the construction and preservation of more than 772,404 square feet of nonprofit, residential, and commercial real estate projects; and have supported 505 construction jobs, preserved 566 local jobs, and created 125 community employment opportunities.
To develop the program, WSU built off of Rush University Medical Center’s initial impact investing commitment in 2017. WSU coordinated collective investment opportunities with its founding hospital partners and other local anchor institutions. Then, Lurie Children’s Hospital and the American Medical Association each made multi-million dollar commitments to the impact investing initiative. Being a WSU anchor mission partner also involves additional support including grants, ongoing collaboration, and subject matter expert contributions from the anchor institutions.
Members from WSU’s Community Advisory Council provided valuable insight into how the area’s history has shaped current economic and social conditions and produced the current need for impact investment on the West Side, and they helped define what success of an impact investing program would look like in the short, intermediate, and long term. Another advantage of this collaborative is that the collective investments of the anchor institution partners allow for flexibility in investment amounts. While some members of the collaborative cannot invest millions of dollars, they are still engaged in the process of disbursing the collective amount to the CDFI partners and informing the collaborative of their specific goals and outcomes.
WSU’s partnership with community development financial institutions is key to their success. Anchor partners are able to invest capital by leveraging the existing infrastructure and expertise of CDFI community lenders who underwrite and disburse a high volume of loans. CDFIs bring deep experience in community-borrower relationships, regulatory compliance, and data collection and reporting on impact investments. Further, the four CDFIs working with WSU bring complementary skill sets and portfolios, allowing investments to span projects in affordable housing, small business supports, and other community assets, areas that together address several drivers of WSU’s community wealth and health indicators.
While partnering with CDFIs optimizes expertise and efficiency, challenges remain around measuring direct impacts of capital infusions on community-level changes to health equity.
WSU is currently working with a consultant to develop an impact framework that combines CDFI data and public datasets to convey a richer portrait of the neighborhood-level outcomes of the investments. Read more about West Side United’s Journey to Impact Investing.
Further reading on collaborative, Place-based Investing:
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Place-based Investing Toolkit, Healthcare Anchor Network (2016)
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Case studies of HAN members’ Place-based Investing strategies (ongoing)
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Investing Together: Emerging Approaches in Collaborative Place-Based Impact Investing, Urban Institute (2018)
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Collaborative Place-based Investing examples:
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Life to Rise, Coachella Valley Housing Catalyst Fund
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Improving Community Health by Strengthening Community Investment
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While this report was written with healthcare partners in mind, the Center for Community Investment offers a valuable framework applicable to multisector partnerships.
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Community Closeups, Build Healthy Places Network (ongoing)
[37] Shena Ashley and Joycelyn Ovalle, Investing Together: Emerging Approaches in Collaborative Place-Based Impact Investing (Urban Institute, 2018), page #1, https://www.urban.org/sites/default/files/publication/98452/investing_together_emerging_approaches_in_collaborative_place-based_impact_investing_7.pdf.
[38] Robin Hacke, Improving Community Health by Strengthening Community Investment: Roles for Hospitals and Health Systems (Center for Community Investment, Initiative for Responsible Investment, and Robert Wood Johnson Foundation, 2017), page # 4, https://centerforcommunityinvestment.org/resource/improving-community-health-by-strengthening-community-investment-roles-for-hospitals-and-health-institutions/.
2.4 Complementary Anchor Strategies
The high impact strategies around Impact Workforce, Impact Purchasing, and Place-based Investing are complemented and reinforced by a secondary set of anchor strategies including policy advocacy, community giving, land and real estate, and skills-based volunteering. These complementary strategies invite institutions to further their commitments to the anchor mission by activating their government relations and policy teams, vacant or underutilized land that they own, their grant dollars and philanthropic activity, and the skillsets of their employees.
Policy advocacy
Anchor institution efforts to improve community conditions can only go so far without the structural support of government funding and policy. Through policy advocacy, anchor collaboratives utilize their collective influence, standing, and government relations resources to positively impact government funding and policy choices—at the federal, state, and local levels—in support of anchor strategy implementation, equitable economic development, and community wealth building. Examples of policy advocacy by anchor collaboratives:
Community giving
Community giving involves the strategic acquisition and allocation of flexible, discretionary, and philanthropic resources toward strengthening the local economic ecosystem in order to better address the drivers of health and economic outcomes. These grants and philanthropic resources can be aligned with or support the implementation of anchor mission strategies from an operational perspective, or paired with anchor strategies programmatically (e.g., pairing grants with loans for affordable housing). In the early stages, anchor collaboratives are typically funded by grants from anchor institutions, which is discussed further in section 3.5 Sustainable Resourcing. Examples of community giving in action:
In addition, MMDC operates two distinct loan programs: 1) Grow loans up to $250,000, sourced through program-related investments (PRI) from national philanthropy, provide direct investments for acquisition, environmental remediation, and due diligence; 2) Build loans—administered, underwritten, and deployed by CDFI partner, Pathway Lending—loans up to $3 million to provide funding for construction, acquisition, mezzanine, and gap financing for real estate projects. In 2023, MMDC provided over $200,000 in grant funding to more than twenty projects, and $570,000 in loans through its Grow fund. Additionally, Partner Pathway Lending deployed $5.8 million for three Build fund projects. Grants and investments in 2023 supported the production of nearly 200 residential units in the district, with more than 50 percent of funding going to minority- and/or women-led development teams. For more, visit memphismedicaldistrict.org.
Land and real estate
As significant property owners, anchor institutions often manage large construction projects. As such, they have an opportunity to intentionally address community needs in the design, construction, and operations of new or expanded properties—as well as repurposing vacant land they own or that may be blighted in their community. Examples of land and real estate strategies:
Skills-based volunteering
Skills-based volunteering involves anchor institutions deploying the talent and passion of their employees to enhance the capabilities of community-based organizations. Skills based volunteering provide employees an opportunity to apply their skill sets in a new setting while meeting the technical and operational needs of community groups. An example of anchor collaboratives implementing skills-based volunteering: