In the 10 years since its founding, the Empire Health Foundation has developed a reputation for making bold investments that have resulted in some big impacts for the health of people living in the Inland Northwest. 

Some of those impacts include: helping to keep kids in school by reducing the rate of out-of-school suspensions, reducing childhood obesity rates by investing in healthy school lunches, and improving the uninsured rate by encouraging residents to enroll in health care plans.  

Foundation President Antony Chiang says in the last five years, the total dollar value of the funds it manages has increased from $45 million to $75 million, a fact he attributes to its early successes investing those dollars into health care initiatives.

“We had some early wins and actually moved the needle on making a difference,” he says. “Just like a great mutual fund manager who’s getting great annual returns sees more investments flow into his fund to be managed, other public and private funders are now seeing our social impact (return on investment) and are hopefully inspired to co-invest with us.”

Chiang says the organization intends to continue its success this year by increasing the size of its staff and investing in new initiatives that will focus on issues such as homelessness, medical education, and using data analytics for social good.

Chiang says that Empire Health Foundation and its subsidiaries, which include Family Impact Network, Spokane Teaching Health Center, Better Health Together, and Philanthropy in Action, currently employ about 51 people.

The foundation is located at 1020 W. Riverside, in a 22,000-square-foot building now known as the Philanthropy Center, which was built in 1931 as the first home to the Spokane chamber of commerce.

“What’s exciting to me is that we’ve been able to demonstrate it’s possible to improve health equity and eliminate health disparities,” says Chiang. “We’re pleased with the amount of resources we’ve attracted to the region so far and we’re excited to keep making measurable differences in our communities.”

Chiang says the foundation was formed in 2008, and received an initial endowment of $45 million in 2010, of which it uses 5 percent a year for grants and impact. 

Chiang says the endowment has grown to $75 million, with most of that growth coming from converting assets inherited with the sale of the hospital system. 

The endowment now funds about $4 million worth of work each year. Meanwhile, the foundation also manages or governs $60 million in annual funds from private and public sources. 

He says those figures are expected to grow to a total $65 million budget in endowed and managed funds in 2019. 

 “Of the grand total of funding that is governed or managed, I’d estimate that 80 to 85 percent flows out to our partners and agencies, while the remainder is put toward our operations,” says Chiang. 

 “However, the key is not our overhead percentage, but rather our measurable impact,” he says. “Whether we spend $10 on staff and $90 to partners, or $90 on staff and $10 to partners, are we having the impact we set out to achieve?” 

Chiang says funds invested by the foundation go toward initiatives or organizations that work to improve access, education, research, and policy to result in a measurably healthier region.

Chiang says the foundation has two main goals—improving health outcomes and eliminating health disparities.

Within those two main goals, he says, the foundation has about a dozen initiatives it’s working toward, which include preventing or mitigating adverse childhood experiences, childhood obesity prevention, increasing medical education and physician capacity, advancing health science and cancer research, increasing access to healthcare and health insurance, and improving healthcare outcomes for Native American and rural senior populations.

When it comes to future initiatives, Chiang says the foundation is exploring new investments in three main areas: artificial intelligence and data analytics, homelessness, and innovation at Washington State University’s Elson S. Floyd College of Medicine.

In the area of artificial intelligence and data analytics, he says the foundation is interested in using technology and data for social good.

“Products you’re shown through online applications like Facebook, Amazon, or Netflix are designed to addict you and change your behaviors,” he says. “But what if your next app helped tip you into staying sober or eating right? The possibilities are really intriguing.”

With regard to homelessness, Chiang says Spokane is flourishing economically, but rising rental rates are still pushing many people toward housing instability. The foundation wants to explore how to address the root causes of the issue.

“The good news is that Spokane is booming. The bad news is we’re at a record low for vacancies and don’t have thousands of new units ready,” he says. “If you look at cities like Seattle, Portland, or San Francisco, homelessness has exploded. EHF wants to try to get upstream of the homelessness issue and potentially invest in affordable workforce and transitional housing.”

Lastly, Chiang says the foundation is eager to get in on ground-floor developments that are happening at WSU’s new medical school.

“How often does a community have a chance to partner in writing the DNA of a new medical school?” he says. “We’re exploring what a big bet there might look like. Could we invest so that Spokane could become a national role model in the pipeline of Native American health care, or rural doctors, translational research, or other exciting possibilities?”

Regarding the foundation’s work so far, Chiang says the organization is particularly proud of its accomplishments in the areas of mitigating adverse childhood experiences, decreasing childhood obesity rates, and decreasing uninsured rates.

“EHF has always made bold, big bets,” he says. “We’ve made million-dollar bets on everything from healthy scratch cooking and the new medical school, to improving the foster care system and the uninsured rate.”

Chiang says improving the region’s uninsured rate was one of the foundation’s earliest successes. 

“We formed Better Health Together five years ago, with the original goal of enrolling 10,000 hard-to-reach uninsured residents across the seven counties,” he says. “We ended up enrolling over 100,000, which was a really surprising and exciting early win.” 

Chiang says the average percentage of uninsured residents in the region has dropped from 17 percent in 2013, to 3 percent today.

“Having more newly insured patients has meant the health care economy in our region has also improved dramatically,” he says. “We estimate it’s added about 6,000 jobs in the last five or six years, which is a really nice bonus side effect of enrolling people.”

The foundation helped launch a three-year pilot program six years ago at Rogers High School that reduced out-of-school suspensions by 64 percent and was expanded last year to include the entire Spokane Public Schools district. The expansion resulted in a districtwide 30 percent reduction in out-of-school suspensions, and an 80 percent reduction in juvenile arrests.

“We really love that our original partnership and investment at Rogers helped them to develop best practices and that the schools were then able to scale that district wide,” he says.

Chiang says preventing childhood obesity was another of the foundation’s early initiatives that has grown since starting with a pilot program in 2011.

“We invested in teaching kitchen staff at two school districts (Cheney and Othello) to make healthy scratch meals in cafeterias and within the first two years we saw a significant decline in obesity rates, which has grown to a 12 percent reduction across nine participating districts,” he says.

Chiang says the foundation’s efforts to reduce childhood obesity have resulted in 6.9 million healthy, scratch meals a year being served across 11 school districts (comprising 58,000 kids) in the region, and an average 12 percent improvement in obesity rates.

“About 55 percent of kids in Eastern Washington schools now have access to healthy food options, and our goal is to expand that to reach 75 percent of kids in the next two or three years,” he claims.

More recently, Chiang says he’s particularly proud of an initiative started last year called Rising Strong, a family centered drug treatment program that includes housing for families.

The program, which is operated by Catholic Charities with funding from the foundation, Premera Blue Cross, and Providence Health Care, aims to keep kids with their families while giving parents the skills they need to get clean and find jobs.

In its first year, Chiang says the program housed 20 families at the former Sisters of the Holy Names site, at 2911 W. Fort George Wright Drive. He says the program will continue to expand later this year to include up to 50 families.

“We modeled this program after what’s been done in other states, where they’ve had 80 to 90 percent success rates at keeping families together and children out of foster care,” he says. “We’re excited to start working toward improvements in this area.”

Although the foundation remodeled the Philanthropy Center and moved in a mere three years ago, Chiang says it may already be outgrowing the space.

“We have several open positions right now and expect to grow our staff by 30 percent this next year. With continuing growth, it’s possible we’ll need to invest in another building in the downtown core,” he says.

“Our goal for any new space would be to choose another building we could improve, with an eye toward revitalizing the neighborhood, as we’ve done with this current space.”

Going forward, Chiang says the foundation will continue to work toward measurable impacts to health outcomes and eliminating health disparities.

“We believe everyone deserves vibrant health and access to health care regardless of their circumstances, and we’ll continue to aim for that,” he says.

The Empire Health Foundation is a private health conversion foundation formed in 2008 through the sale of 

Deaconess Medical Center and Valley Hospital and Medical Center, to for-profit Community Health Services Inc., of Franklin, Tenn., by the former owner nonprofit Empire Health Services.

Health conversion foundations are formed when a nonprofit hospital, health care system, or health plan is either acquired by a for-profit concern or converted to for-profit status. The proceeds from these transactions are then transferred into the endowment of a foundation that maintains the general mission of the entity being acquired.

Chiang says the foundation is governed by a 15-member board of directors, who focus on finding new ways to reinvest the foundation’s funds in health care initiatives.

“Our board is a very diverse group, and includes representatives from three area tribes,” he says. “We’re also a bit unusual compared to other boards. Because we already have funding at our disposal, our focus is more on finding the best ways to reinvest that money, putting it where it will have the most impact.”

The foundation’s coverage area includes seven counties—Spokane, Stevens, Pend Oreille, Lincoln, Whitman, Adams, and Ferry—and the Spokane, Kalispel, and Colville Confederated tribal reservations.