Dogwood Health Trust CEO Chiang makes Buncombe debut

The Dogwood Health Trust received hundreds of questions in the run-up to its October community engagement meetings, the first chance members of the public have had to engage in person with new CEO Antony Chiang. But 90% of those queries, Chiang said during an Oct. 10 event at the Mission Health/A-B Tech Conference Center, could be boiled down into two themes: “When are you funding and are you going to fund in my area?”

Both questions were understandable, Chiang said. DHT, the foundation spun out of the roughly $1.5 billion acquisition of nonprofit Mission Health by for-profit, Nashville-based HCA Healthcare, will be one of the nation’s largest sources of per-capita charitable funding. And its purpose, “to dramatically improve the health and well-being of all people and communities of Western North Carolina,” offers much room for interpretation.

Regarding the first query, Chiang said the DHT has targeted fall 2020 for its first round of grant disbursements, a date it’s been sharing repeatedly over the past six months. “When you keep hearing the question over and over again after the answer’s given — I had a mentor who said, ‘Basically, when that happens, it means they don’t like the answer,’” he added, to laughter from the audience of roughly 290 people.

Although the foundation’s main grants will likely stay on that timeline, Chiang said, DHT leaders have been exploring a “flexible fund” that would provide grant writing and technical support for partner nonprofits. Such an approach would leverage Dogwood’s resources for good more quickly, he explained, while still allowing the organization time to complete its strategic plan.

That plan will inform the answer to the community’s other pressing question, Dogwood’s focus areas under the broad umbrella of social determinants of health. Chiang led the audience in an exercise to provide input on those priorities, asking attendees to write down the three quantitative measures of success — “dream numbers” — they most wanted the foundation to influence.

According to DHT staff who grouped those metrics into general categories, the most common concern was educational attainment, followed by health care access, housing, healthy food and substance use and addiction. Chiang noted that audience priorities were significantly different at the foundation’s other listening sessions in the more rural communities of Marion and Sylva; he said a full report on the results would be posted online within the next few weeks.

Chiang also sought the audience’s opinion on the one Dogwood initiative announced to date: $25 million in spending over five years to support the N.C. Department of Health and Human Services in fighting WNC’s opioid crisis. When he asked the crowd how many communities that funding should reach, the vast majority said some should go to all 18 counties and the Eastern Band of Cherokee Indians.

However, Chiang suggested, spreading resources too thin could fail to achieve the foundation’s goal of dramatically improving health metrics. Splitting $5 million annually 19 ways, he pointed out, equated to just over $263,000 per community. “How’s that sounding per county and tribe to radically do systems change and move the needle on addiction and opioid deaths?” he asked. “This is the type of thing that we’ll be grappling with.”

Speaking during public comment at the end of the event, one attendee noted that Chiang’s example had helped her better understand the challenges DHT will face in stewarding its resources. “I came in with a certain mindset, but because of this meeting, I’m leaving with a greater appreciation for what you have to do,” she said. “It ain’t easy.”