Shifting Power in Maine: Findings From a Six-Year Community-Based Health Initiative

Abstract

Between 2013 and 2019, a Maine Health Access Foundation community-based initiative provided place-based funding to communities to address system gaps and inefficiencies that impede the ability of Maine’s most vulnerable individuals to obtain essential services and supports. To rebalance power between the funder and grantees, the foundation introduced grantmaking practices such as long-term, flexible funding and new ways of relating to and supporting grantees. The theory of change guiding the initiative was that systems change is more effective and sustainable when communities develop cross-sector partnerships and engage community members in planning. The foundation guided the evaluation team to conduct a developmental, participatory, and adaptive approach focused on systems change rather than on individual health outcomes.