Chapter 10. Financing and Funding Opportunities and Strategies
This chapter provides an overview of potential financing
and funding opportunities for community-based oral health
coalitions and programs and then links to specific funders
and examples of funded programs. Tips and worksheets on grantwriting
and other methods of fundraising are included. Issues around
creating sustainable programs are addressed.
A common mistake that groups make when trying to solve
an oral health problem is to think that money, usually in
the form of a grant, will solve the problem and magically
create a program. A second mistake is to think you're
saving time by hiring a grantwriter who knows little about
the problem, proposed project or the local community. A third
mistake is to expect to secure funding based on a grant
application that includes a great deal of rhetoric about the
need for a program, but only vague descriptions about what
the proposed program is, what it will cost, and what the anticipated
outcomes will be. A fourth mistake is to express outrage
when your grant application is not funded, and then send the
same grant application to three more foundations!
Want to avoid these mistakes? Use the tools and tips in this
chapter and in previous chapters to plan a cohesive approach
to program planning and fundraising.
Self-Assessment: Financing and Funding
Chapter 2 provided an overview of several types of resources
you might need. In the assessment process, you probably identified
what resources can be obtained within the community through
creative partnering, and what will require outside funding.
How much do you already know about sources for funding or
financing community-based programs? Do you know which organizations/agencies
provide grant opportunities? What are other fundraising strategies?
How can you take advantage of reimbursement for clinical services,
education or administrative functions? Use the Financing
and Funding Self-Assessment to determine what knowledge
and resources you already have.
Creating a Funding Plan
Fundraising requires good networking, personal relationships,
communication, marketing, investing, perseverance, patience
and planning. To be successful, people need to be passionate
about the cause, persuasive, proactive, assertive and persistent.
Fundraising efforts can easily bog down in the daily realities
of running an organization or conducting oral health activities.
Fundraising requires a great deal of time and effort on a
daily basis and a team of people, not just one person acting
as a fundraiser.
needs to be planned and purposeful-guided by a roadmap
of where you want to be, by when, and how you plan to
get there. The goal is to create sustainability so that
programs function long enough to have an impact on the
community's oral health and are not severely compromised
when funding shortages occur.
The key to sustainability is to not put all your eggs in
one basket. Programs that rely solely on one grant source
are at major risk of dying when that funding dries up. Try
to create a mix of funding that will sustain basic operations,
allow expansion of activities, and generate sufficient cash
flow to maintain smooth program operations. Relying solely
on grants or on contracts based on completion of deliverables
may result in periods of zero cash flow. Some funders may
take months before making a decision to fund your program,
and then there may be a delay in dispersing funds or a reduction
in funding levels. Organizations can't afford to just "sit,
hope and wait" for these funds to appear. Funders also
want to be assured that they are contributing to an organization
that is fiscally responsible and has a financial plan that
When putting together a funding plan, think about how your
fundraising efforts are tied together. Are they for one-time
expenditures or recurring needs? Do you all of a sudden have
brand new dental equipment but no clinic space? A new mobile
van with staff but no dental providers? Providers but an inadequate
system for billing and collecting payments? Not enough cash
flow to purchase disposable products or repair dental equipment?
Fragmented attempts at grantwriting will create such situations.
Once funding is received, review your plan periodically and
create reports to show the mix of resources and how you are
maximizing those resources. Show how the funding has made
a difference in the lives of people in the community. Reports
are a form of marketing and are important not just to funders
but also to individual donors and others who support your
Locating Potential Funding Opportunities
Who are the grantmakers?
(The link provides a description of 5 categories: government,
private foundations, corporate grantmakers, community foundations
and public charities.) Today the most timely and efficient
way to research funding opportunities is through Internet
search engines. Try to be fairly specific in your search,
e.g., "health funding," but not overly restrictive-"funding
for dental sealants"-as most funders will not be this
specific in their funding descriptions. You might want to
search by geographic location such as "community foundations
in Northern California" or "funding for rural health
Some agencies regularly post a list of new and continuing
funding opportunities, usually with brief descriptions and
links to the funding source's website if it is different from
their own. Examples include:
- The Foundation Center: http://www.fdncnter.org/grantmakers
(search by state or type of funding source).
- Rural Assistance Center: http://www.raconline.org/
provides resources for health and human services, including
- California Rural Health Policy Council: http://www.ruralhealth.ca.gov
lists local, state, regional and national funding opportunities.
- The Rural Health Advocate: http://www.csrha.org/advocate,
an online newsletter, lists grant and research opportunities.
- Rural Health Services Funding: A Resources Guide: http://www.nal.usda.gov/ric/richs.
- Check in your community to see if any groups regularly
monitor the Federal Register (http://www.gpoaccess.gov/fr);
they might be willing to alert you to potential opportunities
if they know your interests.
- Some listservs will alert members to funding opportunities,
e.g., the dental public health listserv (subscription information
click on "links").
- Foundations and government agencies regularly post
new grant opportunities on their websites. Bookmark the ones
that are most likely to match your needs and check them at
least once a month.
- County First 5 commissions and the state First 5 Commission
post Requests for Proposals (RFPs) on a periodic basis for
minigrants, statewide initiatives, insurance demonstrations
or other funding opportunities (access the county websites
through the state commission website at http://www.ccfc.ca.gov).
An April 2004 survey of 17 county oral health initiatives
of $100,000 or more (not counting fluoridation) showed the
following types of health health projects: 76% for direct
dental services, 58% for consumer education, 41% for provider
education, and 29% other (e.g., case management, home visits,
screenings.) More than half of these programs were in rural
- The US government has established a website for information
and applications for all Federal grant programs (http://www.grants.gov)
- Other funding resources are listed in the Resources section.
The foundations listed in the box target a fairly wide geographic
area or comprise a group of philanthropists. In addition,
a number of community foundations provide grants to a specific
area such as a city or county. A descriptive list of community
foundations with website links can be accessed through the
Foundation Center website. Community foundations are more
willing to provide funding for small rural community-based
projects. Check their individual websites to view lists
of projects they have funded.
The following organizations or agencies have already funded
oral health projects for stand-alone or collaborative oral
health projects. Funding may not be available every year
as priorities shift, but reviewing lists of previously funded
projects may give you ideas for types of projects you might
want to undertake.
The application process for federal grants is usually more
formal and complex than for most foundation grants. Most
use the PHS 5161-1 grant application form, so become very
familiar with the correct way to complete it; download from
- The HRSA Bureau of Primary Health Care (http://bphc.hrsa.gov)
provides funding for community/migrant/homeless health center
clinics, the Community Access Program (CAP), and Healthy Schools/Healthy
- HRSA's Office of Rural Health provides funding to counties
through a Rural Health Outreach Grant Program to "encourage
the development of new and innovative health care delivery
systems in rural communities that lack essential health care
services." They require a focus on direct services through
networks of at least two partners. Check their website for
eligibility and a list of funded projects (http://ruralhealth.hrsa.gov/funding/outreach.htm.)
- HRSA's Maternal and Child Health Bureau offers a number
of funding opportunities to states and communities for oral
health programs through the state Title V Block Grant, Healthy
Tomorrows grants and other initiatives. Check their website
- The Administration for Children and Families (ACF) provides
discretionary grants through an RFP process. ACF recently
funded three oral health projects and also support minigrants
to states for Head Start oral health forums through the Association
of State and Territorial Dental Directors. View the ACF website
California and National Foundations
These are only selected examples of recent initiatives (some
of the websites are listed on pg 3).
Other Funding Opportunities
- The American Academy of Pediatrics provides CATCH Planning
Fund grants for pediatricians to plan "innovative, community-based
child health initiatives that will ensure that all children,
especially underserved children, have medical homes and access
to health care services." This includes access to oral
health services and dental homes. Annual grants are for a
maximum of $10,000. Extensive technical assistance can be
received from the chapter AAP CATCH facilitator prior to submission
of the proposal (http://www.aap.org/catch/RosterChapterFac.pdf).
- Some faith-based groups (e.g., United Ministries in Missouri)
and service organizations (e.g., Grottos of North America)
provide funding for dental programs or dental care.
- The American Dental Association Foundation offers small
grants of up to $5,000 for community-based non-profit oral
health promotion programs through their Samuel Harris Fund
for Children's Dental Health (http://www.ada.org/ada/charitable/adahf/).
- The Hospital Community Benefit Program (HCBP) resulted
from legislation passed in 1994 (SB 697). Private not-for-profit
hospitals "assume a social obligation to provide community
benefits in the public interest in exchange for their tax-exempt
status." They are required to 1) conduct a community
needs assessment every three years, 2) develop a community
benefit plan in consultation with the community, and 3) annually
submit a copy of its plan to the Office of Statewide Health
Planning and Development (OSHPD) http://www.oshpd.cahwnet.gov/hid/HID/hospital/hcbp/index.htm.
Funding may be given to various local projects or programs
to meet these obligations.
- The California Children's Dental Disease Prevention Program
provides funding to local agencies for school-based oral health
programs that can include preschool-age children. New three-year
grants were just awarded. Check the website for updates, lists
of grantee and funding opportunities for new programs.
- Through the Child Health and Disability Prevention Program
or the Maternal and Child Health Branch (http://www.mch.dhs.ca.gov/programs/lhdmchp/lhdmchpfacts.htm),
local health department MCH or CHDP programs or others can
have local funds matched by the State at a 2:1 or 3:1 ratio
(depending on the type of personnel) for dental-related activities,
including case management for Medi-Cal clients.
- Two options are available through California Dept of Health
Services, Medical Care Services:
1. Local Educational Agency (LEA) Medi-Cal Billing Options
allow LEAs to become Medi-Cal providers and bill the Medi-Cal
program for health services provided by the health care professionals
they employ, and by the schools to get reimbursed for case
management and dental screening for Medi-Cal children.
2. Targeted Case Management (TCM) Programs allow Local Governmental
Agencies (LGAs) to provide case management services to Medi-Cal
eligible individuals in a defined target population to gain
access to needed medical/dental, social, educational and other
services. TCM services include needs assessment, consultation,
and assistance in obtaining needed services. See http://www.dhs.ca.gov/mcs/mcpd/MBB/ACSS/MAAdescription.htm
3. Other opportunities for using Medicaid funding can be found
Securing Funding Through Grants
When should you join with others to raise funds versus
trying to do it yourself? In rural areas where populations
are scarce and there may be limited resources to actively
pursue grantwriting or fundraising, it might be advantageous
to work collaboratively with others in a joint proposal
or ask to be included in a broader grant application. Applications
from individual organizations are best when trying to start
local coalitions or projects, especially when doing pilot
projects to generate more community support and address
local needs, e.g., trying to involve local dental providers
in a project, or local case management for dental care.
A regional approach is good if 1) there are limited numbers
of children in a community and larger numbers are needed
to show an impact, 2) communities can agree on regional
goals and activities that also meet local needs, 3) there
is an organization that can serve as a fiscal agent, 4)
communities are willing to commit and share resources in
a collaborative manner.
Including oral health projects as part of a broader initiative
may be advantageous when funds for oral health programs
are limited, and when additional resources are available
through other project components. Examples
of potential areas for oral health involvement are provided
for those areas that are listed in the box.
for Oral Health Involvement
Head Start/Head Start
Is Grantwriting Worth the Effort?
It is important to estimate how much effort and what resources
are needed to write and administer a grant versus how much
funding the grant will generate. Is it worth writing a grant
for $5,000 for some small part of a pilot project or portable
equipment, or do you really need $100,000 over a three-year
period of time to accomplish your goals? Review the following
tips on grantwriting.
Don't just write a grant because you see that money
is available. The funding needs to be a good match
with your organization's mission, needs and current
Don't be over-ambitious and ask for more than is
needed, only to find you can't spend it all. Don't
try to pursue too much with limited resources. This
gives the impression of fiscal irresponsibility and
poor planning and reduces your chances for future
If certain factors can affect your ability to expend
funds, indicate this in the application and show how
you will shift funds to another activity or compensate
in other ways. This shows that you're aware of what
sometimes are unpredictable and unavoidable environmental
and economic shifts, and you have thought about contingencies.
Make sure you have an efficient way to accurately
track expenditures by budget category and line items,
and that funds can be tracked separately from other
Tips for Writing Successful Grants
Grantsmanship is the art of writing to market ideas.
Therefore, it is important to involve people with
these skills. Numerous agencies provide courses and
tutorials on grantwriting; some are specific to their
own grantmaking efforts. Examples are listed in the
Resources section. The following tips cover steps
in the grantwriting/submission process as well as
"There is a simple way
to package information that, under the right circumstances,
can make it irresistible. All you have to do is find
M Gladwell. The Tipping Point,
Many funders will first ask for a letter of intent to respond
to a Request for Proposals (RFP) or to introduce a proposal
idea (in the case of an unsolicited proposal.) This letter
may only consist of a few sentences or may need to be an overview
of your project and budgetary needs. The funder's guidance
will specify how extensive the letter should be. Letters of
intent 1) allow the funder to screen any applicants who might
be ineligible or who have ideas that don't fit with their
funding priorities, 2) help them plan for the number of reviewers
needed and the amount of time needed to perform the review,
and 3) avoid having people as reviewers who have close ties
to organizations that are submitting proposals.
Basic Elements of a Proposal
Statement of Need
- Goals and objectives
- Methods and timelines
Budget and Budget Justification
Summary or Conclusion
- Most funders, but especially government agencies, will
require a specific proposal format that includes page limitations,
font and other formatting conventions. For those funders who
don't use a specific format, a suggested format is provided
in the box. Sequencing of headings may vary slightly.
- Have more than one person read the RFP or grant guidance
directions, and highlight the key steps, words and dates.
FOLLOW THE DIRECTIONS EXACTLY. Don't get overly creative with
the format unless it is within the proscribed framework.
- Grantwriting will not be successful unless the grant
proposal is written by a GOOD WRITER, (or at least edited
by a good editor)--someone who can write in a clear, consistent,
concise, organized and interesting manner. Remember-you are
writing primarily for reviewers who probably don't have a
dental background and may not be aware of oral health issues
and concepts. You need to paint a picture and put a face on
- Make sure objectives, plans and activities are consistent
throughout the narrative and are reflected in the budget items.
For example, don't schedule a two-day conference and forget
to discuss lodging for participants or matching funds for
items not covered by the funder such as food and beverage
functions. Include everything that is required and use the
correct form, e.g., federal grants make a distinction between
construction projects and non-construction projects and have
separate budget forms.
- Get realistic estimates for budget items, especially
in the quantity you need. Budget justifications are a major
component of many grants and usually are not well done. Your
rationale for requesting funding should not just be "because
we need it." Tell the funder what the budget item will
be used for, why it is needed and how you determined the quantity
- Don't "pad" the grant or appendices with
extraneous information just to make it look larger. "More
is not better."
- Include letters of support that are specific to your project
and that include details about what type of support the writer
is offering, e.g., free marketing, reduced fees, staff time.
View a request
for letters of support and an example
of a good support letter.
- Don't let a great grant proposal be ruined by a secretary
who 1) makes numerous spelling and other typographical errors
during word processing, 2) leaves out pages when copying,
or 3) assembles pages in the wrong sequence. Have more than
one person proof the grant, more than once, and make sure
all appendices are included. Reviewers will not be forgiving!
Remember-the principal investigator or project director is
ultimately responsible for how the grant is submitted.
- Try to submit the grant well before the deadline, and use
an overnight mail service or hand deliver it if the funder's
office is nearby. Most funders will not accept proposals that
arrive even a half-day late. Assume that anything can go wrong,
and plan accordingly-- the Fed Ex truck doesn't show up; you
have a flat tire on the way to the post office; the envelope
gets lost on someone's desk!
Other Types of Fundraising
Individual donors or business donors
Sample fundraising letters and tips are included in the
ADA manuals Obtaining Funding for Dental Access Programs:
An Overview and Meeting the Match: A Guide to Fundraising
that are listed in the Resources section.
Local dental professional societies
Dental, dental hygiene, dental assisting and dental auxiliary
(dental spouses) societies can be good sources of monetary
or other support for local programs. Unfortunately, in rural
areas, local societies may not exist, with professionals only
being active in broader regional groups.
Special events are a good way to establish some immediate
cash flow and involve the local community. If you're trying
to raise money for Head Start oral health programs, then involve
the staff of the programs and the parents of the children.
Events can include auctions, raffles, yard or book sales,
car washes-any creative activity that might raise money for
your programs. Two cautions: don't use unhealthy promotions
such as cookie sales, and don't get sidetracked by focusing
a lot of efforts on these activities at the expense of generating
more long-term funding.
Establishing a reliable source of clinical income is difficult
when developing programs for uninsured or underserved populations.
Most reimbursements from public financing programs such
as Medi-Cal often do not come close to covering the expenses
of providing the clinical service. An online resource that
discusses clinical income and uses an interactive spreadsheet
to balance income needs and sources is available at http://www.dentalclinicmanual.com
(Chapter 3.) Although it was developed for fixed clinic
sites, portions are applicable to any clinical program.
Advocacy for Oral Health Funding
Sometimes professionals or community members will be asked
by foundations or governments to provide suggestions for areas
where there are gaps in research, programs or funding. This
is a perfect opportunity to provide input about the needs
of rural communities. Repeated advocacy from First 5 counties,
dental organizations and individuals led to the First 5 Children's
Oral Health Initiative that was funded in 2004. Discussions
about oral health and access to dental care with legislators
and members of city councils or county commissions will help
raise awareness of the needs and help these officials learn
about experts and resources that they can tap into for more
information. See Chapter 9 for more information about advocacy
and oral health policy development.
- American Dental Association. Obtaining Funding for Dental
Access Programs: An Overview (2001) provides a basic step-by-step
approach to developing dental access programs, preparing for
funding, identifying funding sources, asking for money, and
keeping records. It can be ordered through the ADA website
- Volunteers in Health Care provides two tipsheets on fundraising:
||- A Fund Raiser's Panacea: Easy Does It
||- Eight Tips to Involve Your Board in Fund Raising
||They can be accessed at http://www.volunteersinhealthcare.org.
- Meeting the Match: A Guide to Fundraising. http://coveringkidsandfamilies.org/communications/materials/fundraising/.
This is a very extensive "how to"manual that contains
chapters on corporate funding, foundations, government grants,
individual donors, other donors, how to develop a fundraising
plan and approach donors. An extensive appendix contains worksheets,
templates and other useful resources. It was developed to
help organizations meet the Robert Wood Johnson Foundation's
- The Foundation Center (http://www.fdncenter.org)
provides free training courses and online courses through
their virtual classroom. They also have reading lists.
- Certain organizations support the work of non-profits and
community organizations. Two that might be helpful include:
||- The Center for Excellence in Nonprofits (San Jose)
||Center for Nonprofit Management (http://www.cnmsocal.org)
This chapter asked you to complete a self-assessment of
potential funding opportunities and reimbursement strategies
for clinical services. You learned the importance of creating
a fundraising plan that includes a mix of resources, and
investigated information about a number of these resources.
Grantwriting tips hopefully will help you be more successful
in your fundraising efforts.
What did you learn or accomplish as a result of reading
this chapter? Did it help you to organize your thoughts
about how to create a fundraising plan? Were the resources
and examples helpful? Complete the feedback form for Chapter 10 and tell us what was useful and not useful for