Forging Paths, Building Models

That the New York Foundation was itself an innovation is clear-it estab­lished a new and unproven template for giving. It also sparked creativity among both grantees and prospective grantees, helping to launch programs that would deliver a host of services to New Yorkers, from low-cost nursing care and experimental drug-rehabilitation therapies to new treatments for diseases and major advances in the efficient delivery of health care.

This legacy of innovation is traced to the foundation’s inception. Appro­priation No. 2 went to the Henry Street Settlement, to support nurses who treated victims of infectious diseases. The settlement-federal-style row houses purchased by foundation trustee Jacob Schiff-was headed by Lillian Wald, a nurse who was asked by charity workers in the neighbor­hood to instruct them in home nursing.

The idea got its start when a girl begged Wald to visit her sick mother. Wald did, and found a family of seven living in two rooms in a tenement house. The father, a cripple, begged on the streets; the mother, who had suffered a hemorrhage, was bedridden and in pain. Wald saw them as abandoned by society, and turned to the New York Foundation for help.

See a list of grants related to health»

The grant to Henry Street Settlement established a precedent for a long list of future grants in health care. With foundation support, the Visiting Nurse Service of New York was created. It would become a model for similar organizations nationwide-and the recipient of hundreds of thousands of dollars from the New York Foundation over the years. Another innovation followed in the late 1930s and 1940s that remains a subject of controversy in latter-day politics-health insurance.

In 1939, the Medical Society of New York conducted an experiment in voluntary prepaid medical care. The foundation paid the organization’s expenses and funded the experiment at a low-rent public housing project, the Vladeck Houses on New York’s Lower East Side. The experiment involved offering subscribers the services of a private family doctor whenever needed, including an annual health examination, immunizations, and access to services at the clinic of Governors Hospital.

Although the experiment was discontinued, Mayor LaGuardia appointed New York Foundation President David M. Heyman to head a committee that would recommend a plan to cover the health needs of an even larger population than the residents of the Vladeck Houses. The result: the Health Insurance Plan of Greater New York-or HIP-incorporated in 1945. It pioneered prepaid health care.

HIP furnished comprehensive services, from preventive medicine to major operations, and embodied the principle of group practice. As a public service, it embraced as many persons as possible at the lowest rates under which the plan could remain self-sustaining. By 1950, HIP’s 250,000 subscribers had access to medical, surgical and special care they could not otherwise afford. HIP also dispelled fears that many patients would abuse the privilege of “free” care by tying up a physician’s time with trivial ailments, as well as the belief that the plan would induce physicians to take on more patients than they could properly care for in order to earn larger incomes.
The foundation also joined other funders to support the Rehabilitation Institute, which later became the Rusk Institute, named for its founder, Howard A. Rusk, the father of rehabilitation medicine. The need for such an institute became especially clear in the aftermath of war, when men who had been wounded in battle, along with those suffering from physical handicaps, were treated successfully. Men and women once consigned to lives of inactivity and dependence due to their wounds or physical disabilities became self-supporting. Affiliated with the New York University Medical Center, the Rusk Institute is still the largest center of its kind for the treatment of adults and children with disabilities, and home to innovations and advances that have set standards in rehabilitation care for patients of all ages and phases of recovery.
Other innovations traced to foundation sponsorship include the evolution of public television in New York and the founding of WBAI radio, which played an important role in the evolution of counterculture in the 1960s and beyond.

In 1954, the foundation added arts and recreation to its list of philanthropic programs. That year, the foundation awarded the first of several large grants to Lincoln Center’s building fund. The center’s early objective was to make the performing arts more affordable and thus more accessible to large segments of the population.

In the 1970s, foundation grants went to organizations that sought to stop the practice of redlining in Brooklyn and the South Bronx. It also underwrote tenant homesteading projects, centers for the homeless, and the development of community credit unions. In the early 1980s, it funded some of the earliest work to fight the HIV/AIDS epidemic.

More than a decade before the housing market calamity that led the nation into the current deep recession, the foundation funded organizations that worked to prevent foreclosures caused by aggressive subprime mortgage lending practices. The foundation even supported sustainability projects and “green jobs” programs back in the 1990s, years before federal, state, or local governments took note. It also funded early initiatives in the urban environmental justice movement.

The New York Foundation also established innovative philanthropic practices. In the 1980s and 1990s, it streamlined the process of applying for a grant, developing one-page applications that were soon replicated by other area foundations. It also created one of the earliest programs for capacity-building, seeding nonprofit management support organizations that have continued to provide assistance to New York nonprofits. The New York Foundation has become well known for its bottom-up approach to grantmaking. Wittingly or not, the early trustees created a legacy of board involvement that still distinguishes the foundation from other philanthropies.