Uncomplicated Grantmaking: An Inside Look with TTH Program Manager Tiffany Angeles
At Together Toward Health, we believe that a truly equitable approach to COVID recovery must be led by those who best understand the needs of California’s diverse populations. That’s why we partner with community-based organizations who are locally rooted, providing support their neighbors trust, in ways that reflect community culture and needs.
We sat down with Regional Program Manager, Tiffany Angeles, to tell us more about what the work of TTH looks like from the inside and what she’s learned over the past year. As the program lead for Southern California and parts of the Central Valley, Tiffany supports community-based organizations (CBOs) by building connections and collaboration between organizations and their local health departments.
Q: What’s different about the TTH model in how you support CBOs in a public health emergency?
Tiffany: Even as someone who has spent most of my career in nonprofit program work, TTH has been a big learning experience for me. TTH has proven that grantmaking doesn’t need to be complicated– we identify trusted partners, remain flexible, and allow organizations to make decisions about what works best for their communities. This flexible way of working was challenging at first for me, as someone who is used to grants that come with stricter guidelines and reporting requirements.
Traditionally in the nonprofit world, grants are more structured, and are often guided by what funders think success looks like and what they believe the right steps are to get to the goal. What TTH is doing is very different from what I had been used to – we’ve removed many of the barriers and really centered the community experts, the CBOs, to run with what they know and do best. Rather than specific guidelines and outcomes, the grants give broad instructions, to allow for the flexibility that's needed in the moment. And that can be challenging to manage at times, because there is no one-size-fits-all blueprint and the pandemic has required many pivots and adaptations for the work on the ground.
But it’s absolutely worth it to see the impact each organization is able to have by doing things differently. For example, a group with expertise in community organizing, the Long Beach Immigrant Rights Coalition, used the grant to support their door-to-door outreach to immigrant families that needed a “higher-touch” interaction, through hiring Community Health Workers or Promotores and creating informational flyers. But the Long Beach Center for Economic Inclusion has a different focus, and used incentives to encourage people to get their vaccinations. And in San Diego, the SD Refugee Communities Coalition is serving several vulnerable refugee and immigrant populations by incorporating the more pressing needs for their families, like connections to housing resources and food access, knowing that these basics are essential parts of community health and recovery. So the outreach and education work of the coalition starts with really addressing the whole person’s needs.
The flexibility of TTH grants also enabled CBOs to pivot quickly, which we all know was necessary throughout the pandemic, whether going from in-person education to virtual and back again, or switching from fighting misinformation to getting different age groups signed up for vaccinations.
Q: What can the public health sector learn from the way that communities were impacted by COVID?
Tiffany: The pandemic really highlighted equity issues and the importance of addressing social determinants of health, which have existed long before COVID. We know that communities that were already suffering from injustices like racism, poverty, housing instability, food deserts, and more, have been disproportionately impacted by the pandemic and will take longer to recover.
One organization that sticks out as an example of what’s needed for recovery in communities already facing oppression is a partner in Orange County, Alianza TransLatinx. Khloe Rios-Wyatt, the president and CEO, knew that the LGBTQ community, and particularly the trans community, was disproportionately affected by COVID. Not only do trans people struggle against various forms of discrimination – they also often hold medical distrust and trauma because it is so hard for trans people to receive care that is sensitive to their identity and their gender expression. Why would folks trust a system that has mistreated them or ignored them in the past?
Khloe and her team knew they needed to reach the trans and LGBTQ communities of Orange County in a way that was tailored to them and provided the types of services they needed. So it was really great to see Alianza partner with the Orange County Public Health Department through TTH and host a mobile pop-up vaccination clinic that was geared towards the trans community, offering a safe space for people to feel seen, ask questions, and get vaccinated. From outreach, registration, vaccination, and post-vaccine observation, Alianza ensured that interactions were affirming so that all who came through their doors felt comfortable and respected.
This experience of working with several under-resourced or overlooked communities has solidified for me that, beyond COVID, the public health sector must work to dismantle biases and systems of oppression. We have to work alongside the community to remove barriers, so that every individual can have an equal opportunity to live a healthy life.
Q: What do you think has been the most important element of the TTH model?
Tiffany: Treating grantees as experts who will do what is best to address the needs of their communities has been key to TTH’s success. The flexibility and open-endedness of the grants helped build trust with the CBOs, and enabled organizations to make decisions and conduct activities that they felt would have the greatest impact on their community.
This model also allowed TTH to support smaller CBOs that are often left out of government or foundation grants due to their size and capacity. Some of our partner organizations have only one or two full-time staff and just don’t have the time or the experience to do the level of reporting or grant writing that is required for government grants. But they have the depth of relationships and community knowledge that was essential to getting the word out about testing and vaccinations.
I also hear from partners in Southern California all the time about how powerful the connections and space for collaboration was for them. Organizations that maybe never had a chance to meet with the county agency before, now met and worked with them regularly. And the CBOs really appreciated the deep collaboration with each other, and building a shared foundation. In Orange County, the TTH initiative was the first time that all the LGBTQ organizations in the county had worked together! Collaborative work is often not funded and it turned out to be so important.
Q: What are the most important strategies for creating a better and more equitable public health infrastructure in the next five years?
Tiffany: There needs to be a stronger focus on systems change that is community-led and sustainable over the long term. Public health infrastructure as it exists does not produce equitable outcomes for all communities, so it is critical to address inequities and prepare for future crises. Partnering with organizations that are diverse in size, expertise, population focus, and scope is a key strategy that can contribute to long-lasting change.
Additionally, Community Health Workers (CHWs)/Promotores need to be permanent public health jobs that pay a living wage. CHWs have been a crucial part of COVID-19 response and of TTH partners’ success and impact in connecting with community members, especially for populations that are often deprioritized.
We’ve seen over and over that one of the most effective ways to get folks vaccinated and informed is through trusted messengers. People are more able to trust folks that look like them, know them, share similar values and identities. And throughout the TTH initiative, across every city and region, we’ve seen the CHW model prove its legitimacy.
There are so many health equity issues, from heart disease to air quality, that CHWs and promotores can be so effective in tackling. Public health needs to continue supporting this work post-COVID.
We’ve come so far, but it’s really only the beginning of what’s possible. To be frank, the infrastructure needs continued funding, especially for the smaller organizations that can do the deep community-driven engagement that’s needed.