Key strategies employed
- Designate a portion of investible reserves for community investments
- Allocate to financial intermediaries, including community development financial institutions (CDFI) loan funds and other investment managers offering place-based private debt strategies
- Align community benefit with place-based investing strategies
- Leverage investments to increase access to higher education
Location: Headquartered in Livonia, Michigan (in metro Detroit), Trinity Health serves communities across twenty-two states.
Employees: more than 97,000
Revenues: $16.3 Billion
Investment portfolio: $13.6 billion
Mission of Program
“The Community Investing Program at Trinity Health is a demonstration of our mission to transform and be a healing presence in our communities. Based on the core value—to stand with and serve those who are poor, especially those who are most vulnerable—the Community Investing Program lends capital to Community Development Financial Institutions (CDFIs) which are mission-driven organizations that provide credit, financial and technical services to low-income and underserved people and communities.”
Trinity Health has been investing in communities using low-interest rate loans for more than a decade through intermediaries called Community Development Financial Institutions (CDFIs). The Community Investing Program created a process to leverage Trinity’s “strong balance sheet to advance community benefit.” To date, Trinity Health has invested more than $35 million through this program, including $25 million with CDFIs. In 2016, Trinity launched the Transforming Communities Initiative, a set of six community multi-sector partnerships that will receive a combination of grants, loans, and technical assistance. For this effort, Trinity will allocate up to $40 million in Community Investment Program funds for projects related to this initiative.
Trinity’s approach to investment is centered on their belief that supporting community health and well-being is central to being a people-centered health system. To do this, they invest in CDFIs that support access to:
- affordable housing and supportive housing;
- business start-up and growth;
- charter schools;
- community facilities;
- healthy food production and access;
- job creation;
- transit-oriented development.
When Catholic health systems merged to form Trinity Health, many of the smaller hospitals had legacy community investments, mainly with Mercy Loan Fund—a CDFI that builds affordable housing. Trinity Health administration worked to institutionalize these investments, along with shareholder advocacy efforts, through the adoption of a socially responsible investment policy in the early 2000s. Initial outreach efforts to find new investment opportunities included “cold calls” and letters to CDFIs.
Trinity Health’s Community Investing Program approximates 1 percent of its operating investment portfolio, authorized by senior management and approved by the board. In general, Trinity Health seeks a 2 percent annual return on community investments. Loan terms are typically three years. With larger CDFIs, Trinity will consider a five-year term, which is the longest approved to date. Trinity Health may consider longer-term loans in the future.
Cathy Rowan, the director of socially responsible investments, manages most of the relationships with CDFIs. She is part of a larger Socially Responsible Investment (SRI) team that is housed in Trinity Health’s advocacy department. The location of this management has shifted over the years. Trinity’s Socially Responsible Investment Advisory Group (SRIAG) approves decisions to make loans to CDFIs based on recommendations from the SRI team. The SRIAG and SRI team assist with the community investing loan work of the Transforming Communities Initiative. Treasury department provides support with loan servicing, due diligence, and reviewing financials. The SRIAG provides quarterly reports to the investment committee of the Trinity Health Board of Directors.
Trinity Health invests in CDFIs focusing on underserved communities with an emphasis on the needs of women and children. They look for organizations that do this through one or more of the following:
- support of affordable housing and special needs housing;
- promotion of available childcare for low-income families;
- empowerment of low-income people to create, manage and own enterprises;
- revitalization of urban and rural areas;
- safeguard of the environment, including the sustainability of Earth, and;
- support of healthy communities.
Trinity seeks to invest 90 percent of available community loan funds in states where there are Trinity Health Ministries. Currently, Trinity has channeled more than 90 percent of loans in its target geography. The remaining balance can be placed in other states and internationally.
Trinity Health has not established specific caps on investment size. Rowan explained, “Overall, we don’t want to be the largest investor but we are not afraid to take the lead if there might be a longer term relationship.” Trinity’s partnership with Finance Fund in Ohio, a CDFI that has a lending program focused on supporting childcare centers, is an example of this.
In September 2014, Finance Fund staff were looking into establishing a fund to increase access to healthy affordable food in underserved areas. At the same time, Trinity Health was shifting their investment goals to address obesity and nutrition issues in the local community. In relation, they decided to double their loan to the Finance Fund, to $1 million at renewal. This loan capital helped fund some of the first healthy food projects in Columbus and Cincinnati. Diana Turoff, CEO and president of Finance Fund, wrote, “This early investment…was key to opening doors to additional investment from foundations, banks and eventually the State of Ohio to launch the statewide Healthy Food for Ohio (HFFO) program in March 2016.”1“Annual Gala Honors Champions for Ohio,” Finance Fund, May 26, 2016, www.financefund.org/blog/archives/2016/05/annual-gala-honors-champions-for-ohio.
Staffing and budget
Cathy Rowan spends about 20 percent of her time overseeing the program. Jody Wise also works as a full-time consultant, helping the system become more proactive in building connections between hospitals and CDFIs where Trinity has already made investments. A staff person in Treasury Services assists with reviewing financials, providing questions for due diligence and the loan servicing.
Key strategies employed
Designate a portion of investible reserves for community investments
Trinity’s decision to set aside a portion of investable reserves for community investment was a response to their institutional goal to improve health and well-being in underserved communities. As healthcare reimbursement begins to focus more on community health, Rowan explained, “The business case is the health case. I think with the ACA (Affordable Care Act) and the changes that are transpiring, and the fact that hospitals are becoming responsible for holistically attending to the health needs of their community, there will be an increasing connection to the kind of community people are living in—and needs around jobs, parks, food access, etc.; and that has been the work of community development financing for many years. Community investment can no longer be seen as ‘nice to have’ and an add on, but as necessary to improve the health of the communities that hospitals serve.”
Allocate to financial intermediaries, including CDFI loan funds and other investment managers offering place-based private debt strategies
Trinity Health has decided to invest only through CDFIs. As Rowan noted, “The reason we haven’t provided direct lending is internal staff capacity. We don’t have one full-time person dedicated to do community investing so we rely on CDFIs for developing loan project pipelines, underwriting, and due diligence.”
Align community benefit with place-based investing strategies
In 2016, Trinity Health rolled out phase one of its Transforming Communities Initiative, which is focused on reducing tobacco use and obesity, and promoting overall healthy living. Through a competitive application process, teams in Trenton, New Jersey; Springfield, Massachusetts; Maywood, Illinois; Silver Spring, Maryland; Boise, Idaho; and Syracuse, New York will receive up to $500,000 annually for up to five years. The funding requires a full-time liaison to support the efforts and each community partnership is focused on areas of greatest need in their community. The initiative will also include the availability of $40 million in low-interest investment loans to support complementary interventions (e.g. to address food access, housing, and early childhood).2“Trinity Health Grant Initiative Seeks Community Transformations,” Catholic Health Association of the United States, March 15, 2016, www.chausa.org/publications/catholic-health-world/article/march-15-2016/trinity-health-grant-initiative-seeks-community-transformations.
Currently, Trinity Health’s Community Investment Program has loans with the following Community Development Financial Institutions:
- Calvert Social Investment Foundation (National, headquartered in Bethesda, Maryland)
- Chicago Community Loan Fund (Illinois)
- Corporation for Supportive Housing (National, with offices in New York, California, Connecticut, Washington DC, Illinois, Michigan, and Ohio)
- Disability Opportunity Fund (National, headquartered in Albertson, New York)
- Florida Community Loan Fund (Florida)
- Finance Fund (Ohio)
- Idaho-Nevada Community Development Financial Institution (Idaho)
- IFF (formerly known as Illinois Finance Fund) (Iowa, Illinois, Indiana, Michigan)
- Low Income Investment Fund (National, with offices in California, Washington DC, and New York)
- Leviticus 25:23 Alternative Fund (Connecticut, New Jersey, New York, and additional lending activity in New England)
- Mercy Loan Fund (National, headquartered in Denver, Colorado)
- National Federation of Community Development Credit Unions (National, headquartered in New York
- National Housing Trust Community Development Fund (National, headquartered in Washington DC)
- Nonprofit Finance Fund (National, headquartered in New York)
- Northern California Community Loan Fund (California)
- Northern Initiatives (Michigan)
- Opportunity Resource Fund (Michigan)
- Partners for the Common Good (National, headquartered in Washington DC)
- The Reinvestment Fund (Mid-Atlantic states, with a national Healthy Food Financing Initiative)
- Rural Community Assistance Corporation (California, Idaho, Oregon)
Leverage investments to increase access to higher education
Beginning in 2012, President Barack Obama invited undocumented young people to apply for Deferred Action for Childhood Arrivals (DACA) status. Between 2012 and 2015, over 700,000 young people gained DACA status. However, during this same time period only one third of medical schools surveyed had admitted any DACA status students (who are still not eligible for federal loans).3Elise Foley, “This Medical School’s Effort to Help Dreamers Could Benefit Entire Communities,” Huffington Post, January 24, 2016, www.huffingtonpost.com/entry/dreamers-medical-school_us_568be522e4b0b958f65ce7ed.
Trinity Health, which owns Loyola University Chicago’s Stritch School of Medicine, created a low-interest loan product specifically for seven DACA status students attending Loyola University Stritch School of Medicine. The loan product is designed to provide prospective, financially challenged college students with the opportunity to pursue nursing and other clinical, health-related degrees and, in turn, to strengthen the diversity and quality of Trinity Health staff. Trinity Health has allocated $5 million from its Community Investing Program for these scholarships.4“Community Investing,” Trinity Health, www.trinity-health.org/body.cfm?id=524&iirf_redirect=1. It has also allocated $6 million for scholarships for financially challenged students pursuing health-related degrees at three other academic institutions. Trinity Health lends the money to the universities at a 1 percent interest rate.
To date, Trinity Health has deployed more than $25 million with CDFIs that focus on community and economic development in the communities that the health system serves. Trinity Health tracks impact through the outputs of their investments, such as the number of jobs or businesses created. Stories and anecdotes have been the most powerful way of sharing the success of this strategy, especially with Trinity Health’s Board of Directors.
To highlight the kinds of initiatives that Trinity supports, below is a list of projects the institution has given one or more loans to:
- The Finance Fund in Ohio helped to renovate and expand the only licensed childcare center in Noble County, Ohio.
- The Nonprofit Finance Fund, a national CDFI headquartered in New York, helped provide a mortgage loan to finance the construction of a new, 51-bed family shelter in Macomb County, Michigan.
- The Leviticus Fund, a CDFI that funds in the Northeast, provided a construction loan for affordable homeownership project for low-income families in Newark, New Jersey.
- The Corporation for Supportive Housing, a national CDFI, provided a predevelopment loan for a new building providing forty units of permanent supportive housing to homeless and at-risk parenting youth in Chicago, Illinois.
For more information
Cathy Rowan, Director of Socially Responsible Investments
Cathy Rowan, interview by David Zuckerman and Katie Parker, Bronx, NY, January 29, 2016.
References [ + ]
|1.||↑||“Annual Gala Honors Champions for Ohio,” Finance Fund, May 26, 2016, www.financefund.org/blog/archives/2016/05/annual-gala-honors-champions-for-ohio.|
|2.||↑||“Trinity Health Grant Initiative Seeks Community Transformations,” Catholic Health Association of the United States, March 15, 2016, www.chausa.org/publications/catholic-health-world/article/march-15-2016/trinity-health-grant-initiative-seeks-community-transformations.|
|3.||↑||Elise Foley, “This Medical School’s Effort to Help Dreamers Could Benefit Entire Communities,” Huffington Post, January 24, 2016, www.huffingtonpost.com/entry/dreamers-medical-school_us_568be522e4b0b958f65ce7ed.|
|4.||↑||“Community Investing,” Trinity Health, www.trinity-health.org/body.cfm?id=524&iirf_redirect=1.|