We realize that you probably have a lot of questions about tithing, and its affects on the hospital and the community. Memorial Health System President and CEO (Phil Newbold) has answered many of these questions as he speaks about tithing throughout the country. Here are some of the most frequently asked questions and responses from Phil.

(Q) What happens if you don't spend all the money (10% of remaining operating revenue) in one given year?
(A) It has been our experience that no one that we know of in any given year spends everything that has accumulated from the prior year. These projects and initiatives take a while to get up and running, so it's very difficult to spend all the money in any one year. What we recommend is that accumulated funds roll over into the next year. That's okay to a certain extent because then you can begin to make multi-year commitments. This also allows us to establish trust-building relationships with the community, get pilot experiments started and work out the bugs.

(Q) Why not use the hospital foundation?
(A) We feel strongly that tithing is not about check writing. It is about being active partners in the community. There is a big difference between writing a check out for some interesting project and being an equal partner in the development of a project, in the planning stages, and in the monitoring of the project once it is implemented. We are an active partner the whole way through and so this is not about giving money away, even though it is often depicted that way.

The development and ongoing management of this type of activity is better suited under our hospital operations model than it would a foundation. Typically foundations exist to assist with fund development and management, rarely do they get involved in the operational aspects of a project. Most foundations just don't find themselves in this type of role and many believe that there is no reason to get active and involved in a partnership.

This brings up the question about whether foundations should become more engaging and active. We made a gift to our Community Foundation of $500,000.00 to set up a healthy community fund to provide resources for projects that focus on issues related to community health. This has helped our Community Foundation become more oriented toward community health issues and has helped them become more active in building a healthy community. However, it is also controversial because the hospital foundation solicits money from the community for the hospital and then turns around and gives it away. This was not the case, the funds did not come from money raised in the community. They were an unexpected and unrestricted gift from a will.

(Q) Why not give the money to another organization (United Way for example) and let them distribute it?
(A) There are several reasons why that usually isn't a good idea. Often other organizations who provide funds in the community do so in order to help agencies meet operating expenses and cover costs. They also tend to fund the same agencies each year. Our criteria is aimed at new, innovative, never-been-tried-before initiatives and projects. We are not trying to help agencies get through a tough time or cover operating expenses. We are more interested in getting to the root causes of some of the problems and not just in treating them. We are looking for the opportunity to learn and to build new partnerships and relationships in the community and thus break down barriers and turf between them.

(Q) How far away from traditional medical care do you go?
(A) We have found that the longer you stay in the traditional medical care arena the more you find yourself having to deal with issues outside of that area. Habitat, housing, and other environmental issues are factors that contribute to a person's (and a community's) health. We are mostly interested in areas off the hospital's campus. There are issues like crime and violence that affect us all, particularly someone who will end up at the hospital as a result of them. If we can prevent some of the violence and crime through non-traditional mechanisms (i.e., drug prevention programs, domestic violence awareness, conflict resolution, skills building, etc.) we help to decrease the amount of medical affects of such environmental factors and in turn make our community a healthier place to live and work.

(Q) How do you structure this?
(A) We use Memorial Health System, Hospital and Foundation personnel and resources to administer tithing. The Community Health Advisory Group (CHAG) are hospital, health system and foundation administrators that meet bi-monthly. The Community Health Enhancement (CHE) committee are members of either the hospital, health system or foundation board of directors. At their quarterly meetings community representatives are often invited to participate. It is important to keep an open dialogue between the community and the CHE & CHAG members. In order to learn more about the health of our area we must keep our finger on the pulse of the community. To do this we invite outside speakers, community representatives, political figures and others to our meetings as well as ("community plunges.") This dialogue helps us to break down barriers between agencies, create partnerships and adds to our pool of resources. Through this process the CHE is able to point out areas where we need to pay more attention.

(Q) Can you get spread too thin?
(A) Yes, you can get spread too thin, but that's why you have to develop your criteria and priorities for funding. Maintaining the proper level of balance between current issues and the ones that you are just discovering is very important. Tithing is about partnerships, it's about allocating resources to prevent problems that will later affect the community's health. It's about recognizing that we need a new model to deal with these community issues. We need to target new and different types of initiatives. We can't continue to throw money at the problems as they exist but we need to prevent them from becoming problems.

(Q) Is it okay to fail?
(A) Most definitely! In fact we often learn more from our mistakes than we do from our successes. When you encounter controversy that's when you need to dig deeper. You're bound to learn something. The risk of trying something new, in providing resources to innovative and "different" initiatives will sometimes produce results and sometimes it won't - but what you learn from those outcomes is always going to be valuable. Sharing what you learn, whether it's through success or failure, is very important to others who will try to produce similar programs.