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Wellville’s 100&Change Application

Like just about every other non-profit focused on making the world a better place, Wellville applied for the MacArthur Foundation’s 100&Change grant. In the event we win the $100 million prize our plan is to invest it in our communities to help accelerate their work to make serious health change. While we know the money would make a big difference to our communities, we had more realistic expectations for our involvement in the competition. We found the application process itself worth the effort. It forced us to sharpen our focus, and it encouraged healthy debate among us. Beyond that, we believe the process will lead to broader exposure for Wellville, and our five communities.

Because we think there might be some interest in how we answered simple questions like “What problem are you trying to solve?” we’re going to publish our application here, in regular installments. Below is the third in the series.

Tactics and Technology

Our basic premise is that society at large has the knowledge and capacity to keep people healthy. But in many communities, the culture, affordances (environment, food supply, income), training/management skill, and teamwork to realize this potential are lacking.

Therefore, we have so far focused on fostering teamwork and building capacity. Now we are moving to help the communities implement specific, focused (mostly non-medical) programs such as nurse visiting programs, universal pre-kindergarten, mental health support, diabetes/obesity prevention, coordinated care, and leadership/management skills. For almost all of these, there are national entities, for- or non-profit, that offer curricula, training and guidebooks or apps/online services. In short, we are not handing out fish or even training people to fish; we are helping the communities to build their own training schools for fishers.

This approach will both improve residents’ health and provide them with job skills and opportunities as coaches, whether in specific areas such as diabetes or mental health or cooking/nutrition, or recreational sports and community engagement.

Possible partners include: Nurse-Family Partnership, Friends of the Children, Parenting Journey, School Food Focus, Blue Mesa Health (diabetes), Healthify (care coordination), Medicasafe (addiction), Ashoka (leadership), Google, and Verizon (tech capacity).

Your Timeline and Key Milestones


  • One serious, scalable, outcome-based initiative per community
  • Overall measurement/evaluation partner selected
  • Initial outreach to food companies and national brands
  • Outreach to Greater Wellville communities to leverage learning

2018-2021 (same each year, plus more by year, as described below)

In each community, each year:

  • Evaluation of previous year’s launch, revisions & adjustments, continued rollout/scaling (unless unfixable)
  • Launch of additional complementary initiatives
  • Collaboration with local healthcare and insurance providers as they move towards more outcome-oriented and community-based revenue models
  • Engagement with local food sources (restaurants, schools, hospitals, retailers, producers/distributors) to improve food quality/access

Across communities:

  • Annual leaders’ gathering, with feedback from evaluator; partners and press and experts invited

Wellville National Team:

  • Staff additions as needed
  • Work with food companies to help them offer healthy, affordable, appealing options


  • Start of work with state/federal authorities around payment systems, Medicaid waivers, other policy-oriented issues (re community efforts, not as policy advocate)


  • Focus on financial sustainability: moving from grants to results-based funding, sustainable business models
  • Assessment of impact on health systems’ and insurers’ financial results (under new US payment models)
  • Continuing financial support based on those metrics

2021 — What we’ll see:

  • Five communities showing measurable improvements in health and social factors
  • Sustainable employment and training institutions in caregiving and (health) coaching
  • Vendors making sustainable profits with health-cultivating offerings
  • Sustainable business models
  • A national conference with press, government, business and others eager to copy our approach
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