RWJFs mission and programmatic history set the Foundations long-term direction. Changes in direction typically take place when an incoming RWJF president proposes new priorities. Key stakeholders such as government health policy experts, former foundation officials, and current senior officers are then consulted during a formative stage, leading to a strategic plan that is brought before the Foundations board of directors for their input and approval (Hughes 2000).
Decisions to move into new areas take into consideration many factors. Most important are the current environment (critical population needs), feasibility of programs, the ability to build on existing work, opportunity to be a resource and neutral convener for policy-makers and communities, and whether the Foundations limited resources are sufficient to effect change in the area (Lavizzo-Mourey 2003). RWJF generally aims to exit a program area when the field has advanced sufficiently to sustain itself (RWJF 2004).
In recent years, the Foundation has begun to direct a greater proportion of its resources to multi-year, mission-focused grantsa reflection of its emphasis on a long-term strategy for affecting Americans health and health care. The multi-year commitments reflect the scale and complexity of problems being addressed. More interaction with other foundations, state and local governments, and especially the federal government is perceived by RWJF leadership to be necessary to address such issues. As the RWJF president has noted: Our resources may seem vast, and we may have great expertise among our staff and our grantees, but compared with even the shrinking resources of governmentlocal, state and federalindividual foundations and nonprofits are hard-pressed to create change (Lavizzo-Mourey 2005).