For the past year or so, we have been urging nonprofits to look into two funding sources that can potentially alleviate some federal funding uncertainty, Opioid Settlements and COPA Foundations. At the same time, we have been working behind the scenes to build resources to help you find these potential funders because we couldn’t find a definitive source for identifying them ourselves.
I’ll admit, it has taken a while to pull the information together, in part because these research projects have repeatedly moved to the back burner as urgent client work has cropped up all year. A month ago, I went out on a limb and held myself accountable for getting it done, by standing on a stage in front of about 150 people and promising to deliver these much-needed resources.
Today, KFA Nonprofit is excited to announce the release of the first comprehensive national list of 320 health care conversion foundations and COPA-mandated community investment funds - a resource designed to help nonprofits find dependable, locally governed, and mission-aligned funders at a moment when stability matters most.
Why This Matters Right Now
For decades, health conversion foundations - those created when nonprofit hospitals are sold, merged, or restructured - have played quiet but influential roles in community health and well-being. Many were endowed with tens or even hundreds of millions of dollars intended to support local needs in perpetuity.
Separately, states like Tennessee, Virginia, North Carolina, Montana, and Maine use Certificates of Public Advantage (COPAs) or Cooperative Agreements to regulate hospital mergers. These agreements often require health systems to create new, community-controlled health endowments designed to offset market consolidation and preserve public benefit.
But here’s the problem:
There has never been a complete national directory of these foundations - until now.
As government funding cycles become more erratic, these foundations represent one of the most reliable, recession-resilient sources of community investment in the United States:
- Their assets are endowed and professionally managed.
- Their funding is insulated from political swings.
- Their missions are place-based and tied to community health.
- Their grantmaking continues even when federal programs face disruption.
In times of government uncertainty, these are funders nonprofits can count on.
What Our New Database Reveals
Our research identified 320 health conversion and COPA-related foundations, including:
✔️ 303 foundations previously cataloged by Grantmakers in Health
These originate from nonprofit hospital conversions - typically nonprofit hospitals acquired by for-profit entities - with charitable assets preserved through independent foundations.
✔️ 17 additional foundations and health investment funds created by COPAs, AG settlements, or nonprofit-to-nonprofit restructuring
These include newly powerful entities in Appalachia, the Mountain West, and rural communities - places where public funding instability hits hardest.
Why This Took So Long
Aside from coming through what has proven to be an emergent year, this project required merging disparate, incomplete, and often difficult-to-access data sources:
- State Attorney General records
- COPA agreements
- Hospital transaction documents
- Public filings and IRS 990s
- Legacy health foundation directories (often outdated)
- Deep cross-referencing against national philanthropic networks
The result is the most complete and accurate mapping of community health foundations we could possibly create because we couldn’t find one.
And for nonprofits navigating a chaotic federal landscape, this could not come at a better time.
What You’ll Find in the Database
Each entry includes:
- Foundation name
- State
- Website URL (where available)
Future updates will include more complete profile data such as mission summaries, more detailed geographic focus/service area, asset size, and grantmaking history.
As federal uncertainty grows, we are committed to building an ever more robust tool that nonprofits can rely on.
Accessing the Database
Access the database here. For now, it is a simple spreadsheet. We’re looking into making it a bit prettier, but we wanted to get the data out as soon as possible.
If you know of a foundation or fund missing from our list or find anything inaccurate, LET US KNOW.
A Closing Thought
At a time when government support is unpredictable, communities need funders who are steady, reliable, and deeply invested in local well-being.
Health conversion foundations and COPA-created endowments are exactly that - anchor institutions in times of instability.
By publishing this new national database, we hope to:
- Empower nonprofits to diversify sustainably
- Improve visibility and accountability in health philanthropy
- Strengthen community resilience against federal volatility
- Expand access to long-term funding that communities desperately need
When public funding is uncertain, these foundations can keep critical work going.
And now, for the first time, nonprofits can find all of them in one place.