Illustration by Brian Taylor
In the early 2020s, Richmond had a problem — a global pandemic-sized problem. By the end of 2021, the city of Richmond and Henrico and Chesterfield counties had reported nearly 120,000 COVID-19 cases since the start of the pandemic, resulting in 1,800 deaths, according to the Virginia Department of Health.
Residents were already at higher risk than the state average for heart disease and infant mortality, among other conditions, according to the health department — a host of reasons, including healthcare access, racial inequality and living conditions, were to blame. Solving the acute needs raised by the pandemic and combating the undercurrent of societal health disparities were daily challenges for the Richmond and Henrico Health Districts staff, including their director, Dr. Danny Avula.
Then came the life raft. Aid from philanthropic sources and local, state and (most sizably) federal governments allowed public health experts to fight back by giving a host of professionals and volunteers resources that would eventually help the World Health Organization declare the end of COVID-19 as a global health emergency.
What Richmond made from that aid, though, may have been more beneficial than some first anticipated. Avula and the health district staff, from their office at the corner of Fourth and Main streets downtown, sought to apply millions of aid dollars, leveraged by their public health expertise, to fight the wellness gap in Richmond at its root.
The Richmond and Henrico Public Health Foundation and its Health Equity Fund has delivered millions in grants to nonprofits since its founding in 2021. Five years on, the foundation hopes to capitalize on a big boost by city government and reimagine how healthy communities are made and maintained for the long term.
A Novel Direction
Health equity, as defined by the WHO, is achieved when everyone can attain their full potential for health and wellbeing. The Health Equity Fund was created to address health inequities across the Richmond region, such as disproportionate sexually transmitted infection cases in the Black population and a 20-year life expectancy gap between predominantly Black and White neighborhoods. The pandemic led to inequalities in COVID vaccination rates, hospitalizations and deaths for Black and Latino communities. To date, the foundation has disbursed over $4.3 million into 37 community organizations comprising a mix of grassroots volunteer groups and large nonprofits.
Although the fund and its foundation were launched just five years ago, Avula, now mayor, had sought some form of this funding model since his first days with the city’s health district.
“I’d seen a couple of other models of public health departments that had [launched foundations] around the country,” Avula says. He notes that local analogs include the Richmond Behavioral Health Authority’s 2010 establishment of a charitable arm focused on mental health grants. “[During] COVID, there was a new sense of urgency around trying to figure out how to deploy financial resources quickly. That really brought the idea to the forefront again.”
The cornerstone of HEF’s founding was federal funding from the Biden administration’s American Rescue Plan Act, a stimulus bill that included billions of dollars in emergency funding for state and local governments. Out of the $154 million package that Richmond received, City Council approved $5 million to seed the fund.
Avula and his fellow health district employees, including Amy Popovich and Ruth Morrison, sketched out the fund’s priority areas based on years of experience and health data: improvements to healthcare access, food security, maternal health outcomes, mental wellbeing and health education, among others.
“It was kind of a cool marriage of the government using the things that it’s good at, which is being able to receive federal dollars, being able to do monitoring and evaluation and infrastructure building, [and] marrying that with a community advisory board that knew the landscape, knew the organizations, and could make the decisions about who should receive funding, and then ultimately getting money to where it was needed most,” Avula says.
Currently, the Richmond and Henrico Public Health Foundation is overseen by a board chaired by board President and public health expert Natalie Pennywell.
“Over the last five years, to be able to leverage resources on behalf of the city for the community, making sure that equitable model that has been built through our [Health Equity Fund] process can be applied to the things that the city has been doing over the last, I don’t know how many decades, has been exciting,” Pennywell says.
Organizations can apply for HEF funding to support ongoing efforts based around the fund’s priorities or to develop programs that can fill new gaps in public health and healthcare access.
Delaney Savedge, interim director of the foundation, joined the staff in October 2025 after five years at the RHHD. She sees the grant review process as setting the HEF apart from other foundations. “We have subject-matter experts who review the applications based on, ‘Is it a public health best practice?’” she says. “Then we also have the community advisory committee. That’s a panel with, typically, 11 community members who have lived experience in the health disparities that we’re targeting. ... They bring [a] perspective that is invaluable when you’re working in health disparities, of what the community actually wants.”
“During the grant-making process in the traditional sense, by the time you get to the point where the person who is most impacted by the funds that will be distributed gets a say about what those funds look like, most of the time, the organization has made a decision about who gets funded,” Pennywell adds. “I think the wonderful thing about HEF is that we incorporate that community perspective in the process.”
Representatives from grant-winning organizations gathered in March 2025 with Mayor Avula and foundation staff (Photo by Olivia Golden, Richmond and Henrico Health Districts)
Tracking the Results
This region has no shortage of generous do-gooders; more than 25% of Richmonders volunteer for the nearly 10,000 nonprofits in the metro Richmond area, according to data from AmeriCorps and nonprofit tracker Cause IQ. In the early months of 2020, organizations saw volunteer numbers plummet and funding streams dwindle or halt altogether, while demand for services skyrocketed. As the pandemic swelled to its most volatile in 2021, nonprofits — especially those that provide health services — struggled to meet the need.
That was the environment the HEF stepped into in its first year. “The health equity fund created a pathway to be able to scale up some of these organizations very quickly and both get them resources to drive the work that they were doing so well, and, in some cases, to actually do a little bit of capacity building as well,” Avula says.
The 37 organizations awarded grants since 2021 include the Nationz Foundation, whose funding improves access to STI testing and education; RVA Community Fridges, which added more community cook days to fill its free food fridges across Richmond; and Family Lifeline, a nearly 150-year-old nonprofit that received funding in March 2025 to hire a bilingual community health worker to improve child care in Latino homes.
It wasn’t long before that extra staffer was filling a need, says Family Lifeline CEO Jennifer Case, by helping a Spanish-speaking mother and her 6-month-old daughter find immediate vaccination services and establish ongoing healthcare coverage.
“Our community health worker was able to really be that bridge between the Department of Social Services, get the family clarified on what documentation was needed, get the application processed, and then that child was able to get health insurance again,” Case says. “This grant funding allows us to have a staff member whose whole focus is this resource coordination and referral support work.”
A Path Forward
Now in its fifth year, the Health Equity Fund has disbursed the majority of the initial $5 million ARPA investment, and Pennywell and Savedge must continue to find sources to replenish the fund. The solution came from a familiar name: the administration of Danny Avula, as well as a restructuring of the city’s nondepartmental fund process.
In years past, the city has directly managed its grant funding by accepting applications, reviewing proposals and disbursing funds. With the approval of the fiscal year 2027 budget in May, City Council ceded management of the nonprofit grant process from the city to three partner agencies, United Way of Richmond, CultureWorks, and the Richmond and Henrico Public Health Foundation, effective July 1. The nonprofits, which will receive a changing amount of funds based on the city’s approved budgets, were selected by city officials to administer portions of the allocated funds across four categories: economic mobility, children and families, arts and culture, and health.
Avula cites a 2024 audit that found the city lacked the capacity to properly distribute and manage nondepartmental funds to local nonprofits. “For me and my administration, building better systems, creating pathways to increase transparency, building trust in how local government is using taxpayer dollars — those were all huge priorities for us, and so this felt like a really important thing to invest time in, in the first year,” he says.
As of press time, both the RHPHF and Avula administration acknowledged that details will be filled in over the coming months for the transition from the city’s system to the foundations, although Pennywell and Savedge anticipate few changes to the services they deliver to nonprofits. The city funding, paired with other philanthropic sources and private donations, is the first glimpse at a future for the fund beyond the initial investment.
“It felt really great to see that the city was being very thorough in this process. ... We had to prove that we were the right fit for this new project, and I think we did that,” Savedge says. “We were able to take a really in-depth look about how we want to deliver our services and what that model looks like to keep costs lower on the admin, and so that programs can get as much of these funds as they can. I think we are excited for where the process is going.”
