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When a Donor Comes to You, Be Ready

Kevin Causey
Published:  02/03/2021


Pictured above: Montage Health patron, Bertie Bialek Elliot

Four years ago, a patron of our healthcare system, Montage Health, told our CEO she wanted to make a gift to our hospital that would be transformational. Soon after, she did, giving Montage Health $106 million.

It is a phenomenal gift, especially for an institution of our size. And it illustrates what I have found to be true in my 25 years in this field: philanthropists maximize their giving when their inspiration and confidence are in perfect alignment with the organization they are supporting.

Sometimes, this alignment can develop relatively quickly. More often, and particularly for transformational gifts, it takes years. In either case, it is incumbent upon us to drive the process––to identify, inform, inspire, involve, ask, or, as in this case, accept, and then to include the donor in executing, as much or as little as they desire.

Our relationship with this patron goes back decades. Bertie Bialek Elliott and her first husband have been involved with Community Hospital of the Monterey Peninsula (the keystone asset of the Montage Health system) almost since its inception. The couple moved to Monterey, California the year the hospital opened, and she remembered being dazzled by its modern design. Her husband was one of the first physicians on the medical staff. Bertie was engaged from the outset, as a philanthropist and volunteer, serving on the Board of Trustees and leading more than one of the hospital’s fundraising campaigns. She had a keen interest in the evolution of Community Hospital, supporting, among other initiatives, the creation of its cancer center and its inpatient rehabilitation unit. She became a thoughtful and valued counsel to Dr. Steven Packer, CEO for the last 21 years, serving on a select advisory council at his request.

While Bertie had generously supported Community Hospital for years, her decision to make this transformational gift came the day her then-husband, David, was diagnosed with terminal cancer. She told Dr. Packer her plan the following day.

Dr. Packer had the wisdom and compassion to graciously thank Bertie and to delay further discussion of the gift.

“Let’s take care of David’s journey first,” he told her. “We can talk about this another time.”

Putting the patient first, putting Bertie’s grief first, putting our mission to provide exceptional healthcare first, reflected the relationship they had developed over two decades and exemplified the fundamental reasons for Bertie’s confidence in our organization. This was paramount in setting the process on the right path.

After the end of her husband’s journey, a few months passed, and in the interim I was hired as chief development officer at Montage Health to oversee the Montage Health Foundation. One of my first tasks was to lead the process to bring Bertie’s philanthropic vision to fruition.

She initially did not dictate how she wanted her gift used.

“I have every confidence in Steve and the people who work with him,” she said. “I gave it with no strings. They can take this and run with it.”

That illustrates the first part of my experience with major gifts: they are made when the giver has confidence in the organization and the people who lead it. The second part, that they are truly inspired, would come next.

We set about developing a proposal for a project that would be worthy of the gift. We gathered the Montage Health leadership in a series of sessions where we asked one fundamental question: What would be the most meaningful way for our organization to use $100 million? We discussed dozens of ideas and initiatives. Many were discarded based on Bertie’s desire that it be transformational; simply adding to the endowment, or reinforcing current programming and infrastructure, didn’t meet that criteria.

Ultimately, we landed on four concepts:

  1. A new center for women’s health
  2. A countywide healthcare navigation system
  3. A center for healthy aging
  4. A center and program for behavioral and mental health services for young people

We prepared four, two-page papers that laid out these ideas; they were thought out and articulated, but not overly “produced.” We knew from experience that this would be Bertie’s preference. Dr. Packer then presented them to her.

After reading the four papers, Bertie knew immediately which she would choose. To be sure, she asked each of her three daughters to weigh in, without sharing her own opinion. It was unanimous: the center for behavioral and mental health services for young people.

The directive in hand, we set out to create a more comprehensive proposal.

We gathered national, regional, and local data and statistics. We worked with our internal finance, facilities, and project management teams to get a sense of scope and scale. We worked with our current behavioral health clinicians to get a view of current best practices in working with young people, and the gaps, which were significant. We gathered information from practitioners nationally and globally who were doing innovative and forward-thinking work with young people. We put it together a booklet, telling a compelling story with an arc backed up by rock-solid data.

Dr. Packer met with Bertie again. She had only two requests, both of which tie to my opening point. First, she wanted it to be called Ohana, the Hawaiian word for family, which extends beyond blood relatives to the entire village. The second request was that Dr. Packer remain at Montage Health through the project’s opening, as it was her confidence in him and the organization he runs that made her feel this gift would indeed be transformational.

Confident and inspired, the gift was made. Within two weeks Bertie transferred $106 million.


Staying true to our mission, building meaningful relationships and authentic opportunities for engagement, and putting exceptional care and intention into a proposal, specifically designed for the donor at hand: these were the hallmarks that catalyzed a transformation of healthcare for the young people of this community.

As I share this story with you, our world is facing an unprecedented global health crisis due to the coronavirus (COVID-19) pandemic. Hospitals and healthcare organizations like ours are being challenged to rise to the occasion. Now, more than ever, our donors and our communities are looking to us as a source of confidence and inspiration. And there are many who want to step up and help us succeed.

Be ready, when the donor comes to you.

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Meet The Author

Kevin Causey
Vice President and Chief Development Officer
Montage Health Foundation

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