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Last October, 35 major donor families, calling their collaborative The Audacious Project, gathered in California and committed $1.03 billion to more than a dozen nonprofits whose proposed projects span multiple years and take on major challenges.The collaborative, housed at TED, announced the winning nonprofits Tuesday, after spending more than a year selecting the groups and helping them sharpen pitches for larger projects than philanthropic funders typically support. It’s not until the donors meet in person that they decide how much to give to each group.Jennifer Loving, the CEO of the San Jose-based nonprofit Destination: Home, said it was “shock and awe,” when they learned the donors had met their funding request to help expand homeless prevention services to multiple U.S. cities.“It’s not for the faint of heart to work on this issue in America,” Loving said, referencing the stigma around poverty. “And so you kind of brace yourself. You never know if people are going to see what you see and it was beautiful. It was really beautiful.”Connie Ballmer, cofounder of Ballmer Group along with her husband Steve Ballmer, the former CEO of Microsoft and owner of the Los Angeles Clippers, has been a donor since 2021, when she went with one of their sons to learn more about funding around climate change.“Nowhere that I know of can you raise a billion dollars in two days,” she said. “For an organization to raise an amount whether it’s $40, $60, $80 million, I mean, do you know how long that takes them to do that kind of fundraising?”This year, the grantees also include the Arc Institute, a relatively new research group in California, to support its development of a virtual model of a cell that it hopes will help scientists identify treatments for complex diseases like Alzheimer’s.The South Africa-based group, Tiko, also received funding to expand its services for teenage girls, including contraception, HIV treatment and responses to sexual violence. It was the third time Tiko had applied for funding from Audacious, said CEO Serah Joy Malaba, with the hope of scaling their work to reach more girls.In total, 55 major donor families have participated in at least one round of The Audacious Project’s work. The group expands by invitation and the formal criteria that donors be willing to commit at least $10 million to the funding round. Many end up donating more, in part inspired by the commitments that others make in the room.Another donor, Tegan Acton, who cofounded Wildcard Giving along with her husband, Brian Acton, a cofounder of WhatsApp, said she participates because she believes in collective action and values the focus on funding solutions developed by people close to the problems. Acton also said she’s enjoyed seeing how different donors approach their funding decisions.“Some people come and they have a binder printed and they have a thousand tabs with little notes about every project and they’ve marked up the appendices” she said, whereas others, “show up and watch the videos and see what sparks interest.”As part of the application process, finalists record something like a TED Talk that introduces themselves and their project.Loving, from Destination: Home, said the guidance from Audacious and The Bridgespan Group, a nonprofit consulting firm, helped sharpen their plan for scaling their approach to homelessness prevention. The initiative, Right at Home, identifies people and families most at risk of losing their housing and gives them money and support so they don’t. The approach now has won significant public funding in San Jose.“Going through this process was probably one of the most rigorous things we’ve ever done,” Loving said. “I can say with total confidence that it made us smarter.”Loving’s project is a good example of the kind of big change that The Audacious Project seeks to identify. Her group had not aspired to work nationally but identified a solution they think may help other places. Rather than opening new offices or expanding, they will partner with local groups, bring them funding and ask them to participate in research to assess the impact.For the first time this year, some organizations received a second commitment from Audacious donors, including Last Mile Health. Their initial grant in 2018 helped to train many more community health workers in multiple African countries, going from 2,000 to 23,000. This time, they received $20 million to again train more of these front line health workers but also to support an ongoing project to coordinate and mobilize more domestic funding from the countries where they work.“It’s not just a philanthropic investment and then a cliff,” said Lisha McCormick, CEO of Last Mile Health. Instead, the funds will support a reworking of how governments fund their public health systems following major cuts to U.S. foreign aid, which made up a significant portion of some countries’ health budgets.Anna Verghese, executive director of The Audacious Project, said they’d considered making second round grants for a while.“The honest question that we and our donor community had to wrestle with is, what kinds of partners are we if we walk away right when that momentum is building?” she said. Associated Press coverage of philanthropy and nonprofits receives support through the AP’s collaboration with The Conversation US, with funding from Lilly Endowment Inc. The AP is solely responsible for this content. For all of AP’s philanthropy coverage, visit https://apnews.com/hub/philanthropy. Thalia Beaty, Associated Press
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E-Commerce
As President Trump has cracked down on all kinds of immigration, tech workers and students have been caught in the crosshairs. In a bid to curb use of the H-1B visaa program that allows employers to hire skilled talent from abroad and is widely used across the tech industryTrump imposed a whopping $100,000 fee on new applications last year. The steep cost of hiring H-1B workers has already had an impact on tech companies and other employers that have come to rely on the visa, leaving many students and aspiring H-1B workers with few options to remain in the country. Some employers have been forced to reevaluate their hiring strategy and have opted to sit out the H-1B lottery this year. For small companies, the fee has made an already challenging, expensive process virtually impossible to navigate. Amid this political climate, the immigration law firm Ellis wants to simplify work visa applications for companiesand workersthrough a tech-enabled platform that uses AI to automate parts of the process, which remains complex and largely paper-based. With a new subscription service, Ellis is now offering employers a tiered option that starts at $2,000 a month, which allows smaller startups with under 50 employees to file unlimited visa applications. That includes most of the common work visa types, from the H-1B to the J-1 student visa or TN visa for workers from Mexico and Canada. Most immigration lawyers still bill by the hour or by case, which means companies can spend thousands of dollars per application just on legal fees. (On an individual basis, Ellis charges anywhere from $2,500 to $12,000 to prepare applications; the H-1B visa, for example, costs $3,000 in legal fees.) By bundling its services, Ellis hopes to encourage employers to sponsor more immigrant workers. If you have a fixed platform fee, like you would with Ellis, your marginal cost of sponsoring a visa actually goes down, which is an incentive we’d like to encourage, says Sampei Omichi, the founder and CEO of Ellis. [Screenshot: Ellis] There are other immigration law firms like Manifest Law that also have a flat fee option, which is more cost-effective for employers, as well as tech platforms like Boundless that provide on-demand legal support for visa applications. Some products are fully automating the visa application process, which means there is limited input from actual immigration attorneys. Ellis is pitching its platform as a more comprehensive solution for companiesand especially tech employersthat are looking for tech-forward legal support and the full services of an immigration law firm. Ellis has managed to bring down the legal costs associated with visa applications in part by employing AI agents where appropriateand only with the oversight of full-time staff attorneys. By automating a lot of the rote and manual work that comes with a more operational type of law, you actually open up the attorneys to do what they do best, which is case strategy, Omichi says. Frankly, most of their job now is acting as a therapist for the folks that are going through the immigration process. [Screenshot: Ellis] For workers seeking visas, Ellis not only offers a smoother, more streamlined application process but also holds the promise that employers might be more inclined to sponsor their visa, even in a hostile environment for immigration. Omichi says the platform aims to provide more transparency into the process, allowing workers to keep tabs on their application through a dashboard and additional elements like shipment tracking. (Applications for the H-1B visa, for example, typically involve hundreds of pages and need to be assembled by hand and shipped out.) In advance of the H-1B lottery opening up next month, the firm also introduced an H-1B lottery odds calculator, to give applicants a sense of how likely they are to get approved for a visa based on their title and location. Perhaps most importantly, Ellis claims to have a 99.4% approval rate on its visa applications; when a visa is denied, the applicant gets a full refund of their legal fees or can file again free of charge. Over the last year, Ellis has filed over 400 applications on behalf of employees at AI startups like Adaptive and Wordware; by the end of 2026, Omichi says the firm is aiming to help 1,000 people secure visas. At a particularly volatile moment, Ellis also hopes to help workers wade through the morass of immigration policy, which can change on a dime under the current administration. We really try to be like an extension of their people team, Omichi says. The use of automation allows Ellis to be more responsive to its clients than other lawyers might be. In addition, the firm invests in education and resources to help both employers and workers who are scrambling to keep up with policy changes, along with giving companies a direct line to Ellis via a dedicated Slack channel. Our job is to kind of simplify a traditionally very, very, very complex process into something a layman can understand, Omichi says. For employers, it means retaining their best talent. And for employees, it’s their livelihood. It’s often the most important thing in their life.If they don’t have stable immigration status, nothing else really matters.
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E-Commerce
In medicine, rare is often used to describe conditions that affect relatively few people. But when you work in healthcare long enoughespecially at the very beginning of lifeyou realize rare diseases are not rare at all. As a neonatologist, I cared for newborns whose symptoms didnt follow a familiar script. An infant struggling to breathe. A baby who couldnt feed. A child whose development stalled without a clear explanation. In the NICU, there is no luxury of time. Families are desperate for answers, and clinicians are making high-stakes decisions with incomplete information. Too often, we treated what we could see while suspecting there was something deeper we could not yet name. We ordered a multitude of tests and brought in specialists to consult, but days often turned into weeks. Sometimes answers came, but often they came too late to change the course of care. Those moments stay with you, and those are the moments that brought me here to GeneDx. THE HIGH COST OF UNCERTAINTY The phrase diagnostic odyssey is frequently used in healthcare, but it understates the reality for families. For patients with rare disease, the path to a diagnosis often stretches across yearsmarked by repeated hospitalizations, unnecessary procedures, and conflicting opinions. All the while, disease progresses and the emotional and financial burden on families quietly compounds. For clinicians, that uncertainty is more than frustrating; it limits our ability to act decisively. Without a precise diagnosis, treatments are often generalized rather than targeted, care coordination remains fragmented, and families are left carrying the burden of unanswered questions. From a system perspective, the consequences are significant: longer lengths of stay, higher costs, avoidable interventions, and missed opportunities for earlier, more effective care. What makes this particularly challenging is that, increasingly, we have the tools to do better. Genomic medicine has transformed our ability to identify the underlying causes of diseaseespecially in pediatrics and rare conditions where traditional diagnostic approaches fall short. When used early, genomic testing can shorten the path to answers from years to weeks, days, or even hours. It can inform clinical decisions, guide care planning, and help families understand what lies ahead. Over the past couple of years, genomic technology has evolved. Costs and turnaround time have declined significantly, shifting genomics from a theoretical solution to a viable tool in everyday clinical practice. Now, its a matter of increasing awareness and broadening access to all patients who could benefit. OPEN TESTING ACCESS As Rare Disease Month continues, the question is no longer whether we can diagnose rare disease more effectively, but whether we are willing to make those tools part of routine care. In other areas of medicine, advances that improve accuracy and outcomes eventually become standard practice. Standard newborn screening, imaging technologies, and clinical protocols did not remain optional once their value was clear. They became embedded in care. Genomics is at a similar inflection point. The opportunity before us is not simply technologicalit is systemic. Integrating genomics earlier into care pathways requires thoughtful implementation, clinician support, payer alignment, and real-world evidence. It requires collaboration across health systems, medical societies, advocacy groups, and policymakers. And it requires a shared understanding that earlier, more precise diagnoses are not an added extrathey are foundational to good medicine. A RARE OPPORTUNITY Rare disease challenges healthcare to be bettermore precise, more compassionate, and more proactive. It forces us to confront the limits of traditional diagnostic models and to rethink when and how we deploy the tools now at our disposal. For me, this work is deeply personal. It is shaped by years at the bedside, by conversations with families searching for answers, and by a belief that uncertainty should not be the default starting point of care. Over the course of my career, I have worked across nearly every layer of the healthcare systemas a practicing physician, a health system partner, and a clinical leader within payer and innovation organizations. Im bringing that experience with me as I help usher in the future of genomic medicine at GeneDx. Here I see a rare opportunity to help move genomics from the margins of medicine to its foundation, to shorten diagnostic journeys that have gone on far too long, and to build a healthcare system that delivers clarity when it matters most. Ending the diagnostic odyssey is not about technology alone. It is about trust. It is about giving clinicians the confidence to act and families the answers they deserve. And it is about recognizing that rare disease is not a niche problem, but something that impacts 1 in 10 Americans and thus, touches all of us. Linda Genen, MD, MPH, is chief medical officer of GeneDx.
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E-Commerce
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