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MacKenzie Scott’s office called. A Boston health nonprofit’s future changed forever.

The National Institute for Children’s Health Quality received $4 million earlier this month from the world’s wealthiest woman. Landing the gift was a whirlwind of mystery and joy.

NICHQ received a $4 million donation from Mackenzie Scott earlier this month. From left to right, Stacy Scott, the vice president of the department of health equity and innovation; COO Heidi Brooks; and president and CEO Scott Berns.Craig F. Walker/Globe Staff

The phone rang at 5:30 p.m., while Scott Berns was sitting in his office at the National Institute for Children’s Health Quality, watching the sunset over Fort Point Channel.

The voice on the other end was the associate of an unnamed philanthropist, who had reached out several months earlier through intermediaries. And he had news.

“I assume you’re familiar with MacKenzie Scott,” he told Berns, president and CEO of the Boston public health nonprofit. “If not, I can provide you with more details.”

Then came the words that changed everything: She’s giving you $4 million.

That’s how NICHQ learned it would receive a windfall from the billionaire ex-wife of Amazon founder Jeff Bezos. It is easily the largest donation the 23-year-old organization has ever accepted (In second place? A $100,000 gift) and transformative by every measure, Berns said. The money will supplement projects that NICHQ spearheads across the United States to make improvements in children’s health and elevate access to healthcare for families of color.

Scott’s gift amounts to half of NICHQ’s annual budget.


“We have done our research,” the voice continued that October evening. “We’ve done our vetting.”

Berns nearly fell out of his chair. Then he wondered about the future. Philanthropists often track where their money goes. They want a follow-up e-mail, or several. They want receipts.

“So would you like a report?” Berns asked.


“Did you want any kind of update in six months?” he inquired. “A year?”


And that was that.

MacKenzie Scott, seen in 2018. Evan Agostini/Evan Agostini/Invision/AP

It’s the kind of no-strings-attached donation Scott has made headlines for since 2019. Her net worth hovers around $50 billion, according to Forbes, money Scott intends to give away “until the safe is empty,” she said three years ago. (On Monday, Bezos signaled a similar plan for his $124.1 billion fortune.)


Scott doles out millions unceremoniously, with nothing more than a blog post naming recipients. “Our aim has been to support the needs of underrepresented people from groups of all kinds,” Scott wrote on Medium on March 23. “The cause of equity has no sides.”

Her latest round of donations — nearly $2 billion for 343 groups — was distributed over the past seven months and announced Monday. It includes 10 organizations in Greater Boston, as well as one each in Amherst, New Hampshire, and Maine.

The NICHQ donation is not Scott’s biggest or least conventional gift. (That may be the $37 million Beverly Hills mansion she gave to charity this summer.) In the scale of her efforts, the $4 million that Berns now oversees is quite ordinary. And so it provides an inside look into just how discreetly and easily Scott distributes her money, and how much it means to those who receive it.

“Like most nonprofits, we are sometimes scraping to get by,” said Scott O’Gorman, chairman of the NICHQ board. “This money gives us breathing space. We have a moment to stand back and look at the big picture about what NICHQ wants to achieve.”

‘I initially thought it was spam’

It all started with an e-mail.

Berns was at a neonatal health conference in Norwood in June, scrolling on his computer, when he came across a message from an influential nonprofit consultancy named the Bridgespan Group. They represented an anonymous donor and wanted to meet. Pull together materials on NICHQ’s mission and accomplishments, but don’t go out of your way to craft a proposal, the e-mail ordered.


It was short and cryptic. “I had to read it three times,” Berns said. “I initially thought it was spam.”

A virtual meeting happened soon thereafter, with six executives, including Berns, spelling out the grand visions of NICHQ, a 38-person operation inside the same building that houses the Boston Children’s Museum. They highlighted the ways the group has strengthened American health care: by expanding infant screenings in 12 states, promoting safe sleep for babies, and improving sickle cell disease treatment. The mysterious donor’s representatives asked about efforts to combat systemic racism and inequity in medicine.

Forty-five minutes later, they were done.

“You may be hearing back in the next few weeks or months,” someone told Berns. Or you may not hear back at all.

Much as the inquiry appeared out of thin air, contact then vanished. There was no follow-up date; no recommended point of contact; no details on how NICHQ would be evaluated. There would be no black-tie fund-raiser with jumbo-sized checks — that was clear.

Even now, the organization is not allowed to forward or copy-paste the messages from Scott’s representatives to the Globe or share the names and e-mails of the sender. Details in this story are based on the recollection of three NICHQ executives. Bridgespan would not elaborate.

“As you might expect, we are not in a position to share details about our clients’ philanthropic processes,” spokesperson Liz London wrote in an e-mail to the Globe.


Likewise, Scott shields herself from the public eye. She has a Twitter account, but follows no one. Her first tweet announces her divorce with Bezos; her most recent one is a link to the March Medium post with a straightforward note. “Excited to share this list of remarkable organizations,” it reads.

Her methods make the money feel like the end of a fairy tale, when a white knight swoops in to save the day. Fanfare ensues. In a way, Scott’s hands-off approach and air of mystery amplifies the generosity of the gift, said NICHQ chief operating officer Heidi Brooks.

“The faith she has that people will continue to do good with that check is incredible, the faith that whatever direction we decide to go in is the right one,” she said.

From left to right: COO Heidi Brooks; vice president, Department of Health Equity Innovation Dr. Stacy Scott; and president and CEO Dr. Scott Berns at the National Institute for Children's Health Quality offices in Boston. Craig F. Walker/Globe Staff

Where will the money go?

For months, there was no word. Then came that phone call to Berns, in October. The wire transfer happened on Nov. 1.

Berns told the staff on a Zoom call, where he mandated that everyone keep their cameras on. “I watched their eyes pop out of their heads,” he said.

Now NICHQ executives must figure out how to spend the money. Wish lists are long and circuitous. Scott did not impose any limitations. Nothing will even begin to be decided until the board meeting next month.

Some will probaby go toward NICHQ’s operational costs. The nonprofit mostly sustains itself with grants that fund research projects. But that feeds the “nonprofit starvation cycle,” as Brooks put it. Directed money of that sort can make it difficult to manage day-to-day expenses: wages, insurance, maintenance.


Berns and Brooks also want to buy subscriptions to costly medical journals and licenses for data analysis software. They envision hiring consultants to help teams that are spread thin and matching employees’ retirement contributions, a benefit their budget never allowed before.

It would make sense, too, to increase funding for NICHQ’s Department for Health Equity Innovation, a newly launched initiative led by Stacy Scott, that researches the impact of workplace bias in hospitals and health care organizations.

Nothing is perfect. Philanthropic experts have raised eyebrows at Scott for donating money through less regulated avenues, worried she could evade taxes and accountability. But on the receiving end, Berns said, the $4 million donation feels like a massive declaration of faith.

“To give an unrestricted gift is to put an immense amount of trust and responsibility in a nonprofit,” he said. “I promise we are a worthy cause.”

Diti Kohli can be reached at her @ditikohli_.