A dedicated policy advocacy function is uncommon among foundations—many engage in policy solely through grantmaking. Colorado Health Foundation (CHF) worked with ORS Impact to describe the evolution of its policy advocacy function and explore the question: What does it take for a foundation to successfully integrate program-focused philanthropy and policy functions to advance its mission? Three polarities surfaced in CHS’s internal policy-focused efforts. This brief explores their manifestation over time, and the signals by which staff recognized and were able to manage polarities to enhance impact.