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NKF: Meeting the Challenge Together. John Davis CEO, National Kidney Foundation, Inc. February 6, 2008. 2008 Executive Leadership Conference. Agenda. The Big Picture – Re-Defining Our Challenge NKF Breaking News Program Updates & Announcements Progress in our transition to Divisions

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NKF: Meeting the Challenge Together

John Davis

CEO, National Kidney Foundation, Inc.

February 6, 2008

2008 Executive Leadership Conference


  • The Big Picture – Re-Defining Our Challenge

  • NKF Breaking News

  • Program Updates & Announcements

  • Progress in our transition to Divisions

  • NKF is Meeting the Challenge Together


A New Study in the Journal of the American Medical Association re-calculates the number of American adults with chronic kidney disease. Based on this new data, NKF can report that the current number is:


Re-Defining Our Challenge

  • That is a 30% increase in the number of direct NKF constituents

    • The increase has occurred since 2002

  • And, > 400,000 Americans are now on dialysis

    • Medicare alone is now spending > $ 20 Billion

  • And, > 75,000 Americans are waiting for kidneys

    • That number has doubled since 1996

  • 13,937 kidney transplants were done in 2007

    • Nearly 50% of transplants are from a living donor

Re-Defining Our Challenge

  • All organizations seeking funds from the pharmaceutical industry must cope with increased scrutiny and regulatory challenges

  • Public Policy Challenges Continue

    • Much unfinished business from last session of Congress

    • New conditions for coverage for ESRD facilities

    • 9th Scope of Work for Medicare Quality Improvement Organizations

    • Honest Leadership & Open Government Act of 2007

Re-Defining our Challenge

  • Increasing Competition for Attention & Donors

  • We intend to fight harder for our rightful share of the public’s money and awareness

  • Number of health-related messages increasing

  • NKF and CKD must compete with pharmaceutical and insurance companies, government, hospitals and other not-for-profit organizations

  • Leading the fight for attention is $9 Billion companies spent on medicine advertising last year

Re-Defining our Challenge

We Must Have A Unified and Focused Approach

  • NKF signature fund raising programs must grow

    Kidney Cars  NKF Golf Classic Kidney Walks

  • Continue to increase corporate support for programsKidney Learning System (KLS)  KEEP  Guidelines

  • New major increased focus on individual contributions

    Online Giving Individual Gifts  Planned Gifts

  • Continue high-quality cost effective local special events

Re-Defining our Challenge

The Time Is Now

  • We are making the necessary investment in resources, people, structure, strategy to be more effective so we can meeting these new challenges and fulfill our mission

  • We have our Strategic Plan in place & strong leadership to guide us

  • We have a shared mission, need a shared vision to be successful

  • We are helping more and more of you with your organizational needs

  • That should help free you up to focus on fund raising and program improvement strategies

Re-Defining our Challenge

Building for the future includes:

  • Hiring new high level professionals:

    • John Brown, Training Director

    • Larry Geiger, VP for Marketing

    • Kelly Robertson, Internal Marketing Director

    • Chief Financial Officer

    • VP for Development (Individual Giving)

    • Web Site Editor

    • Recruiting Director

Re-Defining our Challenge

Building for the Transition to Divisions includes:

  • Joan Shepard Lustig, Senior VP

  • Lauren Bruce, Transition Services Manager

  • Stephanie Shipman, Field Services Manager

  • Petros Gregoriou, Field Services Accounting Director

  • Vice President for Divisions

  • Plus outsourcing various technical functions

    • NKF’s Call Center

    • Data Base Management

Re-Defining our Challenge

  • In addition to new staff in New York, NKF has added nearly 60 people to its staff as a result of Affiliates becoming Divisions.

  • This brings our staff numbers to nearly 200. We anticipate being at about 250 by year-end.

  • That nationwide cohesive team will bring new focus to meeting our challenges. We’re very excited about the way we can work together to meet our challenges.


NKF Kidney Cars revenues for the current year are running 33% higher than last year!

  • Car donation rate has reached >40,000 annually

  • Improved Search Engine Ranking

  • Improved online marketing, pricing & program efficiencies is having positive impact on the amount per car

  • New “Drop-off” Option

    • Nationally sponsored program

Fund Raising and ProgramImprovement Strategies

  • NKF Golf Classic National Championship at Pebble Beach got rave reviews:

    • "It was a once in a lifetime golf experience. It was awesome and well organized. The weather was fabulous …all in all a great trip, thanks!”

    • "We had a fabulous time. I don't think any of us wanted to leave. It was a terrific golf experience! Thanks to the National Kidney Foundation for making it possible.”

  • Pebble Beach will again be the site for the 2009 NKF Golf Classic National Championship

Fund Raising and Program Improvement Strategies

  • At Pebble Beach NKF’s Saturday night auction made a Record Breaking $75,000

  • Over 80 tournaments scheduled for 2008

  • NKF benefits from both NKF Golf Classic and Cadillac Invitational events

  • Sponsors include Ping, Golf Digest, Adidas, and Pebble Beach Resorts.

  • New Golf Club Donation Program “Kidney Clubs”

Fund Raising and Program Improvement Strategies

  • NKF New Golf Donation Program

  • “Kidney Clubs”

    • Golfers can either donate clubs at an NKF event OR directly through the new donation website on their own at any time

    • Donations are received and payment is forwarded directly to NKF Affiliates & Divisions

    • Working with “3balls.com” a leading internet retailer of used/like-new brand name golf equipment

Fund Raising and ProgramImprovement Strategies

  • 88 Kidney Walks in 2007 with 40,000 walkers

  • $3.5 Million in 2007; 50% growth from year before

  • Our goal is > $5 Million in 2008 and $15 Million soon

  • Largest Walks in NKF Divisions Serving Greater New York and The Delaware Valley broke attendance & fund raising records!

  • Currently expanding marketing & support initiatives to strengthen program and national brand


KEEP’s 100,000th participant was tested on November 15th in Los Angeles.

Aura Lemus, Inglewood, CA

Fund Raising and Program Improvement Strategies

  • 60 KEEP events are planned for World Kidney Day and throughout March

  • 2008 KEEP goal is to increase KEEP participation to over 3,500 per month

  • Global KEEP Expansion is progressing

  • KEEP Annual Data Report

    • New format, coming in April (AJKD supplement)

Fund Raising and Program Improvement Strategies

KEEP in 2008:

  • Revised Screening Questionnaire

  • Longitudinal Program launch

  • Additional Follow-Up with participants for cohort maintenance

  • Additional Tests

    • HDL, LDL and Hemoglobin A1c (HbA1c)

  • Educational follow-up programs launched

  • Expansion into Alaska and Puerto Rico

  • KEEP event quality has improved since October

  • CKD within DM and HTN is the new paradigm for public health and the NKF




    Cardiovascular disease is the number one killer

    Chronic Kidney Disease multiplies CVD risk

    For every CVD risk factor (Diabetes, Hypertension, Dyslipidemia, Anemia), clinicians must test for CKD

    The patients are sicker

    Risk factor levels are higher

    Control is worse and treatment is more complex

    Outcomes are worse

    Costs are higher

    With CKD, patient management is different

    Treatments are available and effective today

    NKF’s CKD Message

    NKF’s Message in Stage 4 CKD

    Stage 4 CKD is an asymptomatic clinical event!

    • We can slow progression in Stage 4

    • We can reduce the incidence of bad events that occur in Stage 4

    • We can reduce the severity of Stage 4 co-morbidities

    • We can improve the coordination of care in Stage 4

    • We can prevent:

      • Death

      • Cardiovascular events

      • Loss of cognitive function (in aging)

      • Kidney failure

    Fund Raising and Program Improvement Strategies

    • More CKD patients identified and treated

      • NKF KEEP program

      • CDC NKF state detection programs

    • Increase awareness and enhance providers’ ability to detect and treat patients

    • Help providers and payers address the problems of diabetes, cardiovascular disease and CKD

    • Better outcomes


    As of April 1st, KEEP will have a new central laboratory serving all Affiliates and Divisions. NKF’s new lab partner is:

    Fund Raising and ProgramImprovement Strategies

    • Quest is the nation's leading provider of diagnostic testing, information, and services

      • >30 regional laboratories in key US markets, with over 2,000 patient service centers

      • More than 41,000 employees

      • The world’s largest private database of clinical test results

    • Quest tests more than 150 million people a year

    • Multi-dimension partnership that will build KEEP

    Fund Raising and Program Improvement Strategies

    • Rationale for change to Quest:


      • They have size, scope & reach

      • Physician interaction

      • Opportunity to engage Quest in educational programs and other activities

      • Opportunity to involve Quest employees in KEEP events

      • Will make change as seamless as possible; fully operational by April 1


    At the request and initiation of KEEP’s

    Primary Sponsor, Amgen, NKF is launching the:

    “KEEP Affiliate/DivisionDevelopment Fund”

    Fund Raising and Program Improvement Strategies

    • The KEEP Affiliate/Division Development Fund

      • Founding Sponsor is Amgen

      • Other sponsors will be solicited

    • Grants will be made by NKF through applications available to Affiliates and Divisions

    • Grant criteria focused on doing new things:

      • Expansion of the KEEP program in an Affiliate or Division territory, not for simply holding KEEP events

      • Establishing KEEP in new areas

      • Making KEEP events regularly scheduled and longitudinal

    Fund Raising and Program Improvement Strategies

    • Amgen will not fund any grant requests for KEEP from NKF Affiliates & Divisions

      • Amgen will continue to consider program and event grant requests as long as they do not relate directly to KEEP

      • Other sponsors have requested such a program and their funds will be added to the pool

      • All funds must be awarded to Affiliates or Divisions, NKF will not retain any of the money

    • Applications available March 1

    • First Awards will be given on April 1

    • Funding in 2008 will exceed:$500,000

    Fund Raising and Program Improvement Strategies

    Fund Raising and Program Improvement Strategies

    On World Kidney Day, March 13th, NKF will hold:

    • Nearly 50 KEEP events around the country

    • Major events in New York:

      • Closing bell at NASDAQ stock exchange

      • Times Square “jumbo-tron,” NKF public service message

      • Grand Central Terminal mini screening and awareness

    • Major events in Washington DC:

      • Congressional Kidney Caucus Briefing & Reception

      • “People Like Us” patient advocates visit members of Congress

    • In Los Angeles -- “KEEP it Hollywood” mini screening for celebrities & media

    Fund Raising and ProgramImprovement Strategies

    • World Kidney Day Media/Promotion plans include:

      • Satellite media tour featuring Steven Cojocaru (Cojo) of “ET”

      • “Dear Abby” letter

      • CNN feature with Dr. Sanjay Gupta

      • Extensive coverage in major dailies, national magazines & on the Web

      • Editorials in all major nephrology journals

      • Interview on Tom Joyner’s morning show

    • Great local events planned

      • Kidney Awareness Night at a Miami Heat game

      • Kidney Awareness Night at a Denver Nuggets game



    • “RESOLVED that, due to projected growth in organizational strength and resources through transition of many Affiliates to Divisions, the National Kidney Foundation will commit to doubling its research program funding over the next five years.”






    NKF National Budget Research Spending

    Fund Raising and Program Improvement Strategies

    Other Program Improvements:

    • “Hope Street”

      • One of NKF’s best received patient education programs

      • Used in nearly all US dialysis units

      • Supported by both Large Dialysis Organizations

      • Funded through June

      • New funding actively being sought

    • KLS educational programs growing and being tested in collaboration with Affiliates/Divisions

    KLS CME/CE Activities

    • Over 22,500 Learners and growing

    • 45% Non-Nephrology Clinicians

    Fund Raising and ProgramImprovement Strategies

    NKF’s Take Action Network is growing rapidly!

    Fund Raising and ProgramImprovement Strategies

    The Take Action Network:

    • Now has more than 3,000 volunteers

    • 7,634 messages sent to Congress in 2007

    • Can now reach every Senator (100) and 423 of 435 U.S. Representatives with constituent views

    • Network has grown by almost 30% since October

    • All of your Board Members should be included

    • We all should encourage our own Members of the House of Representatives to join the Congressional Kidney Caucus

    Fund Raising and ProgramImprovement Strategies

    NKF’s Public Policy Successes in 2007:

    • Revised FDA label for EPO to be consistent with KDOQI 

    • Norwood Living Organ Donation Actallows paired donation

    • CKD quality measures added to the Medicare

    • Increased appropriation for CKD Program at CDC to $2 million

    • Proposed 4% cut in dialysis payment not enacted

    Fund Raising and Program Improvement Strategies

    NKF’s Public Policy Priorities for 2008:

    • Passing the Kidney Care Quality and Education Act

    • Securing Medicare payment for education at CKD Stage 4

    • Validating bundling of payments for dialysis services before a new bundled payment system is fully implemented

    • Building and increasing funding the CKD Program at CDC

    Fund Raising and Program Improvement Strategies

    NKF’s Public Policy Priorities for 2008 (con’t):

    • Improving access to early transplantation

    • Extending immunosuppressive drug coverage for all who have had a Medicare covered kidney transplant

    • Enhancing use of the Medicare Medical Nutrition Therapy Benefit

    • Maintaining a focus on kidney disease in the development of Healthy People 2020

    • Continuing the prohibition against the purchase or sale of organs for transplant

    Fund Raising and Program Improvement Strategies

    NKF’s Public Policy Priorities for 2008 (con’t):

    • Removing the financial disincentives for living donation

    • Increasing funding for kidney research at NIH

    • Increasing funding for the FDA to assure patient safety while improving access to new drugs

    • Building the membership and activities of the Congressional Kidney Caucus

    • Utilizing People Like Us (PLU) to focus NKF’s public policy program on patients


    UNOS has announced its intention to change the system for allocating deceased donor kidneys.

    • Time on dialysis will no longer be the criteria

    • Additional life years added by the transplant will become the main factor

    • Serious implications for our patients

    • Change is expected by the end of 2008

    NKF 2008 U.S. Transplant Games

    • Pittsburgh, PA

    • Venues:

    • University of Pittsburgh

    • Carnegie Mellon University

    • David L. Lawrence Convention Center

    • Soldiers and Sailors Memorial Hall

    • Heinz Field

    U.S. Transplant Games

    • Part of Pittsburgh’s 250th city anniversary celebration

    • VIPs/Celebrity Presence

      • PR coordinating celebrity appearances and media

    • Pittsburgh Pirates – Organ Donor Awareness Night

    • Expect Largest Games 5K – Working with OPO on outreach to local workplace partners for corporate team participation

    NKF Spring Clinical Meetings

    NKF 2008 Spring Clinical Meetings

    April 2-6, 2008Gaylord Texan, Dallas, TX

    • Debut of a special track for NKF’s new Council of Advanced Practitioners (Physician Assistants and Nurse Practitioners)

    • A total of 323 abstracts were submitted for CM08, compared to 285 in CM07

    • Over 90 exhibits expected

    • Goal is to exceed CM07 registration numbers (over 2,500)


    NKF announces that it will develop and launch a new marketing campaign in 2008 that includes, for the first time ever, paid broadcast and print advertising nationally and in key markets around the country.

    Fund Raising and Program Improvement Strategies

    NKF’s new advertising:

    • Development effort headed by Fitzgerald & Co., a McCann-Erickson company best known for Coca Cola Classic television advertising

    • First step was research on NKF and CKD awareness

    • Development of creative brief well underway

    • Creative concepts and plans to the Board in April

    • Pilot test of ad campaign by 3rd Quarter 2008

    • Anticipated NKF investment could be:



    Three more NKF Affiliates have voted to join the Transition to Divisions with votes in the past week. And, more votes are schedule in February and March. Joining the movement this week are:

    NKF of Upstate New York

    NKF of Kansas and Western Missouri

    NKF of East Tennessee

    NKF Coast-To-Coast

    NKF Coast-To-Coast

    Direct Service Areas

    NKF Coast-To-Coast

    Direct Service Areas

    NKF Coast-To-Coast

    Direct Service Areas

    NKF Coast-To-Coast

    Direct Service Areas

    NKF Coast-To-Coast

    Direct Service Areas

    NKF Coast-To-Coast

    Direct Service Areas

    NKF Coast-To-Coast

    Direct Service Areas

    NKF Coast-To-Coast


    NKF Coast-To-Coast


    NKF Coast-To-Coast


    NKF Coast-To-Coast


    NKF Coast-To-Coast


    NKF Coast-To-Coast


    NKF Coast-To-Coast


    NKF Coast-To-Coast


    NKF Coast-To-Coast


    NKF Coast-To-Coast

    On Deck?

    NKF Coast-To-Coast

    On Deck?

    NKF Coast-To-Coast

    On Deck?

    NKF Coast-To-Coast

    On Deck?

    Transition to DivisionsFrequently Asked Questions

    • What about our money?

      In this structure, Divisions and NKF share the same finances. Plan for next year’s budget to equal this year’s. Growth will come at about the same rate…spending & income go up together

    • What about our autonomy?

      Division Boards (and Regional Boards) will still make priority decisions, develop the budget, evaluate staff performance, set goals and speak to and for the public

    Transition to DivisionsFrequently Asked Questions

    • Will our local programs continue?

      We will not take away the traditional programs you have run…Camps…Research Programs …Patient Assistance Funds… Symposia …. Local priorities will be set by the Division Board, local revenue will support them, they will continue

    • Will we be forced to do National programs?

      We believe KEEP, patient service and education, organ donation awareness and public education are part of a balanced program for Affiliates and Divisions; beyond and within those elements, you decide

    Transition to DivisionsFrequently Asked Questions

    • Will we just be fund raisers?

      No, NKF’s corporate culture is very program oriented. Programs that benefit patients, their families and people who care for them are critical to success.

    • Will we only have to do NKF fund raisers?

      No, again we believe Kidney Cars, golf and walks are important building blocks in a balanced fund raising programs. But, local priorities and doing what works will be local decisions.

    Transition to DivisionsFrequently Asked Questions

    • What about our staff?

      • At the transition, Affiliate staff become part of the National Staff

      • All Affiliate CEOs and Executive Directors will become either Division Presidents or Regional Vice Presidents

      • Only in the largest Affiliates with purely bookkeeping or personnel staff will a staff reassignment/transition be considered

      • There will be at least a six-month transition period

      • Management will be professional and consistent

    Transition to DivisionsFrequently Asked Questions

    • Will this benefit Affiliate staff members?

      • Market-based competitive salaries determined by objective data analysis

      • Access to the NKF health and life insurance program (highly rated, family coverage, cost effective, flexible), includes short and long term disability coverage

      • Paid Time Off Program

      • Pre-tax Flexible Spending Accounts

      • 403b Retirement Plan based on NKF contributions

      • Tax deferred individual retirement plan

      • Longevity incentive (for every 5 years = 1.25% of salary)

      • Time spent at the Affiliate will count

    Frequently Asked Questions

    • Will Division President and Regional Vice President positions be good jobs?

      • They will be very similar to Affiliate CEO and Executive Director jobs, without the administrative burden – focus on doing programs, raising money, working with volunteers & raising public awareness

      • Salaries will be performance-based with an incentive compensation plan to reward achievement of goals (agreed upon by NKF, Division or Regional Board, & the Division President or Regional Vice President)

      • Additional tax deferred retirement plans will be offered

      • Extensive training & personal development opportunities will be offered at NKF’s expense

      • Compensation and benefits review and competitive analysis by Clark Consulting, Inc. and NKF Compensation Committee

      • Performance-based job security

    Transition to DivisionsFrequently Asked Questions

    • Will this be good for our Affiliate?

      Yes, here are some of the reasons why:

      • Financial security

      • NKF marketing and brand identity

      • “Help Desk” operation for IT, HR, PR

      • Continuity of local programs & priorities

      • Additional NKF resources

      • Elimination of legal & regulatory liability

      • Assurance of legal & regulatory compliance

      • Retained voice in NKF priorities and plans

    Statements You Will Never Have to Worry About, Again!

    • Hello, I’m from the IRS

    • When I get elected Chairman, we’re going to do everything my way

    • I’m a prominent doctor, I’ll decide myself who gets our research grants

    • Your staff gets paid more than they’re worth

    • Let’s hire whoever is cheapest

    • This is notice of a legal proceeding in which you are named as defendant

    Transition to DivisionsFrequently Asked Questions

    • Will this be good for NKF?

      Yes, here are some of the reasons why:

      • Consolidated resources and operations

      • Expanded data base of potential donors

      • Program delivery through a consistent plan

      • Economies of scale in administration, program, fund raising and capital expenses

      • Greater ability to provide more help to more patients and fulfill NKF’s mission

    Transition to DivisionsFrequently Asked Questions

    • What will NKF be able to do differently?

      • Provide better ROI to national sponsors

      • Conduct better donor solicitation programs

      • Provide cost-effective “back office” support

      • Implement a comprehensive training program

      • Improve intra-organization communication

      • Launch a real “NKF Planned Giving Program”

      • Fund better research

    Transition to DivisionsFrequently Asked Questions

    • Can NKF live up to all its promises?

      Yes, and here are some of the reasons why:

      • This is a total organizational commitment; made by the Board, volunteer leadership, medical leadership and staff

      • Funds have been identified

      • Staff is being added (short term increase in administrative costs taken into account)

      • Communication and training are being enhanced

      • All commitments made to date have been met

    Transition to DivisionsFrequently Asked Questions

    • How do we define successful?

      We will measure the growth, fund raising experience, program delivery and visibility of our Divisions. That assessment will come after their first two years as a Division. Affiliates’ success will be measured just like we measure the success of Divisions. They won’t have to meet a higher standard, just keep pace with the growth of the Divisions.

    Progress in our Transition to Divisions

    • Continuing to strengthen and build our “national brand”

      • New advertising

      • Combining Division & National databases, including extensive on-site IMIS training

      • IT upgrades in Division offices, including training

      • Staff professional development opportunities

      • Additional volunteer training

      • Convio implementation

      • Automation of HR systems

    Progress in our Transition to Divisions

    • Other benefits coming for divisions:

      • Real-time financial statements by May 1

      • Increased Marketing & Communications

        • New VP doing needs assessment across the organization & immediately addressing Web site, Membership, Professional Meetings, KEEP

        • More regular internal communication: Introduced Foundation Focus, more frequent e-Kidney newsletters and Division/National calls

      • Paper-less resources for staff expense reports, insurance and payroll documents and real-time personnel information

    Progress in our Transition to Divisions

    • More training to include:

      • Career Development for Program & Fund Raising staff at Divisions

      • Staff and volunteer leadership training

      • Walk/Golf Academy enhancement

      • Updated “On-boarding” for new employees

      • IMIS & Convio (basic, intermediate, advanced)

      • Expanded general training

        • Internal/external customer service

        • Individual performance improvement

        • Organization procedures, systems & policies

    2009 Executive Leadership Conference

    February 4 – 7

    New York City

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