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June 2010

June 2010. Success and Sustainability. Tom Ralser Principal Convergent Nonprofit Solutions. Kathryn R. Reed, MHA, CMPE Executive Director Catskill Hudson AHEC. Why Listen to Me?. Our DNA is in over 450 funding efforts All types of NPOS in 49 states Investment Analyst, CFA, CMA

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June 2010

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  1. June 2010

  2. Success and Sustainability

  3. Tom Ralser Principal Convergent Nonprofit Solutions Kathryn R. Reed, MHA, CMPE Executive Director Catskill Hudson AHEC

  4. Why Listen to Me? • Our DNA is in over 450 funding efforts • All types of NPOS in 49 states • Investment Analyst, CFA, CMA • Techniques helped raise over $850 million • Author of . . .

  5. Our Philosophy

  6. “If your organization doesn’t demonstrate its value to potential funders, they’ll fund an organization that does.”

  7. Charity Investment

  8. A financially sustainable program that positions Catskill Hudson AHEC as an investable community asset

  9. Today’s Discussion • HealthMatch, a turnkey solution to rural physician recruitment • A template for developing other sustainable programs

  10. The HealthMatch Program The Problem • Not unlike yours

  11. Review of HealthMatch Program • The Problem • Critical shortage of primary care physicians across New York State • Aging out of provider population • Fewer medical students choosing primary care as a specialty • Demonstrated difficulty recruiting physicians to rural, underserved areas of the State

  12. Reality. . . Hospitals are prevented from assuming the sole responsibility for physician recruitment

  13. HealthMatch Program • Determined that regulatory mandates constrained hospitals from assuming the sole responsibility for physician recruitment • Established the concept of a collaborative recruitment program involving community key stakeholders • Developed a three-phased approach to community-specific health professional recruitment and retention

  14. HealthMatch Program Plan components • Committing to the Community • Educating and engaging communities in the process of needs assessment and establishing incentive programs • Coming to the Community • Community involvement in recruitment of health professionals – assuring the right “match” • Staying in the Community • Consultative services for practice development and management

  15. Timeline of Events • Fall 2006: Began Feasibility work • May 2007: Feasibility interviews • July 2007: Results and Recommendations

  16. Background on Feasibility Process • Prospectus presented a 3 part strategic initiative with a total regional funding goal of $1,485,000 • Interviews conducted with 37 community, political, and business leaders across 11 counties • Interviews were conducted in an informal, conversational style

  17. Key Findings of Feasibility Process • 81% of interviewees had little to no knowledge of the CHAHEC and its services • 90% of respondents answered that access to quality healthcare and retention of physicians in rural areas were extremely important and needed to be expanded and supported • 46% of interviewees indicated that they would like to assume a personal leadership role in this effort

  18. Key Findings of Feasibility Process • 38% gave an indication of financial support • 60% of respondents thought that the CHAHEC’s funding goal of $1.4 million could be raised • 95% of those interviewed felt the program should move forward

  19. Recommendations of Feasibility Process • A regional funding goal of $1.1 to $1.4 million is realistic • Funding levels can improve with early leadership • A strong effort must be made to inform and educate the public regarding the CHAHEC’s programs and services

  20. Conclusion of Feasibility Process • People like idea and realize the need for action • CHAHEC is “obvious choice” to do this • Process needs to be top-down and inside-out • Effort should be launched as soon as possible to capitalize on the momentum generated

  21. Then the Economy Changed • Shelf life of the feasibility process • Board buy-in • Eleven county area a bit large • Needed to regroup: the New Normal

  22. Moving HealthMatchForward

  23. Grant Beginnings • HEAL NY grant was the catalyst

  24. HealthMatch HEAL NY Grant Provides • Consultative services of • Catskill Hudson AHEC – needs assessment, physician recruitment and practice management • Capital Strategist Group – project funding and sustainability strategies • Communication Services – branding, messaging and marketing community • Physician database • Physician recruitment marketing

  25. Grant Beginnings • Although a great start, it was not the complete solution • Still needed a sustainable source of funding for the long run • Primarily for incentive packages

  26. Typical Incentive Programs • Educational Loan Grants • 10% a year • New Practice Establishment • Revolving loans • Grants • Existing Practice Support

  27. The Plan • Establish pilot program • Generate private sector investment to ensure long-term financial sustainability

  28. HealthMatch Pilot program • Why Ellenville? • Community-based hospital • Location - Location - Location • Focus Group of Jan. 2007 catalyst • Demonstration of viability of this approach to physician recruitment • Provides foundation for replication across region

  29. Why Needed? Typical Costs of Recruitment • Recruitment Incentive Program • Average medical student loans $150,000 to $200,000 • New practice establishment costs - $350,000 • Practice Support for new provider - $100,000 over first two years

  30. Why Needed? Community Promotion Costs: • Community promotional material & direct mailings • Average costs - $25,000 • Community website development • Average costs - $15,000 - $20,000

  31. The Challenge:Moving beyond the grant to private sector investment

  32. The Bottom Line We believe that nonprofit and for-profit organizations share the same trait:

  33. Deliver outcomes that investors value

  34. Not unlike for-profit counterparts • Use words like bottom line, investors, and value • Logical conclusion is . . .

  35. The Investment-Driven Model™

  36. The Investment-Driven Model™ An alternative view (revolutionaryto some, common sense to others) of nonprofit funding that focuses on delivering outcomes that investors value

  37. The IDM . . . • Maximizes your strengths • Respects your capability • Focuses on investable outcomes

  38. Investment-Driven Model™ answers… • Why should I invest in your organization over some other nonprofit? • What are you going to really accomplish? • How will my company benefit?

  39. The Investment-Driven Model™ Not a theory . . .

  40. The Investment-Driven Model™ The results speak for themselves

  41. Small Projects

  42. Large Projects

  43. Genesis of the Investment-Driven Model™ • Began with Funders • Embraced by fundraisers • Now an alternative and complimentary way to view nonprofit funding

  44. Today’s Landscape • The Investment-Driven Model • 3 Paradigm Shifts • Lessons from For-Profits

  45. NonProfit vs. For ProfitModels

  46. The grant-driven nonprofit model is a designed to be an unreliable, overly dependent, financial downward spiral

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