Strategic plan 2014 - 2017

14 Horatio Street, Suite 1E, NYC 10014 T 212.645.0536 OR 201.615.6406 F 212.658.9046

www.krasneplows.com E [email protected] OR [email protected]

CALLEN-‐LORDE’S STRATEGIC PLAN

2014 – 2017 Planning for Growth in a

Rapidly Changing Environment

Full Report with Appendices

August 5, 2014

Table of Contents

14 Horatio Street, Suite 1E, NYC 10014 T 212.645.0536 OR 201.615.6406 F 212.658.9046

www.krasneplows.com E [email protected] OR [email protected]

Section 1: Background Page 3

I. The Process 3 II. The Critical Considerations 5

Section 2: Key Outcomes Page 7

I. Values Assessments: Outcomes 8 II. Business Planning: Outcomes 9 III. Implementation: Outcomes and Guidelines 14

Section 3: Summary and Conclusions Page 15

Section 4: Appendices Page 16

A. Callen-‐Lorde Planning Committee 16 B. Interview and Focus Group Participants 17 C. Staff Interview Guide 18 D. Board Interview Guide 19 E. Callen-‐Lorde Staff Survey 21 F. Callen-‐Lorde Board Survey 35 G. Sample Decision Making Tool 47 H. Partnership Life Cycle Chart 48 I. Capacity Expansion Diagram 49 J. Monitoring Protocols 50

Callen-‐Lorde Planning Report August 5, 2014

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Section 1: Background

Callen-‐Lorde Community Health Center (Callen-‐Lorde) embarked on a strategic planning process in Fall 2013 to establish the organization’s key objectives and priorities for the next three years. The previous strategic plan (2009) had focused primarily on expanding mental health services, and managing patient services availability. Leadership undertook the current plan to guide the organization during a period of unprecedented change. Introduction of the Affordable Care Act was expected to change Callen-‐Lorde’s payor mix, a critical component of its successful business model, as well as upend current funding models. The LGBT communities’ needs were changing, and other providers had entered the marketplace, targeting Callen-‐Lorde’s target population. Capacity and resource constraints remained an ongoing challenge. Callen-‐Lorde sought an inclusive planning process that would build upon its past and set the stage for its next phase of growth. The result would link mission, programmatic design, and quality service delivery, with an understanding of available resources and the financial monitoring required to ensure both flexibility and long term sustainability. This report summarizes the key outcomes, process highlights and additional planning work that will be needed to implement the strategic options determined by the planning committee and approved by the board.

I. THE PROCESS

Over a 7-‐month period, KrasnePlows met with Callen-‐Lorde’s planning committee, comprised of multiple stakeholders including four Board members, eight member of the senior management team and four outside leaders in the field. An inclusive, participatory three-‐phase process incorporated the following activities: (See Appendix A.)


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Within each respective phase, key consideration was given to determine: 1. Target Population: Whom we currently serve and how well we serve them? Who

should we serve in the future? Should certain groups within the LGBT universe be “prioritized” and if so, how determined?

2. Outcomes/Impact: How do we define success for our target population, and therefore for us, as an organization? How impactful are our programming choices to our patients and the greater LGBT community?

3. Services/Programs: What programs will best deliver the impact we want for our target population? How do we determine prioritization?

4. Infrastructure: What internal & external resources are required, available and at what cost?

5. Efficacy: How will we define and measure the success of our efforts for the Callen-‐Lorde community? What are the key milestones and benchmarks that help us continually course correct to ensure optimal programmatic content and delivery?

To inform the above questions KrasnePlows (KP) conducted and /or facilitated:

1. A series of interviews with 10 selected board and staff members, 2. Three 90-‐minute focus groups with staff (20), 3. Surveys with all 10 board and 166 staff members (70%), and

Values Assessment

• Confirm Mission • Conduct Interviews & Surveys • Idencfy Target Pop • Decide Impact & Outcomes Wanted • Develop Decision-‐Making Tool

Business Planning

• Idencfy Program Opcons • Assess Fundability • Determine Resource Requirements • Determine Appropriate Infrastructure • Consider Potencal Partners • Apply Decision-‐Making Tool

Implementa\on Strategies

• Idencfy Measurable Performance Targets • Create Accon Plan • Establish Monitoring Process & Tools


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4. Five Planning Committee working sessions. 5. Standing bi-‐weekly calls with Senior Management. (See Appendices B -‐ F for research instruments.)

KP spent additional time working with management to research patient demand, health care trends and critical considerations related to policy and regulatory compliance issues. Additionally, Callen-‐Lorde collected and analyzed limited data on patient satisfaction. The overall intention was to create an inclusive process, proactively collecting input and allowing for anonymity where appropriate.

Separately, Callen-‐Lorde participated in a NYS Health Foundation funded financial project to analyze potential effects of federal health reform on 6 NYS FQHC centers. Cohn Reznick built individual financial models to evaluate each organization’s financial health. Callen-‐Lorde’s model was based on 2012 performance and subsequent forecasts with adjustable assumptions regarding number of patients covered by insurance, third-‐party reimbursement rates and future funding levels for grants, contracts and the public goods pool. Financial analytics also included scenarios such as impact of HIV vs. non-‐HIV services, 340b revenue and payor mix. KP incorporated Cohn Reznick’s findings into the planning process to consider the financial implications of proposed strategic options.

II. THE CRITICAL CONSIDERATIONS

Multiple factors were considered as underpinnings to strategic decisions:

Factors Considerations INTERNAL

1. Rich History & Mission

Leader and pioneer in LGBT Care, particularly HIV and transgender care.

Services always offered to patients regardless of ability to pay.

Provider of choice for patients with insurance and safety net provider for the most marginalized.

2. Geography Historically, Callen-‐Lorde’s target population from its

Chelsea-‐Clinton neighborhood. >60% of patients currently from outer boroughs.

3. Financials Operating surpluses and increases in net assets in each

of the past 7 fiscal years after deficits for 8 years. Cash balance and line of credit provide sufficient liquidity


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Factors Considerations to support current operating needs.

Pharmacy revenue and federal funding historically generated operating surpluses. The Affordable Care Act (ACA) will affect these funding streams.

Limited fundraising revenue; the FQHC board is not a fundraising board by virtue of its structure.

No endowment. Real estate -‐ potential source of capital to fund future

growth and help secure viability. Cohn Reznick analysis -‐ near term financial sustainability,

longer-‐term issues.

4. Key Current Programs

Quality HIV prevention and treatment STI counseling, testing and treatment Pharmacy Adolescent outreach and primary care (HOTT) Transgender primary care Mental health Primary care

5 Capacity

18th St. site’s current configuration / hours of operation limit growth.

New 17th St. site expands patient capacity across both sites.

Patient visits grow from 75,000 to 115,000.

6. Payor Mix

Favorable mix of payors (private insurance, Medicaid/Medicare, ACA products and public funding for the uninsured) critical to Callen-‐Lorde’s financial stability.

Medicaid reimbursements up to three times greater than commercial insurance due to enhanced rate for FQHCs.

7. Efficacy Callen-‐Lorde must systematically track key milestones

and measurable targets that reflect internal and external benchmarks of success and recalibrate as necessary.

EXTERNAL

1. Visibility & Reputation

Positive recognition in the LBGT community. Less recognized outside LBGT community & outer

boroughs. Well known with foundations and government agencies. Limited visibility with individual funders / corporations. Lack of external marketing the last few years (due to

capacity constraints) led to mixed messages in community.

2. FQHC – Strict Compliance FQHC compliance regulations drive programming, target

population and governance. Stand-‐alone FQHC must serve medically underserved


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Factors Considerations population and provide care throughout the life cycle.

Requires HERSA designation. Callen-‐Lorde is sub-‐recipient under Lutheran Healthcare

Network’s umbrella.

3.

Landscape

Pioneer in New York City LGBT primary health care. o Other LGBT-‐sensitive health care providers now

available with varying levels of quality care. o Some providers target segment(s) of Callen-‐Lorde

universe. Need to be part of integrated delivery system including a

hospital, FQHC and social service partners.

4. ACA Funding Impact

35% decrease in grant subsidies over the next 5 years. Pharmacy profits expected to decline with the

introduction of generic HIV drugs. Public goods funding expected to decline with ACA

rollout. o Callen-‐Lorde serves many uninsured patients for

whom the cost of care is covered in part by the NYS public goods pool and the federal government. With the ACA, there will be fewer uninsured, and more patients with ACA products with smaller cost reimbursements.

o $1.5MM is the forecasted net impact, effectively reducing an operating surplus by $1.5MM.

Section 2: Key Outcomes

The strategic planning process resulted in three overarching outcomes:

• An affirmation of alignment between board, staff and patients about Callen-‐Lorde’s mission.

• Cultivation of relationships with other primary healthcare partners, particularly Mt. Sinai and Lutheran Healthcare systems.

• Pursuit of five strategic objectives to be further explored by the board: o Partnerships and collaborations o Long-‐term financial sustainability o Increased capacity/growth (expand services to/for LGBT community) o Provision of services to the Homeless o Become a model of LGBT Care/Center of Excellence


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I. VALUES ASSESSMENT: Outcomes

Callen-‐Lorde staff, board and planning committee aligned around the organization’s core values, including:

• Providing holistic accessible, sensitive and effective care • Being a provider of choice, without jeopardizing the organization’s long term

sustainability • Serving the underserved and most disenfranchised among LGBT communities • Expanding Callen-‐Lorde’s impact (desire to grow) • Continuing to push boundaries to provide necessary services for clients

A. Mission: Unanimous agreement that Callen-‐Lorde’s mission should remain unchanged:

Callen-‐Lorde Community Health Center provides sensitive, quality health care and

related services targeted to New York’s Lesbian, gay, bisexual, and transgender communities -‐ in all their diversity -‐ regardless of ability to pay.

B. Target Population: Callen-‐Lorde will continue to serve all groups within the LGBT universe with priority given to:

(i) More marginalized patients: older adults, youth (13-‐23), and persons with substance use issues;

(ii) Underserved patients, including the homeless; and (iii) Diverse races and ethnicities.

C. Impact and Outcomes: Callen-‐Lorde’s top priority will be to provide sensitive quality-‐

driven healthcare services including: (i) Primary medical care with an emphasis on preventive care and health

maintenance and sensitive, non-‐judgmental behavioral health care that is focused on self-‐actualization and independence -‐ regardless of ability to pay

(ii) While direct clinical care delivery will remain the highest priority, efforts should be made to: • Expand education and training of current and future clinicians • Expand research and evaluation to increase knowledge and understanding of

the LGBT communities health needs, and • Expand social services access to ensure client’s total needs are met.

D. Decision Making Criteria: The planning committee developed a list of criteria for the

board and senior management team to consider when choosing amongst strategic


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program options during the planning process, as well as when pursuing opportunities post-‐project: (See Appendix G for Sample Decision Making Tool.) • Fits mission • Sustainable financially • Fulfills licensure requirements • Resources available or accessible • Achievable or implementable within a limited time frame • Advances services to priority communities • Leverages internal expertise • Demonstrates measurable impact • Raises awareness in targeted communities

II. BUSINESS PLANNING: Outcomes

Strategic Goals and Programmatic Direction Through a series of working sessions, the planning committee agreed upon four linchpin strategic goals:

1. Long term financial sustainability 2. Expansion of services to and for the LGBT community 3. Work towards securing independent FQHC status 4. A model of LGBT care for others to emulate

The Planning Committee then agreed upon the following five short, medium and long-‐term programming initiatives for further exploration and operational planning, each in support of the overarching goals. Each program option was reviewed for its degree of match with the nine decision-‐making criteria referenced in the prior section:

Callen-‐Lorde Planning Report August 5, 2014 Page 10 of 50

The context, resources required and policy recommendation for each option follows:

1. Reach a Sustainable Payor Mix

Context: For many years, Callen-‐Lorde has succeeded in serving all patients seeking care, regardless of payor. With the ACA rollout, Callen-‐Lorde anticipates that a number of key subsidies for the uninsured and under-‐insured patients (NYS Indigent Care, Ryan White, 3408) will be reduced or even eliminated. These subsidies have allowed Callen-‐Lorde to maintain a diverse payor mix, including patients covered by commercial carriers, despite their lower reimbursement rates. In FY 2013 commercially-‐insured individuals represented approximately one third of patients treated. Given the uncertainty of a rapidly changing healthcare environment, the mix of funding streams must be balanced with services to underserved patient populations who do not participate in these plans in order to ensure financial sustainability. It may be necessary to expand services to reach the most disadvantaged patients, which is in keeping with mission and need for financial sustainability.

Policy recommendation: Approve a strategic policy to monitor subsidies and payor mix as a part of the annual budget process and each quarter thereafter and to take corrective action as required.

Resources required: Monitoring and analysis does not require additional manpower or hard dollars. Callen-‐Lorde current staff and current technology can be used.

Successful if… Callen-‐Lorde systematically assesses the financial tolerance for private payors and takes corrective action when needed.


2. Collaborate with LGBT-‐Serving Partners

Context: Community health centers and social services agencies play an integral role in preserving the health and well-‐being of the community. Meaningful collaboration among partner agencies serving LGBT clients will fill gaps in services and help complete a life cycle approach to care, eliminate duplication of efforts, advance patient access to complementary services, and expand access for vulnerable members of the community (including youth, older adults, and persons with substance abuse issues). These collaborations will also foster a more favorable payor mix, since it is anticipated that the referral relationship will result in increased access for publicly insured patients. Such collaborations serve as a replicable model, attractive to funders. Policy recommendation: Approve of the proposed partnership model, starting with the Center and SAGE collaboration. (See Appendix H for Partnership Life Cycle Chart.) Resources required: Partnering with other LGBT-‐serving organizations to expand referral network and service offerings do not require additional manpower or hard dollars. Callen-‐Lorde current staff and current technology can be tapped to explore and integrate partnerships. Callen-‐Lorde will also secure grant funding for a consultant to facilitate partnership relationships. Successful if… • Facilitates access to needed partner services for vulnerable patients. • Assists in driving patients with favorable payors to Callen-‐Lorde. • Achieves a more comprehensive service delivery life-‐cycle model.

3. Expand Capacity – Serve More Patients from the Community

Context: Callen-‐Lorde seeks to ensure ready access to services to meet community demand. Near term, Callen-‐Lorde has the ability to serve additional patients with the opening of 17th St, (which will free up clinical space) and through exploring expanded hours of operation. It is anticipated that these efforts will alleviate physical plant capacity issues only temporarily (5-‐7 years). Identifying, securing, and funding additional and/or new space requires significant analysis, additional capital and a long-‐term planning-‐execution timeline.


Policy recommendation: Approve a plan to: Conduct a patient needs assessment Develop a capital plan, including establishing a capital planning committee to

explore options for accessing the potential equity of the 18th St. site and for physical plant expansion recommendations. (See Appendix I for Capacity Expansion Diagram.)

Resources required: Outside expertise is needed for real estate analyses; Capital expansion dollars are required, although the amount is still to be

determined; Additional staffing is anticipated, and will be based on estimated size of practice and

location; and Equity in Callen-‐Lorde’s 18th Street building will be needed. Successful if… Callen-‐Lorde is able to expand services to address demand appropriately, while remaining financially sustainable.

4. Establish Homeless Health Services Program

Context: Establishing a program to serve homeless LGBT adults meets multiple criteria: it is mission-‐driven, expands services for vulnerable communities and furthers the goal of obtaining independent FQHC status, which in turn enables direct access to federal funding, promoting financial sustainability. Currently 8% of Callen-‐Lorde patients identify themselves as homeless. Callen-‐Lorde has had several promising conversations with government officials around creating safe shelter(s) for LGBT persons and will continue to build upon these during the coming months. Policy recommendation: Authorize implementation of a homeless health program including either mobile health delivery or site acquisition leading to likely submisssion of a New Access Point grant application for homeless health services for LGBT adults. Resources required: It is expected that federal dollars will be available for funding of homeless program applicants in the fall of 2014, which will significantly defray program start-‐up costs.


Capital start up costs and operating expenses are expected, with amounts to be determined; and

Additional staff is anticipated, and will be based on estimated size and scale of facility.

Successful if… Callen-‐Lorde obtains NAP funding to provide health care services for the homeless.

5. Determine How to Best Be a Model for LGBT Care for Others Providing Services to the LGBT Community

Context: Expanding Callen-‐Lorde’s reach and impact through education, training, and research was identified as a high priority in the planning process. This option also may have the potential to diversify current funding streams. Policy recommendation: Authorize plan and allocate resources to explore and develop research and training options, recognizing further research is needed to understand: What government regulations must be met to undertake direct research and / or

train residents in a formal setting; What are the gaps in the current environment that Callen-‐Lorde can address; What is required to establish Callen-‐Lorde’s value as a third party training and

research partner, and what are the advantages/disadvantages of such; and Who are the best potential partners for training and research and why? Resources required: Determine public and private funding available for research and training and secure grant support to build infrastructure and formalize the program. Callen-‐Lorde is committed to allocate resources necessary to build the program, including site visits to successful models (e.g. Fenway Institute), administrative support and grant-‐ seeking activities. There are multiple and distinct routes available to support training and education efforts (e.g. federal sources for graduate medical education) and research (e.g. National Institute of Health, foundation-‐led initiatives). Successful if… Callen-‐Lorde identifies appropriate funding source(s) to formalize existing resources and establish a foundation from which to grow the program.


III. IMPLEMENTATION: Outcomes and Guidelines

There are multiple ways to implement a program option. As service delivery methods are explored further, decisions will be made about if and how to carry out program options.

An implementation plan enumerates the research, planning, and resource solicitation activities that are needed to execute the strategic program objectives successfully. A monitoring tool as part of the implementation plan was developed for use by management, and includes the following components:

• Action steps linked to the plan’s desired outcomes, • Timelines to carry out every task identified, • Responsible parties assigned to every activity, which could include staff and/or board, • Anticipated milestones to measure progress, and • Clearly defined monitoring protocol.

The Executive Committee of the Board and Executive Director will monitor the plan’s progress; Callen-‐Lorde’s Board which will review it every six months and make modifications as necessary. (See Appendix J for the Monitoring Protocols and Sample Tool.)

Clearly defined

strategic goal

Activities aligned with

goals

Defined milestones

Responsible parties

Reasonable time frames


Section 3. Summary and Conclusions

Callen-‐Lorde has been a leader and advocate, providing sensitive, quality health care to the LGBT community for over 30 years. As such, they are known to patients and providers alike as the provider of choice for culturally sensitive LGBT healthcare. The dedication of the staff and board to providing best-‐in-‐class care has been the calling card of an innovative and forward thinking organization. The biggest issue Callen-‐Lorde sought to address in its planning project was how to continue providing quality programs and services in a highly unstable environment. The Affordable Care Act rollout, the revenue decline anticipated from lower commercial and ACA insurance reimbursement rates and decreased public goods pool funding among other funding streams have created a highly uncertain environment. Uncertainty in turn has created the need for scenario planning, particularly as it relates to Callen-‐Lorde’s patients’ payor mix. Even in this changing environment, Callen-‐Lorde seeks to remain open to diverse payor classes of patients as long as it is financially possible. Accordingly, Callen-‐Lorde has committed to analyze its payor mix routinely to ensure fiscal viability and identify mechanisms to improve payment (e.g., contracting with an IPA), using other revenue streams to remain open to all who seek its care as appropriate. The other key consideration addressed through strategic planning is Callen-‐Lorde’s impact upon its target communities. Callen-‐Lorde achieves this impact directly, through patient care, and indirectly, by teaching and educating others to provide culturally appropriate care. Of course, direct impact is limited by capacity, including physical plant capacity. The planning process highlighted the need for Callen-‐Lorde to expand capacity by (i) maximizing the number of patients served within existing sites/programs, (ii) adding new patients, and (iii) providing additional services. Callen-‐Lorde’s commitment to exploring growth opportunities directly through changes of hours/times in existing sites, new sites/service delivery vehicles, and partnerships and collaborations, presents exciting opportunities, particularly as one considers the life cycle approach to serving the LGBT population. Untapped equity from the existing 18th Street facility may be an optimal funding mechanism for capacity expansion. Although the LGBT community has seen recent gains in the availability of sensitive health care, there is still a long way to go before LGBT affirmative care is the rule, rather than the exception. Callen-‐Lorde’s role as a trainer and educator of clinicians, providers, social services and front line staff continues to be important for achieving broader impact. In addition, gains in knowledge made through research can lead to effective interventions and improvements in


population health. Callen-‐Lorde’s objective to expand educational and research focused programming emerged as a longer-‐term goal that can achieve meaningful and lasting impact on LGBT healthcare consumers near and far. The policy recommendations set out in this plan will guide critical business decisions yet allow for the flexibility that Callen-‐Lorde management requires to make the timely and appropriate program choices, demanded in a rapidly changing environment.

Section 4: Appendices

APPENDIX A: Callen-‐Lorde Planning Committee

The planning committee was comprised of multiple stakeholders, including four Board members, eight member of the senior management team and four outside leaders in the field. Planning Committee Members:

Board Members • Karen Sauvigne, Board Chair • David Sandman, Ph.D., Board Vice-‐Chair • Laura Jacobs, LMSW, Board Secretary • Justus Eisfeld, Board Member

Leaders in the Field • Dave Shippee, Executive Director, Whitney Young • Adam Hennick, Mt. Sinai Health Partners • Larry McReynolds, Executive Director, Lutheran Healthcare Network • Wendy Stark, Senior Vice President, Lutheran Healthcare Network

Callen-‐Lorde Senior Management Team • Jay Laudato, Executive Director • Jose Virella, Chief Financial Officer • Anita Radix, MD, Senior Director of Research and Education • Peter Meacher, MD, Chief Medical Officer • Andy Fliegel, Senior Director of Human Resources • Richard Clarkson, Senior Director for Strategic Initiatives • Annie O’Hara, Director of Fund Development and Special Projects • Christine Reid-‐Smoot, Chief Operating Officer

KrasnePlows Team:


• Barbara Krasne • Jan Correa • Denise DeMaio • Stacey Rubinstein • Mardi Strand

APPENDIX B: Interview and Focus Group Participants

In the early stages of this project, 45-‐minute interviews were conducted with 10 selected staff and board members: The following board members were interviewed:

• Karen Sauvigne, Board Chair • David Sandman, Ph.D., Board Vice-‐Chair • Laura Jacobs, LMSW, Board Secretary

The following staff members were interviewed:

• Jay Laudato, Executive Director • Jose Virella, Chief Financial Officer • Anita Radix, MD, Senior Director of Research and Education • Peter Meacher, MD, Chief Medical Officer • Andy Fliegel, Senior Director of HR • Richard Clarkson, Senior Director for Strategic Initiatives • Katie Douglass, Director of Mental Health & Social Services

Additionally, three 90-‐minute focus groups were conducted with 20 staff members:

• Anthony Vavasis, MD, Director of Medicine • Anthony Fortenberry, Director of Nursing • John Bennett, Clinical Director of Mental Health • Eric Yarbrough, Director of Psychiatric Services • Rosie Arocho, Director of HOTT • Manel Silva, MD, Clinical Director of HOTT • William Nazareth, Director Prevention & Outreach • Finn Brigham, Director of Special Populations Services • Jennifer Wilson, Director of Health IT • Seeromanie Subick, Accountant • Rhonda Marks, Coordinator, Oral Health Services • Janette Roman, Director, Patient Administrative Services • Aviva Cantor, Medical Provider • Juliette Widoff, Medical Provider


• Kai Yohman Supportive Case Manager • Lucia Morales, Lead Patient Navigator • Sebastian Colon Otero, Mental Health Provider • Diego Wyatt, Patient Care Associate • Alice Hoang, Dentist • Rudy Guadron, Nurse Practitioner

APPENDIX C: Staff Interview Guide

Preamble: Everything will remain confidential; although incorporated into our findings – without attribution.

1. Interviewee Background (Briefly) a. What is your prior experience with a strategic planning project? b. In a sentence or two, can you describe how you came to join Callen-‐Lorde’s

staff? c. How long have you worked there?

2. General Background & Key Questions a. What are Callen-‐Lorde’s strengths and weaknesses as a whole? b. How might you compare Callen-‐Lorde to others in this field? Do you think there

are services that are not offered elsewhere that Callen-‐Lorde should consider? c. How visible is Callen-‐Lorde in the community? To its stakeholders? d. What would other health centers and hospitals say about Callen-‐Lorde? e. What would your funders say about Callen-‐Lorde? f. Where do you think that Callen-‐Lorde has had the most impact in achieving its

mission? 3. Specific Program Issue Related Questions

a. What are the strengths of Callen-‐Lorde’s programs? What are the weaknesses? b. In your opinion, is Callen-‐Lorde meeting the needs of the LGBT community?

i. If yes, how? ii. If no, why not?

c. In your opinion, what is the most useful service that Callen-‐Lorde currently provides to the community?

d. In your opinion, what opportunities do you think Callen-‐Lorde may have missed? 4. Management & Administrative Capacity—for staff interviews

a. How productive do you think you are or can be in performing your current job responsibilities?

b. What impediment if removed, would help you perform your job more effectively? (time or expense drain)

5. Callen-‐Lorde’s Future (Most important from client’s perspective)


a. How would you describe the impact of ACA on Callen-‐Lorde’s ability to fulfill its

mission? b. What do you think are the biggest challenges facing Callen-‐Lorde over the next

3-‐5 years? The biggest opportunities? c. How do you think Callen-‐Lorde’s programs should change or expand to meet

better the demands of the community in the next 3 to 5 years? d. Describe your vision for Callen-‐Lorde over the next 3 to 5 years? How different is

it from where the organization is now? What would need to happen to realize your vision? How could you tell if you were successful?

6. Is there anything else you want to tell us?

APPENDIX D: Board Interview Guide

Preamble: Everything will remain confidential; although incorporated into our findings – without attribution.

1. Interviewee Background (Briefly) a. What is your prior experience with a strategic planning project? b. In a sentence or two, can you describe how you came to join Callen-‐Lorde’s

board? c. How long have you served? d. What is your “day job”?

2. General Background & Key Questions

a. What are Callen-‐Lorde’s strengths and weaknesses as a whole? b. How might you compare Callen-‐Lorde to others in this field? Do you think there

are services that are not offered elsewhere that Callen-‐Lorde should consider? c. How visible is Callen-‐Lorde in the community? To its stakeholders? d. What would other health centers and hospitals say about Callen-‐Lorde? e. What would your funders say about Callen-‐Lorde? f. Where do you think that Callen-‐Lorde has had the most impact in achieving its

mission?

3. Specific Program Issue Related Questions a. What are the strengths of Callen-‐Lorde’s programs? What are the weaknesses? b. In your opinion, is Callen-‐Lorde meeting the needs of the LGBT community?

i. If yes, how? ii. If no, why not?

c. In your opinion, what is the most useful service that Callen-‐Lorde currently provides to the community?

d. In your opinion, what opportunities do you think Callen-‐Lorde may have missed?


4. Board Satisfaction a. How satisfied are you with your current role on the board? b. What, if anything, could be addressed to increase your engagement? (Lack of

info, training, communications) c. How well does the board function as a whole?

5. Callen-‐Lorde’s Future

a. How would you describe the impact of ACA on Callen-‐Lorde’s ability to fulfill its mission?

b. What do you think are the biggest challenges facing Callen-‐Lorde over the next 3-‐5 years? The biggest opportunities?

c. How do you think Callen-‐Lorde’s programs should change or expand to meet better the demands of the community in the next 3 to 5 years?

d. Describe your vision for Callen-‐Lorde over the next 3 to 5 years? How different is it from where the organization is now? What would need to happen to realize your vision? How could you tell if you were successful?

6. Is there anything else you want to tell us?


APPENDIX E: Staff Survey

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CLCHC Staff SurveyCLCHC Staff SurveyCLCHC Staff SurveyCLCHC Staff Survey

December 3, 2013 Dear Colleague: As you probably know, Callen-Lorde’s leadership launched a planning project to determine the organization’s strategic direction for the next 3 to 5 years, and established a planning committee to oversee the planning process. Over the coming months, the planning committee will clarify Callen-Lorde’s mission and vision, decide the agency’s strategic direction and identify the appropriate infrastructure to support those strategic goals. We seek your input at this time because you bring a valuable perspective to the planning project. Your feedback, particularly about Callen-Lorde’s programs and services and the communities you serve, will help shape the work we will undertake at our planning group meetings and our ultimate recommendations. As a staff member, your candid input into this process is critical. We invite you to contribute your thoughts by participating in the following survey. As you answer the questions, we ask you to respond from your point of view only. Please be assured of the confidentiality of your individual response. All survey data will be handled solely by KrasnePlows, the outside consulting firm engaged to facilitate the planning process. The survey will only take approximately 20 minutes or so to complete. We respectfully ask that you complete the survey by Monday, December 9th. Thank you in advance for your participation. Sincerely, Jay Laudato

Tell us about your role and tenure.

1. How long have you worked at Callen-Lorde?

1. Introduction

2. Your Background and Role

*a. Less than 3 years

b. 3 to 5 years

c. 6 to 10 years

d. More than 10 years















APPENDIX F: Board Survey

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CLCHC Board SurveyCLCHC Board SurveyCLCHC Board SurveyCLCHC Board Survey

December 3, 2013 Dear Board member: As you know, Callen-Lorde’s Board of Directors launched a planning project to determine the organization’s strategic direction for the next 3 to 5 years, and established a planning committee to oversee the planning process. Over the coming months, the planning committee will clarify Callen-Lorde’s mission and vision, decide the agency’s strategic direction and identify the appropriate infrastructure to support those strategic goals. This will result in a strategic plan that will require full Board approval through a vote. We will seek your input throughout the process and share developments as they become available. At this time, we want your feedback about Callen-Lorde’s programs and services and the populations it serves. This information will guide the work we will undertake at our planning group meetings and our ultimate recommendations. Your candid input into this process is critical. We invite you to contribute your thoughts by participating in the following survey. As you answer the questions, we ask you to respond from your point of view only. Please be assured of the confidentiality of your individual response. All survey data will be handled solely by KrasnePlows, the outside consulting firm engaged to facilitate the planning process. The survey will only take approximately 20 minutes or so to complete. We respectfully ask that you complete the survey by Monday, December 9th. Thank you in advance for your participation. Callen-Lorde Planning Committee Chris Bungay, Richard Clarkson, Justus Eisfeld, Andy Fliegel, Adam Hennick, Laura Jacobs, Jay Laudato, Larry McReynolds, Peter Meacher, Annie O'Hara, Anita Radix, David Sandman, Karen Sauvigne, Dave Shippeee, Wendy Stark, Jose Virella Sincerely, Jay Laudato

The board of directors is the body charged with setting an agency’s strategic direction. Board members make sure that the direction chosen fits within the agency’s charge (as stated in its bylaws) and fulfills its mission. Getting critical resource decisions right – allocating time, talent and dollars to the activities that have the greatest impact is what “strategy” is all about. Like all organizations, Callen-Lorde has limited resources. Board members have to make sure that those resources are used effectively to fulfill its mission. They need to consider how they can best achieve the impact they want to have with the resources they have in hand or could readily obtain.

1. Introduction

2. Your Background and Context













APPENDIX G: Sample Decision Making Tool

Decision(Making-Tool-

Fulfills licensure requirement =

Proposed Project: ______________________________

Financially sustainable =

Available or accessible resources =

1-–-Low-!

1-(-Low--

1-–-Low--

3-(-High-

3-(-High-

3-(-High---------------------Misalignment---------------------------------------------------------------------------------------Congruence-----------------------!

----------------------Misalignment - - - - --Congruence!

------------------Misalignment----------------------------------------------------------------------------------------Congruence-----------------------!

2-–-Med.-

2-–-Med.-

2-–-Med.-

Total-Score:-________- Weighted-Avg:______-

----------------------Misalignment - - - - --Congruence!

Fits mission =

1-–-Low-! 2-–-Med.- 3-(-High-

AddiEonal-factors:-see-next-slide-


APPENDIX H: Partnership Life Cycle Chart

Children-and-Youth-

• Community!programming!for!children!(CenterKids)!• Adolescent!Health!(Callen;Lorde)!• Outreach!to!homeless!and!street;involved!youth!(Callen;Lorde,!the!Center)!• Transgender!health!(Callen;Lorde)!• LGBT!Foster!Care!Project!(the!Center)!• Youth!groups!and!events!(the!Center)!

Adults-and-Families-

• Mental!health!and!substance!abuse!services!(Callen;Lorde,!the!Center)!• Sexual!health!care!(Callen;Lorde)!• LGBT!family!and!parenKng!services!(the!Center)!• Care!coordinaKon!and!case!management!(Callen;Lorde)!• Employment!assistance!(the!Center)!• Legal!advocacy!(Callen;Lorde!Medical;Legal!partnership,!the!Center!legal!clinics)!• Transgender!health!(Callen;Lorde)!

Older-Adults-

• Care!coordinaKon!and!case!management!(SAGE)!• Community!building!and!group!supports!(SAGE)!• Medical!and!mental!health!care!(Callen;Lorde,!the!Center)!• Caretaker!support!(SAGE)!• Home!visits!(SAGE!volunteers)!• NutriKon!educaKon!(SAGE)!• Employment!assistance!!(SAGE)!

The!life;cycle!model!of!care!is!designed!to!serve!LGBT!people!and!families!from!childhood!into!their!twilight!years:!!it!builds!upon!the!resources!of!agencies!serving!targeted!communiKes,!linking!them!together!to!create!a!seamless!path!for!access!to!needed!services!across!the!lifespan.!!Shared!systems!and!communicaKon!among!partners!are!key!to!the!model’s!success.!!The!model!may!grow!to!bring!on!other!partners!to!expand!the!web!of!coordinated!services!and!address!gaps!and!unmet!needs.!

The-LGBT-Partnership-Life-Cycle!


APPENDIX I: Capacity Expansion Diagram

Capacity-Expansion-

PaKent!Demand!

Planning-•  Needs!Assessment!

•  Capital!planning!

ExisKng!Capacity!(17th!&!18th!St)!

140,000!visits!

Add!a!satellite!site!in!another!

borough!!

Consolidate!in!a!bigger!site!in!ManhaZan!

Temporary!Relief!;!expanded!access!

Future!Capacity!

Sites!Services!Volume!

Convert 18th to residential &

attain new site

Add a satellite site in

Manhattan


APPENDIX J: Monitoring Protocols

The monitoring tool is comprised of a set of milestones and calendar by which to track the Business Plan’s progress and to make any appropriate adjustments. Individual implementation plans have been established for every program option recommendation.

Monitored by Jay Laudato, Executive Director and the Executive Committee of the Callen-‐Lorde Board

Reviewed semi-‐annually by the Callen-‐Lorde Board

CL Final Report 08 14 14F.docx

Sample-Monitoring-Tool-

Documents

Strategic plan 2014 - 2017