Rebecca Haag, MBA Change Management Consultant PowerPoint Presentation

Rebecca Haag, MBAChange Management ConsultantFormer Chief Executive Officer, AIDS Action Committee of MassachusettsMichael Gifford, MBAPresident & Chief Executive Officer, AIDS Resource Center Wisconsin (ARCW)

Organizational Change to Strengthen the Continuum of Care for PLWHA

AIDS Action Committee Overview

Rebecca Haag, MBA

Change Management Consultant

Former

Chief Executive Officer,

AIDS Action Committee of Massachusetts

Eliminate new infections: “Getting to Zero” Maximize healthier outcomes for those infected, affected and at risk for HIV Tackle the root causes of HIV/AIDSMission: End the Epidemic

Serve 1 in 6 people in MA who are living with a diagnosis of HIV/AIDSClient average annual income of is less than $10,000194 Employees (76 are PT at Boomerangs)Multiple LocationsRecent mergers with Cambridge Cares About AIDS, Strongest Link (North Shore) and Fenway HealthOrganizational Snapshot

FY’13 Results: Net Loss $187,482 (Audited)FY’14 Results: Net Profit $293,159FY’15 Budget: Profitable, sustainable servicesPrivate fundraising on targetContract Status: stable: 50% public Financial Highlights

Evolution of the Agency1983-1997Care for Dying1998-2003Care for the Living

2004-2009

Connected to Care

2010-2013

Improve

Health Outcomes

Crisis/Reactive

Reset

Proactive

Prepare for Future

Grassroots

Build Sustainability

Expand Vertical

Broaden Horizontal

Client Comfort

Client Support

Client Stabilization

Client Independence$ High $ Decrease$ StabilizedNew $ Sources

Strategic

Plan

Strategic Plan

Strategic

Plan

Model of Care

Model of Care

Our Strategic Plan: the Roadmap Environmental/Landscape Scan (SWOT)Mission, Mission, MissionStrategic goals and optionsCriteria for partnerships/mergerList of potential partners: pros/consTimelines establishedBarriers/Enablers

Merger with Fenway HealthIntroductory conversation: Fall ’1260 day go/no go review: Jan/Feb ’13Due diligence: March/April ‘13Decision to merger by Boards: April ‘13Announced: early June ‘13Official on October’ 13New AAC Leadership in place: April ‘14

Programs and ServicesConsolidated services for gay men: expanded testing hours, connection to care, more outreachSTD “Clinic in a Box” access at AAC sitesHealth Library/Fenway Institute: collaboration & accessOrganizationalIn first full fiscal year: saved $500k in back end work: : IT, facilities, finance, communications, purchasingOutreachPrEP Awareness Campaign: clinicians & peer supportImpact: Immediate & Sustainable

Medical Home Model: leveraging AAC’s community based support servicesIdentifying new sources of revenue3rd party billing for community servicesBuild pricing model for integrated services modelNew relationships and partnerships to grow and/or fill gaps Continued integration of brand and organizationTrain young leadership for the future Looking to the Future

Critical Factors for SuccessBe true to your missionEmbrace changeManage organizational/person egoBe open to adjustments as opportunities ariseBe ready to fail; you will learn from theseAlign head and heart before final decisionMove forward with speed and determination

Organizational Models of CareAIDS Service Delivery WisconsinMike Gifford, MBAPresident and Chief Executive OfficerAIDS Resource Center Wisconsin

HIV Medical Home model of care178 staff 12 clinics and offices$56 million annual budget3,500 patients and clients40,000 people at risk with HIV AIDS Resource Center of Wisconsin

Statewide Model of Care

1993 Northwest Wisconsin AIDS Project - Eau Claire1993 Wisconsin AIDS Research Consortium1997 Center Project - Green Bay1997 Central Wisconsin AIDS Project - Wausau1998 Northern AIDS Network - Superior1998 East Central HIV/AIDS Organization - Oshkosh1998 AIDS Service Organization – La Crosse2015 AIDS Network - MadisonSurviving Agency: AIDS Resource Center of WisconsinTransformation by Merger

Wisconsin

Identify the strategic intent of the mergerFocus on patients & clients and their outcomesInvest significant amount of time in communication and relationship developmentFocus on what will be gainedSet aside the history for a better futureLessons Learned in Merger

Integrated Health & Social Services

Legal Services – direct representation & brief legal counselingHousing Services – residential housing, rent assistance, counseling Case Management – medical and social work case managementFood Pantries – pick up and home deliverySocial Services

Lack of culturally competent care, quality careSecured Part C grant; ARCW Medical Clinic openedMedical Care2001

2015

Structure

Direct

provider

Employ all staff

Direct provider

MCW,

MD contract

Employ non-MD staff

Staffing

1 Physician

1 Medical Assistant

6 Physicians

3 Nurse Practitioners

5

Registered Nurses

2 Medical AssistantsLocationsKenoshaGreen Bay, Kenosha, MilwaukeeSpace2 medical exam rooms15 medical exam roomsPatients71,427

Limited access to mental health for patientsJoint grant with FQHCMental Health Care20032015

StructureSubcontract recipient

Employ all staff

Grant recipient

Employ

all staff

Staffing

2

Therapists

2 Psychiatrists

1

Psychologist

7 Therapists

3 AODA Counselors

Locations

Milwaukee

7 locations

Patients14646

Lack of integrated care; unrealized revenueOpening of ARCW PharmacyPharmacy20112015

StructureSubsidiary for-profit LLC

Subsidiary for-profit LLC

Staffing

2

Pharmacists

1 Pharmacy Tech

5 Pharmacists

7 Pharmacy Techs

3 Pharmacy Interns

Locations

Milwaukee

Milwaukee

Patients

417

2,468

Doyne Hospital and its dental clinic closedARCW Dental Clinic openedDental Care1997

2015Structure

Contract w/FQHC

Direct

Provider

Staffing

1 Dentist

1 Assistant

5 Dentists

4 Dental Hygienists

4 Assistants

Space

2 dental exam rooms

10

dental exam rooms

LocationsMilwaukeeGreen Bay, Milwaukee, MadisonPatients671,407

HIV Medical Home

ARCW

Patients

Outcomes of ARCW Model of Care

HIV Medical Home

ARCW

Patients

CMS Approved

Significant increase in HIV/AIDS servicesSignificant increase in the number of patients and clients served Enhanced long term financial strength Increased public & private revenueMore cost-effective operationsEnhanced employee recruitment and retention due to improved salary, benefits, retirementOrganizational Outcomes

Financial Outcomes1992 ARCW Budget2015 ARCW BudgetFederal Government

$0$2,553,318

State Government

1,663,901

6,322,676

Local Government

223,381

767,427

Development

521,949

2,645,000

Pharmacy

0

36,875,350

Reimbursement

0

1,174,343

United Way0350,168Total Revenue$2,409,231$51,044,295

Patient OutcomesPatientsARCW2009

ARCW2014With an Undetectable Viral Load

69%

85%

Prescribed HAART

74%

95%

With diabetes that is well managed

NA

83%

Prescribed preventative PCP treatment

91%

95%

With controlled hypertension

NA

59%

With controlled LDL

NA77%

Thank You

Questions?

Tools and Resources

Tools and ResourcesResourceAuthorDescription

AIDS Action Committee & Fenway Health: A New Vision for HIV/AIDS Services and Advocacy

(Case Study)

Peter Kramer

, Nonprofit Finance Fund

-Overview of AAC

and Fenway merger

-Includes discussion of the rationale, catalyst, and challenges of the merger

Strategic Restructuring for Nonprofit Organizations

(Book)

Amelia

Kohm

and David La

Piana

- Benefits/Costs/Challenges of Strategic Restructuring Partnerships

- Future impact of Strategic Restructuring on the Nonprofit Sector

Tools and Resources ResourceAuthorDescription

Sector Transformation and Organizational Sustainability

(Webinar)

National Center for Innovation in HIV

Care (

Vignetta

Charles)

-Overview of sector

transformation in the world of ASOs

-Cursory discussion of models of merging, growing, and closing (Merge, Go, or Grow)

-Information on resources and grants for sector transformation

Asking the Tough Questions:

Self-Assessment toward Growth vs. Responsible Closure

(Webinar)

National Center for Innovation in HIV Care

(

Vignetta

Charles, Robert Cordero, John Gatto, Monique Tula)

-Overview of sector transformation

-Three organizational leaders perspectives on their process of deciding to strategically restructureGetting your Board on Board

(Webinar)

National Center for Innovation

in HIV Care

(Brian T. Carney &

Kandee

Ferree)

-Overview

of board governance and the role of a board in organizational restructuring

-Includes tips for working with boards around restructuring

Webinars are available on our website for on-demand viewing.You will find slides from today’s presentation posted to the front page of our website: www.nationalhivcenter.org.Please complete the evaluation at the end of the webinar. Your feedback will inform our programming.If you are interested in individualized technical assistance, please visit our website and complete a TA Request Form. Join us for our other webinars this month!Optimizing Linkage, Engagement, and Retention in HIV Care for Adolescents and Young Adults of Color Tuesday, April 14 at

2:00 PM ET

(Registration available at our website:

www.nationalhivcenter.org

)

Conclusion

Slide