Fighting Domestic Violence, One Haircut at a Time

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January 1, 2017; New York Times and NPR, “The Two-Way”

According to a CDC study from 2003, domestic violence is the cause of two million injuries in the U.S. every year. Beginning this year, the state of Illinois has a new law educating hair stylists, nail technicians, and aestheticians on ways to help customers who are victims of domestic violence.

Joan Rowan is a hair stylist and owner of two hair salons in the Chicagoland area. In her forty-one-year career, she has had multiple conversations with clients who were experiencing domestic abuse: “Sometimes they tell you so much they never come back again, because they’re afraid, or they’re embarrassed, they don’t know what to do.” Rowan has provided training to her stylists to help them support their clients, but she has wished there were more she could do.

For a long time, public health campaigns among others have recognized the value of hair salons and barber shops as centers for community education and organizing, so the concept of making use of these venues is not new. But the state of Illinois is now building on these relationships with a new law that went into effect January 1st. Advocated for by the nonprofit Chicago Says No More, the law is the first of its kind to reach out and provide a one-hour training to hair stylists and nail technicians every two years as part of their license renewal. Over the next two years, it’s estimated about 88,000 stylists will participate in the program.

Chicago Says No More created the “Listen. Support. Connect.” program with the help of Cosmetologists Chicago. The program educates stylists on how to identify signs of abuse and assault and provide resources. Stylists are required to participate in the program but do not have to report the violence and are protected from any liability.

Although the number of independent neighborhood hair salons has been decreasing over the last forty years, hair stylists and their salons continue to have a special relationship with their clients and community. Often, they serve clients for many years and sometimes multiple generations of the same family. The relationship is something Illinois State Senator Bill Cunningham, one of the legislators responsible for introducing the law, knows personally: His wife was a hairstylist in her early twenties.

The program was built upon the Professional Beauty Association’s Cut It Out Campaign. The national campaign provides resources “mobilizing salon professionals and others to fight the epidemic of domestic abuse in communities across the U.S.” It was created in 2003 after a similar statewide program was developed by the Women’s Fund of Greater Birmingham and the Alabama Coalition Against Domestic Violence.

There’s an unspoken downside, however: Although the new Illinois law provides resources to women experiencing abuse, since the state is again without a budget, many of the organizations these women will look to for help are not receiving state funding and may not have the staff or programs to help.—Gayle Nelson

 

Original cite: https://nonprofitquarterly.org/2017/01/04/fighting-domestic-violence-one-haircut-time/

What Does It Take to Grow a Nonprofit? Teamwork and Capital

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November 16, 2016; Stanford Social Innovation Review

Although not always an indicator of impact and sustainability, nonprofit growth is a constant focus of philanthropic leadership. A recent study of over 200 organizations found three common attributes among nonprofits that were able to efficiently make the leap from idea to $2 million budget: strong teamwork, effective outcome evaluation system, and access to capital.

The field-based study began in September of 2016 by Kathleen Kelly Janus, a lecturer at the Stanford Program on Social Entrepreneurship. The study’s team examined more than 200 organizations, distributed among those with budgets under $500,000, between $500,000 and $2 million, and over $2 million. The organizations’ missions were diverse; leaders were asked to describe their work by choosing from multiple categories (and could choose more than one). The top three were education, with 48 percent surveyed; 26 percent with youth-based focus; and 23 percent community development missions. (Thirty-one percent chose “other” as one of their tags.) On average, organizations reached the $500,000 milestone in ten months but needed an average of 16 months to double their budgets to $1 million. On average, organizational growth from $1 to $2 million took a similar trajectory.

Since many articles focus on the personality of an organization’s leader as a key element of organization growth, the study began by examining the CEO/Executive Director. It found a wide range of actual job descriptions, but a key responsibility for organizations of all sizes is fund development. Interestingly, as organizations grow, the amount of time leaders spend in fundraising tasks increased from an average of 26 percent for organizations under $500,000 to 30 percent with budgets over $2 million. Study authors also noted a shift from CEO focus on program development for organizations under $500,000 to people management for organizations over $2 million.

Instead, the first characteristic of organizations achieving substantial growth was having a strong team of leaders to support the CEO/Executive Director. An effective team allowed the CEO to focus on capital instead of program. Connected to creating the team was the talent to avoid “bad hires” and purge them quickly when mistakes are made. Often, a strong team was not only made up of staff but key board members. Overall, the study found that “the lack of a high-functioning team can pose significant risks” to organization growth.

The second essential element was a focus on outcome evaluation. The study found that organizations with robust outcome tracking systems could decrease the time to reach the $2 million mark by as much as five months. The study also made a connection between effective evaluation structure and the ability to obtain a large catalyzing grant quickly.

The final element, access to capital, was often linked to the other two elements. Organizations with board members with connections to foundations or individual wealth were able to use their access to facilitate growth. Additionally, organizations with effective evaluation programs were able to discuss their clear program outcomes with funders, leading to more attention by larger foundations donating significant catalyzing grants.

Antony Bugg-Levine from the Nonprofit Finance Fund described in 2012 a key difference in the distinct types of capital essential for organizational growth:

Pay attention to the difference between “buy” money that pays for services and “build” money that enables an organization to invest in its long-term sustainability. As with any business, organizations need to balance both, and this balance shifts as they scale. Funders need to know whether their grantees need build money or buy money and how to be effective buyers and builders.

Overall, organizations of all sizes struggled to raise essential funds and it remains the number one challenge of growth. This is true even for organizations with “a fair degree of earned income,” as the report claims.

At the end of the study, authors identified three opportunities for funders to help organizations scale: fund leadership coaching, aid in building evaluation programs, and refer grantees to other funders in your network.—Gayle Nelson

 

Original cite:  https://nonprofitquarterly.org/2016/11/29/take-grow-nonprofit-teamwork-capital/

18 Months of Budget Impasse in Illinois Stresses Nonprofits and Devastates Lives

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November 29, 2016; Chicago

Throughout the 2016 fiscal year, Illinois government leaders failed to pass a state budget. Without a budget, many nonprofits did not receive any state funding even though they had valid contracts and performed the promised services. One day before the 2017 fiscal year began, state leaders passed a six-month stopgap budget to fund services for the first half of 2017. That budget will end on December 31, 2016.

Last week, the legislative session ended without state leaders passing a budget, leaving many Illinois nonprofit leaders holding their breath on their organizations’ ability to provide essential services after January 1st.

Over the last eighteen months, the Nonprofit Quarterly wrote extensively on the state of Illinois’s lack of a budget and its devastating effects on some nonprofits. During this time, nonprofits providing programs mandated by the state constitution were paid but those providing non-mandated services were not. These nonprofits had valid contracts with the state to provide these essential services, and most struggled to provide the services as required under the contract.

The governor, Bruce Rauner, and his staff promised to pay the providers after the impasse was resolved. But once the stopgap budget passed, the governor used a clause in the contract to limit reimbursements. Additionally, since the state did not have the revenue to make the payments, the disbursements were further delayed. Nonprofit leaders, including Diane Rauner, the governor’s wife, who leads a large Illinois nonprofit organization, sued the state. They lost in county court and the suit is now on appeal.

The failure of the state to pay for “nonessential” services caused great hardship for citizens throughout the state. For example, college students did not receive their MAP grants, K-8 schools did not receive educational funding, and people scheduled to leave prison were forced to stay locked up because halfway houses could not pay the staff that would support their reentry. At the same time, 62 percent of Illinois residents reported the budget impasse did not affect them.

In These Times and Kartemquin Films are creating an eight-part documentary, Stranded by the State, on the effects of the 2016 budget impasse on residents and the nonprofit institutions that serve them.

In These Times is a Chicago-based independent nonprofit magazine dedicated to advancing democracy and economic justice. The first program was released two weeks ago, highlighting the effects on Illinois’s higher education system and the tens of thousands of students served.

The limited late payments and decreased tax revenue continue to devastate an already damaged safety net and the State as a whole. As of November 16th, Illinois owed $10.6 billion in outstanding bills and possess a deficit of over $5 billion. Last month, North Side Housing and Support Services announced it would close a 72-bed shelter on the North Side of Chicago by the end of the year.

Currently, state leaders are meeting behind closed doors to try and reach agreement. Although Democrats lost a small number of state house representatives and senate leaders, they continue to hold majorities in both legislative houses. The Republican Governor continues to demand nonbudgetary items, including term limits on legislative leaders, before he will agree to a budget; Democrats in the legislature refuse to discuss these items. The Democrats won the State Comptroller’s office during the November election, but it is unclear if and how this will affect the impasse.

To create a balanced budget and begin to pay down the debt without instituting major long-term budget cuts, the state needs about $7 billion dollars in additional revenue annually. In the meantime, nonprofit leaders must recover from the presidential election and advocate for a solution before they and the residents they serve are stuck in another devastating situation.—Gayle Nelson

Original cite: https://nonprofitquarterly.org/2016/12/05/18-months-budget-impasse-illinois-stresses-nonprofits-devastates-lives/

Home Care Hospitalization: An Experiment with Promise

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November 11, 2016; Forbes

As the cost of healthcare, particularly in hospitals, continues to skyrocket, a few are exploring alternative methods of providing high quality care for lesser costs. One nonprofit in particular is reintroducing a method of care from decades ago: home visits from doctors.

When Dr. William Terry arrived at Boston’s Brigham and Women’s Hospital with violent chills and a high fever, emergency room staff determined he needed hospital care. Instead of being admitted, however, Dr. Terry became part of a study where he would receive the same care at home, including at least one home visit from his doctor plus two nurse visits every day.

The Brigham and Mass. General studies are limited to patients living within five miles from the hospital who present with heart failure, pneumonia, chronic obstructive pulmonary disease, or infections. (Terry’s chest x-ray showed a “suspicious spot.”) The study is focusing on these conditions because patients do not normally require intensive care or major procedures.

The preliminary results of the Brigham study were published in a recent issue of JAMA Internal Medicine. Patients were found to suffer from lower infection and readmission rates. The cost savings was an average of $2,000 per patient as compared to a hospital stay. More importantly, patients receiving care at home reported feeling happier. Perhaps that is not surprising, given hospitals’ reputations for awful food, harsh lighting, loss of privacy, snoring roommates disturbing sleep, and nurses on a schedule that works for the hospital system rather than the patient. The list goes on.

The study is part of a larger movement led by Hospital at Home, a program created by the Johns Hopkins School of Medicine and Public Health. Their research found the model lowered costs by almost a third and reduced complications of hospital stays. Surprisingly, the first study of these types of programs was conducted in 1997, leaving a supporter to describe the treatment plan as the “most studied innovation in health care.”

Although common in England, France, and Australia, in-home care is not widespread in the U.S., mainly because most insurance companies and Medicare do not cover it. Many of the treatment providers, such as Brigham and Women’s Hospital, are picking up program costs. New York City’s Mount Sinai Hospital is part of a $9.6 million, three-year similar study funded by the Centers for Medicare and Medicaid Services.

Overall, due to technology and revolutionary research, plus the emerging population health and wellness reimbursement structure of the Affordable Care Act, medical care is shifting. As research and technology has disrupted once-deadly diseases like HIV-AIDS and we continue to live longer and healthier, some are describing the hospital of the future as a “NASCAR pit-stop.”—Gayle Nelson

Original cite: https://nonprofitquarterly.org/2016/11/16/home-care-hospitalization-experiment-promise/

New England Sees 900% Increase in Organ Donations Tied to Opioid Epidemic

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October 14, 2016; NPR, “Shots”

This year, some hospitals in Massachusetts, like Lahey Hospital and Medical Center in Burlington, have dramatically increased the number of organ transplants they perform. The sources of these lifesaving gifts are the victims of the opioid epidemic. Although the increase in available organs represents hope for some and brings a small degree of comfort to the families of those lost to deaths from drug abuse, the wait continues for many more on the transplant list as well as families of addicts seeking services.

On June 30, 2015, Colin LePage found his thirty-year-old son, Chris, unresponsive after an apparent drug overdose. Over the next 24 hours, medical personnel from one of Boston’s largest medical centers revived Chris’s heart but struggled to stabilize his blood pressure and temperature. After two rounds of tests displayed no sign of brain activity, LePage listened to his son’s beating heart one last time before Chris was wheeled away. Although Chris died that day, his liver continues to function in a new body, that of a 62-year-old pastor.

The liver represents just part of the dramatic increase in New England organ donations since 2010, according to the New England Organ Bank, the organization responsible for gathering the organs in the six New England states. The expansion is due to the growing number of organ donors who fell victims to the growing epidemic of opioid abuse. Since the beginning of the year, more than one in four organ transplants in the New England area originated from people suffering a drug overdose. Nationwide, organs from deceased drug users accounted for 12 percent of all donations this year. Traffic accidents used to be the fourth-largest source of organ donation, behind deaths from strokes, blunt injuries, and cardiovascular disease, but drug overdoses, now the fastest growing category of organ donor, eclipsed them in 2014.

Before the epidemic took hold, organs from drug users were considered too risky for transplant. Drug users have long been associated with HIV, hepatitis C and other diseases. Although contraction from transplants is rare, tests have sometimes failed to detect infectious diseases, leading to donors contracting the diseases. (For example, in 2007, one donor transmitted both HIV and hepatitis C to four organ recipients.)

But as the shortage of organs continues to grow, the number of opioid overdose victims rises, and testing procedures improve, more people are receiving these donated organs. “We know now that the mortality rate of being on the waiting list for several years is higher than that of getting an organ with an infection that is treatable,” said Dr. Robert Veatch, a professor emeritus of medical ethics at Georgetown University, who has authored numerous articles on organ transplants. At the same time, recipients with HIV can receive organs from donors with HIV without additional risk. Earlier this year, surgeons from Johns Hopkins University Medical Center performed the first transplant of this kind.

“It’s an unexpected silver lining to what is otherwise a pretty horrendous situation,” said Alexandra K. Glazier, chief executive of the New England Organ Bank.—Gayle Nelson

Original cite: https://nonprofitquarterly.org/2016/10/26/new-englands-900-increase-organ-donation-tied-depth-opioid-epidemic/

When Public Parks Become a Civil Rights Issue

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September 29, 2016; The Atlantic

Public parks and recreational areas in urban regions often support activity and healthy living for low-income communities. In the past, these amenities were mostly suburban enhancements, but today’s city leaders realize their importance in encouraging more vital lifestyles for all residents. They can also lead to gentrification driving out the people they were designed to serve.

For three years in a row, Minneapolis has boasted the best parks system in the U.S. as judged by The Trust for Public Land, a forty-four-year-old nonprofit dedicated to protecting and creating public parks throughout the country. The city’s numerous parks are also the center of a bitter dispute with many residents of color, who allege the parks are primarily maintained and presented for the benefit of the metro area’s affluent white residents. As noted in The Atlantic article:

In America, bike trails and baseball fields are luxurious perks of many affluent neighborhoods, boosting property values and creating a sense of community. Meanwhile, in many inner cities, public parks are magnets for crime and casualties of disinvestment.

The battle is most evident at the Minneapolis Parks and Recreation Board’s regular meetings. The semi-autonomous agency, overseen by a nine-member elected commission and superintendent, is responsible for managing the City’s parks. Often, the meetings are disrupted by groups of young African American men carrying signs demanding the agency increase minority hiring and equalize park funding throughout the region. The protest is organized by Voices for Racial Justice and Community and other nonprofits. The park board is all white, while the city is only 66 percent white, compared to 87 percent in 1980. It has a history of funneling substantially more funding to parks in wealthier areas in southwest Minneapolis at the expense of northern areas where most of the city’s low-income minority residents live.

The protests led to Minneapolis being the first city-park system to prioritize capital spending to parks in low-income/large-minority communities and those in the worst condition. State leaders are also advocating for expanded funding to increase minority communities’ knowledge of regional parks. Millions of residents visit regional parks annually, but only three percent are minorities.

The disproportionate access of minority communities to parks and recreational areas is a national concern. Earlier this year, the U.S. Secretary of the Interior, Sally Jewell, recognized the country’s history of funding parks in areas where older, white Americans reside and the need to expand access to younger, more diverse residents.

In Chicago, city residents are celebrating the one-year anniversary of the 606 Trail. Eighty thousand residents live within ten minutes of the 2.7-mile trail, which was converted from an abandoned railroad track. Residents use it year-round for recreation as well as traveling to and from work. It has also sped up gentrification in surrounding communities. The real estate industry has marketed homes near the trail nationwide.

Compare the $95 million project to the Major Taylor, a similar project in Chicago’s low-income South Side communities. The Major Taylor trail is over twice as long, but without the lighting, snow removal, and other amenities of the 606 Trail, it has fewer users and property values surrounding the trail have not increased.—Gayle Nelson

Original cite: https://nonprofitquarterly.org/2016/10/11/public-parks-become-civil-rights-issue/

Is the Future of Higher Education a “Multi-Directional Swirl?”

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September 22, 2016; Inside Higher Ed

It’s no surprise that as the economy goes through a profound shift, driven partly by new uses of technology, higher education has come to an inflection point. But an article in Inside Higher Ed adds information that reemphasizes that the picture that’s emerging needs to be understood as a whole system and understood in a values framework. This, in other words, is a wicked problem.

The article points out that 35 percent of first-time college students were part of what a new report refers to as the “multidirectional transfer swirl,” transferring from one institution to another throughout their college careers. As the number of students who fail to graduate and become unable to pay back their college loans continues to grow, perhaps it is time to explore whether college is the best investment for all.

Last week, the Commission on the Future of Undergraduate Education, a program of the American Academy of Arts and Science, released a report titled, “A Primer on the College Student Journey.” The study, funded by the Carnegie Corporation of New York at a cost of $2.2 million, began with the author’s list of “Top Ten Takeaways” on the undergraduate experience. These included the continued troubling effect of a person’s race and class on their chances of graduating from college and the escalation in the number of students who enroll in remedial courses during their college experience.

In the report, the Commission explored the increased number of students attending college. Overall, 68 percent of millennial students enrolled in college months after graduation from high school and almost ninety percent began their college experience within eight years from graduation. While more are attending, a much smaller number are graduating. Only 40 percent of students entering a four-year institution actually graduated within four years. The figure only improved to 60 percent if the amount of time in school increased to six years. Of the students graduating, less than half (48 percent) attain their bachelor’s degree. Of the remaining graduating students, 26 percent earned their associates degree and 25 percent earned certificates.

The growth in both time attending and tuition has no doubt increased the amount of debt students carry upon graduation. While two-thirds of full-time students pay less than the full cost of tuition, the percentage of students with federal loans increased from around 50 percent to 60 percent between 2000 and 2012. The median loan balance of college graduates increased by almost 25 percent in that same period.

While students are graduating with higher amounts of debt, they are not the students with the greatest chance of defaulting on their loan obligations. Instead, students who fail to graduate and take on smaller amounts of debt are more likely to default. One-fifth of adults over 25 have attended college but did not attain a degree. Twenty-four percent of these students will eventually default on their loans.

Although 18- to 21-year-old dependent students working toward their bachelor’s degree are the stereotype, in 2013, almost a third of enrolled college students, or 5.5 million, were over the age of 25. (By 2014, according to the National Center for Educational Statistics, that number had risen to 41 percent, or 8.2 million.) Fifty-five percent of these students were enrolled part-time. Overall, 37 percent of all students study part-time.

As the amount of state funding of public colleges and universities continues to decrease, it is not surprising schools continue to look toward foreign students, who typically pay the full tuition price tag, to balance their budgets. The number of foreign students in U.S. colleges and universities has increased 67 percent since 2000. University of Michigan researchers found a ten percent decrease in state funding corresponded with a 12 percent increase in foreign student enrollment in public universities. China, Saudi Arabia, and South Korea sent the most foreign students to American universities.

The Commission expects the number of students graduating high school and attending college to remain flat at 3.3 million per year over the next decade to remain flat at 3.3 million over the next decade. Next summer, it plans on releasing a supplementary report exploring the future state of higher education.—Gayle Nelson