ADDRESS

5-Year Sustainability Plan April 2019

4625 44th Street, Room 13 Sacramento, CA 95820

(916) 558-4812 www.herhealthfirst.org

Her Health First believes that strong and healthy communities begin with strong and healthy women! That is why we are committed to a community that prioritizes women’s health care, specifically for women of color. Our support programs Black Mothers United and Girls on the Rise provide women invaluable resources during three key stages of life: adolescence, pregnancy, and motherhood. In 2019 Her Health First was awarded a $1.9 million, three-year contract from First 5 Sacramento to provide pregnancy support services to African American women throughout Sacramento County. At the end of the contract period, First 5 Sacramento is anticipating a 30% decrease in funding and is working with their current grantees to develop a sustainability plan that will allow its partners to continue offering services to the community. With support from First 5 Sacramento, the Impact Foundry and Storywalkers Consulting, Her Health First began the process of developing a sustainability plan that will assist the agency in preparing for potential funding decreases, leveraging current resources, and shifting operations to ensure Her Health First programs remain viable without sacrificing the quality of service. The following plan outlines our current programming, funding sources, challenges and opportunities, and ultimately our strategies for ensuring our critical programs are sustainable so that we can continue to put Her Health First!

Introduction

Existing Funding Sources

             Source                         Amount                        Duration                     Services Funded        

Secured First 5

Sacramento

Anticipated Sierra Health Foundation

Black Infant

Health/MCAH

Cash Match 

Cannady-Ford Foundation

Big Day of

Giving

Annual Jazz & Wine Fundraiser

$1.9 Million

$15,000

TBA

$5-10,000 

$2,500-5,000

$10-15,000

2018-2021

1 year

--

--

--

--

Black Mothers

United

Policy/Advocacy

Maternal/Infant Health 

--

--

--

Existing Funding SourcesProposed Efficiencies

Her Health First is working to develop a comprehensive volunteer recruitment, management and retention plan to support its current pregnancy support service work. Through the implementation of this model, we will be able to develop and enhance current staff capacities, more effectively engage community members, and significantly reduce staffing costs (our initial staff reduction goal is 2.0 FTE). In order to ensure efficacy of the volunteer model, we will also look to increase efficiencies by streamlining case management using technologies/software that will support volunteer management, service delivery, referrals, and data. Additionally, the agency is located within the Fruitridge Community Collaborative, a previous school site that is now home to 20+ nonprofit agencies. PRO Youth & Families has recently taken over management of the site and are discussing potential opportunities for tenants to share resources such as administrative functions (i.e. payroll, finance management/bookkeeping, fund development). Not only would this provide a cost-savings in personnel but would also provide opportunities to enhance and develop partnerships that can be leveraged when applying for larger grant projects. Collaborative Efforts

Through our efforts in moving towards becoming a trauma-informed agency, we will become more intentional about directly addressing the social determinants of health to reduce and prevent trauma among our target population. The social determinants of health include areas such as housing, transportation, poverty, employment, and education—areas our pregnancy coaches spend a significant amount of time supporting their clients. By having an intentional focus and strategies to address the social determinants of health, we will seek to develop partnerships with entities who may not be considered health-related (housing, transportation, education), convening these groups to leverage funding opportunities to address health inequities. This will enable us to reduce and prevent trauma among our target population and open a multitude of opportunities to fund the program. Additionally, we will seek to enhance collaboration with the Black Child Legacy Campaign, Community Incubator Lead sites. Collaboration with the CIL sites can be leveraged to support volunteer recruitment, trainings, as well as in-kind space to meet with clients.

Existing Funding SourcesVolunteers

Our goal will be to recruit volunteers from the community who will support pregnancy coaches with outreach and recruitment of clients into the program. Outreach and recruitment take up approximately .30 of a pregnancy coach's FTE. By taking on outreach and recruitment efforts, volunteers will free up 1.8 FTE, enabling the agency increased capacity to serve more clients and/or reduce staffing if necessary. Additionally, Her Health First will explore ways to adapt and re-implement the "sister-friend" model, established by the agency over 30 years ago. The "sister-friend" pairs a trained volunteer (Sister Friend) to a pregnant teen or woman (little sister). The Sister Friend provides support during the pregnancy up to the baby's first birthday, while encouraging the utilization of adequate and appropriate health care and social services and follow-up for mother and the baby. The strategy of utilizing community volunteers for outreach and recruitment as well as for pregnancy support holds the potential to significantly increase the efficiency and scope of the program. In-Kind Goods 

The program currently receives in-kind goods in the way of infant care items (i.e. diapers, wipes, clothing, strollers, cribs, toys, etc.). We utilize these items as incentives for program participants. Additionally, we receive in-kind space at each of the 7 Community Incubator Lead sites, allowing our pregnancy coaches to spend time on a weekly basis in each of the target neighborhoods we serve throughout the county. Lastly, we have had many individuals come to various meetings and provide trainings free of cost to the agency.

External Factors 

Opportunities ChallengesChange in Leadership - Gavin Newsom is committed to addressing healthcare inequities affecting children and families.

Appointment of state's first Surgeon General - Dr. Nadine Burke Harris has extensive experience with ACEs; attended listening session with HHF.

Significant increase in awareness and momentum in addressing maternal and infant mortality rates —potential to lead to new partnerships and opportunities to leverage funding and resources.

Decreased funding from First 5 - agencies that serve families and children 0-5 need to search for additional funds.

Pool of agencies applying for grants that serve families and children 0-5 will be much larger/more competitive in Sacramento County area.

Difficult to measure program impact - while data signals a decline in perinatal conditions and reduction of African American child deaths in 2016, exact impact measurement will take years.

Decrease in African American perinatal deaths may cause funders to shift priority focus area if infant death percentages fall below Healthy People 2020-30 benchmark.

Internal Factors Opportunities Challenges

Unique program design - BMU offers culturally sensitive support services provided by Pregnancy Coaches who are mothers and grandmothers from the communities we serve.

Agency legacy and reputation - HHF has been a trusted community resource for 29 years, recognized as "go-to" agency with expertise serving Sacramento's African American community; partners with over 40 agencies in Sacramento.

Agency structure - Smaller size and not tied to medical clinic allows us to adapt to changes in climate (medical, political, and communtiy) that impact client needs.

Agency structure - small staff size of 13 would make it difficult to accommodate rapid growth in size to expand programming or serve more clients.

Board of Directors - currently only four members, with limitations in community connections and ability to contribute financially.

Staff turnover—Her Health First has struggled with staff turnover over the past 3 years and it will be critical to identify strategies to recruit and retain employees.

Capacity BuildingDeveloping organizational and staff capacity around trauma-informed care to be more intentional about directly addressing social determinants of health.

Seeking out partnerships with entities that may not be considered health-related (housing, transportation, education) and convening these groups to leverage funding opportunities to address health inequities.

Priority Action AreasRevenue Structure

Goal: Ensure long-term financial security through a diversified and expanded funding

portfolio.

Operational Framework

Goal

Definition: A guide to your organization’s policies, goals, standards, procedures and training, an operational framework helps you align resources to ensure success and growth. What you address in the operational framework helps ensure the technical capacity needed to implement programmatic and organizational strategies.

Rationale: To meet the 30% cost reduction, Her Health First will need to reduce staffing by at least 2.0 FTE. It is our goal to meet the budget reduction without sacrificing the quality/level of service being provided. This can be achieved by restructuring our operational framework to include a framework for utilizing volunteers to provide pregnancy support services.

Definition: A revenue model is a framework for generating revenues and includes measures of financial health such as funding diversity, cash on hand, income risk calculation. It identifies what revenue sources to pursue and is a key component of your business model. Diversified revenue structures better allow you to weather economic downturns and build resources for un-/under-funded mission critical work.

Rationale: Currently, funding from First 5, Sacramento is the sole source of funding for the pregnancy support program. Her Health First recognizes that a critical strategy for mitigating the risk of funding uncertainties will be to diversify the revenue sources that fund this program. It is our goal to establish a base of funding that is reliable, flexible, and varied.

Goal:  Strengthen our operational infrastructure and capacity to ensure growth and long-

term sustainability.

Timeline for Implementation