STRATEGIC PLAN FOR PLANNED PARENTHOOD OF WESTERN PENNSYLVANIA 2013 - 2016 CONFIDENTIAL DOCUMENT Approved by the Board of Directors DATE: November 14, 2012 STRATEGIC PLAN FOR PLANNED PARENTHOOD OF WESTERN PENNSYLVANIA TABLE OF CONTENTS I. Introduction II. Mission Statement III. Core Values IV. Assessing the Organization and Scanning the Environment A. B. Internal Strengths Weaknesses External Opportunities Threats V. Assumptions about the Next Three Years VI. Strategies and Goals 2 INTRODUCTION Section I: Mission Statement. The most fundamental capstone or essence of an organization is its mission. This mission is the central reason that PPWP exists. All of our objectives and goals should be focused on successfully achieving our mission. Section III: Core Values. These are the beliefs and principals that guide us in our programs, services, policies, management, and governance. They are the unique characteristics, values, and commitments that define what PPWP stands for and which must be sustained into the future. Section IV: Assessing the Organization and Scanning the Environment. The strategic planning team reviewed and determined our internal strengths and weaknesses by unflinchingly looking at the outside world in order to figure out the relevant threats and most interesting opportunities with the intent to create a set of new initiatives, goals and objectives that will shore up our weaknesses, lead from our strengths, vanquish the threats, and exploit our opportunities. Section V: Assumptions about the Next Three Years. After an organizational assessment, predictions and forecasts were made about the future of PPWP. By anticipating change, difficulty or new possibilities, we can better direct the organization. Section IV: Strategies and Goals. The strategies laid out in this section are the driving forces of the agency, and all have a significant bottom-line impact. Achieving them (or not achieving them) has significant financial and policy implications; PPWP will look different three years from now for having engaged in activities that pursue the vision of these strategies. These are the endeavors that will allow us to serve our mission, remain true to our purpose and if successful, ensure organizational success. 3 MISSION Planned Parenthood of Western Pennsylvania’s mission is to provide high-quality reproductive health care services, comprehensive sexuality education and strategic advocacy. Planned Parenthood of Western Pennsylvania believes in the fundamental right of individuals to manage their fertility and reproductive health without regard to income, marital status, race, ethnicity, religion, sexual orientation, gender expression, age, national origin, or residence. We believe that reproductive selfdetermination must be voluntary and preserve the individual’s right to privacy. We believe that respect and value for diversity in all aspects of our organization are essential to our well-being and that of our clients. Adopted 1.11.12 4 CORE VALUES – WHAT DO WE BELIEVE? Planned Parenthood of Western Pennsylvania’s values are the principals which guide both our long-term goals and our daily work. These principals are what we as an organization hold true, and they guide us in establishing services and programs and in making management decisions. The following statements summarize the core values articulated by our staff and board of directors: Human Sexuality Human sexuality is a normal and healthy part of life. We recognize that people are sexual beings whose need for human connections extends throughout their lifetimes. All persons are entitled to receive adequate information and medical care in order to enable them to enjoy their sexuality and make reproductive health and sexuality decisions in a responsible, informed, and safe manner. Absolute Reproductive Freedom We believe in and promote the ready availability of comprehensive contraceptive information, birth control methods, and abortion services. Quality All persons are entitled to quality health care. We will continually improve our services to meet the needs of the community and to provide the highest quality reproductive health care available while striving to meet the requirements of the changing health care environment. Education Education is integral to the fulfillment of our mission. All persons are entitled to adequate information and education concerning human sexuality, and the delivery of this information will enable people to exercise responsible, safe, and informed choices. Confidentiality Our services are provided in an atmosphere of absolute confidentiality and privacy. Our clients must feel free to be completely open about their issues and concerns so that we can serve them to the best of our ability. Access to Services Our services and programs are available to all, regardless of gender, race, age, marital status, sexual orientation, or ability to pay. We strive to treat our clients with the dignity, respect, and compassion to which every human being is entitled. Advocacy: Working for Change We must continue to work in spite of legislative, judicial, and financial constraints to ensure that our mission is fulfilled. We will be a strong advocate for reproductive justice and will continue to guard against complacency. Our willingness to advocate for our mission must never waver. Integrity PPWP must maintain the highest level of integrity with respect to everything it does. We are committed to maintaining the highest ethical standards and dealing with all persons in an honest and transparent manner. 5 ASSESSING THE ORGANIZATION AND SCANNING THE ENVIRONMENT In this strategic plan, we have articulated our mission statement, which states our central purpose as an organization. We have enumerated the core values and commitments that define our strategic approaches to meeting our mission. We have established our foundational beliefs and the guiding principles that will focus our organizational efforts through the next three years. Now, we turn our planning attention more specifically to our present organization and the western Pennsylvania region that is our home. To plan confidently for the future, we must clearly understand our organization’s internal strengths and weakness and the external threats and opportunities that face us in the outside world. The direction that we map for ourselves later in this plan represents our best efforts to strategically address our current internal condition in the context of the external geographic region in which we operate. PPWP in the next three years will attempt, through its initiatives, to shore up its weaknesses, lead from its strengths, vanquish the threats and exploit its opportunities. INTERNAL ANALYSIS Strengths: Significant resources are available through our PPFA affiliation including: legal expertise, public relations resources, advocacy on public policy issues, participation in a national insurance program, position-specific professional training opportunities, contraceptive purchasing contracts, the Justice Fund, and special grant and funding opportunities. PPWP’s affiliate status with a national organization provides valuable name recognition which helps fundraising efforts and client recruitment. PPWP’s market niche is confidential, affordable, education and reproductive health services that are utilized most by adolescents and young adults: abortion, full range of birth control methods, STI testing and treatment and information and counseling services. PPWP has strong leadership, commitment to the mission and a diversity of skills, perspectives and community connections on both the Board and the staff. The work of the compensation task force has resulted in a more competitive non-profit salary scale for the agency. Clinician compensation is competitive in the current market. PPWP has geographic diversity—we provide medical services at six health centers in four counties, and education, outreach and advocacy in as many as twelve counties. PPWP provides more “on demand” services as compared to other family planning providers. PPWP offers walk-in opportunities at all health centers and has the capacity for increased appointments and/or walk-ins if service demand increases as a result of the Affordable Care Act. PPWP has a diversified financial base for annual operations with 18% of revenue from community support, 70% from client fees, 10% from government funds and 2% from investments. The organization has established an endowment fund, developed a committed donor base and a positive presence in the community. The Pennsylvania Medicaid Waiver (Select Plan) has resulted in improved access to family planning services for lower income women and increased revenue from clients who previously received free services. As result of the waiver program, an additional health center location and a significant emphasis on customer service and productivity, patient visits have increased by 53% in the last four years and medical revenue has increase 86% from FY08 to FY11. 6 PPWP has an agreement with Magee Women’s Hospital and the University of Pittsburgh Medical School which provides a residency training program for abortion, a medical director and physicians for service delivery. PPWP’s Education Department is one of the few organizations providing sexual health education and training in western Pennsylvania. PPWP has been able to maintain strong community relationships that have allowed the peer education program to maintain its presence in local schools and the community education contacts and programs to double in the last three years, PPWP is the primary organization advocating for reproductive rights and reproductive health in western Pennsylvania. PPWP and the other Pennsylvania affiliates have established an effective statewide advocacy presence via our public affairs office in Harrisburg. There are now 24,730 advocates signed up for the C3 and 16,101 people signed up for the C4 as advocates in western Pennsylvania. PPWP is a member of Better Health organization, a group of ten affiliates that work collaboratively on regional business initiatives. This collaboration has expanded our IT capacity and will support and facilitate the transition to electronic medical records and compliance with future billing regulations. PPWP is considered in a growth mode by PPFA’s analysis and has these strengths for health care reform: o o o o Commercial insurance volume of 21% with contracts with most insurance plans in western Pennsylvania. Increasing patient volume over the last 4 years Strong cash position – more than 4 months cash Operating on a health information technology compliant practice management system and poised to move to electronic health records Weaknesses: PPWP has a mission that is controversial to some members of the community and this has a number of implications: o o o o o fundraising is more challenging with almost no access to corporate gifts and foundation giving dependent on the views of the board members. Education programming opportunities are more limited, especially in public schools, Staff recruitment and retention is more difficult, Expensive security measures is required at our facilities, Anti- Planned Parenthood picketing at health centers affects client satisfaction and our ability to rent space. Hiring can be difficult due to the controversial nature of our services, the part-time status of many positions and a salary scale that is competitive for non-profits but low for the business community. The amount of work required to manage human resources has increased significantly due to additional verification, credentialing, and training requirements from PPFA and state and federal licensing requirements. These responsibilities are shared by several staff members. PPWP’s education department is not self-supporting, and its largest program, peer education, is heavily dependent upon grant-funding which makes it vulnerable. PPWP’s grassroots organizing efforts continue to increase and are essential due to the anti-choice environment and political and regulatory attacks. The cost of technology and staff resources needed to recruit and maintain activists and to educate the community is high. Limited financial resources have made it difficult to add new programs and new health centers. 7 PPWP is a specialty health care provider currently competing with 20 other federally funded agencies in Allegheny County that also provide family planning services. This requires more money to be spent on marketing and customer service. Abortion services must be provided under onerous state regulations which significantly increase the expense, decrease the efficiency of providing the service and make access more difficult for clients. PPWP has weaknesses identified by a PPFA analysis with regard to health care reform: These include: o High percentage of Medicaid clients and low Medicaid reimbursement rates in Pennsylvania. o Capital funds are needed for facility maintenance and future expansion. o Cash reserves and net margins meet current requirements but not the recommendation under HCR (180 days cash and 6% margin) PPWP has difficulty recruiting clinicians in our rural service areas. PPWP has specific areas of customer service that could improve related to managing incoming phone calls and reducing wait time for clients at some health center. EXTERNAL ANALYSIS Threats: Due to the uncertainty about health care reform, planning for its impact is a challenge. Threats include: o Although PP is designated as an essential community provider, the state exchange could adopt rules that restrict the number and types of essential community providers. o Community health centers are also essential community providers and have some potential market advantages including less controversy, ability to provide gynecologic care and generous government funding. o Medicaid clients are expected to increase and this is the lowest paid reimbursement area and the population most likely to come to PP. o Patients who are newly insured may want to go to a private provider and not use PPWP’s services. o Local networks or collaborations that develop may not include PPWP because we are specialized and/or too small. The policies adopted for the health care exchange will determine many factors that have an impact on Planned Parenthood and the delivery of care including decisions around the scope of services, type of tests approved, participating insurers, reimbursement rates, etc. Planned Parenthood must try to be involved with this process through networking and advocacy efforts. PPWP faces business model challenges due to changing regulations and funding requirements. o The financial impact of no-cost sharing for contraceptives and well woman care is not known yet. o The cost of contraceptives is increasing significantly thereby reducing revenue from contraceptive income. Many of the newer birth control methods are expensive to purchase and to provide to clients who are uninsured. o PPWP remains dependent on Title X participation to be able to purchase lower cost contraceptives through the 340 B program. o Reimbursement rates are stagnant, especially for the Medicaid program. o PPWP’s business model depends heavily on the sale of contraceptives, which are increasingly shifting from self-pay to third party, with controlled reimbursement rates. o Government funding for family planning services has decreased and does not cover the cost of delivering services. 8 o o Medical billing will become more complex and greater expertise and resources will be needed for billing and insurance contracting as the percentage of commercial pay clients increases. More revenue cycle assessment and financial oversight will be needed as the medical billing program becomes more complex. The Planned Parenthood experience in Massachusetts and a potential threat identified by PP’s health care reform experts is that many of our clients will be on the cusp of Medicaid and insurance through the health care exchange. As a result, they may go back and forth between different plans, and as experienced in Mass. they may drop their commercial coverage when they don’t think they need care. In addition, there will remain a group of uninsured people who refuse to buy insurance in the exchange. All these factors will create confusion, make reimbursement more difficult, and result in less continuity of care. Anti-abortion activists will continue to engage in strategies to eliminate PP funding, control the legislative process, impact judicial appointments, enact restrictive regulations and harm Planned Parenthood through entrapment campaigns. They remain a serious threat to reproductive health care and sexuality education in Pennsylvania. At the federal level, the trend is toward decreased government funding due to the federal deficit and a lack of support for services to women. This situation is not expected to improve with a second Obama administration. Depending on the election outcome, PPWP could lose all federal funding, including the ability to participate in the Medicaid program. The Pennsylvania State Data Center projects that the population in the, Allegheny (-6.4%), Cambria (-12.3%) and Somerset (-2.7%) will continue to decline through the year 2030. The population of Westmoreland County is projected to increase (1.7%) A shrinking market has a significant negative impact on patient growth and increased revenue potential. Abstinence-only education is still provided in some schools and communities in our service area. Continued work is needed to educate about the dangers of these programs and to get legislation passed that would require comprehensive sexuality education. The large non-profit health care organizations and hospital systems are functioning more like forprofit organizations, investing major dollars in marketing and advertising and pursuing new organizational structures like medical homes and accountable care organizations. Planned Parenthood’s role in these new models is not clear. Planned Parenthood’s image is a provider primarily for low-income women and teens with a shortterm, contractive or abortion need, not as the primary gynecological health care provider over the span of a woman’s life. The gubernatorial election in 2010 resulted in the election of an anti-choice governor. The state house and senate are a majority anti-choice and have been easily able to pass anti-choice legislation. There continues to be increased competition among non-profit organizations for foundation grants and private donations due in part to the recession and to an increased number of charities. The shortage of health care providers is likely to get worse, especially in rural areas. Opportunities: There are opportunities with health care reform. These include: o More people will have access to care. o Provider shortages may drive more people to Planned Parenthood. 9 o o Insurance plans must cover preventive care and with the provider shortage there may be a need for PPWP to provide primary care services. Commercial plans must contract with essential community providers and PP has this designation. Concern among young men and women about environmental hazards that affect reproduction may present an opportunity for PPWP to expand its programming and its scope of advocacy work. Of particular concern is that this issue disproportionately affects black and poor populations since environmental toxins are more prevalent in low income and minority neighborhoods. HIV infection and all STIs in women of color and adolescents continues to be a problem, providing the opportunity (and necessity) for heighten efforts to educate and provide testing and treatment services. While PPWP has worked to cultivate a presence in the local media, there is an opportunity to develop into the “go-to” resource for reproductive health information via more regular communication and contact with representatives in the press. Recent polling data indicates that Americans still support access to abortion but they don’t identify as much with the label of being pro-choice. Continued involvement with Better Health will allow PPWP to operate as a larger organization and gain economies of scale and expand infrastructure and organizational capabilities. The election of a pro-choice president may stave off harmful attacks to defund Planned Parenthood and could result in the appointment of more moderate Supreme Court justices if openings occur. PPWP’s strong message as a legitimate safety net provider and the increased demand for services may assist us in raising more money than other non-profits during this difficult financial time. With the growing popularity of new social networking and media resources, there is opportunity to engage and foster new supporters. Facebook, Twitter, the PPWP website, and blog are all avenues to effectively reach supporters in ways that we have not had available before. The large number of colleges in PPWP’s service area provides many young adults who can be recruited both as clients and advocates. More collaborative national services such as PPOL, the branding campaign, and the national contact center present opportunities for increased expanding business capacity and sharing resources. Unclaimed service area north of Pittsburgh to the New York border is available for expansion of services. Two abortion providers have closed in western Pennsylvania due to the new restrictive regulations and additional state oversight. In the entire western part of the state there is one hospital provider, one for-profit provider and PPWP offering abortion services. The national website with its online fundraising capabilities and social networking efforts has an extended reach into the community supports the local social media work and expands our online reach to potential new donors. 10 ASSUMPTIONS ABOUT THE NEXT THREE YEARS While we are not able to forecast the future with any degree of certainty, when thinking strategically, we must base future plans on a commonly shared set of expectations. Reality may diverge from our assumptions, and we will need to be adept at altering our plans accordingly. The following planning assumptions provide a framework for designing our strategies. Clients/Markets: Teens and young adults will continue to be a significant part of our client base due to their need for confidentiality. The need for confidential, affordable sexually transmitted disease testing and treatment services will continue for both men and women. The increase in societal and individual awareness of intimate partner violence, childhood sexual abuse, substance abuse, human trafficking and HIV/AIDS will increasingly impact the reproductive health, education and counseling needs of our clients. The continued decline in population in the western Pennsylvania region would seem to indicate a smaller client base; however the impact of the Affordable Care Act may make demographic trends less relevant. Western Pennsylvania will continue to have an aging population creating a greater demand for primary care services in this region. There will be less access to abortion services in Pennsylvania in the future due to fewer providers and increased regulations. PPWP needs to continue to strive to be a customer-driven organization. In order to be attractive to clients, PPWP will need to be competitively priced and provide services clients want and need in attractive locations and during hours that are convenient for them. Competition for commercially insured clients will continue to be intense. Clients will increasingly use technology to access sexuality and health education. There will continue to be opportunity and demand for in-person education but minimal funding will be available to support service delivery. There may be a need or a market advantage for PPWP to provide primary care services. Once the Affordable Care Act (ACA) is implemented, many of PPWP’s clients will be borderline for Medicaid or commercial insurance and shift between insurance coverage. There will be some clients who will have no coverage and won’t understand the new insurance system. PPWP will need to have the staff resources to assist clients with the insurance process, and to have more resources and systems in place for insurance verification prior to service. Over the past 10 years, the Hispanic population has continued to grow in western Pennsylvania with an estimated population of 7,000 people in 2010. To better serve to the health care needs of this population, PPWP will need to invest in infrastructure improvements to establish better communication options for Spanish speaking clients. In addition PPWP should actively recruit bilingual health care providers. Financial: Client needs, health care industry regulations, supplies and services costs will continue to increase, resulting higher service delivery costs. 11 PPWP will need to have more expertise and oversight of its billing processes to maximize third party reimbursement and fee collections. PPWP will need to contract with Medicaid and commercial payers for more profitable reimbursement rates. There will be increasing focus on client outcomes which will be tied to provider payments. PPWP will need to meet meaningful use criteria, quality care indicators proposed as best practices and show a positive impact on health outcomes. Current family planning funding (Title X) is likely to be eliminated and rolled into Medicaid or commercial insurance coverage. There will continue to be uninsured people under the ACA. This will include undocumented immigrants and people who decide not to purchase insurance through the exchange. Another huge gap would be created if Pennsylvania does not accept federal Medicaid expansion funds, which would leave people with incomes between 138% -400% of the poverty level without health insurance unless they purchase it in the exchange. The Medicaid family planning waiver expires January 2014 and will not be renewed if Pennsylvania accepts Medicaid expansion funds. If Pennsylvania does not accept expansion funds, PPWP will need to advocate for continuation of the waiver to cover services for women up to 175% of the poverty level. There will very limited or no health insurance coverage for abortion services when the affordable care act goes into effect. PPWP will need to do financial modeling to understand and manage the potential revenue impact of the ACA due to changes in client insurance or Medicaid coverage, reimbursement rates and government funding. This may require decisions that impact our mission. Medicaid reimbursement rates are low in Pennsylvania it is very unlikely they will increase under the current administration. As a result private providers will not be interested in accepting Medicaid clients and PP will see an increase in this population. Accountable care organizations (ACOs) will be formed to drive down health care costs. PPWP will need more cash and reserves for: o capital improvements, o marketing initiatives particularly targeted to commercial clients, o to stabilize cash flow, o to manage reimbursement delays, o to demonstrate financial stability to potential contractors o technology changes. Health care providers will need to demonstrate strength in order to attract network partners and collaboration opportunities. PPWP will need to be able to demonstrate: o Cost effectiveness (Staffing ratio of 48-54%, Overhead 12-15%) o Financial stability (180 days cash, 6% margin) o Market saturation & volume growth (10% per year) Competition for donors will continue to be a fundraising challenge; however, concern about reproductive health care issues and repeated attacks on Planned Parenthood may result in increased donors and fundraising revenue. 12 There will be a continued opportunity for expansion of the donor base through prospecting and cultivation as a result of continued attacks that galvanize Planned Parenthood supporters and better fundraising tools available through PPFA including PPOL, the national website, and increased use of social networking. More women are expected to have commercial insurance coverage for contraceptives and PPWP needs to implement pharmacy billing software that is integrated with our practice management system to increase the efficiency and accuracy of pharmacy billing. Afaxys, the Planned Parenthood affiliated company, will have a generic oral contraceptive and an emergency contraception product approved by the FDA and for sale by January 2013, with additional products available in the next two years. These products will cost the same as current contraceptives on the market; however, there will be more stability in pricing and availability of the product. A generic hormonal IUD will be on the market within the next year with a price that will be one-half or one third of the brand cost. PPWP will be eligible for a small business subsidy under the ACA that will offset the cost of providing health insurance to employees. Political/Legislative : The November 2012 election will have a critical impact on Planned Parenthood and its future. If we continue with a democratic White House, the Affordable Care Act will move forward and Planned Parenthood should be able to stave off attacks. If there is a republican White House, the Affordable Care Act could be eliminated and Planned Parenthood could face defunding. Pennsylvania legislators will continue to propose and work to pass anti-choice legislation until there is a significant change in the composition of the state house, senate or governor’s office. PPFA’s market research and national branding campaign will result in more effective messaging on for reproductive health care issues and a national client recruitment campaign in 2012 or early 2013. There may be policy and/or regulatory changes needed on the state and federal level for clinician scope of practice to allow expanded services to be provided by mid- level clinicians to address the provider shortage. There will be the need for expanded advocacy work on regulatory issues that create barriers to services. There will continue to be a strong conservative movement that opposes Planned Parenthood. As a result the political and regulatory attacks will continue, which should activate supporters and help PPWP engage more advocates. The Catholic church and religious conservatives in western Pennsylvania will continue to actively oppose birth control and abortion using professional lobbyists in Harrisburg, legal attacks supported by pro-bono anti-choice attorneys and harassment of PPWP staff and clients through frequent protests organized at health centers. Personnel: The market for physicians and all mid-level clinicians and nurses will continue to be competitive and may be a critical problem when the Affordable Care Act is enacted. Increased demand for these 13 medical professionals will require PPWP to pay competitive market rates to physicians and clinicians. The expansion of services and/or development of relationships with more third-party payers will require different skills among management and medical staff, requiring the use of consultants or personnel with different skill-sets to augment services. PPWP will need to invest in staffing and training in these areas to ensure financial success and meet market and regulatory requirements for a health care provider: o Pharmacy and medical billing o Insurance contracting o Finance o Human resources o IT Staff turnover will continue to be a challenge with the loss of staff to the private sector. PPWP will need a board with these skills and connections represented: finance and legal, IT and medical informatics, operations/medical management, access to media/communications, development, access to delivery system partners (health plans, FQHC, insurers), access to regulators and community leaders. Technological: PPWP must transition to electronic health records in order to exchange patient records and billing information safely within Health Information Exchanges Integrated Information systems will be relied upon even more to interact with patients, activists, donors, and future supporters. It will be critical that information is available via high-tech communication modes and that marketing, public relations and education methods are sophisticated. Clients will be expecting increased use of technology in accessing their services. PPWP will need to have a client portal and online appointments. Telemedicine and virtual office visits will increase as a way to improve access to care and manage provider shortages. PPWP will add a patient portal after adopting electronic medical records which will bring additional improvements to client care and customer service including the ability to email clients, schedule appointments online, and provide them with access to their medical information. 14 PLANNED PARENTHOOD OF WESTERN PENNSYLVANIA STRATEGY AND GOALS—JANUARY 1, 2013-DECEMBER 31, 2015 SERVICE DELIVERY – MEDICAL STRATEGIC INITIATIVE: Increase the number of people served by engaging in business strategies that improve efficiency and profitability, improving customer service, expanding services and preparing the organization for health care reform. 1. Goal: Improve health center technology. Objectives a. Develop and execute an implementation plan for electronic medical records and achieve meaningful use as defined by Center for Medicare Services. Primary Responsibility CEO/VP for Operations/ Cost $450,000 for full implementation – equipment/staff/ software. Anticipated Outcome PPWP will implement EMR and achieve meaningful use through a coordinated plan. Completion Date Implementation plan by 2/13 and first stage meaningful use by 12/13. All phases completed by 12/15. b. Implement a patient portal to give clients online access to health information and appointments. CEO/VP for Operations/ $30,000 for portal software Completed by 12/15 c. Establish efficiently operating internal call center using new phone system technology with ongoing monitoring of customer service indicators. d. Continue to evaluate the opportunity to join PPFA’s national call center. CEO/ IT/ VP for Operations $22,000 Portal will provide online access to client data and appointments. PPWP will achieve 2nd stage meaningful use. Better data to evaluate appointment services and improved customer service. CEO/VP for Operations Cost for participation to be determined. Ongoing until sufficient information is available to make a decision. e. Evaluate opportunities to use telemedicine to reach rural areas and manage provider shortages. CEO/VP for Operations To be determined PPWP will move to the national call center depending on pricing and service advantage. PPWP will understand the market advantages, cost, etc. of telemedicine and make informed decision about its role in service delivery at PPWP. Anticipated Outcome Decision made to add service area and plan for services in these areas will be in place. Completion Date June 2013 2. Goal: Explore opportunities to expand services or service delivery models. Objectives Primary Responsibility Cost a. Evaluate adding service area CEO/Board of No cost to add service north of Pittsburgh to the New York Directors area. border and establish a plan to Cost for service implement education/advocacy or expansion to be medical services in the community. determined. 15 Ongoing Ongoing until sufficient information is available to make a decision b. Evaluate the cost and benefits of adding limited primary care services. VP for Operations/Medical Director c. Seek out opportunities to add new health centers and assess based on market and financial indicators. d. Monitor the availability and demand for abortion services and pursue expansion as needed. CEO/ VP for Operations 3. Goal: Surgical Site Supervisor/VP for Operations Estimated $50,000 for staff training expenses. Collaborative physician cost estimate $25,000/year. Cost to add health center $125K -$200K. An assessment will be completed and limited primary care services will be provided based on financial indicators and client demand. Health centers will be added if demand exists and it is financially feasible. December 2015 Expansion should be revenue generating or revenue neutral otherwise only implement if additional funding is received to support expansion Additional service days will be added if demand for the service increases and additional providers can be obtained. Implement as needed. Ongoing Maximize efficiency, productivity and customer service at PPWP health centers. Objectives a. Consistently use productivity standards and revenue cycle indicators to assess health center performance. Primary Responsibility VP for Operations/Family Planning Supervisor Cost No additional cost b. Assess PPWP health centers and update and relocate as needed to accommodate service needs, and to have offices that are comfortable and inviting to clients (Johnstown, Somerset and Bridgeville are priority). c. Once health care reform is implemented, develop a system to assist clients in understanding their benefits and financial obligations for health care. CEO/VP for Operations Estimate $75 $125K. VP for Operations/Family Planning Site Supervisor Approximately $5,000 for print materials. 16 Anticipated Outcome Performance will be monitored and PPWP will have tools to manage and assess staffing and performance. Health centers will be professional in appearance, welcoming to clients and strategically located. Completion Date March 2013 and ongoing Clients will be better advocates for their own health care, and PPWP will minimize financial loss due to insurance coverage issues. System developed by 1/2014 and implemented ongoing. December 2015 4. Goal: Pursue collaboration as a strategy to maximize resources and expand capabilities. Objectives a. Continue to work on collaborative projects through Better Health to maximize resources. Primary Responsibility CEO/ VP for Operations/Controller Cost Cost determined by project b. Monitor community activity and be aware of and understand opportunities to participate in accountable care organizations and medical homes. CEO/Medical Director/ VP for Operations No additional Cost Anticipated Outcome PPWP will maximize resources and increase efficiency through collaboration and shared expertise. PPWP will participate in new models of health care delivery that are appropriate to strengthen and improve the viability of the organization. Completion Date Ongoing Ongoing SERVICE DELIVERY – Education STRATEGIC INITIATIVE: Establish PPWP as the most caring, non-judgmental provider for comprehensive sexuality education and sexual health information for young people. 1. Goal: Continue the Peer Education and Life Skills programs to increase the number of youth participating in long-term or multiple session programming. Objectives a. Identify and implement the Peer Education program in additional schools as needed to replace schools that are closing or that can no longer offer the program. b. Add two schools each year to the list of those participating in the LifeSkills only program. e. Promote the LifeSkills program to youth-serving community groups in the summer months by contacting 5 non-participating groups with program information each year. Primary Responsibility Peer Education Coordinator/VP for Education Cost No additional cost VP for Education/Community Ed. Specialist VP for Education/Community Ed. Specialist No additional cost No additional cost 17 Anticipated Outcome The program will continue to operate according to the grant program and reach the maximum number of students with the resources available. More young people will have access to the comprehensive sexuality education. More young people will have access to the comprehensive sexuality education Completion Date Ongoing Annually Annually 2. Goal: Engage community leaders and professional in advocating for fact-based sexuality education in schools and at health care facilities. Objectives a. Recruit and train at least 5 volunteers and board members to be PPWP ambassadors. Primary Responsibility VP for Education Cost No additional cost Anticipated Outcome Board members will be trained to represent and speak about PPWP services to community. Completion Date First group trained by February 2013. Additional trainings annually. b. Seek out groups and organizations for speaking engagements and to distribute information about the importance of comprehensive sexuality education. VP for Education/ Board of Directors No additional cost The community will be better informed and have accurate information about the programs and services PPWP provides. Ongoing c. Use technology and social media on a regular basis, in addition to more traditional media, to communicate and advocate for factbased sexuality education. VP for Education/ Education staff No additional cost PPWP will reach more people with its advocacy message. Ongoing 3. Goal: Provide education in our service area, particularly in those communities where we have health centers, in order to reduce sexual health disparities and improve sexual health. Objectives a. Work to expand programming to additional communities by identifying funding sources and developing a program implementation plan. b. Reach new audiences and promote sexual health through a Q & A forum which may be video on PPWP’s website or through this format on radio. c. Promote and participate in national reproductive health campaigns such as “Get Yourself Tested” . Primary Responsibility VP for Education/Development Director/CEO Cost $40-$50/year for a full-time staff and travel. VP for Education/ Education Staff Cost to be determined. VP for Education/ Education Staff $1,500 per campaign 18 Anticipated Outcome If funding is identified and secured, PPWP will hire an educator and expand services to more communities. PPWP will reach more young people through the use of additional media and methods of promoting services. PPWP will create awareness and educate people about specific health issues. Completion Date December 2015 December 2015 Ongoing FINANCIAL STABILITY , AGENCY CAPACITY and INFORMATION TECHNOLOGY STRATEGIC INITIATIVE: Establish a strong agency infrastructure and secure adequate reserves to support operations. 1. Goal: Secure adequate staffing commensurate with agency growth. Objectives a. Add a part-time human resources professional or HR support as needed. Primary Responsibility CEO/Board of Directors 2. Goal: Prepare for health care reform. Objectives Primary Responsibility a. Prepare financial models to Controller understand and manage the potential revenue impact of the Affordable Care Act due to anticipated changes in client payer mix and government funding. Cost Salary – estimate $25-$45K/year Anticipated Outcome PPWP will have adequate staff resources to manage human resource responsibilities. Completion Date December 2015 Cost No additional cost Anticipated Outcome PPWP will anticipate and understand the financial impact of the ACA and make informed management decisions. Completion Date December 2013 b. Increase cash reserves to fund building expenses and new technology and to manage reimbursement delays, demonstrate financial stability and implement strategic initiatives. CEO/Board of Directors Approximately $15,000 plus staff to raise $1.4 mil through a capital campaign. Through strategic budgeting and a capital campaign, PPWP will have sufficient cash for future operations. December 2015 c. Participate in PPFA insurance contracting project and invest resources as needed. CEO Estimated $3,000 More financially advantageous third party insurance contracts will be secured for PPWP. December 2013 Anticipated Outcome More cost-effective software will be used that will reduce manpower needed for pharmacy billing, reduce errors, and increase revenue. There will be billing expertise and staff resources to maximize revenue and manage all accounts receivable followup. Completion Date May 2014 3. Goal: Conduct revenue cycle monitoring and strengthen billing. Objectives Primary Responsibility Cost a. Implement pharmacy Controller/Billing Manager $3,000/year billing software that is integrated with Next Gen. b. Secure adequate expertise and staff resources for medical billing. Controller/CEO To be determined depending on strategy selected. 19 January 2014 c. Support health center management with monthly financial and revenue cycle reports. Controller No additional cost d. Develop a plan to get staff trained for ICD- 10 coding change, and to monitor billing to ensure compliance. VP for operations/Controller Estimate $5,000 Supervisors will have the reports needed for adequate monitory and management decision-making. Staff will understand and efficiently implement new coding system. June 2013 and ongoing October 2014 for training completion. Monitor ongoing following adoption of new coding. INFORMATION TECHNOLOGY STRATEGIC INITIATIVE: Establish the IT support and services that meet accreditation and industry best practices and that facilitate the work of the staff and agency. 1 Goal: Provide IT support to facilitate PPWP’s move to electronic medical records (EMR). Objectives Work collaboratively with BH to identify IT issues that need to be addressed for EMR including network wiring and internet capability issues for each health center. Primary CEO/IT consultant Research and identify equipment best suited for EMR for PPWP. CEO/IT consultant/Better Health IT Review and update PPWP security policies as needed for EMR. CEO/IT consultant/Better Health IT Cost Estimate$10,000 for all health centers. No additional cost Anticipated Outcome The all networking, internet and IT issues will be addressed prior to EMR go-live. Completion Date April 2013 Equipment will be selected and purchased prior to EMR go-live. April 2013 Additional securities policies for EMR will be adopted as needed. September 2013 GOAL: Ensure that the IT support and management of administrative server is adequate to safeguard information and minimize risk exposure. Objectives Evaluate options for administrative server including off-site hosting. Primary CEO/IT Consultant Cost Cost to be determined. Assess and update current system for data back-up. CEO/IT Consultant Cost to be determined 20 Anticipated Outcome Administrative data will be stored in a secure, costeffective manner. Data back-up system will be evaluated, tested and secure. Completion Date January 2014 February 2013 FUNDRAISING AND COMMUNITY SUPPORT STRATEGIC INITIATIVE: Implement a fundraising program that achieves the annual fundraising goal while providing the funding needed for initiatives critical to the goals represented in the Strategic Plan. 1. Goal: Provide a diverse set of fundraising opportunities that best represent the philanthropic preferences of a variety of donors. Objectives a. Continue to cultivate major donors through house parties and personal solicitation. Primary Responsibility VP for Development/CEO/ Board of Directors Cost No additional cost Anticipated Outcome Completion Date Major donors will be more invested Ongoing in the work and mission of PPWP. b. Continue prospecting activities to expand donor list. VP for Development List purchase $750 Ongoing c. Continue to identify appropriate opportunities to educate about and grow the planned giving program. VP for Development/ Board of Directors No additional cost There will be at least 2 prospect mailings and 2 PPFA donor mailings annually. Donors will be aware of the opportunity to make a planned gift to PPWP. d. Continue the patient giving program in each health center and meet budget goal each year. VP for Development/Family Planning Program Supervisor No additional Cost Patient giving goal will be achieved and more resources will be available for program support. Ongoing e. Offer the community a variety of special events to appeal to diverse constituencies. VP for Development/Special Events Committee Special event cost included in operating budget Special events offered will be targeted to different age and income groups. Ongoing Ongoing Goal: Utilize technology, social media and creative engagement opportunities that work to extend our reach in the community and encourage a variety of supporters to prioritize PPWP in their giving initiatives. Objectives Primary Responsibility a. Encourage online donations and VP for Development/ communicate with donors through Marketing and strategic use of social media Development tools including: e-newsletter, Facebook Coordinator and twitter. Cost No additional cost 21 Anticipated Outcome A variety of social media will be used to communicate with donors on regular basis and to secure support for agency campaigns and events. Completion Date Ongoing b. Engage board members in fundraising by providing opportunities for note writing, personal solicitation, special event work and prospecting. c. Encourage a variety of volunteer opportunities. Develop a special events committee and volunteers that represents a diverse mix of individuals for the community. VP for Development/Board of Directors No additional cost All board members will activity participate in fundraising. Ongoing VP for Development/Special Events Committee No additional cost PPWP will engage new people in the organization and broaden support for its services. Ongoing Goal: Work with board members, donors, and foundations to fully fund “high priority” initiatives. Objectives a. Manage a capital campaign to secure needed funding for a building maintenance, health care reform initiatives and for Ambulatory Surgical Facilities Regulation compliance Primary Responsibility VP for Development CEO Cost $10,000 for campaign costs Anticipated Outcome PPWP will raise $1.4 million for capital projects. Completion Date December 2015 b. Secure funding for implementation of electronic health records through government and private grants. VP for Development/CEO $450,000 for all implementation costs. PPWP will have the resources needed to effectively implement EMR. December 2015 GOVERNANCE STRATEGIC INITIATIVE: Develop strong organizational leadership that furthers the work and mission of the organization. 1. Goal: Maintain a diverse, well- educated board that assists PPWP in gaining credibility and access in the community. Objectives a. Prioritize in Board recruitment: diversity; access to foundations and major donors; skills needed for future leadership, i.e. finance, legal, IT, medical informatics, medical operations, media/communications. b. Ensure Board receives adequate education and information around issues affecting PPWP and those relevant to current decision-making. Primary Responsibility Board Development Committee Cost NO additional Cost Anticipated Outcome Successful leadership of PPWP Completion Date Ongoing Board Chair and CEO, Community Development Committee Additional costs not determined Informed Decisions Board information to be available online Ongoing informed decisions, Online access to board information within 1 yr. 22 c. Monitor implementation of the strategic plan and continue to help develop and evaluate PPWP’s strategic direction to manage the impact of health care reform, ASF and other market forces. d. Increase the geographic diversity of the board as service area expands. 2. Goal: Executive Officers of the Board, & CEO No additional cost PPWP’s success in service delivery, advocacy and education ongoing Board Development Committee No additional Cost New board members from areas surrounding service areas Ongoing Provide adequate fiscal oversight and assist with securing needed funds for programs and services. Objectives a. Identify and cultivate donors from diverse communities and support the development department in implementing the annual fundraising plan. b. Support a $1.4 m. capital campaign through personal giving and securing foundations and other donor support. c. Monitor and facilitate the establishment of a building fund for PPWP. Primary Responsibility Fund Development Committee; all Board Members Cost No additional cost Anticipated Outcome Accomplishment of budgeted fundraising goals Completion Date Ongoing Fund Development Committee; all Board Members No additional cost Accomplishment of budgeted fundraising goals One to three year campaign Finance Committee & CEO No additional costs Building fund will show resources available and capital expenditures provided for Ongoing ORGANIZATIONAL VALUES AND DIVERSITY Strategic Initiative: Utilize best practices in achieving diversity among the staff, board and in the delivery of services to the community. 1. Goal: Build a diverse and culturally competent staff that meets or exceeds civilian labor force data for racial diversity and includes all core dimensions of diversity (culture, age, gender, ethnic heritage, language, national origin, spiritual belief or tradition, sexual orientation, physical ability, and socio-economic circumstances) Objectives a. Monitor staff diversity by maintaining hiring data for each position and analyzing hiring annually. b. Train all supervisors on diversity and evaluate hiring patterns. Primary Responsibility Supervisors/ CEO Cost No additional cost Anticipated Outcome PPWP will identify any hiring issues related to diversity. Completion Date Ongoing CEO No additional cost Supervisors will understand the value of work place diversity and this will be reflected in their hiring. Ongoing 23 c. Implement quarterly staff education on diversity and cultural competency issues and provide training annually or as needed. Family Planning Program Supervisor $500 Staff will be more aware of diversity issues and culturally competent in delivering services. Ongoing 2. Goal: Achieve diversity and cultural competence in our service to the community. Objectives a. Offer additional appointment options for Spanish –speaking clients. Primary Responsibility VP for Operations/Family Planning Program Supervisor Cost No additional cost b. Evaluate forms and information distributed through the medical program and provide in additional languages as client volume requires. c. Evaluate and market services to immigrant populations in western PA as demand and resources allow. VP for Operations/Family Planning Program Supervisor No additional cost Marketing Coordinator Included in annual marketing budget d Enhance cultural “friendliness” of PPWP by using materials that illustrate diversity by building relationships with culturally diverse organizations & by recognizing various cultural holidays. e. Explore opportunities to increase services to LGBTIQQ and transgendered populations. Marketing Coordinator/Family Planning Program Supervisor No additional cost VP for Operations/Family Planning Program Supervisor Cost to be determined Anticipated Outcome PPWP will be more accessible and Spanish speaking clients will have better access to PPWP services. PPWP services will be more accessible to clients with limited English proficiency. Completion Date March 2013 Immigrant populations will be aware of the services available at PPWP and will utilize those services. The staff and the organization as a whole will become more culturally competent. June 2014 Additional services will be added that are cost effective to provide and needed in the community. June 2014 Anticipated Outcome PPWP will have a diverse Board of Directors. Completion Date Ongoing Ongoing Ongoing 3. Goal: Build and retain a board that is diverse and culturally competent. Objectives a. Identify and recruit board and committee members from PPWP’s service area that represent a diverse group including people of color, LGBTIQQ communities, and both genders. Primary Responsibility Board Development Committee Board of Directors Cost No additional cost 24 b. Provide ongoing information to the board on diversity needs and encourage nomination of candidates meeting all dimensions of diversity to committees and the board. c. Increase supporters in more culturally and geographically diverse populations by using a variety of techniques including online giving, networking and community outreach. d. Implement mentoring strategies that welcome and support members that help them feel comfortable, engaged and productive. Board Development Committee No additional cost Board members will be educated and committed to diversity and this value will be reflected in nominations to the board. Annually as part of board recruitment process Board Development Committee No additional cost PPWP will have volunteers and supporters from culturally and geographically diverse communities. Ongoing Board Development Committee No additional cost PPWP will implement new activities and procedures to facilitate board/committee retention. Ongoing PUBLIC IMAGE AND COMMUNITY AWARENESS STRATEGIC INITIATIVE: Expand awareness and support of PPWP through marketing and advertising. 1. Goal: Increase use of social media and direct marketing. Objectives a. Allocate resources to allow more staff time for social media, including Facebook, Twitter and e-newsletter. Primary Responsibility CEO/VP for Development Cost $6,500 staff time Completion Date March 2013 Included in marketing budget ($1,500/yr for materials) Anticipated Outcome Increase the frequency of contact placed in a variety of social media platforms to further engage broad based support and awareness. Connect individuals in need of an affordable health care option with PPWP health centers. b. Implement face- to- face marketing initiative to front line staff working at community organizations in targeted locations within PPWP service area. c. Implement one or more agencywide marketing initiatives across departments each year. VP for Development/Marketing Coordinator VP for Development/Marketing Coordinator Included in marketing budget ($1,000/yr for promotion) At least one program or service will be promoted and will result in increased utilization. Annually Ongoing 2.Goal: Integrate PPFA’s new branding campaign into PPWP’s communication strategy and marketing plan. Objectives a. Incorporate PPFA’s new research-tested branding messages Primary Responsibility VP for Development/Marketing Cost Included in marketing budget 25 Anticipated Outcome PPWP will implement a plan to effectively use the new Completion Date Implement by May 2013 and ongoing afterward. into PPWP’s written and print material used to retain and recruit clients and communicate with our supporters. b. Work with PPFA to implement the national branding campaign and evaluate its effectiveness in our market. Coordinator b. Develop a work plan with the timeline and cost of implementing the new logo with signage, letterhead, brochures and all agency materials. VP for Development/Marketing Coordinator VP for Development/Marketing Coordinator for FY13. Need for additional funds to be determined. No additional cost No cost for work plan branding and be more effective in messaging to target audiences. Create stronger brand recognition for PPWP and use evaluation data to maximize the effect of the campaign. PPWP will be able to transition to the new logo in a planned and cost effective manner. December 2013 Work plan – March 2013 Implementation done by December 2015 ADVOCACY STRATEGIC INITIATIVE: Engage the community and political stakeholders in grassroots organizing, media, and lobbying to advance and defend reproductive health care and rights. 1. Goal: Engage media professionals in meaningful press strategies designed to shift the discourse surrounding Planned Parenthood and reproductive health care from a defensive strategy to a more holistic perspective of the work of PPWP. Objectives a. Build relationships with select press professionals including the Pittsburgh Post-Gazette, Pittsburgh City Paper, and Tribune Review. Primary Responsibility VP for Public Affairs b. Engage the press on several awareness campaigns throughout the year that focus on services and pro-active initiatives. VP for Public Affairs c. Submit op-eds on a range of topics outside of legislative response op-eds including public health issues and provision of services. VP for Public Affairs Cost Anticipated Outcome Completion Date No additional cost PPWP will establish key Ongoing media contacts who will advise about story development and help publicize PPWP’s issues. No additional cost PPWP’s will secure media Ongoing attention for pro-active initiatives and campaigns that promote a positive image of the organization. No additional cost PPWP will gain recognition for Ongoing expertise on public health and preventive service issues. 2. Goal: Engage clients in our advocacy messages and campaigns through clinic advocacy and advocacy strategy to further grow our supporter network. 26 Objectives a. Develop a program for clinic staff that helps them engage patients in PPWP advocacy initiatives. Primary Responsibility VP for Public Affairs/Grassroots Organizer b. Develop a program for advocacy in waiting rooms including actions you can take while at PPWP, waiting room education, and signups for further action. c. Develop a system to capture patient stories in a meaningful way that can later be used in advocacy efforts. VP for Public Affairs/ grassroots organizer 3. Goal: VP for Public Affairs/grassroots organizer Cost Anticipated Outcome Completion Date No additional cost Clinic staff will be able to May 2013 take a more assertive role in advocacy and PPWP will gain support from clients who choose to become public policy advocates. $1,000 PPWP will gain support from May 2013 clients who choose to become public policy advocates. No additional cost PPWP will have real stories to use with legislators and media to educate about the need for our services. May 2013 Expand youth activists through recruitment, retention, and training Objectives a. PPWP will continue to support student groups and college level classes and further engage these groups through planned programming and event support. Primary Responsibility VP for Public Affairs/grassroots organizer Cost Anticipated Outcome Completion Date $750/group per PPWP will have selfOngoing year sustaining groups of activists established on at least three college campuses. b. PPWP will work to capture alumni of our education programming as new advocates for the work of PPWP by starting an alumni network and alumni advisory committee. c. PPWP will further educate our youth activists in reproductive justice issues to further prepare young activists for action on these issues when they arise. VP for Public Affairs/ VP for Education $300 per year PPWP will increase youth activists with first-hand knowledge of our sexuality education services. January 2013 VP for Public Affairs/grassroots organizer No additional cost Youth activists will actively engage in advocating for reproductive rights issues as needed. Ongoing 27 4. Goal: PPWP continue to build political power in western Pennsylvania and nationally through focused strategy. Objectives a. PPWP will conduct basic training of PP issues and goals to all newly elected officials in our region. Primary Responsibility VP for Public Affairs b. PPWP will work to further identify and build relationships with grasstops. Priority will be placed on pro-choice republicans, Senator Casey’s supporters, and supporters of Representative Critz. VP for Public Affairs/CEO and Board of Directors Cost Anticipated Outcome Completion Date No additional cost Legislators will be informed Ongoing about the services PPWP’s provides and the value these services bring to the community. No additional cost PPWP will have contact and Ongoing relationships with people who have influential relationships with western PA or statewide legislators. 28