Archive for the ‘ Organizing Your PRC for Success ’ Category

A Pregnancy Center Executive’s Journey to an LSM: Wisdom Applied

If you are following the story of the Pregnancy Center Executive’s journey to a Linear Service Model (LSM) the first step

In Pursuit of Wisdom

is to acquire wisdom. This post deals with the Executive application for being more intentional around the personal pursuit of wisdom. As executives we are constantly forced to make decisions. Those decisions are almost never binary. Meaning we don’t have the luxury of making choices that are black and white, right or wrong. Our choices are usually determining which of four or five good options is best. This is why we need wisdom, to discern what is best. Will we make mistakes? Yes. Is there grace in those mistakes? I believe for those who are pursuing wisdom with all diligence that there is an ocean of grace. So below are some practical steps to begin building into your personal executive experience to be more intentional around the virtue of wisdom.

1.  Get wisdom (Proverbs 4:7) because the understanding needed for yesterday will not be enough for tomorrow.

__Identify at least two professional experts (i.e. Current executive of a medical service that consistently reaches and serves women at risk for abortion, a marketing professional, a strategic planning consultant, etc)

__Compile questions you can ask them that would help shed some light on issues that you are facing as an organization.

__Call those two people and ask them those questions.

__Create a reading list for executive leadership (See suggested reading list at prcoptimizationtool.com)

2. The staff of the organization are key to accomplishing the mission:  Affirm and support them.

__Provide them with the resources they need to get the job done

__Determine two ways to reward your staff within reason in the next month

__Give them clear direction

__Determine the primary goal to be accomplished by the organization this year (e.g. It should be the biggest obstacle to accomplishing the mission of reaching and serving more women at risk for abortion.).

__Initiate weekly one hour staff meetings (Click on the follow for a sample Strategic Leadership Tool used in CompassCare’s LSM call the Optimization Tool: Weekly Core Staff Meeting Agenda)

__Communicate that goal to the staff and begin to brainstorm on ways to overcome the obstacles to accomplishing that goal.

__Begin to have weekly one on one meetings with your key staff (e.g. Client Services Director, Development Director, Nurse Manager) in order to begin to set clear expectations for them with respect to the organization’s overall mission and annual goal.

__Begin to communicate the goal and plan of the organization to accomplish its annual goal to donors through every means available.

A Pregnancy Center Executive’s Journey to an LSM: Wisdom Part B

Walking into the office on his first day George was met with two very valuable surprises.  The first was a phone message from a local doctor saying she wanted to somehow be involved in the organization not knowing in what capacity a non-medical facility could use a medical doctor.  The second was a business card that was given to him by the organization’s client services director, Val.  She had heard this man speak at a conference from which she had recently returned and thought that he may be someone that could be helpful.  His name was Bob.  As George read the card he realized that he knew this man.  Coincidentally, eight years earlier his wife had once worked for Bob in a CPC in the southeast as a counselor coordinator.

Wasting no time George made the call.  “Hi, Bob?  You may not remember me but my name is George Knight.  My wife . . . .”

With that Bob interrupted saying, “Oh, yes, George, how is your wife, Linda?  I really appreciated her servant’s heart.  We miss her around here.”

Surprised by the immediate and warm reception of this most certainly very busy man, Bob asked George to explain the events that led to his being hired as the Executive Director of a CPC in the northeast.  George described how after finishing their master’s degrees in Chicago they moved to Florida so that he could take a position as the pastor of a small church north of Tampa.  George describes, “Bob, we had no idea what we were getting ourselves into.  The church was fraught with issues including moral ones that needed to be addressed.  When I attempted to address some of those issues, the people that held most of the influence pushed back telling me to leave things alone.  Finally, it became clear to me that at the next church business meeting I would have to make a decision about my tenure there.  One of the hot button issues was going to be decided upon and if the church voted the wrong way I would have to choose to either stay and look the other way knowing that something was gravely wrong or take a stand and ultimately resign my position.  The church business meeting was scheduled for the next Wednesday.  That Monday, just two days before, I received a call from the interim executive saying that the board of Crisis Pregnancy Services had received and reviewed my resume wondered if I was available for a conference call interview that same day.  In describing the situation to the interim executive saying that my preference was to remain as pastor bBut if the situation did not change I could not in good conscience do so.  We both agreed that a board interview would not hurt anything.  To make a long story short the board unanimously decided to extend an offer to me that evening should God free me from my current situation.  Two and a half weeks later we had moved.

With that Bob exclaimed, “George, welcome to the club.  How can I help you?”

“Well, here we are in a medium size town with a small operation.  Furthermore, I know virtually nothing about running a pregnancy center.  What do you think is the first thing I should do?” asked George.

“First let me take a minute and applaud the fact that you are seeking wisdom.  In the Bible the book of Proverbs 4:7 says, ‘The beginning of wisdom is: Acquire wisdom; and with all your acquiring, get understanding.’  George, to me the fact that we are even having a conversation says that you are off to a great start.  Keep seeking understanding about what it is you should do and you will be rewarded.  Never stop seeking wisdom because you will never have enough. The world continues to change around us and the understanding you had yesterday will not be enough to handle tomorrow.”

“Thank you for your encouraging words, Bob.  But you know, I truly feel at a loss as to where to even begin.”

“Well,” began Bob, “your staff are key to your organization’s success and there are two things you must never fail to do for them; a) provide them with the resources they need to do their jobs and b) provide them with clear direction.  You can start by spending a little money on showing them how much you appreciate them.  Do you have any money in the bank?”

“A little.”

“If your organization is anything like the other organizations I’ve seen in the past the staff does not get paid very much.  So do whatever you can to thank them for their dedicated service.  It is they who will be accomplishing the mission.  Give them bonuses, buy Christmas gifts, and take them out to lunch.  Do as much as you can within reason to show them you really appreciate the sacrifices they have made for the organization.  It will be worth every penny in the moral boost you will gain from it.”

“O.K.,” George scribbled down another note on a piece of paper a little reticent about spending the precious dollars he new they would need in the not-so-distant future.  “What next?” asked George.

“Then,” said Bob, “you need to start digging.  If you are going to provide direction for your staff you need to know more about what it will take to get where you want to go.  Do your homework about what it will take to add a medical service to your operation in your State.  It would be good to locate a doctor that would be willing to work with you.”  George smiled at the note on his desk from the doctor offering to volunteer.  “Other than that, just settle in and start to get to know some of your donors.  You’ll need money pretty soon in order to sustain a more professional service like medical care.”

After a few more miscellaneous questions the conversation ended with Bob expressing confidence in George’s ability to accomplish the lofty task of moving toward a medical model of service leaving the door open for George to call again any time.  George new that the wisdom he had just received was solid gold and he wanted more.  He looked down at his notes after he hung up the phone and reviewed what he wrote.

See the post next week for Executive application of Wisdom virtue for a linear service model or click HERE to go to the CompassCare Training website for a suggested reading list.

A Pregnancy Center Executive’s Journey to an LSM: Wisdom Part A

Two months in to his new role as Executive Director at Crisis Pregnancy Services George Knight sat starring down at the city street from his second floor Executive office.  It was a nice office but the walk up the cavernous lonely stairwell from the busy city sidewalk felt a lot like being transported into a private detective novel where the PI’s office was in an old ACME building complete with metal desks and Spartan wooden chairs.  A chill wind was blowing and somehow managed to find its way through the failed molding of the big windows that were part of the old 1900 brick façade.  It was only 3 P.M. and already it was starting to get dark there up near the boarder of Canada.  The cloudy sky did not help to brighten things up.  Sitting there he wondered what it would really take as an Executive to turn around this small, fledgling non-profit Crisis Pregnancy Center (CPC).  He wondered . . . would a handful of volunteers, no professional services to speak of, few clients being served from day to day, and just three part time staff be enough to bring the organization to a new level of professional medical service?  Not to mention the fact that the annual budget was just a little over $100,000 supported by a couple hundred small but committed donors.  Yet they did have $48,000 in the bank to invest in rejuvenating the organization.  Secretly though George wondered if it would be enough.

Balancing What You Have with Where You Need to Go

The Board of Directors brought George on with the primary commission of converting the operation from a traditional lay counseling CPC to one that offered professional medical services to women facing unplanned pregnancy.  The board felt that the organization was not reaching the women the organization was created to help; pregnant women who were at risk for an abortion.  They reasoned that adding a professional medical service like ultrasound technology could be the one thing that may make the organization appear more relevant to the women they needed to reach.  George did not question that assumption at first.  However, adding medical services was not an easy task especially in a State where this was uncharted territory as well as a State that seemed to over legislate everything.  Added to that the town had a history of being pro-abortion, and currently housed 13 practices that provided abortion with an estimated 8000 abortions occurring in town annually.  The competition for the attention of the women facing unplanned pregnancy was almost overwhelming.  Additionally the organization and its supporters were grieving the untimely death of the previous executive who George was replacing.  But George felt a deep sense of commitment, as if God Himself had called him to this mission of reversing the abortion trend in the community.  And therefore in his more optimistic moments believed that the resources he had at his disposal would be enough to get that little organization where it needed to go.  Two things George new for sure: 1) He did not know enough to get this job done on his own and 2) He knew some people that might be able to help.

For case studies of pregnancy centers that have implemented a comprehensive linear service model click here.

Virtuous Leadership and a Linear Service Model (LSM) Part 2

What are the primary virtues of an effective leader and why is virtue in a leader so crucial to a linear service model?

In our initial attempts to ascertain what it was that drove executives that led organizations that performed better than others, what made them so different, we noticed that there were no obvious answers.  It was not education or fundraising ability.

Virtuous Leadership and Effective Organizations

We realized that it is not enough that the executive be passionate about helping woman that find themselves in the unfortunate position of having to face an unplanned pregnancy unsupported and alone.  Furthermore each executive represented very different levels of management skill compared to other executives who enjoy similar success.

The one thing that emerged that appeared common among executives that lead organizations drastically more effective at reaching and serving women facing unplanned pregnancy is their personal character, the level of mature Christian virtue manifesting in the mundane life of the leader.  What also became clear was that system or services do not matter as much as character.  The reason for this is because all systems are developed and driven by the innate character of the executive.  In thinking about the specific character traits or virtues that represent an effective PRC executive we began to notice that the character traits or virtues were similar.  And to a greater or lesser extent these executives manifested the same virtues which influenced virtually all of their behavior thereby setting the tone and expectations for the organizations they lead.  This executive influence over time caused the organizations themselves to become more virtuous and consequently more focused, more effective at accomplishing the mission.

Virtue is the basic building block to an effective PRC and emanate from the executive director’s personal commitment to virtuous living.  I am speaking of virtue in the classical sense of the word.  Those virtues are informed by the Bible and fall into five categories; wisdom, empathy, courage, temperance, and justice.  Each virtue has great depth and it is the intention of the following posts to only focus on those aspects of each virtue that make it valuable to the pregnancy center organization.

Check out the results a pregnancy center in Lakeland, FL after the Executive Mary Rutherford implemented a Linear Service Model by clicking here.

Virtuous Leadership and a Linear Service Model Part 1

Virtuous Leadership and a Linear Service Model (LSM) Part 1: As goes the Executive so goes the organization.

Virtuous Leadership=Focused Organization

In the process of both running a medical PRC and helping others to develop and operate their medical PRCs it occurred to me that there are certain questions all of us PRC Executives need to have answered.  Questions like:
-How can we get more abortion-minded women to call our center?
-How can we get more abortion-minded women who call to schedule an appointment?
-How can we get more of those who schedule an appointment to show?
-How can we get more of the women we see to have their babies?
-How can I as an executive get more control over the organization and out of the daily grind of wondering just how effective our counseling methods really are and know for sure?
These questions are linked to each other and often if you answer one you solve another.  The good news is that the answers to these questions are available.  Even better than that many center executives are experiencing the freedom and comfort that comes with knowing that their organization is accomplishing the mission of reaching and effectively serving women at risk for abortion better than they ever dreamed they could right now.  The next few posts are written to address these questions.  It is my hope they will help propel you as an executive as well as the organization which you lead to a higher level of effectiveness than you ever let yourself believe was possible.

In the process of thinking through how to convey the answers to the most pressing questions every PRC executive seems to share, something occurred to me; there is only one guarantee for success.  I have seen many organizations face the difficult questions, make difficult decisions about how to answer those questions, and go on to greater effectiveness at reaching and serving women facing unplanned pregnancies, while others do not.  At first glance the organization that ultimately succeeds at that worthiest of all goals versus the one that does appear the same.  But after having observed and worked with both types of PRCs over the years, a key difference began to emerge between them.  But that key difference was not manifesting as the usual suspects such as a specific type of operation.  It was not that one offered a specific service like ultrasound technology and the other did not. Nor was it dependant on access to money.  It was not even that the successful organizations had developed a strategic plan, because unsuccessful ones had too.  What we began to notice was that while the organizations that were effective and gained greater effectiveness at reaching and serving women at risk for abortion were the ones that were committed to sticking to their strategic plan and creating systems of service to intentionally improve (LSM), there seemed to be an underlying driving force to that commitment.  These organizations had the fortitude to do the really, really hard work of facing their brutal reality and creating a new reality through focused action.  Incidentally it is difficult to have consistently focused activity without a strategic plan driving the development of the approaches that are taken to accomplish the mission. But the specifics of a strategic plan seem to be secondary.

Admittedly, I was a little surprised at the revelation that the specific details of a strategic plan were secondary to just simply having and religiously sticking to that plan.  The end result is almost always some level of a step by step Linear Service Model. You must forgive my bias toward the value of the CompassCare LSM.  However, once my proverbial eyes adjusted to the light of this new revelation we started asking ourselves:  “What made some organizations able to pursue a strategic plan while others seemed content to let their strategic plan, if they had one, sit on the shelf?”

Over time we began to observe a common element in pregnancy centers that continued to get better and better at their mission.  At the heart of the organizations that were able to purse a strategic plan and enjoy the resulting benefits of a more or less linear service process for reaching and serving the high risk abortion-minded woman was the activity of a particular person; the executive.

We began to realize that the activity of a PRC, over the course of time, reflected the behavior and expectations of the person who occupied the  executive director position.  In fact this realization became so obvious that we began using the following phrase in all our PRC Linear Service training:  “As goes the executive so goes the organization.”

In part 2 we will discuss the role of personal virtue in executive leadership and what its practical implications are for developing and implementing an effective linear service model (LSM).

Check out the results of a pregnancy center in Omaha, NE after their executive, Michelle Sullivan, decided to implement a Linear Service Model by clicking here.

Part IV: Ethical Standards for Serving Abortion-minded Women

Transparency, Integrity, and Full Disclosure:

Due to the political, passionate and divisive nature of abortion women facing unplanned pregnancy are often the

Every woman has 3 Choices

victims of biased information and sales tactics at abortion clinics and elsewhere. It is our belief based on serving thousands of abortion-minded women across the country every year that women need to be insulated from these added agenda driven pressures. Furthermore, if they are insulated and at the same time given all the information and about all their options (abortion, adoption, and parenting) as well as the medical support needed at the moment more often than not she will choose to have her baby. Not a sane woman alive actually wants to have an abortion. They feel trapped, like abortion is their only way out. It is the job of the pregnancy center to provide support and security such that she realizes that she can actually pursue other options, a real choice.

So, in the interests of fairness and the desire to avoid non-exploitative behavior, organizations should:

1. Fully disclose the financial profit they stand to gain if the woman chooses one option over another.

2. Refrain from manipulation and coercive tactics such as inflaming irrational fear and panic.

3. Ask and obtain permission at each stage of the consultation process.

4. Conduct anonymous paper-and-pencil exit surveys to assess client/patient satisfaction with the organization. (See Attached Sample Exit Survey Here Client/Patient Exit Survey)

Is Your Employee Compensation Right?

An issue has recently come up within the CompassCare OT network of PRCs regarding employee compensation. Namely when is it right to determine if an employee should be paid for holidays and whether or not that employee should be salaried and therefore exempt from being paid overtime?

Regarding holidays and paid time off it is right to be policy driven. Typically organizations only provide holiday pay for those who work full time. Part time workers generally do not get paid holidays. Also, it is a matter of policy to determine which holidays will be observed by your organization. The big federal holidays are typical like Labor Day, Memorial Day, New Year’s Day, Christmas Day, Thanksgiving Day and Independence Day but you may want to add a few others such as New Year’s Eve Day, Christmas Eve Day, Good Friday, etc. So when a holiday falls during a weekend or when your office is otherwise closed it is no big deal for part timers because they would not get paid anyway but your full time employees should be able to ‘bank’ it and take the day at another time since that paid time off is as you said a ‘benefit’ and an employee should not be penalized if the calendar works against them.

Regarding the issue of getting paid a ‘set amount’, this is determined by the Fair Labor Standards Act of 1938. This is a Federal law regulating when an employer can and cannot do this. The term used by the government regarding a person who gets paid a predetermined amount irrespective of hours worked is ‘exempt employee’. This means that the employee is exempt from the laws requiring overtime pay.

The term used by the government regarding a person who gets paid by the hour is ‘non-exempt employee’. This means that the employee must receive overtime pay when working more than 40 hours per week.

Generally speaking it is up to the employer to determine whether an employee is exempt depending on their salary and the type of work they do. ‘Exempt employee’ is a class typically referred to as ‘White Collar’ exemptions. This category is comprised of executive, administrative, and professional employee types. This means that an employer cannot assign exempt status to just any employee they want since it could prove an unfair labor exchange. The following are criteria for determining exempt employee status and can be found at the following website: http://www.blr.com/compensationtips/exempt-nonexempt .
“Exempt white-collar employees must generally be paid on a salary basis and receive a minimum salary of at least $455 per week. (There are exceptions: Computer programmers, systems analysts, and similar employees may be exempt if they are paid at an hourly rate of $27.63 or more). To be exempt, employees must generally be paid a predetermined amount each pay period. The amount paid may not be reduced because of a variation in the quality or quantity of the work performed. With limited exceptions, the employee must receive his or her full salary for any week in which he or she performs any work, without regard to the number of days or hours worked. However, the employee need not be paid for any workweek in which he or she performs no work.”

10% of All Client Appointments Are At Risk for Abortion Is Average?

At the average medical PRC, why is it that only 10% of the entire client load actually pregnant women seriously considering abortion? We have found that it has to do with how services are provided . . . based on a secular humanistic model of counseling. Can those Pregnancy Care Centers reverse that trend to 90% or more? The bad news is that we have only found one way to fix this problem and it cannot be done in less than 4 months and with nothing short of changing the way services are offered. To read a more detailed history of the pregnancy resource center model and why it is not working click the following link: Analysis of Why the PRC Is Not Working and How to Fix It

Let me clarify. Ultimately we need to have a trend reversal in the mission critical areas of the pregnancy center. This number of just 10% of all clients seen as at risk for abortion represents a deeper problem. For example, let’s say that your organization schedules an average of 200 appointments per year that actually show up. And of those 200 only 20 are considered pregnant and at risk for abortion. Furthermore lets say that you have the capacity to see 500 more clients this year. Since the typical PRC service strategy affords you the opportunity to see approximately 10% of your entire client load at risk for abortion (20 out of 200) you need to find a way to increase that.

Is this a marketing problem or is it deeper?

Let’s explore that question. To increase your client load to 700 using your same service strategy will only get you 105 total pregnant women at risk for abortion assuming you get all 700 women in the door. If the annual number of women in the market for an abortion in your area is 2,000 and you want to reach them all you immediately have a problem. To reach 2,000 using your current strategy would mean you would have to serve a little under 14,000 clients per year. I don’t know about you but our organization could not afford that. We had to find another way.

While advertising may be a valid concern it is not the primary problem. Women respond over time more to what an organization does and less to how it advertises. The real challenge for us is to come up with a model of service delivery that is laser focused on that one type of woman who is seriously considering abortion in our respective communities (i.e. 18-24 year old, college or young professional, single woman who is predominantly Caucasian). If you can reach her you can reach anyone else who may be considering abortion. But to do that you will need to re-engineer the services you provide as well as how you provide them. Building an organization that consistently reaches pregnant, at risk women requires 1) adopting a new more Biblical philosophy of service, 2) re-engineering your service to be consistent with that philosophy of service, and 3) time for news to spread into the population (6-18 months after re-invent).

I have uploaded a position paper Analysis of Why the PRC Is Not Working and How to Fix It providing more historical background on these issues. Also, consider exploring some of the case histories of PRCs that have made the jump to a new model of service and have seen a dramatic shift in their patient load on CompassCare’s Training website at www.compasscaretraining.org.

Part III: Ethical Standards for Serving Abortion-minded Women

What do therapy dogs have to do with pregnancy care centers? Therapy dogs have proven to raise morale of long term hospital patients which in turn improves the patient’s overall health. But are their times when there are NO DOGs ALLOWED? If you don’t know your ethical standards anything goes and it will become increasingly more difficult to determine what should and should NOT be done when serving clients/patients. Without know your ethical standards and how they apply it is very easy for good intentions to degenerate into poor or unethical performance.

Dogs in a Hospital? Where to draw the line.It is the same way with serving women facing unplanned pregnancy. There are things to do and things not to do. There are times to do them and times not to do them. This post is the third of a four part series of knowing your pregnancy center’s ethical standards of care.

Informed Decision-making:

To promote informed decision-making organizations should help to answer the 3 basic questions every woman needs to have answered in order to determine the outcome of her pregnancy:

A. Am I really pregnant? It is possible to not have a viable pregnancy and have a positive home pregnancy test.

  • A woman needs a medically definitive diagnosis of pregnancy confirmation using ultrasound technology or blood tests.

B.  How far along in the pregnancy am I? The further along in the pregnancy a woman is increases the complexity of her options.

  • A woman needs an ultrasound scan to determine the exact gestational age of the baby. Gestational age determines the type of abortion procedure she would be eligible to receive.
  • All abortion procedures are medical procedures. Therefore each abortion procedure has different costs and different risks associated with them.
  • Gestational age is important to know in terms of providing medically accurate information about fetal development.

C.  Is it important to know if I have a sexually transmitted disease (STD)? STDs can negatively impact future reproductive health if left untreated.

  • Some STDs if left untreated prior to an abortion procedure increase the risk of infection which can put a woman’s reproductive health in jeopardy.
  • Testing and treatment for the most common STDs, Gonorrhea and Chlamydia, is essential to prior to an abortion to safeguard a woman’s reproductive health.

To learn more about how to apply ethical standards through a linear service process that holds all staff and volunteers accountable to those standards go to www.compasscaretraining.org.

Update:  See Part IV:  Ethical Standards for Serving Abortion Minded Women.

Part II: Ethical Standards for Serving Abortion-minded Women

The only way to ensure that your pregnancy help medical clinic’s good intentions actually are provided in a way that is consistent and ethical requires that we as Executives know what our ethical standards are and that those ethics are applied with every step of a client/patient interaction. Just because we believe in the good intentions of our volunteers and staff does not necessarily mean that they are interacting with our clients in an ethical manner. Being a Christian is not enough for ethically delivering services medical or otherwise to women facing unintended pregnancy.

Upholding Ethical Standards of Care

Sadly, you and I know that a woman’s decision about the outcome of her pregnancy is so often fraught with irrational fear, inadequate information, little to no counseling, sales tactics from financially vested interests, and coercive pressure from self-interested others that a woman does not feel like she has any other choice. In a 2004 study published in the Medical Science Monitor 84% of the American sample of women said that they did not receive adequate counseling before receiving an abortion. Additionally 64% felt pressured by others which would include boyfriends, parents, spouses, etc (Medical Science Monitor, 2004; 10 (10): SR5-16, Induced abortion and traumatic stress: A preliminary comparison of American and Russian women; Vincent M. Rue, Priscilla K. Coleman, James J. Rue, David C. Reardon).

Given these considerations and the importance of insulating women facing an unplanned pregnancy from intentional or unintentional negative influence, all organizations seeking to assist these women should employ 3 categories of ethical standards in their delivery of services: A) Supportive Decision-making, B) Informed Decision-making, and C) Transparency.

A.  Supportive Decision-making:

To respect and enhance a woman’s ability to make decisions regarding pregnancy outcomes, organizations should help by using these important pregnancy decision-making tasks:

Assessment of woman’s current social situation including relationship support structures (i.e. father of the baby, parental involvement, etc)

  1. Assessment of woman’s current social situation including relationship support structures (i.e. father of the baby, parental involvement, etc)
  2. Identification of circumstantial pressures (i.e. finances, education, unsupportive relationships, medical care, child care, age, long-term goals, etc)
  3. Careful exploration of the full range of available options including abortion, birth, and adoption.
  4. Careful consideration of potential short and long-term physical, social, and emotional outcomes of each available alternative.
  5. Maintain a safe environment that helps a woman firmly resist pressure from self-interested parties.

Update:  See Part III:  Ethical Standards for Serving Abortion Minded Women