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Nonprofit Radio for May 19, 2017: Healthcare Funding Options & Leadership Options

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Chris Labbate: Healthcare Funding Options

You have options today! First, Chris Labbate walks us through fully insured; self funded; level funding & minimum premium, so you understand your choices paying for your employees’ health insurance. Chris is with Marsh & McLennan Agency.

 

 

Gene Takagi: Leadership Options

Gene Takagi

Then, we talk leadership options with Gene Takagi, our legal contributor and principal of NEO, the Nonprofit & Exempt Organizations law group. Co-CEOs anyone? How about holacracy?

 


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Oh, hi there. Hello and welcome to tony martignetti non-profit radio big non-profit ideas for the other ninety five percent on your aptly named host this is show number three hundred forty, the three hundred fiftieth non-profit radio is going to be coming up it’s on july twenty eighth, three fifty music comedy special news i hope you’ll be with me for three fifty i’m sending spies special a pre show special live listener love to the fans of crystal a bat this insurance guy has a big fan base that this guy’s, a rock star who sells insurance live listener love to chris’s special live listeners, and i’m glad you’re with me. I’d suffer with my own militia if you try to soften me up with the idea that you missed today’s show health care funding options today is options day first, kriss la bat walks us through fully insured self-funding level funding and minimum premium. So you understand your choice is paying for your employees health insurance chris’s with marsh and mclennan agency and shared leadership options. We talked leadership options with jean takagi are legal contributor and principle of neo the non-profit and exempt organizations law group co ceos. Anyone? How about holacracy shared leadership on tony’s? Take two. My finger is still wagging, responsive by pursuant full service fund-raising data driven and technology enabled, you’ll raise more money pursuant dot com, and by we be spelling supercool spelling bee fundraisers. We be e spelling dot com for all his fans. And, of course, for everyone else. Here is crystal bat with health care funding options. My privilege to welcome chris lay back to the studio as regional executive vice president at marshall mclennan agency, chris is an authority on employee benefits, including customer driven health plans and alternative funding. He shares his expertise and twenty eight years of industry experience to help you see how innovative employee benefits and hr programs can lower your costs. The company is at mm a hyphen and e dot com crystal bat. Welcome to studio. Thank you, tony. Pleasure to be here. I’m glad you are. Thank you. Read your colleague last week. Mark. So you’re going to shine like mark shine did yes, i know you’re up to it. All right? So we are we’re talking about funding funding options for employee health. Let’s, let’s reassure listeners first, this is not going to be impacted by health care reform that may come or is not going to be impacted seriously, right? Yes, that’s that’s correct? Most likely, the funding options will stay the same. Okay? Because we really can’t predict what’s coming out of congress, but we don’t expect the general ideas around funding that you and i are going to talk about to be impact. Correct, okay. Right? We don’t make the show irrelevant in two weeks after. Okay. All right, so it turns out you don’t have to fully fund. I mean, i think probably the majority are ah, now i know you do have some stats, actually, but i’m thinking small and midsize non-profits probably most of them are just osili insured, fully insured, really insured plan. Correct, but you have options. Correct. So? So in a fully insured plan, you’re just paying a fixed monthly rate that the insurance carrier sets for your organization and if its profitable to them it’s profitable them. If it’s not profitable, they’re taking on the all the risk skin and losing out. Yeah, okay. They probably don’t lose out too often, though. I’m guessing they might lose one year, but they’re probably gonna lose two years in a row over the long term state business. They have to make profit. Okay. Exactly. All right, so i think pretty. Yeah. People are pretty accustomed to that. The fully fully insured and ah it’s easy it’s level payment, i mean, and you know exactly what to expect. Her employees have a set of benefits and it’s all easily defined and of course, insurance, company’s, managing it right. So we’re just talking about the financing of the benefit plans, right? So that’s, often transparent to the employees, don’t get involved with that. So the employer is just paying the fixed costs, and they’re all there are alternatives to the fully insured, called self-funding, which can be explored for more, most organizations, five employees on up. Ok, so even for the smallest organization, correct benny on the state. But, yes, okay, okay, cool. S so this is going to be impacted by state law. Also, correct, yes, all right. Um now, if we are, if we are self-funding then we’re taking on some risk, correct, you’re taking on a portion of the claims risk so that portion you’re going to fund as the claims come in, but what’s often misunderstood about self-funding is that there are insured components built into self-funding so it may not be at the same level that you have. You’re fully insured, fixed rate, right? But you do have insurance components to protect you. Two different suits to specific types. There’s ones called specific insurance to protect you against any one person having a claim over a certain amount. Okay, you decide is the employer and you purchased that coverage of twenty five thousand fifty thousand. If a claim hits that level, the insurance kicks in, and then the second is called aggregate insurance, which is protection that your total claims that going don’t go over certain amount. Okay? All right, so i got you. I got you so you can. There are some. Yes, there are some insurance protections built into self-funding. All right, now you do have some stats about, um um about what? What? The percentages are around. Who’s self-funding. And how it’s. Been changing since nineteen, ninety nine like percentage self-funding vs versus the full, fully, fully insured thank you write. So especially since health care reform has has kicked in there’s been a movement towards self-funding on dh that basically is benefiting employer groups that have a favorable risk of benefits around the country. They’re showing. About sixty one percent of covered workers that have health insurance through their employer are covered under some form of a self-funding plan. Yeah, well, okay, so almost two thirds correct under some form of self self-funding and that’s changed from nineteen, ninety nine that was forty four percent correct. A big change. Okay, okay, um, so if we’re if we’re going to consider this self-funding option, there are some different kinds of costs that we need to be aware of, correct. Right now, we’re just like we have about two minutes before break. So why don’t you just kind of tease out the idea of these different kinds of costs we have to be aware of? And then you’re not going to more detail. Perfect after right after that. So in general there’s, two categories of cost, you have your fixed costs that you’re paying on a monthly basis and you have your variable costs will be, which will be your claims costs as they come in. Ok, fixed, invariable. All right, we’re going to dive into that a little more. We take our break a minute and a half earlier, so and then kristen are going to keep talking, finding out what your options are around, maybe self-funding all are a part of your employee health stay with us, you’re tuned to non-profit radio tony martignetti also hosts a podcast for the chronicle of philanthropy fund-raising fundamentals is a quick ten minute burst of fund-raising insights published once a month. Tony’s guests are expert in crowdfunding, mobile giving event fund-raising direct mail and donor cultivation really all the fund-raising issues that make you wonder, am i doing this right? Is there a better way there is? Find the fund-raising fundamentals archive it. Tony martignetti dot com that’s marketmesuite n e t t i remember there’s a g before the end, thousands of listeners have subscribed on itunes. You can also learn maura, the chronicle website philanthropy dot com fund-raising fundamentals the better way welcome back to big non-profit ideas for the other ninety five percent with chris sabat when we’re talking about funding options for your employee health now, christine, you do not have lots of letters after your name. Last week we had i says that mention mark your colleague market lots of letters especially easy, like sees after name there’s all your where’s, all your credentials, they’re all just built into yourself. Yes. You know, i’ve been in industry since eighty nine, and i have my master’s in finance and marketing. I’m just really the experience in the industry on the benefits side. Okay, okay. Your bona fide? Yes. Okay. Okay. All right. So let’s. Now, zai promised diving a little more on these. Some of these costs that you have to think about taking on if you were goingto fundez self-funding fixed costs like like what? Like what? So the first fixed costs you would have is your cost to administer the plan. And typically you’re hiring an insurance carrier or a company. It looks like an insurance carrier called a third party administrator to perform all the tasks that that insurance carrier would under a fully insured plan. So paying claims customer service id cards for employees booklets. So from the employees perspective, if they don’t know what the funding is, it looks and feels like a fully insured plan to them. There’s no difference. Okay, so you’re outsourcing this administrative work. Exactly. No need for you to hire people to be doing this for you. Exactly. Cos that’ll do it for you. Yes, at a fraction of the cost of a fully insured plan. Okay. Okay. Um and the what? What else? Fixed costs. There’s this ways that now we now we get into some of the insurance coverage mentioned earlier, protecting us against a really unhealthy employer employee or or or or or aggregate. Go ahead. Absolutely. So so most companies that self-funding will have two types of insurance associated with their plan and their purchasing this protection. And the first is called specific insurance protection against anyone large claim going over a predetermined amount. And as the employees you, you picked that amount, whether it’s twenty five thousand, fifty thousand and as that amount goes up, the premium associating it kind of goes down exactly. Okay? And the second type of coverage is called aggregate insurance. And that’s protection that your total paid claims will not exceed a certain amount. Okay. And that’s, very inexpensive coverage. All right. And so these air part of your fixed costs that you’re going to be absorbing? Yes, if you’re if you’re exploring self-funding, you’ll get a monthly bill with your admin costs and your stoploss costs all printed out per employee, just like you get a fully insured premium bill. Okay, okay. On. And then you had the variable costs, which is basically what you’re going to be paying out for doctor visits. Right, etcetera. That right. Exactly. So the variable cost will be the claim’s paid out for your employee population covered under the plan. And in general, when you’re purchasing your stoploss insurance, the underwriter at the stoploss carrier will determine what they expect. Your claims to be given your employee population and then they’ll determine a maximum exposure. So if your claims go above this maximum amount, the insurance will kick in and cover it. Okay, that maximum exposure is usually set ten to twenty percent higher than your expected claims for your popular do-it-yourself kush. Exactly. Okay, exactly. Now, what about reserves in all this? I mean, if we’re going to be doing that, we have to have money set aside for the payment of claim. Exact. Exactly. So when you first go into self-funding plan in the first few months, you typically will not see any paid claims. Somebody goes to a doctor today. It doesn’t get reported two to three weeks from now when it gets paid. Okay, so there’s a cash flow advantage upfront going into a self funded plan, but on the back and if you ever terminate a self-funding plan, there’ll be claims coming into the third party administrator or the carrier that need to be paid based on service states prior to when you terminated, right? Right. That’s called run out or term a terminal liability. Okay, yeah, while you were self-funding toe at the end mean, you benefited in the beginning, right at the end. Claims are still going to be coming in as you exact your i guess. Or now fully insured. And you ended your your self-funding crackers. But but so that has to be a reserve fund, right? Don’t law must require something like you’ve gotta have ah dedicated account or something with the money. For the old yes, so typically a joint bank account set up with the third party administrator there paying claims out of this account when you had that crash flow advantage at the beginning of the program when your first during out self-funding we recommend that you just bank that money and that’s setting up the reserves for the event if it ever happens where you cancel the self-funding plan, okay? And how about knowing? Oh, well, i guess that goes into your expected cost. Me knowing how much to put into this reserve correcting for for a decent sized organization, i don’t know, like ten employees, i mean, could conceivably be half a million dollars or something. I mean, i’m just numbers don’t stop my head, right? You’re going to be more precise, you’re probably gonna say, well, it’s gonna depend on age, right and correct help histories, etcetera and it’s broken out by the underwriters on a monthly basis. So, you know, so when you get your stoploss coverage, they’ll give you a claims factor per employee per month. And that is how you calculate the number of employees times that claims factor gives you your exposure for the expected exclaims focus and that’s the amount that’s got to go in this dedicated reserve for typically yes, now you can’t you can’t be using this money for other purposes correct it, sze designated restricted or something for the self-funding plan? Yes, it should be air marks for the self-funding plants. He had the money available to pay their letting your employees down your absolute, obviously seriously. Okay. Okay. We don’t want people run operating that. Okay, um all right. So we’re talking a lot about self-funding what are what are some of the reasons you that non-profit might actually think about doing it? There’s some advantages? Yeah. There’s some big advantage associate with self-funding the first is there are a bunch of hidden taxes and fully insured plan. So under health care reform, there’s four four and a half percent in taxes that get attacked right onto a fully insured great. Okay, now, health care reform. Today on the day now, we’re recording couple weeks earlier, then this is going to air. So health care reform by that you mean the affordable care act? Correct? Or obamacare? Correct. Okay, not something that may be happening in congress in april of this year in may of this year is that right? That’s correct. So in the affordable care act, there’s a tax on non-profits that are any fully insured krauz any fully insured plan has attacks built into it that gets funded, the funds go right towards offsetting the cost of the affordable care act. Was it attacks on the amount of premium? You correct? Oh, interesting. Okay, right. Forty five percent you sent were correct and there’s also in some states and local taxes that get applied to fully insured plans. So when your self-funding you’re circumventing the state rules and some of these fully insured taxes at a federal level, yeah. Okay. All right. This one advantage. All right? What else are there? Other reasons it we have? Ah, younger, healthier group. You’re going to benefit because you’re paid claims will be much lower then expected or similar to expected. And then you’re paying less than you would under a fully insured plan now wouldn’t and ensure offering full insurance? Wouldn’t they be factoring in that you have a younger, healthier workforce. So health care reform change some of the factors that go in. They do account. For age coverage, tear with a single or family coverage if you’re a smoker or a nonsmoker, but generally you’re paid claims in a small group will not count towards calculating your rate. Wait a minute, we better impact that statement. Hold on, you’re paid claims in a given group will not will not what? I came here if you’re unaffiliated, if you’re in a fully insurance plan small group market? Yes, your claims do not drive your rates typically. Oh, they don’t correct because it’s the law of large numbers, they’re playing, they’re not going to base your rates on your claims. If you’re five people or ten people that’s what healthcare form actually did away with to try to stabilize the small group market just like those of us who are individuals, we go to the exchanges. It’s my premium is not at all based on my history could i mean, i think they might have asked if i’m a smoker. But that’s all yes, that’s one of the factors taken you okay? So we’re getting very small. So that’s at one end of the spectrum, tiny individual. I see what you’re saying. They’re all right there it applies to small groups as well. So i’ll give an example of you if you’re in a fully insured plan, you’re paying fixed rate every month and say your premium comes to one hundred thousand dollars a year. Okay, now, if you wanna self-funding plan, you’re paying your fixed costs, which might be twenty or thirty thousand will estimate and then there’s seventy thousand and projected claims what your claims only coming at ten thousand, you’re only paying ten thousand wonderful insure plan you pay the full hundred thousand still alright, so there’s an opportunity here for a new organization to engage in employee health, health, health and wellness, right? Yes, if you’re going to go fully every, i’m sorry if you’re goingto self-funding you can enjoy some benefits of every every, every two weeks, we have a five k run or, you know, whatever i say, right? I mean it’s perfect segway twenty foot that one of the next advantages. If you have an active wellness program where you’re engaging your employees and getting healthy, that can parlay into fewer claims and under self-funding plan, you benefit directly from that you’re not paying out claims on un employees that don’t go to the doctor. Okay? What size organization do we have to be? Or was it eliminated completely under affordable care act, where they would start looking at our claims history and our wellness programs? If we were going fully insured so it vary state by state eso it khun b fifty employees, one hundred employees and and more. All right, you have to be that size for them to start factoring in your individual act. Your program’s done. But i mean, you could have, like, smoking cessation. You could have, i don’t know. Organization provided fitbits and everybody’s got eight or ten thousand step daily minimum, right? You can have all kinds of programs to try to save yourself. Money. Those air, those air common wellness programs. There’s not innovative thinking, innovative now company and fried. It provided fifty. Now they’re doing that. Yes. Alright. I thought maybe i had some some great insights. Okay, um all right. So i just happened to be a big wellness fan so you could save some money if you doing self insurance. Self-funding self-funding i should say on and there’s a couple there’s. A couple more advantages. Get more transparency. You see, you’re paid claims were under fully insured arrangement. You typically do not especially smaller employers, so you don’t get to see the claims them all employers typically, we’ll not see their claims history because they’re not allowed or that usually carrier policy not to give out paid claims to smaller employers, especially if they’re rates aren’t dictated by plane. So that gives you the ability to better budget for future costs because you have all the information and it helps you design with plan design. So if you know people are over using the emergency room, you might up the co pan the emergency room copay and you might lower the copay on your urgent care centers or tele medicine to try to drive people with lower cost setting. Yes. Okay, so you could drive some behaviors. Okay. I could see that there’s one last one. It gives you the ability to not have to include state mandated benefits in your plan. And that’s, a big benefit for companies who have people across state lines because they can provide one seamless plan designed for all their employees. You say companies. But we non-profit organizations exactly. All right. So different. States have different mandated benefits, correct packages? Correct. Okay, i saw a bit of a little i mean, this is kind of interesting, well, privacy issue coming out of what you were just saying, if you’re self-funding you’re able to see claims history now you know who the unhealthy people are, right? Who’s got bad behaviors, etcetera mean, who wrecked a lot of so the reporting khun b done where’s d identified which just means you’re seeing general information, but it is if you have a smaller the company, you might be able to identify who those people are. S o typically you would want tohave an internal privacy policy, which which follows the hip national privacy standards with a privacy officer and a policy in place to protect that information and only have certain people buy-in certain people given access to the information within your organization. Ok, ok, that actually dovetails with what? What mark and i talked about last week levels of compartmentalization correct categorization, i believe he called. Okay, um, who typically would be looking at this data if we’re going self-funding who looks at this on a monthly basis so typically be somebody in hr maybe. Something in finance and it’s almost it’s, almost always d identified so you know, you’re not going to know who the people are, but they’re looking at it, just seeing what claims were being paid out and budget and future years, and then also the behaviours trying toe like you said, friends instance, if we see emergency rooms being overused, correct plan design, and then we could also just have meetings about listen, people, you know, you’re hurting our you’re hurting the organization by using the as your primary care or something like that, you know, you’re hurting. We’re trying to stay self-funding for for the these reasons because we think it’s better for you then than being fully insured. But you’re making it hard for us to do so right? Get a primary care physician. Yeah, you can have meetings about the right can you talk about? You can talk about that, you can have any things. And you, khun target wellness programs like you reference if you see your population has a history of high blood pressure or a lot of smokers, you can use that information to taylor educational program. Bring people in current, bring people in to talk about hypertension. Manage? Absolutely. Okay. Diabetic diabetes management? Yes. If people are having a lot of diabetes related issues. Okay. Okay. All right. So we still have some time left. What? My voice just cracked still. What? What happened? I asked you what else? What else could we talk about? Some of the some of the negatives with self-funding. So if you’re moving to a self funded arrangement, you have the variable cash outlay potential. So one month your claims can be very favorable. The next month you can have high claims. You do have those reinsurance caps built in protection. Stoploss is you’ve already examined all the jargon. I got tongue now, stoploss but you can still have some variants and some come organisations prefer the fixed costs associated with a fully insured plan. You know what you’re paying your budget for it and that’s your costs for the year where self-funding can vary over the course of twelve months. Okay, um, how does it work? This is a very basic question. But if you if you are self-funding, how does it work in terms of a network of hospitals and doctors? Have you that’s? Good cause. You choose what providers are available to your employees. So when when you hire the third party administrator or insurance carrier to administer the plan there, providing that service for you so you can hire a big insurance company and use their network, you’re renting their network to access those discounts. That’s part of the administrative fees it gets broken out into network rental fee utilization management, he gets into a very a lot, a lot of details broken out, focus. Okay, well, because you can use somebody’s network and not be insured by the exactly you’re taking the risk, you’re just using them to administer the plan. Roger. Okay, i say interesting. Okay, um, what else? We still got a few minutes left, so that zoho your disadvantages of having any of that was that was one big one. The other one is if you ever want to get out of self-funding you have that terminal liability. So if you say i’m canceling my self-funding plan today, you’ll have a couple months of claims to pay out. Still for claims that were incurred prior to your cancellation date. And at the same time, if you’re signing up for a fully insured plan, you’re paying the fully insured rates so it’s like a double payment for a few months to get out of this self-funding plan. I got to get to cool things. I got terminal liability and stoploss yes was going around saying, you sound like a genius, alright stoploss german labbate that’s a term reliability problem on dh that i could touch on to two other quick thing before you do, though dahna the terminal liability i mean, could that could that go on for years? I mean, suppose someone made a claim while you were still self-funding and then they continue to have related issues to that claim like so i don’t know what a surgery that went bad or something, and then years later, they’re still having, like following surgeries to that infection from when you were self-funding what good question so it’s driven by the nhk earl date of the claim? So if i go to a doctor today and i’m self-funding today, it gets paid dahna self-funding plan for that same condition if i go to the doctor next month and next month i’m under a fully insured plan gets paid by the flame. Shirt plan. Oh, so the general liabilities just the run out. They call it from the from the self-funding period when people went to the doctor during that plan here. All right, so it’s not considered like a pre existing condition. Correct? Where the now insurance company, because you’re fully insured kicks is going is going to kick it back to you from what? Your self-funding days doesn’t work like that. Correct? It does not. Does not. Okay. Okay. All right. That’s, some reliability thisyou xero everywhere you’re in our daily lives. Term liability stoploss okay, what else you got? I could do real quickly to other hybrid type products between fully insured and self-funding. So you have some combination once called level funding, and this gives you the fixed costs of a fully insured plan where you paint a rate every month for employees. But at the end of the year, if your claims are favorable, there’s the potential to get a refund of a portion of the terrible claims. Oh, so you benefit if if claims air. Good. Act. Okay. And if claims are are not good. You’ve paid your rate for the year and you walk away. Okay, well, that’s, because you have what you want had some stoploss coverage it’s all built into, like, a fully insured rate. So you have that fixed rate, and then if your claims are favorable there’s something called a settlement done at the end of the year, you know, if you would get money back, but there’s no potential. The additional dellaccio more correct. Okay. And then you have you said in which another hybrid? Yeah. There’s there’s one more call the minimum premium arrangement. And this is sort of like a fully insured rate, but you’re carving out the claims part of it and your funding the claims as they actually come in. So similar to level funded. But you don’t have the wait till the end of the year to get the benefit of favorable claim get, like month the month? Correct. Exactly. Well, okay, so there’s. A lot of issues to think about, and i guess way just have, like, a minute and a half left or so, but i guess this all comes down to risk tolerance. Exactly. Do you do? Do you want to just write off the wrist completely and give it to an insurance company? Or would you like to get some of the benefits of doing it yourself and maybe even having healthier employees? But you’re taking on some of that risk. Correct your risk tolerance and your ability to handle some cash flow changes from one month the month with self-funding and it really comes down to analyzing what would my costs be under a fully sure plan. Total costs. What may cost being herself funded plan at the maximum claims that’s where the stoploss carrier says you would not pay more than that. Yes, you’re a total costs on. Then what would your cost be under the expected where they expect your claims to be? Given your employee population and looking at those numbers will give you a good feel for where he should be. Okay. All right. Crystal bat. Andi. I demoted him because he’s, a crystal bat is a regional executive vice president at marshall mclennan agency. Okay. I wanna thank you very much, chris. Thank you. Tony called my pleasure. Coming up. We have jean takagi and shared leadership options. More options for you first. Pursuant, they’ve got a new webinar. Big surprise. It’s free designing experiences. That inspired donorsearch every brand elicits a feeling, you know this like think disney, starbucks, united airlines and each of your donors has an impression of your organization based on their experience and interactions with you with your brand. On thursday, may twenty fifth, you can join lutheran, our ministries, brad never ary and pursuance senior vice president hillary noon and learn how to create immersive experiences that inspire greater engagement from your donors and potential donors. 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Are you properly registered in each state where you solicit donations? You need to be listen to my admonishing tone. It’s not going to stop. Where are you sending e mails? Sending direct mail hosting events, maybe buying ad space. Do you have a donate? Now button that admonishing tony’s not going away. Each of these things is a solicitation, and it triggers the registration requirements. Charity registration. You need to get it done. I can help you. You could do-it-yourself. You need to be in compliance in each state where you are soliciting donations. My video is that tony martignetti dot com that is the admonishing tony’s. Take two live lesser love. I’ve got a ton here in the united states of america and not too much abroad. Really. So let’s, uh, let’s. Start here in the us of a with tampa, florida. Very loyal, lifeless and live. Out to you special tampa. You’ve been with us for a long, long time. Woodridge in new jersey, swan’s borrow north carolina, new york, new york and brooklyn. New york really got two out of three borrows this week last week. Course we had all five. But brooklyn. I’m glad you’re with us. Manhattan. Thank you so much, but gives he with that westchester that’s. Not bad. North of the city. Poughkeepsie live. Listen, i’d love to you also, white plains neighbors in westchester live. Listen level so to newjersey caldwell, new jersey, hackensack, new jersey. Still no altum pandu jersey, where my mom and dad are sitting right now. Uh, moving ah! Moving way down south san marcos, texas live. Listen, love out to you, san marcos on then coming back to the northeast, stratford, connecticut were all over except on the west coast. I know what west coast person who’s listening but he’s on the line so it doesn’t count. Not this week. And let’s do germany got to live listeners in germany? We cannot see your they’re so concerned about privacy in europe we cannot see your cities in germany nonetheless live. Listen, love guten tag the podcast pleasantries. They got to go, you know that you’re tired of me saying it, but i’m not going to stop the podcast. Pleasantries have to go out to the over twelve thousand, listening in that method pleasantries to you. Thank you for being with us on your schedule on demand, and the affiliate affections were looking to grow that affiliate list. Our outreach director, belly, betty mcardle belly. No, she’s. Not ever. Billy. Betty mcardle is working on that. But for the effect for the affiliate stations that exist right now. Of course i am. And fm stations affections to you. So glad that you’re station includes us on your schedule. Thank you. Jean takagi is with us waiting patiently. He’s the one i was alluding to, um and he is the managing attorney of neo the non-profit and exempt organizations law group in san francisco. He edits the wildly popular non-profit low block dot com and he’s the american bar association’s twenty sixteen outstanding non-profit lawyer he’s at g tack on twitter and i believe he’s calling from an airport. Welcome back, jean takagi. Hi, tony. How are you? I’m very good. Very well, are you, in fact, in an airport? Is that what happened? I’m now at an airport hotel. A little bit better. Okay, where are you? What city you’re in? I’m in los angeles, los angeles. So that’s not far from you for san francisco. Okay. Okay. S a little background noise. I kind of like that. Mixes things up a little bit. Um, if anybody gets difficult while you’re on the phone, you know if you have to drop the phone, you know, and fight somebody off, just explain what you’re doing first before you just dropped the phone. Okay, i’ll make sure i hold them off, ok? All right, well, do what you have to do but inform me first that’s the first your safety is secondary to informing me that’s what? I’m that’s basically, what i’m saying, it makes understood, ok, thank you very much for that. So we’re talking about some shared leadership options. Um what? What brought this to your attention? You know, shared leadership has kind of been a little bit of a hot button issue recently amongst non-profits that are thinking of more equitable practices and in attracting younger people. Millennials, you might refer to the you know, to that group and say that they may not be is ingrained with the hierarchical structure that those of our generation tony, maybe comfortable within used to, and they’re really wanting tio have more of a say early on in their careers, so, you know, shared leadership issues, all sorts of forms are really starting tio to take hold in some practice on dh starting t gain in more popularity so are you seeing this? I guess mostly then in organisations where the leadership is thirtysomething or so well, you’re seeing it from from a lot of younger people, for sure. So living in the san francisco bay area in with silicon valley nearby, and this is not just a non-profit management or organizational structure, this is started in the for-profit world in this sort of spread into some non-profits but yeah, it’s a lot of younger tech companies, like suppose that that sort of kicked it, kicked it off some of experimented with it and left it like medium, but one of my organization that i’m on the board of a compass point non-profit services also experimented with holacracy and while it isn’t continuing in a whole keeping the whole model, we’re keeping aspect of it because you feel it’s really valuable. Okay, now i’m not going to put you in jargon jail because i know we are going to talk about holacracy but you just try to slide by me, and i want you to know that i’m quicker than you. So i i noted it, but you’re you’re you’re pardoned thiss time because where i know we’re going to talk about holacracy alright, so so sort of following from what you’re suggesting i can see the advantages there’s empowerment, there’s, there’s, there’s shared, there’s shared buy-in and empowerment of others. Yeah, and i think that works for leadership development with the team more people having more voices, teo impact what’s happening with the organization, what they’re doing, they become more interested in it that probably helps in recruitment and retention. It helps internal communication and collaboration, and it i think, necessitates cross training because you’re talking and trying to understand what your little part of the organization, how it may impact every other part of your if you’re one of the decision makers, are you’re making decisions as a group? You got to know the other three other parts of the the organization how your decisions are going to impact them. Yeah, i can see that this is not something you embark on overnight, right? Especially in the need for cross training and understanding. What’s going on across the crust of our organization for the thing people are going to be sharing in leadership now. Yeah, absolutely. The other, you know, benefit that has some people. Have been writing about it lately than it actually helps facilitate and succession planning. So we have more people who maybe pull, you know, in the pool of candidates to take over for for a ceo or an executive director. That maybe leaving the organization? Yes. Okay, that’s a good one, right succession plan. We’ve talked about that. Uh, ok, alright. See cem value. Um, but i see some potential downsides to this is going to be a lot more cumbersome for decision making. Yeah. I mean, you can imagine when you have too many chefs in the kitchen. I guess it is the metaphor analogy that people make on dh. So yeah, definitely neo-sage delayed decision making and that khun delay implementation of ideas. So you’re kind of the slow ship that takes forever to turn around. It can result in inefficiencies, and then you may lose opportunities, not acting’s. Quick enough cause confusion at the start. A cz you’re trying to figure out, you know, who’s accountable. How how do we, you know, make a decision? What if we’re split for? For what? If we start tio a form cliques within our organization and then we start to battle or engage in disputes with other factions of the organization. So their their potential bound falls that you have to actually really account for careful. Yeah, potential for open conflict. I mean, one of the things we’re going to talk about his co ceos and, ah, i mean, if the two people don’t agree. I don’t know. Yeah, get factions and jesus, you could start running like our white house. I don’t know. Okay, we’re gonna get to co ceos. All right, um, let’s. See? Well, we may as well go there. Um, what air you saying? Have you seen this? Have you have you seen this one in practice, where there were two ceos? Maybe any of your clients execute this? I mean, i’m just i’m just wondering if you’ve seen it firsthand co ceos, yeah, way have so definitely on. And i think this is actually becoming more of a trend, and i’ve seen it more in the nonprofit sector have limited exposure to for-profit sense since since i left that that world but i think you know, times are getting much more complicated. Management has also become much, much more complicated with, you know, technology changes non-profits are exploring earned income and advocacy and collaborations and employees laws are changing and then non-profit corporate and tax laws are ever changing, and right now there there’s some big, big changes that are planned, of course, on dh. So with all of that complexity, can one person really be the leader through the organization understand all of those those factors and be ableto lead the organization through all of it and that’s kind of why there’s been a little bit of a draw forming co ceos and succession planning is the other thing is, i think there’s supposed to be a huge turnover of executive lake leadership is the baby boomers are starting to age out of their employment, and they’re starting to retire on dh succession is, uh, is a problem if we don’t have adequately trained and experienced people in those roles, and coke co ceo platform’s can really help ease that problem. Ok, but with with all those issues that you mentioned for leaders to deal with, i’m not even sure that to people with their combined skills could manage, you know, can understand all that in the level of depth that that’s necessary. I don’t know, i’m not even sure two people could do it, so yeah, ee don’t know that i’ve ever seen three tio, no, but i’m just wondering if if i’m not sure to really adds that in my sense of it, too doesn’t really add that much more value. You could say it doubles, but i’m not even sure that’s enough, so if if i’m right, then why not just stick with one who has a strong team of people directly reporting to him or her it’s an interesting argument, tony, and indefinitely the single ceo structure is the one that were more comfortable with and probably the one that’s going to teach comin in for a long time still. But first, for some organizations, experimenting with two ceo structures can work out. And i think where we’ve seen this practically is where the two leaders share kind of a long term relationship, so they’ve already comfortable with how they work on dh, how they would make decisions together hyre the areas of responsibility, maybe divided so that one person has final decision making over these fears of the operation and the other one over other spheres, and sometimes, you know, in a very simplistic way, some people just refer to it is the internal management and the external management. Yeah, okay, some of that makes me makes me think of mika brzezinski and joe scarborough. I don’t know, okay, all right, let’s go out for a break and when we come back, jean, i’m going to keep talking about the shared leadership options. Stay with us. Like what you’re hearing a non-profit radio tony’s got more on youtube, you’ll find clips from stand up comedy tv spots and exclusive interviews catch guests like seth gordon, craig newmark, the founder of craigslist marquis of eco enterprises, charles best from donors choose dot org’s aria finger do something that worked and they only levine from new york universities heimans center on philanthropy, tony tweets to he finds the best content from the most knowledgeable, interesting people in and around non-profits to share on his stream. If you have valuable info, he wants to re tweet you during the show. You can join the conversation on twitter using hashtag non-profit radio twitter is an easy way to reach tony he’s at tony martignetti narasimhan t i g e n e t t i remember there’s a g before the end he hosts a podcast for the chronicle of philanthropy fund-raising fundamentals is a short monthly show devoted to getting over your fund-raising hartals just like non-profit radio, toni talks to leading thinkers, experts and cool people with great ideas. As one fan said, tony picks their brains and i don’t have to leave my office fund-raising fundamentals was recently dubbed the most helpful non-profit podcast you have ever heard, you can also join the conversation on facebook, where you can ask questions before or after the show. The guests were there, too. Get insider show alerts by email, tony tells you who’s on each week and always includes link so that you can contact guess directly. To sign up, visit the facebook page for tony martignetti dot com. I’m peter shankman, author of zombie loyalists, and you’re listening to tony martignetti non-profit radio. Big non-profit ideas for the other ninety five percent. Welcome back to big non-profit ideas for the other ninety five percent um, jean, i’m thinking this is goingto take some time to to implement and, uh, before you start to reap benefits from it, if you if you do it’s not you, you’re not going to see this immediately. The advantages? Yeah, you know, i think it’s going to take an investment on depending upon what level of shared leadership you’re talking about co ceos is probably the a fairly simple level, relatively speaking of shared leadership, but yeah, it’s going to require an investment, it may take a failure, teo, actually get it going the way you want it. So there’s definitely a lot of learning. It relies on it, you know, having a shared vision and common values amongst the shared leaders on if you don’t have that established, you really shouldn’t do this. You have to be careful of the amount of money, time and other resource is that you’re going to have to invest because that’s all got to be budgeted in if you don’t incubated and invested and nurture it, it means it’s probably not going to work. We’re also gonna need a lot. Of patients among our staff. Yeah, yeah, i think that’s absolutely, absolutely right. You run the risk of having that go to mom, go to pop kind of run things, right? Good cop, bad cop. Yes, right. Somebody’s, thie other ones said this, but i said no. So i’m coming to you, right? Right? You got to beat that stuff down. All right? Interesting let’s go to one that i want to make sure we spend enough time on this. To me, it sounds like anarchy, but you’ve said your organization you’re on the board of is doing some of this. The pro you call it program autonomy is what is that? So the general idea and they’re different forms of this, but this this is on the other end of the spectrum of complexity. So this is a complex form of shared leadership where each program or each division oven organization is fairly autonomous, so doesn’t all rely upon going to the ceo on the ceo makes the final decision. Each group within the organization which might be divided into programs, will make their own decisions now don’t know, probably be working with the budget that’s been approved by the board on then segregated out into the different programs. So they know what the operating rules are within within their group. But figuring out how to distribute the leadership and that’s the one of the buzzwords, sum, sum. Avoiding drug in jail again, it’s. Really just distributing the leadership amongst the different programs or the different groups within the organization and there’s. One particular type of model that i mentioned earlier, which i should have waited until we got to this segment. That’s called holacracy on dh. That is a particular form of distributed leadership, where the different groups that that are taking on these local decision making authority rolls are called circles. No, james, no, jane. Yeah. Can you still hear me? Yes, i hear you. Okay, last thing we heard you say was holacracy is made up of circles, but you need to explain. Yeah, so you know, generally the way holacracy works is so it’s a form of program autonomy, although again, the circles or self managed groups don’t necessarily have to be divided into a program that could be divided into function. So there might be one for fund-raising for service delivery, for grants, for events, for public communications. So however, you decide you want to divide up the circles, it’s going to be an iterative process where you’re always modifying it. So every month you’re going to consider whether you should have the same circles or different circles, and each individual is actually going to take a role with multiple circles, and in some cases they’ll be the leader of a circle that’s going to help decision making and help facilitate that circle or that group of individuals within that circle to make a decision. And in other circles they may not be see that that leader on dh, so they’ll just be part of the group that makes the decision making, and they might be on three or four, five circles depending upon what their skills are. All right, this is anarchy to me, but you’re saying it works a compass point, it weaves we’ve tried it for maybe a year and a half, and we’ve decided to modify it so we’re keeping aspects of it. But we’re not keeping the whole thing, so you’re anarchists of anarchy. You can’t even follow the anarchic model of program autonomy. Okay, well non-profits pride themselves on their ability to experiment and hopefully do yes, alright, yeah. So who is but who’s orchestrating the overall? I mean, there’s got to be, doesn’t there? Well, i’m i’m answering my question, but better ask it as a question, doesn’t there need to be one or maybe two people if the co ceos overseeing the coordination of all these pola craddick circles yeah, there, you know, so it’s it’s, largely governed by two principles, one is you’ve got the law on the latto has the board of directors on top of the organizational hierarchy and does require a ceo in most states, or or a president that that’s going to be ultimately in. Charge however, they’re going to be a set of rules and systems, and this has to be very transparent and holacracy so you’re not leaving everybody to go. I don’t know who to go, teo, you know, maybe i’ll ask this person so in holacracy there’s a large set of rules that everybody knows and everybody has to abide by, including the ceo and that’s where how the different relationships between the circles are all codified and how the decision making goes from one circle to another. But ultimately again, it would be a non non-profit corporations you have a board of directors and ceo have to oversee the whole thing and can decide how to modify accordingly. Okay, maybe something for listeners toe look at program autonomy, let’s say i wanted to jump to the most complex one because i want to make sure enough time sometimes our talk at the end, our topics at the end get cut off a little bit. I don’t want that to happen with program autonomy and the holacracy pola craddick circles still feels very crystal lee to me, i don’t know dahna all right, let’s, go to we just have about two. Minutes left explain how the ceo and the board might be the leadership share well for small organizations that particularly all volunteer organizations it’s usually all hands on deck, right? The board is completely active in running the programs of the organization as well as just doing their regular board duty. So, you know, you got the ceo because somebody has to be ceo of a corporation that might be called president or chair of the board, but somebody has got to be identified in that way, and what their decision making authority is going to be will depend upon what the board wants to give to that position, but board make decisions board takes actions on lee at meetings or by written consent, so whenever individuals are actually running programs, they’re not running them as board members. They’re running them of volunteers with certain delegated authority. And what the board has to really be careful of is that they’re making sure that they’re delegating authority for somebody to run an event or somebody to run a specific program there delegating with due care, meaning that they’re not quitting somebody who would be totally unqualified and in experience latto lead. Something of importance to the organization because if it is, gets into trouble, you know, the board could be held for violating the produce very duty’s not exercising reasonable care in making that delegation, and they can’t just say, well, that was another board members, i couldn’t tell them what to do. That’s not the case. Yeah, yeah. Ok, i see. I see i see a greater responsibility and risk for for the board under this one, but it makes sense. I mean, they’re taking a more active role in the leadership of the organization. That’s, right? So that’s, that’s very much shared leadership where all board members see themselves as equal, but when they’re exercising roles that are different from meeting at boards and taking actions like approving contracts are approving, you know, the by-laws there acting as volunteers, so they have to realize that they’re wearing a different hat and the authority has to be properly delegated. We’re gonna leave it there. Jim takagi from ah hotel in los angeles managing attorney of neo and you’ll find him at g tak neos, the non-profit and exempt organizations law group. Thanks so much, gene. Thanks. Have a great day. I pleasure. Thank you. Next week, diane lettered returns with your grants team in and out. If you missed any part of today’s show, i’d be seat. You find it on tony martignetti dot com, responsive by pursuing online tools for small and midsize non-profits data driven and technology enabled, and by we be spelling supercool spelling bee fundraisers, we b e spelling, dot com, our creative producers, claire meyerhoff. Sam liebowitz is the line producer. Betty mcardle is our am and fm outreach director. The show’s social media is by susan chavez, and this cool music is by scots. Time you with me next week for non-profit radio big non-profit ideas for the other ninety five percent go out and be great. What’s not to love about non-profit radio tony gets the best guests check this out from seth godin this’s the first revolution since tv nineteen fifty and henry ford nineteen twenty it’s the revolution of our lifetime here’s a smart, simple idea from craigslist founder craig newmark insights orn presentation or anything? People don’t really need the fancy stuff they need something which is simple and fast. When’s the best time to post on facebook facebook’s andrew noise nose at traffic is at an all time hyre on nine a, m or p m so that’s, when you should be posting your most meaningful post here’s aria finger ceo of do something dot or ge young people are not going to be involved in social change if it’s boring and they don’t see the impact of what they’re doing. So you got to make it fun and applicable to these young people look so otherwise a fifteen and sixteen year old they have better things to do if they have xbox, they have tv, they have their cell phones me dar is the founder of idealist took two or three years for foundation staff to sort of dane toe add an email address their card, it was like it was phone. This email thing is fired-up that’s, why should i give it away? Charles best founded donors choose dot or ge somehow they’ve gotten in touch kind of off line as it were and and no two exchanges of brownies and visits and physical gift mark echo is the founder and ceo of eco enterprises. You may be wearing his hoodies and shirts. Tony talked to him. Yeah, you know, i just i’m a big believer that’s, not what you make in life. It zoho, you know, tell you make people feel this is public radio host majora carter. Innovation is in the power of understanding that you don’t just put money on a situation expected to hell. You put money in a situation and invested and expected to grow and savvy advice for success from eric sabiston. What separates those who achieve from those who do not is in direct proportion to one’s ability to ask others for help. The smartest experts and leading thinkers air on tony martignetti non-profit radio big non-profit ideas for the other ninety five percent.

Nonprofit Radio for November 2, 2012: Grow Your Grateful Patient Program & Disaster Relief

Big Nonprofit Ideas for the Other 95%

Listen live or archive:

Tony’s Guests:

Interviewing Nancy Johnson and Bill McGinley at bbcon 2012
Nancy Johnson & Bill McGinley: Grow Your Grateful Patient Program

Bill McGinley, president and CEO of The Association for Healthcare Philanthropy (AHP) and Nancy Johnson, senior consultant at Target Analytics, sat with me at the bbcon conference to talk about healthcare grateful patient fundraising: why these prospects are critical and very generous; privacy concerns; and, how to start the relationship.

 

 

Gene Takagi & Emily Chan
Gene Takagi & Emily Chan: Disaster Relief

Charities want to help Hurricane Sandy victims. In the rush to help you can’t ignore the rules around private benefit, needs assessment and documentation. You’ll be on the right path with our regular legal contributors Gene Takagi and Emily Chan, from the Nonprofit & Exempt Organizations Law Group.

 


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