Under health reform legislation, community health centers were to have received $11 billion over five years to expand their capacity to care for the 32 million people who will be newly insured as of 2014. However, federal budget deals have effectively gutted the expansion allocation for 2011 – and 2012 is looking equally grim. With just three short years to prepare for a dramatic increase in demand, community health centers can no longer be certain of the funding necessary to build or upgrade facilities, or to hire additional staff, to ensure that the millions of newly insured have a place to go.

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AbilityFirst is a Southern California nonprofit serving people with developmental disabilities.   They came to La Piana Consulting at the height of the Great Recession in 2009 in order to think about strategies for responding to economic change.  Our Real-Time Strategic Planning (RTSP) process was a perfect fit for their needs because they wanted to know how to make good decisions in the face of change, and RTSP focuses on creating a Strategy Screen—or list of criteria—to guide decision making.

The challenge: the state of California provided approximately 50% of AbilityFirst’s funding either directly or indirectly—and the state was in the throes of a major budget crisis.  The last state budget process had resulted in significant cuts to state funded services, and the prospect for additional major cuts in coming years was certain.  AbilityFirst knew they had to be prepared to survive these cuts.

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