Nonprofit Finance Fund

For the 2.9 million New Yorkers who live in poverty, community-based organizations address many of their health needs, including substance use treatment, behavioral health, food security, and supportive housing.

Many health care delivery systems partner with community-based organizations to offer these types of services to their patients and members. However, community-based organizations often are not well equipped to negotiate appropriate contracts and consequently can end up with inadequate funding to support their work. In 2019, NYHealth awarded the Nonprofit Finance Fund (NFF) a grant to help community-based organizations to partner and align more effectively with health care payers, improve health outcomes and equity, and sustain critical services for vulnerable New Yorkers.

Under this grant, NFF partnered with United Neighborhood Houses—one of the largest human services systems in New York City, representing 42 settlement houses—to negotiate more sustainable contracts with health care delivery systems. Settlement houses are neighborhood-based social services organizations with strong connections to high-need communities that provide a variety of wraparound services focused on social determinants such as education, physical environment, and access to health care services. Through this partnership, NFF helped settlement houses understand the full costs of their wraparound services to better prepare them for contract negotiations. NFF provided settlement houses with financial literacy education to help ensure their long-term sustainability and ability to deliver high-quality services to vulnerable New Yorkers. NFF convened leadership from each settlement house to conduct interviews and gather information on their financial and programmatic needs. Based on their feedback, NFF developed a training curriculum to help participants build capacity and create a forum for peer learning and exchanging of ideas. NFF then built a user-friendly cost allocation model reflecting the typical business model of a settlement house, which participants can use to gauge the full cost of providing services. NFF also conducted a full-cost analysis of the components that settlement houses need for sustainable service delivery (read accompanying blog). Together, these resources helped settlement houses identify the best services to be delivered, scaled, and replicated on a financially sustainable and adaptable basis. Coaching and group training were offered to finance and leadership teams on how to use these resources effectively. NFF shared learnings with United Neighborhood Houses’ network and other networks across New York State on how to negotiate pricing with health care organizations.