The Cameron School of Business

The Cameron School of Business – University of St. Thomas

September 9, 2016


Contact Information:


Ted Hanley – (409) 682 6218 or thanley@jessetree.net

David Mitchell - (409) 599 4847 or dmitchel@jessetree.net

Rosa L. Salinas – (409) 762 2233 or rsalinas@jessetree.net

Questions from the Students:

Thanks for your challenging and insightful questions! Here is an initial packet of information that will be helpful as we begin the creative process of finding financial leadership and stability for The Jesse Tree. Some of these will directly answer your questions and others will require subsequent information, charts and financial information. We are at your service!

  • We are open to any and all suggestions to improve the operation and sustainability of The Jesse Tree; the processes and activities will be described in detail for your evaluation; reverse engineering, new approaches and techniques that improve sustainability are welcomed.
  • The Jesse Tree is designated as a 501c3, non-profit organization under the IRS. As such, it can receive donations, provide charitable care and benefit from being able to offer its donors receipts for their contributions. However, it must operate within the guidelines of its IRS designation.
    • Board Development is critical to sustaining the organization. The addition of Advisory Boards (perhaps one for each program/project) has been suggested.
    • The IRS requires a 990 form filed for each 501c3 organization annually; in addition, we have had annual audits performed by a CPA.
    • It has been suggested that The Jesse Tree form a companion "for profit" structure under which some aspects of the work can generate fees, etc.
  • Identifying leadership roles going forward will be critical to sustainability; we are open to whatever changes will inspire and support sustainability;
    • Develop job descriptions that attract quality personnel with appropriate skill sets;
    • Creative places to advertise for potential candidates
  • We will focus on the following Programs/Activities for this particular Project:
    • Patient Discharge Network Planning, which includes:
      • The Health Equipment Loan Program (HELP) and Medical Supplies
      • The Best Cost Formulary – Prescription Assistance Program
      • Health Education and Chronic Conditions Management Classes
      • Integrated Resource Coordination and Case Management
        • Screening, Triage, Enrollment Portfolio, Application, Planning
        • Currently using Efforts to Outcomes Software (ETO)
        • Unveiling the "APP" in September 2016
  • We will provide detailed cost-processing for each activity; attached you will find the expense/revenue report for the month of July 2016 detailing income/expense. Happy to answer any questions.
  • We welcome you to visit our offices or attend any activities or events. We will provide a calendar or you can contact us individually.
  • Fund and Resource Development:
    • Grant Writing
    • Fundraising
    • Developing regular network of donors
    • In-Kind Contributions and Volunteer labor
      • We will provide a budget of actual and in-kind
    • Generating Revenue from Programs/Activities and the newly developed "APP"

Suggestions from Tony:

Clear/Narrow Focus and Value Proposition:

  • Galveston County has a disproportionate number of uninsured residents
    • 30-40 % as compared to states with 7 – 10% who actively participate in Affordable HealthCare
    • 25% of those eligible for Medicare and Medicaid live in poverty limiting their benefit from healthcare;
    • By law, all hospitals must admit some uninsured patients causing them to incur enormous costs that are not reimbursable;
    • The Jesse Tree's Patient Discharge Network Planning Program responds to this by locating resources that shorten the hospital stay; connects the patient to on-going supportive care; locates or provides prescriptions and other medical supplies that immediately improve the patients ability to get well and provides case-management, education and support that reduces re-hospitalization and unnecessary use of the emergency room.
  • Although The Jesse Tree has several diverse programs/activities in place, for the purposes of this project we will focus on:
    • Patient Discharge Network Planning, which includes:
      • The Health Equipment Loan Program (HELP) and Medical Supplies
      • The Best Cost Formulary – Prescription Assistance Program
      • Health Education and Chronic Conditions Management Classes
      • Integrated Resource Coordination and Case Management
        • Screening, Triage, Enrollment Portfolio, Application, Planning
        • Currently using Efforts to Outcomes Software (ETO)
        • Unveiling the "APP" in September 2016
  • Business Plan for introducing "APP" to other organizations:
    • Identify Target Organizations:
      • Medical
        • Mainland Medical Center
        • Clear Lake Regional Medical Center
        • Shriner's Burns Institute
        • Galveston County Health District
        • ADA Women's Center
      • Ministerial
        • Greater Saint Matthew's Church, Hitchcock
        • Spirit and Truth Center, Webster
        • New Life, Galveston
        • Dickinson Ministerial Alliance, Dickinson
      • Social Service
        • Galveston United Way
        • Mainland United Way
        • The Children's Center
      • Other

What does The Jesse Tree "APP" offer them?

How will they benefit from a partnership with The Jesse Tree and using the APP?

What can we offer them?

How much will it save them and how?

How much will it cost?

Five transformative aspects of the APP:

  • Improved visibility of the organization (better marketing, more awareness, more visitors) by focusing on the domain and the marketing aspects
  • Better usability of the material you're offering. Visitors can find information more efficiently inside of the system to help or guide them to what they need
  • Internal improvements. The app should manage a good degree of the repetition when you're suggesting resources to patients, visitors and even employees. As people learn the system and visit the site more, your team may be able to spend less time suggesting the same things and more time on higher level tasks.
  • The Jesse Tree is ultimately a better, more valuable resource using the app. Technology allows for the Jesse Tree to offer a more diverse service and solution to more people.
  • Potential to scale. Now that the system is built, the Jesse Tree can scale by using it to train other trainers in more location, and facilitate more partnerships that they may not have been able to handle prior.

Additional Suggestions:

  • Reflect all on updated Website
  • Advertise and display transformative qualities of The App
  • Invite applicants to apply for training/downloading, etc.
  • Attract candidates for employment (post positions/job descriptions, etc.)
  • Attract Volunteers
  • Inspire Donors: individuals, charities, businesses
  • Inspire fundraising
  • Forward website to networks of funding organizations, businesses, churches, etc.

A Case Study:

An uninsured, unemployed patient is admitted to Mainland Medical Center through the Emergency Room; His unemployment is directly related to his health condition, which includes severe diabetes accompanied by depression and other complication resulting from poverty and lack of medical care (patient did not know where to find affordable primary care); patient lives alone with no family network; is now medically stable, but cannot leave the hospital without meeting several critical requirements, such as needing a wheelchair, fourteen prescriptions and other supportive resources;

Jesse Tree visits hospital and meets with patient, physician and case managers; Develops a four-part plan which includes immediate, short-term, long-term and adherence planning.

Jesse Tree Response:

  • Thorough screening and assessment to determine eligibility
  • Establish Medical Support Network
    • Enrollment in Primary Medical Care Provider (Galveston County Clinic) with education about avoiding use of the emergency room through early intervention; regular check-ups, etc.
    • Enroll in Diabetes Management Classes
    • Obtain Prescriptions
    • Provide Durable Medical Equipment and Medical Supplies
  • Establish Social Service Network
    • Food/Nutrition, household needs, hygiene, etc
    • Transportation
    • Financial Assistance – assistance with bills, temporary disability, etc.
  • Case Management and Resource Coordination

Cost Analysis

  • Mainland Medical Center invested $310,000 in emergency room, intensive care and hospitalization, medical/nursing staff, pharmaceutical, specialists (PT, OT, etc) to treat and stabilize this patient; average daily cost of nearly $15,000 per day for twenty-one days; present cost is $3,500 per day awaiting discharge;
  • Challenge: patient must have hospital bed at home, wheelchair, adaptive equipment, prescriptions, etc
  • Jesse Tree creates, plan, makes connections; provides durable medical equipment (DME); reduces discharge process by five days, plus the additional support reduces the likelihood of re-hospitalization.

The Jesse Tree, Inc Profit & Loss July 2016

Ordinary Income/Expense
  Income  
  Direct Public Support  
  Business Contributions 9,167.43
  Church 1,650.00
  Business Contributions 40.00
  Individual Contributions 42,531.00
Net Ordinary Income    
Net Income    
Public Support   53,388.43
Total Income   53,366.43
Expense    
  Benefits to Individuals  
  DA – Food 390.87
  DA - Medical Drugs/Need 495.34
  DA – Other 439.37
  DA - Rents/Deposits/Shelter  
  DA - Transportation  
  DA – Utilities  
Total Benefits to Individuals   1,545.58
Contract Services    
  Accounting Fees  
  Contract Labor 3,540.00
  Contract Services 15,000.00
Total Contract Services   18,540.00
Facilities and Equipment    
  Rent, Parking, Utilities 925.01
  Reoairs/Maintenance 1,493.28
  Software Maintenance 971.25
Total Facilities and Equipment   3,389.54
Operations    
  Supplies/Advertising 450.00
  Telephone, Telecommunications 456.45
Total Operations   1,996.78
Other Types of Expenses    
  Automobile – Gas 456.45
  Service Charge 13.00
  Cash Handling Fee 25.00
  Insurance-Auto 352.45
  Insurance-Health 270.00
  Insurance – Health 825.00
  Meals and Entertainment 155.62
Total Other Types of Expenses   1.996.78
Payroll Expenses    
  Payroll Fees 219.08
  Payroll Taxes 1,741.43
  Wages 22,055.00
Total Payroll Expenses   24,015.51
Total Expense   50,393.86
Net Ordinary Income   2,994.57
Net Income   2,994.57

Questions and Notes: