1. Trends & Tips for Diversifying Funding Streams: A Closer Look at Healthcare, Independent Living, Aging, Vocational Rehabilitation, Veterans, and/or Public Education Collaborations Joy Kniskern, Pass It On Center Chris Brand, FODAC Cathy Valdez, Project Mend Helen Baker, STAR Program

2. Learn three tips to leverage funding for your reuse program. Identify the components of the Calculation of an Approximate Value of Investment in Assistive Technology Reuse (CAVIAR) as a tool to calculate costs, benefits and ROI for AT reuse programs. Learn how two programs – FODAC and Project Mend diversified their funding to strengthen and expand services. Learn marketing tips and strategies from Alabama’s STAR Program.

3. Three tips for leveraging funds for reuse: Know the pain points of your state partners concerning DME and AT Build your business case for Return on Investment (ROI) for your reuse program Use the data to tell your story, tell it well, and tell it.

4. CAVIAR: An ROI Tool to Promote Funding of AT Reuse Programs Joy Kniskern, Pass It On Center August 31, 2015 4

5. Moving beyond anecdotal evidence to make the business case for reuse The beginning: tracking volumes and equipment values Adding business analysis: return on investment (ROI) Considering the value of avoided outcomes Calculating societal impacts Working toward a more comprehensive calculation

6. BASIC: R euse programs track  Number of usable devices donated  Value of donated devices based on MSRP or some percentage thereof  Number of devices reassigned  Number of individuals served  Value of reassigned AT  Most helpful tool: a good inventory system with flexible reporting capabilities (Kansas, Paraquad, Project MEND and others)

7. Using business analysis  Kansas led the way in recommending that programs apply a standard business practice and calculate Return on Investment.  This calculation requires only the total program expenses and the value of equipment made available for reuse.  Calculation: Divide NET value (value of reused equipment minus total program expenses) by expenses to derive return percentage or return for each dollar invested.

8. Example of simple ROI….. Application of business model of return-on- investment analysis to Kansas AT reuse program in 2010: ROI: (Value of donated equipment minus program expenses) divided by program expenses Example: $960,004 - $271,487 = $668,517 divided by $271,487 = 2.46 or a return of $2.46 for each dollar invested

9. ROI is a useful tool for: 1.Making program decisions:  pickup and delivery,  shipping,  collection drives,  methods of cleaning and sanitization (volunteers, paid staff, contractor, purchase of sanitizing equipment ) 2.Measuring the impact of the use of taxes, public and private donations, and foundation support for reuse.

10. Volume tracking (donations, devices assigned, value of donated devices) – AT Act Programs Use of business tools, from cost- benefit to ROI analysis (Kansas) Calculation of avoided costs (e.g., lost work time avoided, healthcare expenses avoided, environmental impact minimized) based on customer follow-up: FREE Foundation/VATS Combining those and more to identify a more accurate calculation of the financial impact of reuse We need to show the real value of AT reuse!

11. Proposing a more comprehensive calculation of value CAVIAR 1.Sum values 2.Subtract program expenses 3.Divide result by program expenses Improved ROI KS: ROI VA KS, GA VA PIOC

12. T Compiling Values for CAVIAR  Value of Reusable AT  Track value of donated AT devices in a standardized manner (e.g., MSRP or a percentage)  Value of Prevention  Use specific healthcare costs for customer population  Collect survey data to show avoided expenditures

13. Compiling Values for CAVIAR  Value of Reusable AT  Track value of donated AT devices in a standardized manner (e.g., MSRP or a percentage)  Value of Prevention  Use specific healthcare costs for customer population  Collect survey data to show avoided expenditures

14. Compiling values for CAVIAR, cont.’  Value of Environmental Impact Savings  Track the weight (use some standard tables for simplicity and ease of calculation) of AT diverted from landfill (that is, reused)  Determine cost (per ton) of landfill disposal in program area  Economic Value of Work  Determine number of lost work days avoided  Use minimum wage for the state or use federal poverty guideline to be conservative

15. Identifying avoidable societal impact What other costs does reuse of AT avoid?  Lost income due to missed work for customer or caregiver  Landfill costs for disposal

16. Calculating Environmental Impact Determine average weight of items kept from landfills Identify landfill costs in your area Calculate savings for tonnage kept from landfills Add the landfill savings to the value

17. Original ROI Using only the value of the donated equipment: FY 2011 data resulted in a Return on Investment (ROI) of $3.49 for each dollar invested. Adding conservative avoided healthcare costs For FY 2011, assuming that only one percent of Kansans who received DME delayed or avoided a move to assisted living (versus 8% in found in Virginia), the ROI increased to $4.13 for every dollar invested. 17 Recalculating for Kansas

18. Analysis of Cost Savings For every 100 persons served:  26 hospital stays were avoided. 26 (average 5 days x $1,149) = $149,370  29 Emergency Room visits were avoided. 29 x $1,896 = $54,984  11 moves to skilled nursing facilities were avoided. 11 (average 50 days) x $10,150 = $111,650  11 moves to assisted living facilities were avoided. 11 (average stay 50 days) x $4,879 = $53,669  112 falls were avoided (1 in 4 falls results in doctor’s visit) 28 x $155 (average cost doctor’s visit ) = $4,340  16 family members avoided quitting jobs to stay home and care for recipients. 16 x $5,723 = $91,573 TOTAL SAVINGS FOR EACH 100 PERSONS SERVED: $465,586 18

19. Calculating the costs  Average cost of ER visit = $1,896  Typical doctor’s visit = $155  Average daily cost of hospital stay = $1,149  (Typical stay is five days = $5,745.)  Average annual of cost of stay in SNF = $74,095  (Average stay for recovery is 50 days = $10,150.)  Average annual cost of stay in ALF = $35,616.  (Average stay for recovery is 50 days = $4,879.)  Financial impact of a job loss to a family of three at the poverty level = $17,170. 19

20. Questions?

21. Joy KniskernJoy@passitoncenter.orgJoy@passitoncenter.org Carolyn PhillipsCarolyn@passitoncenter.orgCarolyn@passitoncenter.org Liz PersaudLiz@passitoncenter.orgLiz@passitoncenter.org Trish RedmonTrish@passitoncenter.orgTrish@passitoncenter.org DISCLAIMER Pass It On Center is supported under cooperative agreement #H235V060016 awarded by the U.S. Department of Education, Office of Special Education and Rehabilitative Services, and is administered by Tools for Life, Georgia’s Assistive Technology Act Program, a program of AMAC Accessibility Solutions of The Georgia Institute for Technology (Georgia Tech.) However, the contents of this publication do not necessarily represent the policy or opinions of the Department of Education or Georgia Tech, and the reader should not assume endorsements of this document by the Federal government or Georgia Tech.