Study Reports Up to Half in US Impacted by Pre-existing Conditions for Health Insurance Coverage

http://www.msnbc.com/ reported on a study that as many 129 million Americans at risk of being rejected for insurance coverage or having to pay more.

As many as 129 million Americans under age 65 have medical problems putting them at risk of being rejected by insurance companies or having to pay more for coverage, according to a U.S. government study reported by the Washington Post on Tuesday.

The Department of Health and Human Services is scheduled to release the study on Tuesday, the Post said, the same day the House of Representatives is expected to begin considering a Republican bill to repeal President Barack Obama's healthcare overall.

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..The report is part of the Obama administration's effort to convince the public of the advantages of the law, which contains insurance protections for people with pre-existing medical conditions.

"Americans living with pre-existing conditions are being freed from discrimination in order to get the health coverage they need," HHS Secretary Kathleen Sebelius said in a statement to be released Tuesday, the Post reported.

The study found that one-fifth to one-half of non-elderly people in the United States have conditions that trigger rejection or higher prices in the individual insurance market, the Post said. They range from cancer to chronic illnesses such as heart disease, asthma and high blood pressure.

A Republican House aide, speaking on condition of anonymity because the report was not yet public, told the Post: "When a new analysis is released on the eve of a vote in Congress, it's hard to view it as anything but politics and public relations."

The repeal vote would fulfil a campaign promise of Republicans who won control of the House in November elections. But the measure will likely die in the Senate, where Democrats held on to their majority.

Charities Seeing Slight Recovery in Giving, But Not Enough to Keep Up with Demand or Budget Cuts

Nonprofit organizations have seen a slight turnaround in giving so far this year that mirrors the slow economic recovery, a new survey from the Nonprofit Research Collaborative (NRC) finds. But the small rebound hasn't been enough to help many nonprofits that are grappling with staff and service cuts even as demand for their services has increased.

The national survey showed that 36 percent of charities reported an increase in donations in the first nine months of 2010, compared with only 23 percent in the same period of 2009.

Thirty-seven percent of charities reported a decrease in giving, a dramatic change from 2009's 51 percent. Among those experiencing a decline in giving, the main reason cited was fewer individual donations and smaller amounts. Lower amounts received from foundations and corporations also contributed to the overall lower giving amounts at these charities. Giving remained unchanged at 26 percent of nonprofits in 2010 vs. 25 percent in 2009.

"We are beginning to see some positive signs, but despite that giving still has a long way to go to return to the levels it was at three or four years ago," said Patrick M. Rooney, executive director of the Center on Philanthropy at Indiana University, which spearheaded the collaboration. "One-fifth of charities in the survey said their budgets for 2011 will be lower than for 2010, forcing many of them to look at cuts in services, salaries and staff."

Among the 20 percent of nonprofits anticipating reduced budgets next year, 66 percent say they will have to reduce programs, services or operating hours, 59 percent expect to cut or freeze staff salaries or benefits, and 49 percent are planning layoffs or hiring freezes.

"The Nonprofit Fundraising Survey: November 2010" is the first product of a collaboration involving six organizations that serve the nonprofit sector: the Association of Fundraising Professionals, Blackbaud, the Center on Philanthropy at Indiana University, the Foundation Center, GuideStar USA Inc., and the Urban Institute's National Center for Charitable Statistics.

"For the first time in two years, there is cause for cautious optimism about the nonprofit sector in this economy," said Bob Ottenhoff, president and CEO of GuideStar. "Nonetheless, in this latest study, as in all prior years, nonprofits also are reporting increased demand for their services. Even as giving increases, philanthropic dollars fall short of the amounts needed to help people in our country and abroad."

Demand for services increased at 78 percent of human service nonprofits and 68 percent of charities overall in 2010. Charities will be hard-pressed in 2011 to secure funding for growing needs, especially as individual and foundation donors are cautious about boosting support and other sources of funding — including government contracts for services — are cut.

"Younger, less well-established nonprofits have been especially hard hit by the recession," noted Lawrence T. McGill, vice president for research at the Foundation Center. "Many foundations, seeking to maximize more limited resources, have steered their grantmaking toward organizations they believe have the best chance to weather the economic storm."

Other Key NRC Survey Findings:

• In four of eight subsectors, the share of organizations reporting an increase in contributions was about the same as the share reporting a decrease. The four with nearly equal percentages of organizations with giving up and giving down are: arts, education, environment/animals, and human services.
• International organizations were the most likely to report an increase in contributions, reflecting donations made for disaster relief.
• In three subsectors — health, public-society benefit, and religion — a larger share of the organizations reported declines than reported increases.
• The larger an organization's annual expenditures, the more likely it reported an increase in charitable receipts in the first nine months of 2010 compared with the same period in 2009.
• Most organizations were guardedly optimistic about 2011. Forty-seven percent plan budget increases, 33 percent expect to maintain their current level of expenditures, and 20 percent anticipate a lower budget for 2011.

The Collaborative and Survey Methodology

By working together, the Nonprofit Research Collaborative can reduce the number of surveys nonprofits are asked to complete, collect information more efficiently, and analyze it in more useful ways to create the benchmarks and trends that nonprofits and grant makers use to guide their work. Each partner has at least a decade of direct experience collecting information from nonprofits on charitable receipts, fundraising practices, and/or grantmaking activities. Survey participants will form a panel over time, allowing for trend comparisons among the same organizations. This approach provides more useful benchmarking information than repeated cross-sectional studies.

The first NRC survey, based on questions that GuideStar used for its annual economic surveys, was fielded between October 19 and November 3, 2010. It received 2,513 responses. More than 2,350 charities completed the questions, as did 163 foundations. The analysis for grant makers includes responses from charities that make grants but that are not foundations. These include United Ways, Jewish federations, congregations, and a number of other types of organizations. There were responses from 386 grant makers.

The respondents form a convenience sample. There is no margin of error or measure of statistical significance using this sampling technique, as it is not a random sample of the population studied. However, given the long-running nature of GuideStar's economic surveys and the strong relationship between findings in those studies in prior years and actual results once tax data about charitable giving are available, the method employed here is a useful barometer of what charities experience and what total giving will look like. In the future, the NRC surveys are expected to occur in early winter, spring, and fall every year.

"The Nonprofit Fundraising Survey: November 2010" (PDF), which includes responses broken down by types of nonprofits and budget size, can be downloaded at no charge from the Gain Knowledge area of the Foundation Center's web site.

Nonprofits Seek Increased Support for Advocacy

Supporting a cause is central to the mission of most nonprofit organizations in the United States, but a lack of resources often forces lobbying and advocacy to the backburner, according to a roundtable of leaders and experts gathered by the Johns Hopkins University Nonprofit Listening Post Project.

Besides having limited funds and small staffs to devote to lobbying, nonprofit leaders also worry that taking strong stances on the issues will offend their donors and board members.

"Nonprofits are supposed to be the agents of democracy and give voice to the powerless," noted Lester M. Salamon, director of the Center for Civil Society Studies at the Johns Hopkins Institute for Policy Studies. "But their ability to do this is hampered by limited funding."

The roundtable brought together experts in nonprofit advocacy and practitioners representing both service organizations and intermediary organizations. Participants explored nonprofit involvement in the policy process and identified steps that might be taken to boost the scope, scale, and effectiveness of policy advocacy.

Issues raised by roundtable participants included:

• A lack of funding for nonprofit advocacy and lobbying efforts.
• Concerns among nonprofits that policy advocacy efforts would be frowned upon by their local community, offend their donor base, or encounter board disapproval.
• The need to strengthen and underwrite the activities of advocacy coalitions and intermediary groups, which are increasingly important in nonprofit advocacy efforts.
• Concerns that while nonprofits can be somewhat effective in "playing defense" by responding to a proposed policy or legislative cut, they often lack the resources or sophistication needed to develop new policy proposals.

Participants also identified steps that might be taken to boost nonprofit policy advocacy including:

• Taking a more strategic and inventive approach to advocacy by encouraging board members to tap into their own social networks or by bringing the people organizations serve directly into lobbying efforts to build greater credibility.
• Integrate advocacy into all aspects of an organization by including it in mission statements, strategic plans, staff job descriptions, board job descriptions and budgets.
• Encourage foundations to support nonprofit policy advocacy and invest in local, state, and national nonprofit advocacy coalitions and intermediary organizations.
• Learn to act strategically and build long-term positive relationships between nonprofits and government officials.
• Rely on a wide range of tools, not just e-mail but also blogs and social networking sites such as Facebook.
• Educate legislators and the public about the nonprofit sector's critical role in public service and advocacy in order to build recognition of the value of engaging nonprofit organizations in the policy arena.

A survey conducted by the Listening Post Project in 2007 found that:

• 85 percent of responding organizations spent less than 2 percent of their budget on advocacy or lobbying.
• Nearly three-fourths of all responding organizations reported undertaking some form of advocacy or lobbying, such as signing correspondence to a public official.
• However, when it came to more involved forms of participation, such as testifying at hearings or organizing a public event, the proportions reporting any involvement fell to about a third.
• The vast majority (90 percent) of surveyed organizations agreed that "nonprofits have a duty to advocate for policies important to their missions;" a comparable proportion also agreed that organizations like their own should be "more active and involved."

The full text of a report summarizing findings that emerged from the "Roundtable on Nonprofit Advocacy and Lobbying" is available at http://www.jhu.edu/listeningpost/news.

The Listening Post Project is a collaborative undertaking of the Center for Civil Society Studies at the Johns Hopkins University Institute for Policy Studies, the Alliance for Children and Families, the Alliance for Nonprofit Management, the American Association of Homes and Services for the Aging, the American Association of Museums, Community Action Partnership, the League of American Orchestras, Lutheran Services in America, the Michigan Nonprofit Association, the National Council of Nonprofits, and United Neighborhood Centers of America. Its goal is to monitor the health of the nation's nonprofit organizations and assess how nonprofits are responding to important economic and policy changes. The project maintains a nationwide sample of over 1,000 nonprofit children and family service, elderly service, community development, and arts organizations. Support for the project has been provided by the Carnegie Corporation of New York, the Bill and Melinda Gates Foundation, the Ewing Marion Kauffman Foundation, the Kresge Foundation, the Charles Stewart Mott Foundation, the Rockefeller Brothers Fund, and the Surdna Foundation.

Most New Yorkers back health-care reform in Siena survey

The Central NY Business Journal reported that nearly three-quarters of New Yorkers believe health-care reform is long overdue, but respondents are split over whether current proposals will adequately address the problem.

That's according to a special survey on health care and personal finances the Siena (College) Research Institute (SRI) released today.

When asked to consider the current proposals, 35 percent of respondents supported the plan, 26 percent opposed it, and 39 percent said they needed more information.

In the survey, SRI asked respondents to consider the effect of a government insurance option on private insurers, the potential impact on senior citizens, and the affordability and quality of reform based on current proposals.

Nearly 80 percent of respondents have either been paying a great deal or some attention to the national debate over health-care reform, according to SRI.

At the same time, the survey's 538 respondents continued having concerns over the economy.
One of every seven New York households saw a family member lose a job or had the need for their work eliminated over the last six months, the survey found.

In addition, less than 40 percent of state residents have been able to save money for retirement over the last six months, and only 41 percent have a savings account with enough money to pay household expenses for six months, according to SRI.

Survey: Nonprofit Mergers, Sales Not On The Table

The Nonprofit Times reported on a recent Nonprofit Finance Fund survey that related very few organizations are even considering mergers or selling assets. Instead, nonprofits are more likely to develop worst-case scenario contingency budgets and engage more closely with their board.

Nearly half of respondents (48 percent) said they would freeze all hires and current salaries or have funder conversations to explain the situation and/or use of currently restricted grants to “keep their doors open in difficult times.” Only 4 percent called it “business as usual” and plan no change.

Asked what type of technical assistance would be helpful to their organizations, respondents most wanted “tools to communicate financial picture to the board and/or funders” and “financial scenario planning” with some also looking for assistance analyzing their current financial situation or program finance analytics.

About 16 percent anticipate being able to cover operating expenses in both 2009 and 2010. More than half expect the recession to have a long-term (more than two years) or permanent negative financial effect on their organizations. Read the full article here.

Foundation Center survey finds two-thirds will reduce grants in 2009

A new research advisory from Foundation Center shows foundation giving is expected to decrease in 2009, in a range of high single digits to low double digits; nearly two-thirds of respondents predict reductions in the number and/or size of their grants in 2009. Still, about 80% of respondents expect to maintain their current program areas, while a small handful (3%) anticipate increasing the number of areas they support.

Only 14% of all respondents report launching special initiatives in direct response to the current economic climate. However, community foundations are particularly focused on responding to the downturn; 35% say they are engaging in special initiatives to help communities cope with the fallout from a deteriorating economy.

As funders’ resources have diminished, many plan to participate in non-grantmaking activities. Two-thirds of funders expect to engage in more collaborations and partnerships, while one-third anticipate initiating more convenings. Other non-grantmaking responses include providing for more technical assistance, offering more bridge/emergency financing, and engaging in more advocacy.

While most funders plan to use investment income to meet their grantmaking budgets (88%), about 39% expect to use their endowment principal to make grants. This is particularly notable given the asset declines most funders experienced in 2008 and continue to experience in 2009.

The Foundation Center surveyed 5,000 large and mid-size foundations in January 2009 about their outlook for giving in 2009 and 2010, and about how they plan to respond to the economic downturn. Approximately 1,200 foundations responded.

Post provided by the Minnesota Council of Foundations.

New Study: Nonprofit Leadership Gap Widening During Recession

CNBC related a newly released Bridgespan Group survey of U.S. nonprofit executive directors shows that a leadership deficit forecast in 2006 may have widened last year. Meanwhile, in 2009, despite tightening budgets, nonprofits already foresee a need to fill 24,000 vacant or new roles in areas like finance and fundraising, amid increasing management complexity and baby boomer retirements. Developing leaders within the sector remains critical. In addition, three quarters of respondents saw value in "bridging" talent in from outside the sector to fill the gap, but underscored the need for cultural adaptation. Study findings will be presented at the American Express Nonprofit Leadership Academy taking place from April 27th-May 1st in New York.

American Express commissioned Bridgespan to conduct the survey in order to determine the nature and dimensions of the evolving nonprofit leadership deficit, the training and development needs within the sector, and to look at how managerial skills from the business sector can boost leadership capacity among nonprofits. The leadership vacancy anticipated so far for 2009 includes 24,000 managerial slots. Respondents reported that actual senior job openings in 2008 were running at 77,000, or 43% above a leadership gap forecast in Bridgespan's 2006 study "The Nonprofit Sector's Leadership Deficit." Twenty-five percent of nonprofit leadership vacancies in the past 18 months were filled through career progression, 41% through in-sector hiring, and 21% via bridging talent in from the corporate sector. Survey respondents highlighted that there is strong competition for the same in-sector talent pool and a lack of resources to find or cultivate new leaders from within nonprofit organizations.

Read more about the study's findings or download it.