Hero's Path Palliative Care

Children with medical complexity, fragility, disability, and/or genetic conditions frequently have less access to their communities, school programs, quality health care that meets their needs, and psychosocial support.  Their family members also face increased stress from high-acuity caregiving (parents often run the equivalent of an Intensive Care Unit in their homes), the unpredictability of their child's daily (and even hourly) health status, lack of home health support, and increased isolation from their community.  The most medically complex children constitute about 1% of the population, and that number is increasing yearly due to advances in prenatal and perinatal care.  Yet, the health care system struggles to provide adequate services for these children because one-on-one home-based care is human resource dependent and the national nursing shortage and lower pay rates for home nurses augment the shortage in home-based settings.  As the need for home-based services increase, we need better community health models that address all aspects of well-being, for not only the child, but also the entire family.  About 19.4% of children have special health care needs.  This portion of the population can also benefit from better home/community based services and the goal should be to work toward providing these services for that entire population.  Many home care companies also do not provide all the resources necessary to provide whole-person, whole-family care.  Instead, programs often have to be pieced together through multiple organizations which does not cohesively address the needs of the family. 

Hero's Path Palliative Care utilizes community and organizational resources to achieve better access to the community, increased wellness, and higher levels of equity and quality of life for children with serious illness/medical complexity and their families.  Our design comprehensively addresses these challenges by coordinating these services as one organization, lessening the burden on families to coordinate across many systems.

Children with medical complexity often do not have access to enrichment education or after school programs because of their medical needs.  Hero's Path Palliative Care partners with local outdoor recreation districts, nature education providers, and local pediatric nurses to run enrichment education programs in accessible outdoor open spaces for the entire family.  We are about to expand these services to include after school programs with nursing support so these children can experience enrichment education at their own schools.  By helping these families get the medical and educational support their child needs, they are able to access their community spaces.  Without nursing support, it is very difficult for these children to safely participate.

Children with rare disorders/medical complexity/serious illness have unpredictable lives.  They experience high levels of medical trauma, lack of sleep from their medical conditions, and social isolation.  The families that care for them also experience PTSD from medical emergencies, anticipatory grief, medical trauma, social isolation, and lack of sleep from 24/7 care giving.  These families need specialized psychosocial support at home.  To do this, we have created needs-specific virtual support groups for small cohorts (our current cohort is for families with a child with heart conditions).  Because of the unpredictable nature of the child's health conditions, we also provide hands-on therapy boxes that provide activities that coincide with the month's coping mechanism they are learning about.  If a family misses a virtual support group meeting, our therapist can reach out to them by phone to touch base, provide one-on-one support and lessons on how to utilize the coping mechanism that month.  We would like to expand these services by offering home-based visits, more specialized cohorts, and more one-on-one sessions.  Even if these families need to isolate due to risk of exposure to viral illnesses like Covid, they still can experience community through the use of virtual support groups.

In the future, we will provide home-based pediatric palliative care and a respite house/hospice place that families can utilize when they need a break from care giving.  Our facility is expected to be built in three years with our full respite program at that location and palliative care services will start at that time.  One comparable model to our respite house is Ryan House in Phoenix.  In the meantime, we offer short-break respite programs in accessible local open spaces.  These respite programs include the entire family.  The child and siblings go explore with a fun educational activity with the support of nurses, and the parents and caregivers spend time at that location socializing with other parents and experiencing a fun activity like art or dance.

All the needs of the child and their family members are taken into account for each activity and program.  The specialized nature of each connection means the family and child get the support they need all within their home and community. 

By utilizing various technologies, we are able to serve families across the state virtually.  We are also able to make more connections individually when in-person program dates are missed due to medical concerns.  Forming and maintaining community partnerships enables us to do more with less resources, and recognizing the usefulness and healing properties of nature (see references below) within local open spaces has allowed our programs to operate within the community safely.

References for  Health & Wellness Benefits of nature:

1. Wells, N.M. & Evans, G.W. (2003). Nearby nature: a bugger of life stress among rural children. Environment and Behavior. 35(3):311-330.

2. Feng & Astell-Burt (2017) The relationship between neighborhood green space and child mental wellbeing depends upon whom you ask: multilevel evidence from 3083 children aged 12-13 years. International Journal of Environmental Research and Public Health. 14(235).

3. Dadvand et al. (2015). Green spaces and cognitive development in primary school children. Proceeding for the National Academy of Sciences of the United States of America. 112(26):7937-7942.

4. Chawla et al., 2014). Green schoolyards as havens from stress and resources for resilience in childhood and adolescence. Health & Place. 28:1-13.

5. Sallis et al. (2000) A review of correlates of physical activity of children and adolescents. Med Sci Sports Exerc. 32(5):963-975.

6. Lloyd-Strovas, J. Moseley, C., Arsuffi, T. (2018). Environmental literacy of undergraduate college students: Development of the environmental literacy instrument (ELI). School Science and Mathematics. Pg 1–9.

Children with medical complexity/rare disorders/medical fragility/disability have many challenges to equitably access their community, education, and health care.  Most of these children have medical equipment they use daily that are life-saving.  They often are wheel-chair bound, and face mobility issues.  Many times they have an intellectual developmental disability that makes educational programs difficult to participate in.  These children need specialized health care, but often families find themselves needing to travel out of state to get the care their child needs.  Even going to the grocery store can be impossible for these families without a nurse supporting the medical needs of the child.  Imagine a toddler on a ventilator, with a large bag of emergency supplies and suction machine that need to be within arms length at all times.  Imagine taking that child to Costco.  Even with the large carts, you cannot fit the child, their ventilator, and the emergency supplies in one cart and have room for food.  You need two carts.  Because of the medical needs, these children are supposed to have home nursing.  The national nursing shortage means that many of these families have no nursing support, which means they have to quit their jobs and provide Intensive Care Unit level nursing at home.  Parents are the respiratory therapist, doctor, nurse, custodian, and social worker 24/7/365.  There are no sick days, shifts off, or even a full night of sleep for these parents.  Without a nurse, making it to appointments, school, or work can be near impossible.  Yet, these families do phenomenal work to ensure their child's shortened life will be the best it can be.  For this reason, we serve not only the child, but the entire family with our programs.  Everyone needs better support to live a good quality of life.

By bringing services and programs to the family in their home or community with extra medical support, we are able to start to make education, medical care, and psychosocial services more equitably accessed by these families.  Children are more able to experience the joys of childhood when they have adequate support.  Families are able to not only survive, but thrive through this extra layer of support.  They learn together, make memories together, and explore their communities in meaningful, memory-making ways.  Through these programs, we see better coping strategies develop, more engagement with the community, and decreased stress levels.  We like to look at the families as part of our ecosystem (our community).  If any one of them is missing because of isolation, or difficulty accessing the community, we all are negatively impacted.  Each of these children and families are vital to the health of our neighborhoods, cities, states, and world.  The impact of these programs, then, extend far beyond the individual or family.  It makes our community healthier and more vibrant.

I am a mom to 5 children, two who are medically complex and have rare disorders.  One of those beautiful children died 3.5 years ago from medical challenges.  I am joined in our team by three other bereaved parents to medically complex children.  Two of those parents are medical doctors.  Our team also has a child life specialist/therapist who has worked with these children for over 17 years.  Our personal experience is what makes us the perfect team to design and implement the best programs for families and children like ours.

Before starting any program, we ran a needs assessment that surveyed all stakeholders, including families who have a child with medical complexity.  We used that data to address the most critical needs of the community and started to design smaller programs that would immediately help while we worked to fulfill our mission.  These smaller programs involve gathering input several times throughout the program.  We interview families on video, take anonymous surveys through google forms, and also get feedback from our referral sources.  For an example of our video interviews, go here.

Our barriers are primarily financial.  We founded our nonprofit in September 2019, right before the pandemic started.  While we have been successful at obtaining small grants and donations, we have not been able afford to hire any staff.  This limits how much our programs can expand as it relies on volunteers and contract work.  We have interest to expand our smaller programs to the Navajo Nation through partnership with Navajo Family Voices, but we don't have capacity to train Navajo people to run the programs there.  We also have been asked to expand to other rural areas of the state and face the same difficulty.  If we could hire part-time staff, we could expand into rural and indigenous communities. 

Right now we are also about to launch a capital campaign for building our respite/hospice house, educational institute, and home-based pediatric palliative care services.  As you may be aware, oftentimes a capital campaign makes it more difficult to fund existing programs as funders/donors prefer to fund the capital campaign.  Not only is my volunteer time being divided between the capital campaign and the programs, the funds we have will be directed in more places as the campaign ramps up.  I currently already spend about 40 hours a week volunteering as the Executive Director, and need more support from hiring paid staff to accomplish our ambitious plan.

The capital campaign is very needed in the community, as well as our smaller community-based programs.  Trying to do all of it on volunteer time is increasingly difficult to meet the demand for the services.  The Horizon Prize would help us be able to meet the demand by increasing services across the state.

I sit on the National Pediatric Palliative Care Task Force, and I believe this model (that incorporates not only health care in palliative care, but also educational support and respite) will be a model for the world in caring for these children and families.  Many business advisors here in New Mexico believe this can go national and then global, but I will need support to get there.  The Horizon prize is a key element to gaining the momentum we need to ensure the model can be duplicated and effective in any culture or community.

By leveraging community based partnerships, successful single approaches to education, complex medical care, and family support and combining those modalities, we have larger impact that is more sustainable than piecemeal systems. 

For instance, home health agencies often strive to provide respite for their clients.  However, during a nursing shortage, those services dissipate.  Many medical services do not integrate the need for community based involvement or educational needs.  Educational programs rarely account for the medical support needs of a child, and often these children cannot access those programs because of that unmet need.

By taking a holistic approach to viewing these children AND their families, we can design programs that meet the medical, educational, and psychosocial needs of entire families without the family needing to coordinate all of those services separately.  Ensuring that there are multiple, specialized avenues for each family to access these services  helps them be able to engage more effectively no matter what their immediate condition is.  If they cannot safely leave their home due to medical safety concerns, we can provide virtual or home-based programs.  If their child has a sudden emergency, we can deliver the programs in personalized, one-on-one support when they are again able to participate.  These families experience frequent unpredictable emergencies, and flexibility from the service provider is key to enabling equitable access to the community, educational programs, psychosocial support and specialized medical care.  Providing programs that incorporate all of these services ensure the largest gain for the entire family unit.

Families often do not have the capacity to navigate so many complicated systems for their child.  They are simply trying to survive.  By combining all of these systems into one program, we make it easier for these families to access their communities and move beyond survival into thriving.

Our model has gained attention for being a great way to expand services to resource-poor communities.  We believe that the synergistic nature of the program design will be a way to provide specialized care in many under-served communities and cultures.

1.  Provide high-quality, specialized educational programs for children with serious illness and their families that address each individual's medical, behavioral, mobility, educational, and emotional needs.  Programs will take place in community settings (like open spaces and schools), or at the family's home when community access is not possible.
2. Provide psychosocial support and connection throughout the state of New Mexico (and beyond) through small virtual support groups.  Each cohort will be provided with curated therapy boxes each month to highlight the coping mechanisms we're learning/developing as a group.  The medical, cultural, educational, and spiritual needs of each individual is addressed sensitively and compassionately.
3. Provide short-break respite programs that allow families to refresh while learning, having fun, and connecting with their community and other families like them.
4. Realize the Move Mountains Campaign!  Having the right resources on your journey can change the cumbersome terrain into a joyful journey. The hiking backpacks full of burdens can be carried by our supportive staff. As we walk the path with families, we choose a wrap-around approach that addresses their emotional, psychosocial, educational, spiritual and medical needs. This will be the first comprehensive model like this in New Mexico.  There are five supporting "legs" of this campaign:

• Respite Place: Like a welcoming cabin in the woods, the respite home will allow children with serious illness to have serious fun as their caregivers (parents, siblings, grand parents) catch their breath and refresh.

• Home-based Pediatric Palliative Care Hub: Our specialists meet the families on the path, in their homes, to provide comprehensive individualized medical support. The families stay on familiar turf and the kids have less trauma than being in a medical setting.

• Hospice Compassion Center: Dark parts of the path should be honored with extra care utilized to bring comfort as the family navigates the most difficult part of their journey.

• Nature Institute: To fully experience the world of nature on this path, families are provided with educational enrichment opportunities. They learn how vital they are to their ecosystem (their community).

• Family Connection Axis: The journey is a narrow one. We can’t always see others who are hiking with us, but our family connections program ensures that everyone has a buddy to go with them. Someone who is experiencing a similar trek. Someone who understands the arduous parts and the stellar views.

Short-term (small program) measures:

1. Afterschool & Respite Programs: We will use pre and post test verbal questioning to evaluate what the students know before the program versus after. For kids who are non-verbal, we’ll use pictures, sign language, or another form of evaluation to ensure we’re getting accurate data.

   1. In addition to evaluating what they learned, we’ll be using established measures by the school to determine how the kids are doing at the end of the school day and if that changes for the better or worse after the after school program.

   2. We will record the number of afterschool programs administered, the number of students served, and the total number of families/people served during the respite programs.

   3. In person and phone interviews for families to measure success of the afterschool program and areas where we can improve.

   4. Families will fill out surveys at the respite programs to indicate what worked well and what could be improved.

2. Support Groups. We utilize survey forms at sign up for each family. Throughout the progression of each program, we conduct family interviews to determine what is working well, what work still needs to be done, and how the families have grown. These interviews are often recorded with family permission. We have found that families with medically complex children do not have time or capacity to fill out exit surveys, but they are happy to talk to us during our program itself. These interviews have been very meaningful and enlightening and can be used to show funders the impact of their partnership for these families. 
   

Scale for Support Group

Measure feeling connected

I feel a sense of connection to: 

• My friends

• My family

• My community

• Myself

• My interests, hobbies, & passions

Measure ability to ‘effectively manage stress’ 

• I feel I can effectively manage my stress

• I find myself getting easily overwhelmed

• I can lose my temper if I get too stressed out

• I have enough resources to support me when things get too hard

• I know how to take care of myself, even if things feel impossible

Measure ability to express/understand anticipatory grief 

• I feel I can adapt to manage even the worst possible outcomes

• When thinking of my child’s future, I feel unprepared to handle the stress ahead.

• I understand enough about death to know how to take care of myself and those close to me when I grieve

• I can communicate effectively the most challenging fears & emotions

• I have people in my community with whom I can share my most sorrowful times

1. One-On-One Family Therapy. We will use the same survey methods and interviews discussed in #2 for support groups.

2. We also collect participation data and obtain reasons why someone cannot participate as expected. Usually, these families face a lot of sudden medical emergencies that can hinder perfect attendance. Because of these challenges to attend, we offer videos, workbooks, and other manipulatives and one-on-one calls/zoom meetings to ensure the family stays caught up and connected.  They need us to be understanding and supportive of their often chaotic lives and their inability to meet consistently.

Long-term (Large programs like respite house/home-based pediatric palliative care) measures:

We utilize capital campaign support through Pride Philanthropy.  They help us to train volunteers for our Philanthropy Council and ensure that we stay on task through our Team Gantt service.  This ensures that we meet the goals of the feasibility study conducted through Pride, and stay on track to achieve funding for these larger programs. 

After the capital campaign is funded, we will measure our Pediatric Palliative Care Programs through CAPC's guidelines. 

We will measure our Respite Program's effectiveness through ARCH respite's program evaluator. 

By providing enrichment education opportunities with built-in medical support, we see children with serious illness/rare disorders and their families be more engaged with their communities.  They learn effectively through the hands-on, adaptive education.  They build problem-solving skills.

Combining our educational/respite programs with support groups and one-on-one therapy, families build a toolbox of coping mechanisms, build connections within their family, and make meaningful memories. This reduces stress and increases well-being.

Over time, we see resilience, greater advocacy and adaptability, and connection to their communities.  The community then becomes healthier and more vibrant because of the presence of these families and children.  Having better health care services within the home and community coupled with enrichment educational and mental health opportunities right where people live contributes to overall health of the community at large.

We utilize advances in adaptive educational and therapeutic avenues in our programs.  For instance, we work with experts in Blind and Visually Impaired specialties to construct manipulatives and educational resources for children who have visual impairment or blindness.  We utilize occupational, speech, and physical therapeutic approaches to help families navigate fine and gross motor needs, understand and address other forms of communication than speaking (sign language, non verbal cues, body language, etc).  AAC devices can be used during our programs to help students communicate in ways that work for them.

We also use zoom and other online/internet based technologies to stay connected to families virtually, across the state.

We use video frequently to help families who are not able to participate immediately, but need to "catch up" later.

We use nature and culture to connect with each individual, being sensitive to their individual needs, belief systems, and faith. 

Our leadership team has six women and two men.  Within our team, we have Native American and Hispanic cultures represented (which is reflective of New Mexico's cultural and ethnic makeup). 

Recently, we partnered with Ciudad Soil and Water Conservation District to apply for a Trails + grant.  We learned through our educational programs that our local outdoor open spaces were not truly "accessible" to the families we served.  We advocated for a fully accessible trail that would actually go deeper into nature spaces, complete with sensory stations.  As part of the Ciudad team, we were awarded the grant!  We were connected to various state and city recreation leaders, and they have determined that it is an important enough issue to address statewide, with this first trail being the pilot.  Please see the video we made to showcase the needs of the families we serve that motivated this movement toward equity:  Equity in Outdoor spaces

Our DEI policy is copied below:

We are committed to creating an equitable workplace where diverse life experiences are respected and valued. Hero’s Path Palliative Care sees diversity and inclusion as paramount to the mission of our organization. Our company provides promotion, compensation, and benefits to all employees regardless of nationality, race, ethnicity, age, gender, sexual orientation, religion, physical ability, or medical history. Employees and contractors are guaranteed equal opportunities throughout their tenure with Hero’s Path Palliative Care.

At Hero’s Path Palliative Care, ‘diversity’ refers to the representation of individuals with differing experiences, perspectives, faiths, beliefs, communities, traditions, and customs. What ‘Inclusion’ means to us is investing in nurturing a true sense of belonging across the company and promoting the respect, consideration, and appreciation of members of diverse backgrounds.

Our Vision: To empower children with serious illness to live fully by providing outstanding, customized palliative care services.

We commit to understand the cultural, spiritual, and emotional framework of each family and child and incorporate that into the care plan for each individual child with sensitivity and compassion.

Our Mission: To provide compassionate, thoughtful, family-centered, home-based pediatric palliative care and to offer resources including respite, education and networking to support child and family on their path to wellness.

Our compassion will be a direct reflection of our pursuit of understanding how each individual family’s beliefs, background, and culture shape their definition of quality of life and whole- person wellness.

Values:

Connected: Children and families enjoy connection to each other and the community through effective, collaborative care, education and inclusive events.

Our events, educational opportunities, and collaborations will be inclusive of all faiths, cultures, and disabilities. We seek to connect our staff and families to meaningful, diverse opportunities within our community.

Empowered: Children and families benefit from an extra layer of support as the palliative care team ensures their advocacy is meaningful.

We will advocate with the family to ensure that all spiritual, cultural, and whole-person attributes are incorporated in our understanding of the family and child’s wishes and the impact to their health plan.

Understood: Children and families feel validated throughout goal-setting and decision making by an understanding palliative care team.

Our palliative care team commits to continuously learning more about our clients’ culture and belief systems to ensure we provide an understanding framework where trust is facilitated.

Important: Children and families experience customized services that highlight their unique value and importance.

We acknowledge that diversity is a strength and should be embraced as part of what makes each child and family member unique and important. All aspects of their wellness is important to us and will be treated with respect and valued.

In order to promote both diversity and inclusion, and ensure equal opportunities to all staff, Hero’s Path Palliative Care has taken the following measures:

• Compulsory sensitivity training for all senior employees and managers

• Regular employee surveys gather consensus on attitudes around diversity/inclusion

• Formal leadership training to mitigate biases and increase cultural competency

• Informal discussion sessions and support groups to discuss bias and equity issues

• Blind screening of résumés and diverse interview panels for job candidates

• Recruitment outreach initiatives for more diverse talent pools

Our board of directors is responsible for ensuring that all employees feel safe, confident and comfortable to live their day-to-day lives at work, without harassment, prejudice or judgment and to have their concerns heard and attentively listened to otherwise.

Our diversity and inclusion efforts are heartfelt and we are committed to continuously developing new, better and relevant strategies for our workforce. To make suggestions or discuss additional measures that could be taken to support diversity and inclusion in your department, contact board@herospathpalliativecare.org

Children with serious illness/medical complexity and/or fragility/rare disorders/disability and their families face many challenges to accessing adequate health care, educational opportunities, and their community.  Stakeholders in the community want to see these families represented, well-cared for, engaged, their quality of life increased, and health care costs going down. 

Our educational programs combine high-quality, specialized/individual curriculum to the entire family with the added support of trained skilled nursing staff.  This allows children who normally cannot safely access enrichment education programs the ability to learn and engage in the local open spaces.  Families learn together, making meaningful memories while enjoying the benefits of nature.

Our virtual support groups and one-on-one therapy sessions allow families to process and address medical trauma, develop and hone healthy coping mechanisms, and utilize hands-on therapy boxes to augment their learning and build a toolbox of therapeutic modalities to use.

Our future respite/hospice house will enable children to have camp-like experiences in highly interactive therapy rooms while their family takes a needed break from the challenges of extreme caregiving.  At the end of life, our home becomes a familiar, comforting, and supportive space to receive comfort and medical care as they face the most difficult seasons of caring for their dying child.

Our Nature Institute will provide an immersive, accessible and inclusive space for learning outside, interacting with therapy animals, and engaging the community.

Our home-based pediatric palliative care program will travel to family's homes, where children feel more comfortable for receiving medical care, and ensure that their goals of care are followed, respected, and culturally relevant to each individual.  Our home-based team will be medical doctors, nurses, social workers, child life professionals, psychosocial specialists, and aides who will ensure that the child and family can stay home out of the hospital as much as possible, increase their quality of life, and decrease medical trauma.

Combining all these modalities/programs together ensures that the care is truly comprehensive, and that families spend less time coordinating care and more time enjoying their time together.

Our smaller programs require donations and grants.  As we pursue our mission/vision, medical insurance will cover about 50-75% of medical costs (we plan on working with legislators to achieve higher/more adequate payment reimbursement).  Several studies have shown that there is high cost savings to home-based pediatric palliative care of about $3331/patient/month.  The increased rates that we advocate for will help ensure that these cost savings are realized AND better health outcomes and services are delivered.  We are establishing a 30-50 member Philanthropy Council who will continue to pursue donations and grants as an ongoing part of our funding stream.  We also plan on establishing a $1M endowment through our capital campaing, Move Mountains, which is expected to launch in September of 2022.

We utilize individual donors and grants currently for funding our small programs.  We have established a Philanthropy Council to achieve our capital campaign goals and will continue to utilize these volunteers long-term.  One goal of the philanthropy council is to establish an endowment. On top of philanthropic efforts, we will be able to bill health insurance plans (including medicaid) for approximately 50% of our home-based pediatric palliative care program, and we will be working with state government to be able to increase current rates for our respite program.  The respite program will likely be covered by the state through waiver and medicaid programs it if we can raise those daily rates.  Our hospice program will be covered through insurance reimbursement.  Our educational program will be covered from philanthropic endeavors.  Our family support program will be covered by philanthropy and insurance reimbursement.  Together, Insurance coverage and waivers will cover between 50-75% of our program and operational costs, with philanthropy/grants/donations covering the remainder.

Despite starting our nonprofit right before the pandemic, we have seen our donations/grants approximately double each year.

2019 total contributions:  7,070

2020 total contributions: 23,238

2021 total contributions: 42,069

We started to be awarded grants in 2021:

ABQ Involved: 3,300

EDD Outdoor Equity Grant: 18,050

Nusenda Grant: 6,500

MSRGN Grant: 1,200

For 2022, we completed a feasibility study through Pride Philanthropy and it was determined that Hero's Path Palliative Care will be well-supported in our capital campaign that will launch in September 2022.  We have focused on building a philanthropy council of notable New Mexicans, and have started to cultivate major donors. 

For the insurance reimbursement piece, we have been talking with some Medicaid leaders, looking at bundled/tiered payment structures for our home-based pediatric palliative care program.  We also have a business team working with us through the Palliative Care Leadership Centers to design that pillar of our organization.

We have been in communication with the new Respite house leadership that is setting up under Children's Hospice International.  We have worked with them to determine reimbursement rates needed to fund the respite program, and we have a plan on how to address that in the next three years as our capital campaign raises the funds for the building.  It is likely through precedent set by other states, that we can get our respite program fully reimbursed.

We went from a 10 person board doing all the fundraising to now establishing a 30-50 person volunteer Philanthropy Council who will be able to accomplish so much more.  We also have the Pride Philanthropy team behind us, training us in best practices for fundraising and how to ask major donors for impactful donations.  We also have a seasoned grant writer who is about to join our team, who will help us write more effective grant proposals.

As the founder of this nonprofit, with no business background going into this, I am very proud of how our board of directors have moved this organization forward so quickly in such difficult times.  We continue to form meaningful collaborations and partnerships that ensure our success long-term.