 |
No More Homeless Pets Forum
September 1, 2003 Running a Spay/Neuter Clinic |
Should you open your own spay/neuter clinic? Paul Berry of Best Friends and Quita Mazzina of Humane Alliance answer your questions about running your own mobile or fixed spay/neuter clinic.
Introduction from Paul Berry:
I've helped organize low-cost spay-neuter clinics in some of the more economically depressed regions in the country -- the rural south, inner city New Orleans and on the Navajo Reservation. By creating a working coalition among municipalities and humane groups we were able to provide low-cost services even in limited funding environments.I'll be happy to answer your questions about launching and running a successful mobile spay/neuter clinic; everything from revenue/expense planning, to coalition building, to how to set up goals and milestones that help you measure the success of your project.
Introduction from Quita Mazzina:
Our clinic is a high volume, low-cost regional facility that partners with 32 animal welfare organizations in 20 western North Carolina counties. An average of 75 surgical sterilizations are performed each day, 5 days per week, 48 weeks per year at the Humane Alliance Spay/Neuter Clinic.The staff at the clinic will spay and neuter more than 16,000 companion animals this year alone. To date, we have sterilized over 100,000 pets. Our program includes a unique free transport system with two climate-controlled vehicles.
Our staff is the driving force behind the mission of the Humane Alliance; they are the heartbeat of the organization.
The success of this program is a result of the tireless efforts of all the partners. The purpose of this alliance is no longer simply to reduce companion animal overpopulation, but to end it.
This model is intended to be duplicated. We are convinced that this regional model, strategically placed across the nation, is pivotal to achieve the goal of No More Homeless Pets in this nation.
Questions
Determining a budget for a spay day
Is it better to book appointments or do first come first serve?
When vet associations won't let mobile vans operate
Spreading the spay/neuter message in rural communities
Debate between a fixed clinic and a mobile van
How do you find a vet?
How do you advertise your programs in outlying areas?
How do you get vets not to oppose your efforts?
Can clinics and vans be self-supporting?
What areas do you focus on with limited funds?
What can organizations do if not ready for a mobile or fixed clinic?
Determining a budget for a spay day
Question from Phyliss:
We are in the very early stages of planning. We are looking to do 75 cat spay/neuters in one day at no cost to the community. We are looking to have a pick up location in the parking lot of a church with a tent and transportation vans.Two questions: What is a good over-all budget to aim for in order to provide spay/neuters for cats at no cost to the community and what should we expect to pay a vet office who is set up to do large volumes of spay/neuter for use of the facility on a day when they are normally closed? Can we ask them to do it for free, or should we expect to pay each vet and vet tech?
Response from Paul:
Assuming this is a one-time "event", i.e., not a daily operation (week to week), a good first step is to shop around for adequate liability event insurance. The cost of event insurance will affect your overall budget and depending on your area and the complexity of the event, costs could range from $600 to $2,500 for a single day.In addition to the event insurance cost, you'll have the unit cost per surgery that includes labor, materials, supplies and administration. If you keep administrative costs to a minimum, a lean, average unit cost should be around $40 per surgery (assuming a balanced ratio of male to female patients (cats)). So, for 75 cats at an average cost of $40 per surgery, the estimated cost for labor (one vet and two techs), materials, supplies and administration is $3,000. Vaccinations and post-op pain meds are not included in these cost projections, but you should consider offering such items (at least) at-cost to the customers.
A third major cost item in your project would be the facility costs which include two-way transport from staging area (church) to clinic and the lease cost of the clinic itself. If you have dependable volunteers with vehicles and a good stash of pet carriers (require that owners drop off cats in their own carriers), then you can save some dough on these items. And, of course, if you can get use of the clinic donated you'll save even more. I could only venture a guess at what a one-day cost would be for lease of the clinic facility, because that is dependent on the condition of the clinic. But, just for grins, assuming it is a modern facility, you might offer, say, $300 - $400 to lease it for the day. Be sure and offer them full indemnification of all liabilities.
I have not had much luck getting veterinary labor donated, (the labor costs are included in unit costs above). Besides, if you are trying to accomplish 75 cat surgeries in one day with one vet, you will need an efficient, skilled surgeon who has experience with volume surgeries. These folks are rare, and even more rare is one who would want to do it for free. Also with that volume, you will need a good lead vet technician and a technician's assistant (costs also included in unit costs above). The lead tech is key to the rhythm of the operation and the tech assistant is key to the lead tech's good temperament, so I'd pay them as well; they will have a very long day.
Hope all this helps - Best of luck with your project!
Response from Quita:
If this is a one-time event, you can probably secure volunteer services. If it is an event you would like to host on a regular schedule, you need to consult with the owner of the veterinary practice to address the total expense of that practice. For instance, the total expense to operate our facility for one day is $3,288.00. We perform 75 surgeries a day, 50% cats and 50% dogs. Pharmaceutical costs and time is certainly less for surgical sterilization of felines. Keep in mind that many veterinarians are still making payments on their college loans.Comment from Celeste:
I coordinated NeuterFest 2002 here in Oregon, a multi-organizational s/n event in honor of National Homeless Animals Day. Several local clinics participated to alter 60 cats, dogs and rabbits - read more. The bulk of the animals (about 40) were done at a single clinic, with one lead veterinarian, two certified veterinary technicians, and around 8 volunteering vets, techs and laypeople.Because check in and out, as well as the surgeries, all took place at existing veterinary facilities, no special event insurance was necessary (of course, we still designed admission and waiver forms releasing us of liability, just in case, which I'd be happy to email upon request.
We paid the veterinarians $20 per tom, $30 per queen, and $50 each for all other species of patients.
We started planning this modest event 2 months in advance, and were able to pay the vets through a sliding fee schedule for clients, through private donations, and through nonprofit sponsorship (budget breakdown available upon request).
One important thing we did right was to have the cost per surgery go down when a client brought in multiple patients - a 'group rate' turned out to be a great incentive.
One thing we'll concentrate more on in the future is insisting on a pre-event meeting with ALL veterinary clinic staff present, instead of just communicating with clinic managers and owners, and having last-minute points to clarify.
We'd be happy to share literature, including promotional and fundraising materials, concerning this event, if contacted.
Is it better to book appointments or do first come first serve?
Question from a member:
In a mobile van or fixed clinic do you recommend taking appointments or just doing a first come first serve basis? We have had a mobile van come to our community before and we had a hard time getting people to show up even though we booked appointments. Do you recommend overbooking (and by how much?) or just telling people that the first X amount of people there will get their animals done? Also, have you ever had people not show back up at the scheduled time to pick their animals up and you are ready to close? What do you do then?Response from Paul:
I definitely recommend making appointments. As a practice, I wouldn't overbook with public clients, but I would work with local shelters and rescue groups to be on stand-by in case of no-shows. We did this in Louisiana, and it helped us maximize use of the clinic as well as improve relations among local groups. Good luck with your project.Response from Quita:
We recommend booking appointments for two reasons: (1) Pre-op instructions are mandatory to our surgical protocol. (2) Our veterinarians perform a specified number of surgeries per day based on a point system.Generally we overbook, typically with male animals. If they all show, the males are a simpler surgical procedure. Many of the organizations that participate in our program phone clients the evening before surgery to confirm the appointment. We have never had a client not return for their pet. Our admission form includes a specific statement with regards to the procedure we follow if they do not retrieve their pet.
Comment from Celeste:
For the Oregon Neutermobile, we book appointments whenever possible, based on a point system (happy to explain more about point specifics if asked). After that, we will take patients that haven't eaten since the night before, surgical team availability permitting. That means that if we're fully booked and someone walks up with just one more animal that morning, we get the veterinarian's okay before accepting the patient.After scheduled patients are admitted, feral cats get priority for walk up appointments, since sometimes it can be now-or-never with trapping logistics. After that comes all other walk up patients (tame cats, dogs, and rabbits, etc).
If we're full, they can book an appointment for an upcoming surgery day, by paying in advance.
That's a key point; surgeries are paid for in advance. No appointment is secured without payment, and nobody leaves animals with us without paying first. Some communities set up a kiosk or storefront where people can drop by payment in advance, others take mail in appointment fees. And, of course, if they're a same-day walk-in, clients can just pay the morning of, but they don't get the assurance that an appointment will for sure be available that day for their animals.
Because of these policies, not only do we have a less than 10% no show rate, but we've yet to have an animal abandoned post-op.
Hope that's helpful... I'm sure every clinic has just a slightly different way of doing things...
When vet associations won't let mobile vans operate
Question from a member:
There is a low-cost spay/neuter mobile van in West Virginia that is sitting idle because the West Virginia Board of Veterinary Medicine has restricted the group from operating its unit outside of a 50 mile radius from the group's fixed clinic, thus denying the vast majority of state residents access to this important service.I feel this is ridiculous when the majority of places they would visit don't even have a vet in the nearby vicinity. This would not compete with them in anyway but would help a lot of people and animals. Do you have any suggestions on what can be done to stop the VMA from doing this and get the mobile going?
Response from Paul:
We had a similar problem in Louisiana. I dug into the State Veterinary Practice Act Guidelines and found that we could offer services in areas beyond the "restricted" radius (50 mile radius in your case) if we contracted our post-op emergency care to veterinarians within 50 miles of our customers. This added expense, but did enable us to get into those rural areas that needed services the most.I recommend you research the State Veterinary Practice Act codes in your state and negotiate a similar solution with local vets and the BVM. Good luck.
Response from Quita:
It is unequivocally unfortunate that a mobile surgical unit is sitting idle when it could be staffed with a spay/neuter team. Unfortunately, it is not uncommon to hear of controversial issues with regards to low-cost spay/neuter programs. I am convinced that a dialogue between animal welfare organizations and veterinarians is critical. It will serve to create trust and to connect us as partners in our endeavor to end the companion animal overpopulation dilemma. I understand your frustration. We have experienced the frustration; but, we all have to establish an effective channel of communication. In your specific situation, I would suggest that the leaders of your organization request a personal meeting with your state's Veterinary Medical Board. Define your mission and your program. Request the director of your state's VMB provide a clear definition the Veterinary Practice Act specific to your state. Clearly, neutering is recognized as our best defense against all the sources of shelter overpopulation. It is compulsory to a national response to pet overpopulation. We need a strategic national animal welfare response in cooperation with the American Veterinary Medical Association to address this specific issue. There is obviously a huge gap in communication.Comment from a member:
But this is a monopoly! How can this possibly be legal to restrict a program such as this when vets voluntarily agree to do the surgeries? Can this/has this been challenged in the courts? We are facing the same situation in Texas... and while we don't have the van, the need is there. A few years ago, community members even tried to do it... and it got squelched by a few greedy vocal old vets. Really, I don't understand how this can be legal.Spreading the spay/neuter message in rural communities
Question from Ann:
I have been thinking about starting a mobile spay and neuter program for the rural areas of the state that I live in. I know a big part of the program has to be education (to get them to want to spay/neuter and understand its importance). Most rural people think differently of their pets than the average person in town, so how do you approach this subject in a rural area? We want to get their attention but not turn them off. We want to do some tabling at feed stores and Co-ops and we don't want to come across as intruders and radical activists.Response from Quita:
We do not operate a mobile unit but we provide a free transport service for companion animals belonging to residents in 20 rural western North Carolina counties. We partner with 32 animal welfare organizations in this region. Our model has 2 components:1) A dynamic sterilization program, a high volume, low-cost spay/neuter clinic.
2) Unique and innovative education, foster/adoption programs.
As a partnership, we have raised literally hundreds of thousands of dollars in the past three years to subsidize the cost of spay/neuter. We have found that cost is a definite factor in the decision of the majority of our clients to sterilize their pet. We are able to provide information/education in our process of actually booking the appointments. We conduct yearly surveys with our clients and we have found that 92% of our clients indicate that money/cost is the number 1 factor in the decision to neuter their pets.
100% of our clients indicate that they believe a wellness program is important for their pets, 94% of them indicate that it is cost prohibitive for them to participate in a wellness program.
We will typically cultivate a relationship with 2 to 3 key people in a community. Their introduction is invaluable. You might arrange a speaking engagement with several of the community organizations, for example 4H, Lions club, PTA's, churches, etc.
Paul's response:
Got a quick story for you --When we first started branching outside the suburbs of New Orleans, into the rural areas of southern Louisiana - and let me tell you ‘cher, I'm talking Boudreaux-and-Cecil Rural - we ventured outbound with much trepidation.
One of our first rural trial runs was in Plaquemines Parish. We went out with our mobile clinic and did 20 pre-scheduled surgeries for a small rescue group (of two ladies). The ladies had alerted the local press (a once/week newspaper flyer) a few weeks prior to our event. Lots of folks stopped by that day - I think to see just what we were sp-r-aying on the dogs. This gave the local ladies a perfect opportunity to talk to their neighbors about the cause - in a fashion that the locals could understand and trust. And by the time we got back home that night, we had 87 reservations for the next trip!
Similar, pleasant surprises happened in every rural area we ever tried. And, I believe, all because the lesson we were lucky to learn early on was not to speak our city/suburban propaganda to the rural folk, but enlist supporters from those rural areas and let them be the mouthpiece for the cause.
Hope this helps. Good luck y'all.
Comment from Celeste:
In Oregon, we have the Neutermobile, a mobile spay/neuter clinic that travels statewide. Surgeries are performed on the vehicle, and we only service rural or economically depressed regions without adequate existing programs.In some cases, we visit areas that don't even have an existing clinic or animal welfare organization, so they haven't had anyone to explain the benefit of sterilization surgery.
I agree wholeheartedly that this has not been an obstacle to fully booking up our surgery days, and that local advocates are key.
One hidden help is that more residents seem to subscribe to AND ACTUALLY READ the local newspaper than in larger, 'busier' areas - it's easier for a farmer to read the paper to get local news than to go into town every day and hang out at the barber shop!
And, the papers are more news-hungry.
We were recently in a smallish town where we made the FRONT PAGE, replete with color photos, several weeks in a row.
There are often local radio shows too, and sometimes local TV programs. So, it's important to make sure each location has a volunteer who's comfortable in the limelight, so those opportunities don't go wasted.
A wonderful snowball effect occurs, even in areas where we meet initial resistance; each person that takes advantage of our low cost s/n facilities spreads the words and acts as an example for others. Lots of people who bring in feral cats refer us to other colonies in the area. After the first week or so, the common refrain is, "I heard about you because my neighbor/friend/relative brought their dogs/cats/rabbits to you...."
Also, our innovative and much beloved Director of Marketing, Lisa Wahl, hatched a plan for local volunteers to conduct a phone survey using the local phone book, asking people if their pets are altered, if they have a vet already, etc. When people respond that they haven't gotten their pets altered because of price, they can be referred to our program. Which makes for a nice segue.
Bottom line: don't worry, people will come as long as your operation is run as safely, economically, and professionally as possible, clients are treated with courtesy and respect, and the word is spread locally about what you'll have to offer.
Comment from Josie:
Living in a rural area and having help run a rural s/n voucher and transportation program for some years, I would advise simply letting people know that you have low-cost services is the single most crucial thing. A few folks will never be convinced, and few folks are already so much on board that they would go without a meal before they'd let their animal go unsterilized, but most are in between. Don't waste your energy on the intransigent people, who can be found both rural and urban; when you run out of poor people who need your help, you can go on to the next!Comment from Judy in TN:
Paul's response to the question on the spay/neuter message in rural areas was perfect! It's true that some country folk will never understand why spaying and neutering is so important but I've encountered city people who don't get it either. If the group goes in without having prejudices against the people they're trying to help and if they sincerely speak to them and not lecture them and make them feel inferior, I think she'll find they can have a lot of success. I live in a small rural community and am fortunate to volunteer with an organization that had our state's first mobile spay/neuter clinic. Since April of 2000, over 14,000 spay/neuters have been done in 19 counties for qualifying low-income people in the Middle Tennessee area. Once you get outside Nashville, it doesn't get much more rural than that. In addition, our organization is sponsoring a spay/neuter discount program to help working people in our county who don't qualify for the Spay Station, our mobile unit. That has been very successful as well. It's all about education and treating people with respect. If Ann is interested in learning more about how we got it started, she can check out our website and contact Sara Felmlee with the Humane Association of Wilson County. I know Sara would be glad to give her some tips.Debate between a fixed clinic and a mobile van
Question from a member:
Our board is discussing investing in a spay/neuter clinic. The big debate is whether to go with a fixed clinic or a mobile clinic. Your insights would be helpful; what do you each see as the advantages and special challenges? Is one more cost-effective than the other? Or easier to operate?Response from Quita:
We operated a mobile surgical unit in the year 2000. Today we are strictly a stationary facility. Below are listed some of the limitations we experienced with the mobile unit:We traveled a radius of 100 miles. The days averaged 14 hours for our staff.
The space was adequate for cats but extremely limited for dogs.
We never took the unit that a piece of equipment did not fail us, including the generator.
The numbers of spay/neuters we can perform at our facility far exceed the numbers we could sterilize on the mobile unit.
Our spay/neuter model is based on high volume, low-cost. We are able to perform up to 115 surgeries per day in our facility. We have analyzed our total expenses and we know that we can keep our costs low if we perform 75 surgeries per day, 5 days per week, 48 weeks per year. The actual cost to open a surgical facility matching ours:
Surgical equipment: $109,000
Consumables" $5,000
Office Equipment: $12,000
Total: $126,000
The actual cost of the mobile unit we had $95,000
We prefer the stationary facility. We will sterilize 16,000 companion animals this year. We are able to provide these services to a region that is within a 120-mile radius of our clinic with a human population of approximately 1 million.
Please reference our website: feel free to visit anytime.
Response from Paul:
Mobile clinics serve specific needs, and, especially early on in the "spay - neuter movement", helped progressive groups get into clinic services with relatively minor investment and limited risk - if the clinic didn't work out, you could always sell it...Now, over a decade into the spay/neuter movement, low-cost spay/neuter services are no longer a progressive concept, but a de facto standard for any community building a comprehensive animal control policy. The bottom line on spay/neuter facilities these days is really about the bottom line: what's the biggest dent you can make with your fundraising dollar. And much as I hate to admit it - because I cut my teeth in this movement on a mobile clinic - I do believe the future of spay/neuter in the No More Homeless Pets Movement is the regional super clinic such as the model Quita has built in North Carolina (group hug).
And I'm not just kissing up to Quita. Hear me out...
If you read my study about mobile clinics, you may remember the analysis on the Salt Lake City Mobile Clinic. These folks run an impressive coalition-based, mobile operation, and truly maximize their clinic investment. They are limited only by the physical limitations of the clinic. And if there is a drawback on the mobile clinic, it is it's physical limitation of space. There are only just so many animals that can be done through a small, mobile facility.
The positive thing about mobile clinics, though, is their mobility. But what Quita and her staff have done in North Carolina with their fixed super clinic is merged the best of both types by perfecting the practice of the shuttle service. Quita can explain in more detail, but the basic concept is that she provides a shuttle service that goes out to far, rural reaches of her state and routinely transports pets in for the low-cost service, returning them at the drop-off spot the next day to their owners. The key point here is that Quita has "perfected" this practice, because it can be fraught with challenges. (Hopefully, she'll have time to elaborate on it in this forum.)
Both the Salt Lake Clinic and Quita's Clinic are regional facilities, covering several counties. The bottom line is that because Quita's clinic is fixed, she can expand the physical limitations of the facility as far as her shuttle outreach can reach. If she is ready for a second pair of surgery tables to meet increased demand, I believe it easier to expand another 300 square feet of floor space than buy another mobile clinic and annual mobile maintenance, etc.
I do believe that mobile clinics are a preferred option in specific situations, especially for coalition-based efforts and start-ups with limited fixed assets. But if you own floor space and have regional and/or statewide goals, Quita has proven that the fixed super clinic with regional transport is a formidable investment with potentially huge returns (you go girl).
Hope this helps.
How do you find a vet?
Question from a member:
We've had a lot of trouble finding a vet. How do you find and hire a good veterinarian for a non-profit clinic? It seems that most of them don't want to just do spay/neuter all day, or they are slower and can't keep up at the pace we are hoping for.Response from Quita:
We have 4 full time veterinarians at our clinic. We regularly employee relief vets to fill in for our staff vets. Word of mouth has proven invaluable within our own community. We are fortunate! People want to live in Asheville. Spay/Neuter veterinarians are a breed unto themselves. All 4 of our vets have these common characteristics:- Animal welfare comes first/ they are passionate about the mission.
- Their surgical skills are impeccable.
- They want only to perform surgical sterilizations.
- The safety of the animals comes first.
- Money is not a motivating factor. That does not mean they do not have to make a comfortable living.
- They do not want to manage staff.
- They prefer weekends off.
- They do not want to deal with clients.
- They prefer emergencies referred to an emergency clinic.
I would recommend you advertise in animal welfare publications, colleges of veterinary medicine, state veterinary medical associations publications, and JAVMA.
Response from Paul:
Doo daa, doo daa...Oh man - this has got to be the most potentially frustrating ailment of non-profit clinic operations - as sure and sorry as a stubbed toe. At some point or other it happens to anyone on the move, but nobody can offer any sure advice on how to avoid it.
I've seen a few state-of-the-art facilities sit idle for months, just selling leashes and collars, because they just had no luck attracting or keeping a vet. The happy ending is that every one of those clinics is now fully operational and doing fine, so stay focused and hopeful...
I've been there a few times, too (focused, hopeful and vet-less). And best advice I can give is to maximize the employment opportunity. Volume surgeons will have to work much harder than any general practice vet, and in the non-profit sector, rarely get paid comparable industry wage. Knowing this, non-profit clinic operators must work harder to provide competitive pay and benefits.
To get started with our New Orleans Clinic, we organized our clinic in shifts and utilized a few relief vets - each at one or two days per week and at-or-just-above standard relief scale for our area. It's also true that as soon as one vet wanted to do more, it seemed like another was wanting to back off. We just kept on working the relief community until a few solid performers rose above the others. Then we upped their pay just high enough above relief scale for a few of them to want to do it at least a few times per week, for the extra money if nothing else.
Eventually, we negotiated a full-time deal with one of the better surgeons, but we always kept a few relief vets involved just in case. Hang in there...
How do you advertise your programs in outlying areas?
Question from Jill:
When you are taking a mobile van into an outlying community or using your transportation van to go to other counties, how do you let people know in those areas about your services, book appointments, and determine a suitable location to park to do surgeries or meet people to transport their animals? It seems this would be difficult if you are not familiar with these communities. Do you have local people who help with these things? If so, are they paid or volunteers and how do you find them?Response from Paul:
I advocate working with local folks (volunteers) from the outlying communities to manage the waiting list, appointments and stand-bys in those communities. One way to solicit their support is to advertise your service in those outlying communities and mention that you are aiming to help those folks trying to help animals by extending your low-cost services to shelters and animal rescue groups. They'll be delighted to trade some admin work for a few cat spays each week. Good luck.Response from Quita:
One of the two components to our model is the partnership with 32 animal welfare organizations in 20 western NC counties. These organizations are tireless in their efforts to end the homeless pet crisis. The Humane Alliance Spay/Neuter Clinic provides the free transport service. We have a policies and procedures contract that the partners follow. They actually book all of the appointments in their communities, they provide all of the pre-op instructions, they arrange for the site pick-up and return, they are responsible for their own communities. It is an effective and innovative program that is implemented through the coordinated efforts of many talented and committed people. We do not find them, they find us.... absolutely amazing people. Last year we transported more than 10,000 companion animals to our facility for sterilization. Our vehicles traveled more than 55,000 miles.How do you get vets not to oppose your efforts?
Question from a member:
Our biggest problem is that our vet community is completely opposed to any type of low-cost spay/neuter program. They have threatened to stop us if we proceed with a clinic or mobile van. We have told them we will only focus on low-income areas and strays but they still view it as competition. How did you overcome the vet opposition to get your clinics up and running and show that you wouldn't be competition? Do they support your efforts now or is there still animosity?Response from Paul:
Got another story for you.When we first got started on the idea of opening that first clinic, I was dumb as a puppy about the whole thing - went around asking local vets for their advice on how best to get it started, asked them to think about how they'd like to help and asked that they please call with any advice... I got mostly blank stares and unreturned phone calls.
Some clarity did come, when, at a meeting with a few of the local "concerned" veterinarians, one finally said - out of astonishment, I think - "you do realize if you try to open this clinic, we're gonna have to protect ourselves."
...Protect what? How?
"The integrity of veterinary medicine!", he said. "You can't put people's pets on a surgery treadmill and expect to maintain high medical standards - it cheapens our profession".
All I heard was "profit, boy - we'll shut you down".
After that meeting, we very quietly continued our fundraising until we were able to purchase our mobile clinic. We hadn't pre-applied for a clinic license or even secured a vet - just drove the new clinic into town and called a press conference to announce the new project. At the press conference, we excitedly explained how the project would benefit our community, applauded those caring citizens who had helped fund it's purchase, and thanked, in advance, the caring veterinarians in our community who would help us make this project a success. We thanked the press for their interest and promised the press we'd keep them posted on our progress (with the vets).
We got a lot of initial press coverage, and eventually, a few caring veterinarians came forward to help. I sent all our press clippings to the state vet board along with our application for clinic license. We soon got our license and the project eventually came together and launched. But it was only just starting to get interesting...
During our first two years, we were TWICE required to defend our clinic through the State Attorney General's Office, and with a lot of sweat and research (and some tears), we prevailed each time. Those were tough times, and yes, almost ten years later, maybe there are still some hard feelings, but mostly there are fewer homeless animals being killed. And that is what we were working for all along.
I'm not necessarily advocating that you take the "workaround" approach that we did, just letting you know that you are not alone in your challenge with the vet industry. I recommend you get a copy of your state's Veterinary Practice Act Guidelines and get to know your options for non-profit ownership. Enlist other humane groups in your cause and share the clinic with them - harder for the vet board to fight a coalition than a single organization. Research volume clinic standards in quality clinics such as the Salt Lake Mobile clinic and Quita's clinic in North Carolina - get to know the business and medical issues (and myths). Form your business plan, get your funding together and go for it. The vets will eventually come around. Good luck.
Response from Quita:
I cannot begin to report the numbers of times I have heard "the local veterinary community is opposed to our low-cost spay/neuter clinic". To be completely honest, I have yet to hear a report of any local veterinary community enthusiastically welcoming a plan for a low-cost spay/neuter clinic. Please do not misinterpret that statement, just because I have not heard of it, does not mean it has not occurred.In our own community, 10 years ago, the local veterinarians did not greet the plan with open arms. The veterinarian that owns the practice received many concerned phone calls. Our founder, Bill McKelvy, met with the local veterinary association, and specifically defined the mission of our organization. The mission of the Humane Alliance Spay/Neuter Clinic is to provide low-cost sterilization services as a non-lethal solution to the companion animal overpopulation dilemma. Today, I believe the majority of the veterinarians in our community support our efforts. Experience has shown them:
We are committed to our mission. We do not provide any medical program other than spay/neuter. We do provide routine vaccinations but only at the time of sterilization. We offer that service, because rabies vaccinations are required by law.
We reference our clients to our local veterinarians for post-op checks. Most of the veterinarians in our community actually provide that post-op check at no charge to the client. Our post-op sheets are designed to encourage follow-up with a regular veterinary clinic.
I believe that the majority of the veterinarians in our community today realize that 87% of our clients do not have a regular veterinarian. As a matter of fact, 85% of our clients have never visited a veterinarian. I prefer to think that it is our failure to adequately inform and communicate with the veterinary community that causes their uneasiness about spay/neuter facilities.
Our medical protocol is impeccable.
10% of our clients are direct referrals from private veterinarians. We have never advertised our services.
Veterinary Practice Acts are the law of the state. Veterinary Medical Boards enforce those laws. Until a law is challenged it is constitutional. I am no lawyer but I think it is the right of every citizen in this country to challenge a law that might be considered unconstitutional. Please reference day one questions with regards to our response to contacting your state's veterinary medical board.
I am hoping that we all (animal welfare organizations and private veterinarians) have the wisdom to reflect on the true source of our conflicts. I refuse to accept that any of us would purposefully disregard that which is in the best interest of the animals. I have yet to meet an individual who does not hate the fact that we euthanize millions of companion animals every year in this country. I believe that it takes a cooperative partnership of the entire community to solve the homeless pet crisis. I know for a fact that private veterinary practices continue to open in our community. I do not know of one practice that has closed since we opened. That, to me, is a clear indication that the Humane Alliance Spay/Neuter Clinic, sterilizing 16,000 companion animals per year, poses no financial risk to the commerce of a private veterinary practice. I know that the last thing any of us need is another task BUT it is our responsibility to unify our efforts in a national campaign to dialogue with the veterinarians. Generally, human beings react fiercely when they feel threatened. I am concerned that any veterinarian would feel threatened by an endeavor to end the homeless pet crisis.
Can clinics and vans be self-supporting?
Question from Mary:
How can you make mobile vans or fixed clinics to be self-supporting? It seems they are so expensive and labor intensive to run. Can they support themselves or do you need to do other fundraising? What are your break even numbers of animals you have to do in order to stay out of debt?Response from Paul:
Great, Huge question. I'd like to refer you to the financial study on mobile clinics. There is extensive analysis on actual non-profit clinics that have achieved financial sustainability through various creative and ingenious means. It's actually good news!Response from Quita:
I would not have the answer to a mobile surgical unit, but yes, there is a way to meet the major portion of your costs in a stationary facility. The key is volume. We addressed this issue in the spring of 2000 at our clinic. I know it is late but we are hosting a seminar in Asheville, Sept 12th and 13th, "How to Open and Operate A High Volume, Low-Cost Spay/Neuter Clinic."My first question to you would be, can you book 25 surgical sterilizations per day, 5 days per week, 48 weeks per year? If you answer yes to that question, you could open a one-vet practice and meet the majority your costs.
We carefully analyzed our budget in the spring of 2000. We significantly increased our volume of patients and our staff.
This year we will sterilize 16,000 companion animals at our clinic. We have 3.5 veterinarians, 6 veterinary assistants, 1 kennel person, 1 transport driver, 1 office person, and a director. Absolutely, you are correct, it is labor intensive. The staff is the one indispensable element to any clinic program.
Please reference our answers to previous questions.
What areas do you focus on with limited funds?
Question from Jen:
We have limited funds and are trying to figure out what area to focus on - feral cats, low-income/owned pets, or shelter animals. Do you have any recommendation on focusing on one area over the other to start with? What have you found the area to be most successful in targeting and have you seen any results in terms of impounds going down or less animals being euthanized since your programs have been in effect?Response from Paul:
GREAT question. Answer depends on several factors. What all is going on in your community? Where are the voids in your community with respect to the big three: Low-cost spay/neuter, Adoption Outreach and Feral Cat TNR?If your community is weak across all three areas, and you want to focus your energies on a greatest-impact project, then the easy answer is focus on increasing low-cost spay-neuter services. Let that be your thing, do it well, and target the services to low-income folks, animal rescue groups (including TNR folks) and shelter adoptions. If there is already an adequate, accessible spay/neuter facility in your community, check it's customer demographic. If the mix of low income/med income folks is sufficient to meet low-income need in your area, check their volume on feral cat work. If not enough ferals come in, find out why. Are they pricing out ferals or are there not enough advocates in the area. If pricing is problem, focus on funding, and sponsor TNR folks. They can always use the support. If pricing is appropriate, but not enough ferals coming in, bust out your cat lady clothes, borrow your mother-in-law's car and go trap some cats.
Re your question about results:
In my hometown, we tried two experiments - in one parish, we focused high volume spay-neuter in a specific area overcome with feral cats. We worked in cooperation with a handful of TNR volunteers and the Animal Control Director in that parish, who monitored nuisance calls over a 10-month period. In the 10 months, nuisance calls had dropped 80+%. The Animal Control Director noted that for every nuisance call received, she had to send out an employee to investigate and file a report. So that was a measurable, cost-saving project. Plus, we got to meet some really cool feral cats.
In a second parish, over a three-year period, we targeted an aggressive high-volume, low-cost spay/neuter service to low-income pet owners. Over a three-year period, the parish achieved a 22% reduction in euthanasia. That, too, was really cool.
I've never seen a study that looks at overall impact of high-volume spay/neuter on all problem areas across the board. But if I had to guess, I'd say that as the problems in the lowest income areas improve, the problems across the board are positively affected. I do remember that when I was first trying to get my head around the whole pet overpopulation thing, I was shocked to learn that every single shelter director I interviewed about the problem confirmed/admitted that at least 90% of their shelter euthanasias were picked up in the lower-income areas of their AC district. That was most enlightening to me. Hope it helps.
Response from Quita:
The primary focus of our program's resources is targeted sterilization of pets belonging to low-income residents. We know that the majority of the companion animals being released to our shelter are from 2 zip codes in our county. We focus our resources on owned pets because adoption fees typically cover the cost of sterilization for shelter pets. Mandatory, pre-adopt sterilization is a component of our shelter and our foster/adoption programs. The euthanasia rate at our local shelter is down by more than 50%.I urge you to read, "New Hampshire's Campaign for a Publicly Funded Spay/Neuter Program", an interview with Peter Marsh. That interview is posted on Best Friends site, along with his e-mail address. The accomplishments of that program are tremendous.
What can organizations do if not ready for a mobile or fixed clinic?
Question from Carol in NC:
While a low-cost S/N clinic or mobile van is great, what can organizations like ours do? We are located in a rural county with an 86% kill rate at the county-run shelter. We don't have a lot of funds to help pay for spay neuter for low-income people, our county refuses to look into the I Care license plate spay neuter fund and the vets don't want to cooperate with us much. We get calls on a daily basis from owners who truly cannot afford to S/N their pets, who realize the problem it creates but have no place to turn. There is a mobile unit that comes to our county 3 times a year, which doesn't even make a dent in the problem. Any encouragement or direction for organizations like ours?Response from Paul:
I'm not sure that your organization is fundamentally different from most animal welfare groups...Here's what I got from your question:
You have a high kill-rate that you want to reduce.
You want to help poor folk's pets with low-cost spay-neuter.
You have limited funds.
Your community is not so inspired to help.
The first two issues are your goals and the third issue is your problem - funding!I'll get back to the fourth issue later.
Given that clarification, I'd like to reword the third issue this way: You want to increase funds to support your mission (#1 and #2).
And just to restate your question: "(Do you have) any encouragement or direction for organizations like ours?"
Yep, you need to increase funds so that you can afford the resources necessary to accomplish your goals... So, tomorrow and going forward, I'd encourage you to spend at least a third of your animal welfare time working on Goal Three.
I hope you'll accept that encouragement and direction, and if so, please read on...
Meaningful progress in your community will inspire your community to help (Issue 4). That's not haiku - just true.
If you want to affect meaningful progress in your community, you need to:
Quantify the problems that you are trying to address.
Identify resources that can remedy those problems.
Qualify your accessibility to those resources.
Implement a plan to acquire the necessary, accessible resources
Deliver the resources and monitor your progress. As problems arise, go back to step one.
Trust that any group out there that is making positive progress in their community follows some version of that approach - whether they realize it or not. Certainly, any for-profit business that succeeds - whether Elmer's Snowball Stand or Sam's Wal-Mart, follows that basic approach. So, I'm encouraging you here to approach your work a bit more like a business.
I do, of course, realize that it is much easier to offer such advice than to follow it. The process outlined above can be a bit complicated if you've never done it before, but I've got a deal for you: If you are game, I'll work with you over the next week to help you develop a basic strategic plan that encompasses steps one through five above. It'll be up to you to follow it through, of course, but there's another catch: if we do it, you have to let us post it for the NMHP forum readers next weekend...
Response from Quita:
I would suggest that your organization review some of the grant sources available online. Just do a search (animal welfare grants). Also some of the national organizations list grant sources on their sites. One foundation you might want to look at immediately is DJ&T Foundation. They provide spay/neuter funds and their guidelines are clear. If you receive funding from that foundation, they have a voucher program. You will need to meet with the veterinarians in your community to determine which ones will participate in the voucher program.There is also a great publication, National Guide to Funding for the Environment and Animal Welfare. Access information at www.fdncenter.org.
