Podcast – Business of Giving

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Larry Brilliant has had a career that lives up to his name. In the 1970s, he played a key role in work in Bangladesh and India to eradicate smallpox, personally witnessing the end of “an unbroken chain of transmission that went back to Pharaoh Ramses.” He then co-founded the Seva Foundation, which helps prevent and treat blindness in the developing world. He was the first director of tech philanthropy Google.org, and today he chairs the Skoll Global Threats Fund, tackling issues such as climate change and water security that, like smallpox before them, pose an existential danger to enormous swaths of humanity.

In his new memoir, Sometimes Brilliant, the physician and philanthropist details that remarkable journey, from his youth in Detroit and early medical career, through immersion in the ‘60s counterculture and Eastern philosophy, to his work today with tech moguls like eBay co-founder Jeff Skoll to achieve social change on a truly massive scale. In this edition of the Business of Giving, Dr. Brilliant walks us through some of his adventures as a civil-rights marcher, radical hippie doctor, meditating mystic, and groundbreaker in global health and Silicon Valley giving.

The following is a conversation between Dr. Larry Brilliant, author  of Sometimes Brilliant, and Denver Frederick, host of The Business of Giving on AM 970 The Answer in New York City. This transcript has been lightly edited for clarity.

https://soundcloud.com/business-of-giving/10-9-16-larry-brilliant-joins-denver-frederick/s-hiY6O

Denver: Back in July, Dr. Larry Brilliant joined us to discuss the launch of an HBO movie he had produced called Open Your Eyes, a compelling story of a husband and wife in Nepal whose sight is restored as result of the work of the Seva  Foundation founded by Dr. Brilliant and his wife. Well, he’s been good enough to come back and join us again… this time to discuss his memoir that will be released on Tuesday and aptly entitled Sometimes Brilliant. Good evening, Larry, and welcome back to The Business of Giving.

Larry: Nice to see you again, Denver. Thank you.

Denver: You have had a most remarkable life, so much so, it’s hard to know where to begin. But I think I’ll start with you sitting in Hill Auditorium at the University of Michigan campus on November 5, 1962… listening to a speech. Tell us about that day and the impact that it had on you.

Larry: I think everybody who’s gone to college remembers the sophomore year. It’s a tough year, anyway. And for me, it was tougher because my dad was dying of cancer.  As it would turn out, my dad and my grandfather both died inside of five days.

So, it was a tough time, and I had no inner resources to deal with that. I sort of locked myself up in my room in South Quad in Ann Arbor, and I think I was gobbling down burnt peanuts and reading Superman. That was my high and exalted way of dealing with depression. And I saw a little note in the college newspaper “The Michigan Daily” that said  Martin Luther King was going to be on campus. Nobody really knew who Martin Luther King was. He hadn’t yet given his speech “I Have a Dream.” He didn’t yet have his Nobel Prize. The world outside was filled with the Cuban missile standoff. Bob Dylan was singing “A Hard Rain’s A-Gonna Fall.”

It was a pretty complicated moment. It was raining and miserable weather, but somehow I took my sophomore ass out of the dorm and wandered into the auditorium.  And hardly anybody came. This huge auditorium that holds 3,000 people, it was hardly half-filled, or even less. The President was embarrassed, introduced Martin Luther King, and he looked out.  Instead of feeling bad, he laughed. He just laughed. And he said, “You all come on up here and sit on the stage; there will be more of me to go around.” And not everybody went up on stage…it kind of crowded the stage, and we all listened to him. And it was not like anything I had ever heard before. I had never heard someone talk about brotherhood. I had never heard anyone say, “We are all God’s children. We’re all in it together.” I had never heard anybody say that there’s a great movement for justice. I had never heard anyone say that “the arc of the moral universe bends toward justice, but you and I have got to jump up and help bend it.” I had never heard anybody say, “Join me, and make the world a better place.” He said things that opened up a space for me — a depressed, wonky, kind of pimple-faced kid — something I could do. I could kind of crawl out of my depression, and it wouldn’t all just be about me and the pain that I felt. And, of course, everybody that was on stage with him that day… that was in the auditorium, just began to march. Most went down that summer to Mississippi. Many had encounters that would change their lives. I stayed home with my dad because he was sick, but shortly afterwards I was marching in Chicago.

Denver: Got arrested, right?

Larry: Well, when I went to medical school and had a white coat on, the Medical Committee for Human Rights said, “Come on down to Chicago. Martin Luther King is going to make his march to the city. We want people wearing white coats with their stethoscopes dangling ostentatiously to form a cordon to protect him.”  I marched with Martin Luther King. We were all arrested together. And here’s a little secret: If you are ever going to be arrested — I tell my children — for a good cause, and there are some good causes, get arrested with 200, 300, 400, 500 of your best friends because then they put you in “pretend jail.” And you’re “pretend arrested.” And you can bring a guitar.

Denver: That’s great advice.

Larry: The cops were wonderful. This was not the kind of scene you think of when being arrested. They had to arrest us because we were blocking traffic. We had to go into Grant Park. They had to build a pretend jail, and Martin Luther King was there, and he just kept talking to us. I can’t remember the number of times I marched with him, but it certainly became the organizing principle of my life — the Civil Rights Movement, the movement against the war in Vietnam, and the movement itself. Because as it led into the ‘60s and the ‘70s, my generation, we thought we sensed that right around the corner was a better world… a world that had room for all of us, a room where black or white or male or female or tall or short or old or young… that we were all allowed into this great dream called America. And that was the magic that led to Haight Ashbury and the counterculture… and all rest of it.

Denver: And all the rest of it. Well, that day did have a profound influence on your life. As you noted, you became a doctor, I think, in part  because your father had cancer.  I know you had your own bout with it as well. So I’m going to move to the part of the book which really reads like fiction– not great fiction… because it’s almost too preposterous!  We’re going to start in 1969 at the infamous Alcatraz prison in San Francisco Bay, and it’s going to end in Bhola Island in Bangladesh in 1977. Take us on that extraordinary journey.

Larry: I was in pretend jail in Chicago. It was a real jail in Alcatraz, but I wasn’t a prisoner. I was finishing up my internship at what was then called Presbyterian Hospital; now, it’s called Pacific Medical Center.The treaties that the Indians had with United States of America were breached more often than they were upheld. But there was one treaty called the Laramie Treaty that said that if any land– having been taken from Indians, any federal land having been taken from Indians– is declared surplus, it must first be returned or offered to be returned to the Indians from whom it was taken. It seemed like a fair deal.

Alcatraz was Indian land, and it was seized and turned into a prison, and then the prison was closed in the early ‘60’s. And when the prison was closed, a number of Indians invoked the Laramie Treaty and said, “Give it back!” And the government didn’t want to do that. So, one night, undercover, several dozen young Indians from many different tribes — the Mohawk Indian Richard Oakes was leading, and a Lakota Sioux Indian named John Trudell was later one of the leaders — they occupied Alcatraz before the name “occupy” had much meaning. And they took over, and they would stay on the island for 18 months.  That became a big social drama. Every day in the newspapers and on TV shows in San Francisco, there would be interviews with the Coast Guard, who were ordered to put a ring around it and embargo and quarantine the island.  And somehow there’d be an interview with Buffy Sainte-Marie, who would fly out there, or Joan Baez who would go out there; The Grateful Dead would do a concert on Alcatraz. And they did a scorecard, and they asked people in San Francisco Bay, “Who do you want to vote for?” They loved the Coast Guard… I mean, we do love the Coast Guard of San Francisco. But it was 90/10 for Indians over the Coast Guard.

This was the most popular occupation imaginable.  But there was no water, no electricity, no medical care. And John Trudell’s wife was nine months pregnant. She wanted to give birth to a baby on Indian-held or reclaimed land, and the local columnist said, “Is there no doctor anywhere? Is there no doctor willing to go out there?“ Then, of course, that was made for me!

Denver: Yeah, absolutely! You were the guy!

Larry: So, I went out and I lived on Alcatraz, and the baby was born and given the name Wovoka, after a Paiute/Sioux Indian medicine man 200 years earlier who had prophesied that after his demise, he would return in 200 years, and it would be the beginning of the return of the Indian way. It was a magical night. A lot of bad things happened – a couple of Green Berets… Indians… who had taken some weird drugs started cutting themselves;  there was bleeding.  I had to sew people up, and in the end the Coast Guard had to medevac me and this one former Green Beret who was bleeding pretty badly. When our boat got to the shore… and I had finished sewing them up, an ambulance came and paramedics took him to the hospital. Then I looked up, and it seemed as if every television camera on the planet was there.

Denver: You became a media star.

Larry: And I was asked “What did the Indian want?” And, of course, I had never met an Indian until three weeks earlier.

Denver: Right. You’re their spokesman, all of a sudden.

Larry: Which, of course, no white kid from Detroit, Michigan could possibly carry that load. But Warner Brothers and some friends saw me on television. I got a phone call the next day asking if I wanted to join a movie caravan and play the role of a young doctor in a movie that Warner Brothers was making…kind of like a sequel to Woodstock… a bunch of hippies do rock and roll music.  And they wanted a Rock Doc.

Denver: Medicine Ball Caravan.

Larry: Medicine Ball Caravan.

Denver: And you went around following the likes of Jethro Tull and Grateful Dead and Joni Mitchell and Jefferson Airplane and…

Larry: B.B. King!

Denver: Yep, absolutely! And then that movie actually ends with a concert with Pink Floyd in Canterbury, England, correct?

Larry: Yes. it was incredible. Pink Floyd was amazing and, of course, I was in the Rock Doc tent taking care of people who would have minor cuts or bruises… or had taken the wrong pill or the wrong color, and trying to bring them down and make them healthy.  And that was the end of the caravan.

Denver: Then the caravan is going to start up again. From England, you’re going to drive across Europe… But instead, fate intervenes, and there’s a cyclone in Bangladesh.  

Larry: Yeah. I mean what happened was — we’ve all heard of the expression, “You’re either on the bus or off the bus,” the Ken Kesey expression. We started off driving, my wife and I —  Elaine was her name at that time… before she changed her name to Girija. But Elaine and I had a little microbus — we had a VW — so we were like the caboose. There were 25 or 30 big buses, and then there was our little putt-putt, the doctor’s VW. And over time, the charm of being on the real bus and being part of, for me, the Hog Farm commune — Wavy Gravy’s commune, the old Merry Pranksters — that became pretty seductive. When we got to England, a lot of the people were going home after the formal Warner Brothers movie ended.  A lot of others were thinking, “Can we get a couple of buses here and drive to Kathmandu?” K-K-K-Kathmandu. And it was the time of the hippie trail.

Denver: Yeah, sure. 1970 or so at that time.

Larry: Yeah, that was just succeeding the Silk Road. So we did. So we did a concert at the Round Tree with Stoneground, the band from the film. We raised $10,000. We brought a German MAN bus and a British Leyland transport. We had these two buses with 40 young people living in various different arrangements, living on that bus.  And the trip took us well over a year. But I have to say this: we drove through Turkey, Iran, Afghanistan, Iraq, Pakistan. These are names that when you hear them today, you tense up. It wasn’t like that. They were the nicest people in the world. And again, we — just as in walking in Nepal — we looked like Martians!  Can you imagine a bus — psychedelic-painted buses — and hippies wandering off wearing feather dusters and looking like cartoon characters? But everybody treated us so well. In fact, I can’t tell you — Afghanistan once, Iran once, in Pakistan several times — we’d be taken into the smallest little villages off the road, and if it was a Buddhist village, there’d be a little shrine with the statue of Buddha. If it was Hindu, there’d be a shrine to Shiva or Ram. If it was a Muslim village, there’d be a little drawing… maybe of the Kaaba of Mecca. And right next to that holy of holy places, there’d be a photograph framed of John F. Kennedy. It’s going to be a long time before there’s another photograph of an American President in those villages.

Denver: In those places, that’s for sure.

Larry: And that to me is the saddest part about having had this experience that my children cannot have now. My kids can’t go  thru the Khyber Pass; they can’t walk up and down through Iran, and we can’t see these people as anything other than through the lens of the military efforts that have gone on. And it isn’t like that!  That’s not who they are, and this is not who we are!

Denver: Not the way it was. Well, you end up in a Himalayan monastery. What happens there?

Larry: When I was an intern, you don’t get a lot of days off.  But I got Thursdays off. A fellow named Baba Ram Dass — used to be called Richard Alpert–had been a professor at Harvard — he was doing three lectures in San Francisco every Thursday night, as it turned out, at the Unitarian Church. He had just come back from India. He had become Baba Ram Dass because he had met a guru. The guru’s name was Neem Karoli Baba, called also Maharaj-ji, and people hid his location; it was kind of opaque where he lived. But this guy Ram Dass, he had a way about him, not unlike Martin Luther King– that when you listened to him, the world stopped. I mean I remember him telling a story of a young man who is asked to kill a chicken, and his dad told him, “Take the chicken out where nobody can see you, and cut off its throat.” And after a couple hours, the guy comes back to his dad and says, “I didn’t do it.” He says, “Why didn’t you kill the chicken?” He says, “You told me to take the chicken out and kill it where no one sees.  But everywhere I go, the chicken sees.” And that kind of light humor but if you think about that– a little deeper wisdom, coupled with the fact that he’d be talking about God… or the meaning of life… and trying to open the way to think about Judaism, Christianity, Islam, and Buddhism.  There’d be a baby crying, and he would just incorporate that. I could never reproduce what Ram Dass did that night, but it was magical!

And all of the sudden on the bus trip– now years later, we are driving into India after having gone through the journey to the East–every night we read the book Journey to the East and here we are…we’re driving into New Delhi. Like all the other kids on the road, we want to get our mail, and you got your mail at the American Express office. So we’re parked in Connaught Circus, walking into American Express, and who’s in line in front of us? Ram Dass! That same guy who put us on top of the world years earlier. And one thing led to the other. My wife became extremely interested in the teaching of Ram Dass and his guru, and she immediately went to live in the ashram. And I wasn’t as smart as she was; I never have been.  I stayed on the hippie trail for another six months, came back to San Francisco, paid off our debts.  Then my wife and I had some tough negotiating over crackling phone lines when I was in San Francisco…I’m saying, “Come home.” And she was saying, “No. You come to the Himalayas and meet Maharj-ji.”

Denver: Sounds like not the first one you lost.

Larry: No. Well, I got lucky… there was a war, and all the Westerners were kicked out of India because the India-Pakistan war happened. She came home, but only on the provision that after we cleared up my medical school debts, that we would go back.  And we did. We went back, and I met this teacher Neem Karoli Baba who at first I thought was a cult.  I didn’t want to touch his feet. He has all these idols there. I mean it was really–

Denver: Not your cup of tea.

Larry: It was not my cup of tea. And then after about a week, I was totally hooked — hook, line  and sinker. And I’ll tell you why that was. You can talk about theology, or you can talk about meditation or the practices.  But for me, it was pretty simple. I would sit in front of this strange-looking man — he was a fat Indian, old, wrapped in a blanket — looked like a Scottish plaid blanket — and I sat there, and he would just emanate a feeling that he loved everybody in the world.

And that wasn’t what did it for me. In my young 26-year-old way, I sort of thought, “He should love everybody in the world; he’s a guru. Right? That’s sort of his job.“ But that’s not what got me. What got me is that when I sat in front of him, I loved everybody in the world, unconditionally!  I forgave the guys at the hospital who had taken my photograph that was on a medical magazine, and had put it on the bulletin board with a hypodermic needle in my nose saying, “We welcome our young, radical doctor.” I forgave everybody. I didn’t feel hatred at all. So it was what happened to me, the feeling that I had of this universality that made me realize that whatever this guy has learned, whatever he’s doing, I want some of it. And that’s why I stayed.

Denver: Well, then your guru… or your yogi… speaks to you about smallpox. What’s going on in the world with smallpox at that time?  What does he tell you?

Larry: I was like everybody else there at the ashram. We’d come in in the morning, and we’d meditate.  He would come in, and we’d sit around him. It’s called darshan. It’s like having an audience. An audience means to hear the pope or to hear someone you respect; darshan means to see them, and it’s the same idea. It was just kind of an ordinary day. The rhythm of the ashram was going on. There’d be praying and chanting and singing and walking around and going to the little town and looking at all the temples. And this one day he just called me in, and the name that he had given me was Dr. America. So he would go, “Dr. America!” I didn’t even like the name because Ram Dass got a name Ram Dass… Krishna Das, the Das brothers.  I wanted a spiritual name.

Denver: A little more exotic than Dr. America, but that’s what you got.

Larry: Dr. America. That’s the name that I got. He’d call; he’d say, “Dr. America!” And I came in,  and he said, “How much money do you have?” And I went–I mean my first reaction was, “I thought this guy was above money.” And now, what’s he going to do?

Denver: This is what it’s all about?

Larry: Every little paranoid bit that I thought that I had squished in my brain came back up. And he said, “How much money do you have? “ And I thought about it. I said, “I have $500.” He turned his head back to me. He said “$500. That’s not a lot of money. Is that all you have?” And I said, “Yes, that’s all I have.” He said, “Oh, that’s all you have here. What do you have back in America?” And I’m thinking, “This is really going–” I said, “Well, I have $500 there, too.” And then he said in a sing-song way, “500 here, 500 there. That’s not much money.” He’s doing all this in Hindi. And then he looked at me and he said, “You’re going to have to go to work?” And I’m thinking, “Work? No, we’re living in a monastery.”

Denver: Right, I’m meditating all day.

Larry: He said, “You’re going to have to go to work.” I said, “Work? No.” He said, “$500. That’s not much money. You are no doctor.” He said,”You are no doctor.” And this is all in Hindi. “Tum ho doktar nahin.” And then he goes into English, and he says, “You are no doctor.”. He says, “You are no doctor. You N-O doctor. You N-O doctor. You N-O doctor. You’re going to be a UN doctor. You’re going to go work for the United Nations. That’s right. I can see it now. You’re going to go work for the United Nations. You’re going to give vaccinations in villages, and you’re going to help eradicate smallpox, a terrible disease that’s been killing children. This is God’s gift to humanity, that this one burden, this one disease that has killed people for thousands of years, it’s going to be obliterated.”  It’s going to be “unmoolan,” which means literally pull out the root. It’s the same word in Hindi as eradicate.

Denver: And you know smallpox from nothing.

Larry: Well, I think in medical school, there might have been one slide and one course on tropical medicine. But I’d seen children in India while I was there with pock-marked faces… blind… and pock-marked faces. In that year, there were a quarter-of-a-million children who were afflicted in India with smallpox.

Denver: So you have to go to the World Health Organization’s offices to see if you can get a job, which is a long, long trip. Tell us how that all went down.

Larry: After he said that I was going to go become a United Nations medical officer, it was just so preposterous to me. I mean, I was a hippie. I graduated medical school and got an internship; that was it. I’d never had a job. I ran away with the circus. I didn’t have a job, and I just wanted to pretend he never said it. So for the next couple of weeks, Girija and I would avoid him, and we hoped that he wouldn’t raise the subject again. It was too embarrassing because I was so inadequate. And after a couple of weeks he said, “Did you get your job yet?” And I said, “No, Maharaj-ji.” “Did you go to WHO?” I said, “No Maharaj-ji.” He said, “Go! Right now.” So, we had to take a taxi to the bus station, take a bus, take a taxi and then a rickshaw, and go to the WHO office. I walked in there– Lord, help me, I walked in there with hair down to the middle of my back, a big bushy beard down to my belly, and I was still wearing an ashram gown that looked like a dress. I mean…where to change?

Denver: Yeah, good luck.

Larry: And I walked in there, and they looked at me and they said, “What are you here for?” And I said, “Well, my guru who lives in the Himalayas says that I am here to work with you to help eradicate smallpox. It is God’s gift to humanity because of the hard work of–” And that was it…I was out of there. And I went back to see Maharaj-ji, “Did you get your job?”

I said, “No, Maharaj-ji.” He said, “Go back.” And I went back again, and after four or five times–I got a little smarter. I trimmed the beard. I put on pants. I got a shirt.

Denver: And this was a 17-hour trip; this is not just down the street.

Larry: It’s  17-hours–yeah; this is not down the street.  And I would come back, and I would say,  “No.” And after a while, it was getting kind of old. I mean, even for somebody who was enthralled by the ashram and the monastic life, this was getting old. And then one day he said something like, “Did you get your job yet?” And I said, “No.” He said, “Go right now. Go this very minute.” And we were at his other ashram, which was only about a 4-hour ride away. We took a rickshaw to a train, a train to Delhi, a Delhi rickshaw. And I walked in–and by this time I had a white shirt, but still no tie.  When I walked into the office, the receptionist named Edna Boyer, who was an Anglo-Indian — her mom had been Indian; her dad had been a British officer — and she didn’t look like the other Indians… didn’t wear a sari, and she was always very kind to me. I walked in there, and there was another American there, and he looked like a football coach.

And I walked in, and he said, “Son, what are you doing here?  Who are you?” I said, “Oh, my guru who lives in the Himalayas says that I’m supposed to come work for the smallpox program. Did you know that this is God’s gift to humanity because–” And I said, “Who are you?” He said, “Oh, my name is D.A. Henderson. I’m the head of the smallpox program and I’m here from Geneva, but we have no smallpox program in India. It’s not one of Mrs. Gandhi’s priorities.”

Denver: That’s right!

Larry: “And that’s actually why I’m here. I’m here to go see her and try to convince her that we should have a program here.”  I sat down.  I was despondent. Mrs. Boyer came up and said, “The French woman who runs the smallpox program asked if you want to come up and be interviewed.” And so I went up to her office– Nicole Grasset. She looked like she was out of the pages of Vogue or had been walking down the Champs-Elysees. She didn’t look like the other people in India look.  And there was D.A. Henderson, and she said, “Look, we can’t hire you; there’s no job, but D.A. Henderson said he’d interview you for the record.” And he did. He took me inside. He interviewed me.

Years later, after we eradicated smallpox– 10 years later– D.A. asked me to go back to India — by then I was a Professor at Michigan — and asked me to close down the shop because we had finished eradicating smallpox– take all the records, take them back to United States, microfilm them, put them in order so that there’d be a historical record. I found his interview of me. And he said, “I’ve just interviewed a young man named Larry Brilliant. He says he’s a doctor. He doesn’t look like a doctor. He appears to have gone “native.”  Nice kid. I hope he does well, but he’s got no training. Got no medical training after internship, and we don’t have a program, so there’s no job for him. Good luck kid!” I mean that was it.

Denver: But eventually you do get hired… and probably– predominantly– because you speak Hindi… and you can type. And you begin to work on that program.  I think the strategy for that program– working in India around smallpox– was really started by Bill Foege.

Larry: That’s right.

Denver: He went on to be the head of the CDC. I think he was very influential in Bill Gates’  life in terms of having him support global health. What was his strategy that saved the world from smallpox?

Larry: Well, the first thing was that in order to hire me, Nicole had to create a lower category than had ever been created.

Denver: Congratulations.

Larry: I was not hired as a doctor. I was hired, as you say, as a typist, and I could speak Hindi.  Indians liked me. I liked India, and I was comfortable with the customs. I lived in India for almost 10 years. And then after I was working as a typist for about six months, the big program began–which was  “search and containment”: to find every single case of smallpox everywhere in the world.. at the same time, and draw a ring of immunity around it.  Instead of just kind of haphazardly vaccinating everybody that you can…That was Bill’s strategy. He created that!

And on the eve of the first all-India search, there was a shortfall in epidemiologists.  Some of the professors — these were all professors– 15 years older than me, and D.A. is almost 20 years older than me — I was the youngest person ever hired by WHO. I’m 26 at that point; these were all people in their 50s. And a professor of epidemiology from Leningrad, a Russian, couldn’t make it; a couple other people couldn’t make it. And Nicole said to Bill, “Do you want to try the kid?” I mean I can’t even imagine what their conversation was like, “Do you want to try the rookie?” I mean, “Put him in, coach.” And Bill offered to take me to the field; my first time in a village with smallpox was with Bill Foege.

And I remember going into this village, and we didn’t find any smallpox. And the driver said,”Let’s go,” and Bill said,” No, there’s probably some smallpox here.” We couldn’t find any, We went door to door. No one has smallpox. And Bill said to me, “You speak Hindi? Why don’t you tell them the tallest man in the world has come to their village, and let’s see what the kids do.” And I translated into Hindi, and the head man repeated — Bill was 6’7”, 6’8”– the tallest man in the world, and all of a sudden, these kids come flocking in.  And we see children with smallpox on their arms, on their face; and then we start asking, “How many cases are there at home?” We were brought back … behind the curtain — and we found children who are dying of smallpox. And I had never seen anything so horrible in my life. My reaction, in retrospect, was crazy. I said, “How do you call 911? How do we get an ambulance?” And Bill put his arm on me and said, “Listen, son. There’s no treatment. There’s nothing you can do. That’s why we have to eradicate this. We have to prevent it.”

Denver: Every single case.

Larry: Every single one. Because no child should be in the situation that these are in right now.  I was crying like — not only did I not look like a UN officer, I didn’t look like a doctor… I was crying like a baby. And then he said to me, “Every one of us has been exactly where you are right now — crying in the face of this unimaginable suffering, and feeling so helpless. And now you’re going to have to go through a transition where you can’t be a clinical doctor and think only of that one child in front of you. You’ve got to think as an epidemiologist, of all the people with hundreds of thousands of children in India that have this disease, and we have to build a program that scales, that’s well managed. It’s going to be difficult, but I think you can do it.”

Denver: And at this time in India, the rivers are not even flowing because there are so many dead bodies in them.

Larry: That was only true for one river, and that was in a place called Tatanagar, the main city of  then the largest corporation in India, and I never saw that. Certainly, that was the rumor, that there were so many dead children that their rivers didn’t run. But Tatanagar had become the largest exporter of smallpox in the world. That was when we were close to cleaning up… finishing smallpox everywhere else.  But this one industrial town was like Detroit in the ‘60s or Pittsburgh;  it was a place that you can always go and get a job. And so young, uneducated Indians from all over the world came there, got a job– or were looking for a job– contracted smallpox, and then wanted to go home, and died on a train, and carried smallpox back all over. And that’s where we heard that the rivers were so clogged with bodies.

Denver: So you begin to go door to door. At this time you reproduced a picture, which at that time was the most reproduced picture in the world. Tell us about that.

Larry: I didn’t reproduce that, but it was reproduced by CDC. It was a young boy whose name was Muhammad Ali, a different Muhammad Ali, obviously. He was a Pakistani. A CDC epidemiologist was living in the area that this family that got smallpox.  One brother got it; another brother got it,  and this little baby then got it.  The moment that the baby got a rash, the CDC epidemiologist came back and photographed him every day and chronicled and documented what the evolution of the smallpox rash was. And then that photo was reproduced as a placard, and every one of us carried it because Hindi had 1,200 languages. Smallpox was called “chechak”  and “sheetla mata,”  “mariamman,”  “boshonto,” and so you couldn’t say, “Is this disease in your house?“ But you show the picture, “Is there any child that has a disease like this?” Inevitably, you’d be taken in.

We also turned it into leaflets. We dropped it from helicopters. I got into trouble dropping leaflets of all things–again– God, forgive me– on top of the WHO building. I got a little enthusiastic. Even my wife went up in helicopters. I remember a Russian who was dropping these leaflets all over India. Of all the different kinds of structures in the Indian government, it was the Indian Air Force that really liked the idea of eradicating smallpox. They had seen so many children die of smallpox in the Air Force barracks. And they would give us planes, and we were all over the place dropping these leaflets.

Denver: And you’re leading the peacetime army of 100,000  or so in Northern India.  Eventually this culminates in Bhola Island in Bangladesh in 1977. Tell us about that moment.

Larry: So the last case of smallpox in India was a woman named Saiban Bibi, who was a Bangladeshi, who had crossed over into Assam, which is a northern state of India. Smallpox made her destitute; she was a beggar, and she got on a train and went across the border. And there were increasing numbers of importations into India as Pakistan had eradicated smallpox; Nepal and Sri Lanka had eradicated smallpox; India was now free, but there were cases coming across from Bangladesh. And I was asked to go to Bangladesh — they were struggling with the very last cases in the world — and I was sent down to Bhola Island, which was the same island that had that horrible cyclone in 1972. The Hog Farm had had its first idea to bring medicine to the survivors of that cyclone. Ironically, I went down to Bhola Island, and I sat in front of this young girl Rahima Banu, who was the last case of smallpox, the last case of variola major, a killer smallpox —  but there’s another milder form — the last case of killer smallpox in the world. And I meditated and sat in front of her.  I realized that when she coughed, and the last viruses left her body and landed on the soil in front of her in Bangladesh… and the sun killed off those viruses…that was the end of an unbroken chain of transmission that went back to Pharaoh Ramses. That was it.

Denver: Yeah, that’s right.

Larry: Now that I’m an adult, and I see a world filled with so much hate and pessimism, I think back to that moment. How could anyone not be optimistic when you think that a disease that killed half a billion people… 500 million people… only a generation ago– that that disease is gone.  And we did it by Russians and Americans working together… Indians…doctors in 30 countries. That’s what makes me optimistic. And she is the symbol to me of the end of one form of suffering, and to me, as a religious person, the symbol of what my guru had said would happen.

Denver: And it did. It’s one of the extraordinary achievements in human history. An interesting footnote to that is that the vaccine for smallpox was actually found around 200 years earlier by Edward Jenner, and the story around it is utterly fascinating. Tell us about it.

Larry: I do love looking back into history and seeing some of these ridiculous, crazy ideas — I forgot what the aphorism is. “First, they laugh at you, then they deny what you’re saying; then they indict you; then they agree with you, and then they steal your idea.”

Denver: That’s the progression.

Larry: So this fellow who made his name studying cuckoo birds, and many people thought of him as cuckoo, Edward Jenner– he observed the aphorism that they used to say in England at the time… 1790s, that “she had a complexion as pretty as a milkmaid.” In fact we’ve said things like that even 20, 30 years ago, if you read literature from the ‘50s. And I always thought it meant that milkmaids drink milk, and that it gave them a nice complexion. I may have taken a glass of milk or two myself as a young teenager with acne. But that’s not what it meant. It meant that everybody else had pocks on their face and scars on their face… except milkmaids.

And he reasoned, “Why was this? Why does a milkmaid not have pocks on her face?” And he saw that sometimes a milkmaid had pock marks on her fingers, and these were the fingers that had milked the cow. And then he looked on the cow, and the udder…the nipple of the cow… had on it a pock mark. And — remember that nobody knows germ theory at this time. There’s not been a microscope yet. We think that miasma and bad air cause diseases in 1790s. And he thinks:  “Well, maybe something hopped from that cow’s udder to the finger of the milkmaid, and then she was spared from getting smallpox on her face.”  And then he does something absolutely crazy. He takes the oozy pus — no other way to say it — and he puts it into the arm of a young boy, and the boy’s name is Phelpps, and he carves a little scratch on the boy’s arm and puts the oozy pus in. Then he tells the boy to go out to a village near London that’s filled with smallpox into the market place. And the boy comes back, and they wait one week, two weeks, three weeks… and he doesn’t have smallpox.

By the reasoning of the time, he should have had smallpox. And Jenner takes this idea and he believes now–and you have to understand, this is a medical impossibility at the time. It’s a trans-specieal immunogenicity. And he goes to the Royal Society, which is the oldest learned academy in the world, and he says, “My idea is that if we take oozing pus from the fingers of milkmaids, and we give it to children, they will be spared from smallpox.” And they laughed him out, over and over. For years, they laughed him out. And over time, people began to realize that there is a disease cowpox–which if you get it– it protects you from smallpox. And because the process of scratching the hand with the cowpox–it used to be called “inoculation,” he changed it to “vaccination.”

Denver: It’s where vaccine came from, right?

Larry: That’s where vaccine came from. And the word “vaccine,” do you know what it means? It means cow, vaccas. So every time you’re sending your kid out to get a measles vaccine or influenza vaccine, you’re giving him a cow. Vaccine means cow. And so I just love the story of how we’ve all taken cows to protect us from the worst diseases in the world.

Denver: Well that is a great story. I’m gonna fast forward to 2006 and you, Larry, have just been awarded the TED prize.  In your speech, you stated that your one wish for the world was to build a global system to detect each new disease or disaster as quickly as it emerges or occurs. Now as I understand it, and I may be wrong, if nothing were to be done — scientists believe that we are headed for an era of pandemics. But the tools and technologies you spoke about in 2006, they’re coming on line now to address these outbreaks. So let me ask you about each. First, why are we headed toward an age of pandemics?

Larry: Oh, I think we’re already here. Zika, Ebola, SARS, MERS, Swine Flu, Bird Flu, all of these diseases. More people…we’re living closer together. We’ve cut down forests that used to be places that only animals live with their viruses. HIV/AIDS jumped from chimpanzees and monkeys to humans. Many of the diseases that we know, like Ebola, jumped from bats to humans. SARS was a bat disease that jumped to a civet cat in a wet market in Hong Kong. So these are so zoonotic diseases, and over the past 30 years there have been 30 novel zoonotic diseases with pandemic potential. And as we move more into animal areas and consume more animals…

I mean, last year Africans alone consumed 1.8 billion wild animals. We’re heading into what looks like a prolonged battle with these new diseases.  In fact, the other day, I was talking to some people who, with money from USAID and others, are trying to put together an atlas of all the bad viruses in animals  everywhere in the world– to try to understand what the possible scope and scale of the problem are. So that’s one thing. I think we’re in for a photo finish against Zika, which is potentially one of the worst diseases we’ve seen since HIV/AIDS. But the photo finish is because… just as modernity is creating the circumstances that puts us more at risk of a pandemic, the same modernity is giving us the technology to avert getting those pandemics. And the major, major part of that technology is the ability to have early warning.

Some of the digital disease-detection systems — when I was at Google, we built Google Flu Trends. Now, there’s a participatory surveillance health map out of Harvard, Boston Children’s Hospital, and it now is running a program called Flu Near You.   That’s able to show where influenza is in the United States a week or two before CDC can, because people are online, and they’re getting a little email or text message every Monday or Tuesday saying, “Are you sick, or are you well?” They answer it, and you can make a spot map immediately of the country and see where the disease is.

And the most important thing I learned in smallpox is that early detection, early response–that mantra– is what made it possible to eradicate smallpox. And that’s true for polio.. and every other disease. Ebola, which took six months to detect, that’s the reason that WHO and the rest of the world fell behind it. And there’s sort of a mathematical progression. If every disease leads to three more, every two or three days… or every week, you can see that if you leave that unattended for six months, you have a billion cases.

Denver: Yeah, it happens fast.

Larry: And you can’t do anything much if you start off with a billion sick people. But if it’s one case leads to three, leads to nine, leads to 27,  and you’re there after there’s only three cases, then it’s pretty easy to draw a ring around it– even if you don’t have a vaccine or an anti- viral… if you just quarantine the old fashioned way. So we’re now in a position where the tools for early detection are growing, becoming more sophisticated…

Denver: And especially these informal networks which were never allowed before, correct?

Larry: That’s right. Until 2006, the World Health Organization and the United Nations were very stiff. They had by contract, by treaty, by agreement that WHO could not take cognizance, could not notice, could not act on a report that came from just a regular person about a new outbreak of an exotic disease. That report had to go to your local doctor, who had to put it out to the hospital, had to put it to your district or state, to your country, and then only to your health minister or health secretary who was allowed to call WHO.

In 2006, that was all changed. A new global treaty called the International Health Regulations was ratified, which now says WHO must take action if they get a phone call from a citizen, if they get a phone call from a church, if they get a phone call from a hospital, or if they get an electronic message from one of these new digital systems.

Denver: That’s a game changer.

Larry: Well, let me tell you how much of a changer it is. We estimate — it’s only an estimate — that 15 years ago, the first case of one these bad bugs — these pandemic potential viruses that jumped from an animal to a human — the first case took six months to be reported to WHO and acted upon. Now, we’re down to two, three, four weeks. And if we can get that number down, so it’s less than an incubation period, then I think that in the photo finish–

Denver: That’s a photo finish.

Larry: –between humans and bugs, humans are going to win. If we don’t, then–well, I don’t think I can bet on the bugs… I’m much less optimistic.

Denver: Right, for sure. Let me take it to one of your current reincarnations,  and that’s as the Chairman of the Skoll Global Threats Fund, which was started by the Ebay founder Jeffrey Skoll. Now, there are five global threats that they’ve identified: climate change, water security, pandemics, nuclear proliferation and the Middle East conflict. So let me ask you, Larry, at the time when organizations are trying to narrow their focus so they can have an impact, why would an institution come into being with such a daunting agenda?

Larry: Well, Jeff Skoll is a lovely, wonderful man. He not only started this Skoll Global Threats Fund, he started the Skoll Foundation, which he’s endowed with $1 billion and has funded close to 100 social entrepreneurs to start them on their way in a whole variety of different activities. These young kids… you meet them, and it looks like they’ve got searchlights in the middle of their forehead.  They really inspire you. He also started Participant Media which just won the Oscar for Spotlight and did movies like Contagion, Last Chance, Marigold Hotel, The Visitor, The Soloist, so many other great movies. So he’s a pretty eclectic guy.

I gave a speech at the Skoll World Forum one year. I met Jeff, and I said, “Have you been to India?” and he said, “Not much.” And I said, “All the things you’re doing, if you haven’t been to India, you’ve wasted your entire life. You have to come to India.” So he came to India, and we spent a week going around and looking at the new, modern companies. But I also took him to villages that had little children with polio. I showed him where the last cases of smallpox were; I took him up to my ashram, and we traveled the length and breadth of India together.

He came back saying that all these good things that he was trying to do with his movies and the Skoll Foundation… and all these other people, these new philanthropists, the Medicis of Silicon Valley, the Benioffs of the world, all the good things that people are trying to do… in the face of that, there are a category of events that could happen–maybe low probability but highly consequential– that could bring humanity to our knees.

And he had his list; everybody has their own list. And his list was pandemics; it was nuclear war; it was water; and certainly, it was climate change; and regional conflagrations that become World Wars. So he said, “I’m going to start an organization that looks just at these global threats.” And that was the rationale. Because whether you’re talking about cyber terrorism or bioterrorism, the instrumentality can be a virus that’s an organism or a virus which is a computer virus.  But the motivations of the people who are willing to let loose these horrible things will be the same. So, you can gain a lot by looking at the governance issues, the psychological and social issues. If you’re looking at water and climate, there are people who argue the effects on the world are the same, that because of climate change, water…

Denver: They’re all interrelated, in other words.

Larry: So interrelated. Yeah. And I just take my hat off to him for being brave and courageous enough to create something with such a daunting vision.

Denver: Yeah, absolutely. Let me get you out on this. You have said that you’ve often wrestled with the meaning of this line — “Live your life without ambition, but live as those who are ambitious.”  What does that phrase mean to you, Larry?

Larry: That’s a line from a theosophical book called Light On The Path by Mabel Collins. I think if you’re doing good work because you’re hoping to get a Nobel Prize or be feted at the next meeting of the hospital board, that’s great. Whatever your motivation is, the good work that you’re doing will live after you, and it’s noble and wonderful.

But there is another level. We all know people like this in our life — the people who do great work.  And then when it comes time to get the awards, they’re the ones you can’t find. We know people in our Boy Scout groups and our church groups. We know people in our schools who are always there, always doing the work, but not the first to say: “ I did it!”  Not the first to take credit. To be ambitious to do good: I think that’s Christian, it’s Jewish, it’s Buddhist, it’s Hindu, it’s the highest of all of ours. And then to say: ”I’m doing it for God; I’m doing this  for the greater good; I’m doing it for the kids; I’m not doing it for me.  That’s a little harder, and that’s what my teacher told me I should do. Now I fail every day… a hundred times. In this last two- minute conversation, I failed 50 times. You shouldn’t be afraid of failing; you should aspire to do the best you can with the tools you’ve been given, and not worry so much about taking credit. Even if you’re thinking about your own enlightened self-interest and counting karma points, leave that for the others.

Denver: It’s intrinsic motivation, not extrinsic, that really makes the difference. Well, Dr. Larry Brilliant, I want to thank you so much for being with us this evening. The book again is Sometimes Brilliant.  It’s published by HarperCollins. And not only is it a wonderful read of a remarkable life, but the wisdom and insights provided will better inform your own life and your search for meaning in it. It was a real pleasure to have you on the show, Larry.

Larry: Thank you.

The Business of Giving can be heard every Sunday evening between 6 and 7 PM Eastern on AM 970 The Answer in New York and on I Heart Radio. You can follow us at bizofgive on twitter and at facebook.com/businessofgiving.

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Caryl Stern says that when she became CEO of the U.S. Fund for Unicef, she replaced its hierarchical “pyramid” leadership structure with “a series of circles” built on teamwork and feedback.  She also details the charity’s wearable-tech venture, Unicef Kid Power, and some of the special relationships it has forged in the business world, and talks about combating donors’ “disaster fatigue.”

The following is a conversation between Caryl Stern, President and CEO of the US Fund for UNICEF, and Denver Frederick, host of The Business of Giving on AM 970 The Answer in New York City.

Ms. Caryl Stern, President and CEO of the US Fund for UNICEF

Denver: There are leaders of major international aid organizations that possess all the skills and talents and managerial capabilities to successfully lead their organization in its life changing work. But there are only a few who not only possess those traits but just  strike you as having been born for the job. Caryl Stern, the President and CEO of the US Fund for UNICEF happens to be one those people, and she’s with us now. Good evening, Caryl, and welcome to The Business of Giving.

Caryl: Thanks! Nice to be here.

Denver: Let’s begin by having you tell us the mission and goals of the US Fund for UNICEF.  And what exactly is the nature of the relationship between the US Fund and  UNICEF?

Caryl: Sure! Well, UNICEF International is the organization that does really whatever it takes to save a child anywhere in the world. Working in 190 countries, 12,000 boots on the ground, under the phenomenal leadership of the Executive Director, Tony Lake. Underneath that, independent of it, there are 34 organizations around the world that enable that work.  I have the privilege to run the US arm of that– the US Fund for UNICEF. We are a 501(c)(3) located in New York City, and we have a tripartite mission. First and foremost, we raise money; it is our job to raise the dollars to help to make UNICEF’s work possible. Secondly, we are the voice of children from around the globe here in the US.  So, a part of my job is to go and bear witness to what’s going on around the globe and come back and talk about it. And then the third part, hopefully, is to raise a generation here in the United States that will do a better job than we have done thus far of saving, protecting and insuring that the the world’s children thrive.

Denver: That’s a great mission. Let’s talk about the current state of the world for a moment.  Perhaps you could do that through the lens of the three emergency levels that the UN uses to classify a crisis. What is the look these days?

Caryl: The UN does classify emergencies.  Obviously, not every emergency rises to the same necessity of response.  So, there’s a level 1, a level 2, and level 3 is the highest level of emergency. And up until about a year and a half ago, on occasion, you’d have one or two level 3s at the same time.  Currently there are five and unfortunately for those who respond… and not just UNICEF…all of the UN agencies that respond, the other NGOs..these are not either/ors.  You can’t say: “Okay, we’ll fund what’s happening in Syria right now instead of funding the response to Ebola, or the response currently to Zika.” They have to be “ands”; you’ve got to figure out how you are going respond to this, and this, and this, and this and this. Its an “and,” and an “and,” and an “and,” right now.

Denver: One of those level 3s is the refugee crisis.  Matthew Bishop of The Economist was on the show earlier this year, and we were talking about Davos.  He said it was the Number 1  topic of conversation there. And I said: “Well, is anybody talking about a potential solution?” He said: “No.”  You have been the leading voice and a strong advocate for the children caught in the middle of this unprecedented crisis. Is the world getting any closer to figuring out how we can handle this?

Caryl: I don’t think so. I think we are responding better, not solving better. Unfortunately, there are more children on the move right now, unaccompanied and accompanied, but more children on the move right now than in any period since World War II.

Denver: That’s remarkable!

Caryl: Really, it is remarkable. And we don’t get to pick where we’re born,  and surely wouldn’t pick poverty or a conflict zone if we had a choice. And the children on the move are really victims of the politics of adults.  These are not the choices they’re making that are forcing them to leave the home they’re familiar with, the community they’re familiar with, the practices and rites and rituals they’re familiar with.  To usually walk, not drive, great lengths for many days in the hopes of finding better space. And we are definitely not equipped around the world to treat the children as children when they arrive on those shores.

Denver: I bet. There have been a lot of recent stories, Caryl, around disaster aid.  Some of them haven’t  been been all that good. Supplies not getting through… and millions and millions of dollars being spent, and not much to show for it. But UNICEF operations are quite distinct from many of the others. Tell us how you’re unique in this regard.

Caryl: UNICEF International is responsible for the supply chain.  Frankly, there’s a huge warehouse. The primary warehouse is located in Copenhagen, and it was a gift of the government there to give us the space,  and it operates there. But there are also a series of pre-positioned supplies and warehouses around the world.  The reason that’s really critical is — you take what happened in Myanmar in Burma. While the world waited to see if planes were going to be allowed to land there when the crisis hit, we had a warehouse there; we had supplies there, and people went right to work.

Denver: Logistics.

Caryl: Logistics! UNICEF ships from UNICEF to UNICEF…

Denver: That’s a big difference!

Caryl: And actually I got to test that during the Haiti earthquake because we did some of what I called a “stack and pack” here– of Americans sitting together and putting together packages for children that had 14 different items. It was a great project. And then I literally wrote my name on some boxes because I knew I was going down with the Haiti warehouse.  I really wanted to see:  Did my box go where it was supposed to go?  And lo and behold, there I was in Port Au Prince with boxes with my name on it in the UNICEF tents.

Denver: Very impressive. When we look at these disasters, it seems that the general public responds quite generously and very enthusiastically to catastrophic events… like an earthquake, or floods, or something that makes the news. But the slow moving crises– whether it would be a famine or drought in Sub-Saharan Africa, or the refugee crisis that you were talking to… not so much!  Is that the case?

Caryl: It is the case. I think what happens is it’s very easy to feel your heart string pulled or your brain to get around: “Oh my God, that building was there a minute ago, and now it’s gone… Mom and Dad were able to feed their child yesterday, and today they can’t.” As opposed to: “We ate less today, a little less tomorrow, a little less the next day and then, Oh my God, there’s a famine.” I think that’s part of it.  I think also there’s a little bit of donor fatigue around those things that happen annually. That happens as well. It’s hard to entice the public, the press, the media to pay attention to those ongoing emergencies and keep them on the front page.

Denver: Exactly right!

Caryl: I also think as Americans, we are geographically selective. When it’s close to our backyard, when we know people from that country, we’re much more generous than we are when it’s very far away, and we don’t really have to think about it.

Denver: It is strange, since we’ve become such a global society… with the internet, etc… that part of the way we respond hasn’t changed all that much…

Caryl: No, it really hasn’t. And then I think politics places an overlay on it all.  So, do we support those children versus those children?  And you get to define those and those for yourself.

Denver: Well, speaking of children, one of your big missions is to stop preventable causes of death. And while that number is still too high, it has come way, way down in recent decades, despite the growth of the world’s population! Give us a sense of what those numbers are, and what some of the big culprits are still out there causing these preventable deaths every day.

Caryl: Sure! Well, in the early 1980s especially, over 35,000 children were dying each and every day.  Now these are children under the age of five,  and the deaths we’re talking about are preventable deaths. So not the disease we don’t have a cure for or the earthquake you can’t predict is going to happen. But really, things like lack of water, lack of food, freezing to death for lack of a blanket, abuse and violence, are things you actually could do something about. And today that numbers stands at 16,000, so we have more than halved the number. UNICEF and partners, obviously not just UNICEF, have more than halved that number which is a great success. I mean, I wish I had a product that could show that success.

Denver: Yeah, absolutely! I don’t think many people are aware of that too. I think if you asked most people, they will say it has probably gone up.

Caryl: Well, exactly!  And when you think about the size of the world population, as you just stated… Since the 1980s, the world’s population has tripled! So theoretically, if there had been no interventions, there would be 105,000 children dying each and every day…..and we brought that number down to 16,000!  So, on the one hand:  great success, lots to celebrate.  70,000+, well actually, more than 80,000+ children alive today… that wouldn’t have been, had we done nothing–each and every day, not just today. But at the same time, if it’s your child…One child… the idea of one child dying of something we can prevent... is one death too many.

Denver: No question about it. You mentioned Tony Lake before.  He’s the Executive Director of UNICEF.  Armed with some rigorous research and statistical data, he altered the strategy of UNICEF with an approach called “The Equity in Human Rights Approach.”  Tell us about that.

Caryl: For many years, most of the aid that was being brought to bear, was being brought to bear in the urban environments and the places where you had the most people. It seemed to make sense: if you went to the place where there were the most people, you could do your most cost-efficient response!

Denver: Yeah!  

Caryl: He did a study that was really kind of fascinating.  By going to some of the more remote places, the hardest to reach, the child no one was getting to, you actually could have greater impact!  We’ve also seen over the course of these years, where that number has dramatically come down, that  two interventions made the biggest difference. One… immunization clearly has had a dramatic impact on preventable deaths. But, the other is teaching children to wash their hands…So there are some very low-cost interventions. If you bring them to places where this has not been looked at, you’re not only not competing with others who may be doing the same work, but you’re actually going to have a greater impact.

Denver: Well, all those things cost money.  So, let’s turn to your fundraising for a moment. And an important source of financial support for you in addition to creating awareness as well, are some of your corporate partners.  And you have a great list of corporate partners.

Caryl: We sure do!

Denver: GE and Google, Disney and Pfizer, American Airlines and UPS. Let me focus on UPS for a moment, because of what they do for you in terms of their “know-how,”  I find to be really fascinating. How do they help support your work?

Caryl: Not only are they a cash donor, to the tune of millions of dollars now. But they also have provided two things that have been phenomenal. One is technical expertise; they have actually loaned us employees who went and looked at our supply chain. They’ve given us advice. They are obviously the world’s largest experts on logistics, so to have them give input is invaluable. But they also give us in-kind donations, which means air movement.

The Haiti earthquake–when I talked about this “stack and pack”–this is a great example of what UPS did for us. I got a call asking: Could we amass a child response kit with pajamas, jackets, toothbrushes and soap, and as I said, 14 items. And we said, “Of course we can!” and they said: “Caryl, it’s 14 items… “  “Of course, we can!”  Well, we actually need 50,000 of them… and we need them in 2 weeks.”  Oh….No big deal……

So, you  hang up after saying you can do that, thinking: “I’ve never done this before!  What do I do?” And the first phone call I made was to UPS. And within three hours, they had flown their employees up from Atlanta to New York. They were in my office with someone from Supply at UNICEF.  And they gave us warehouse space;  we were able to get these items from a whole variety of sources. They gave us the trucks that picked up the items and brought them to the warehouse space…and then they gave us the cargo plane that actually brought the supplies in…

Denver: That’s a relationship… That’s more than a partnership. That is a relationship!

Caryl: Phenomenal!  And so we have an ongoing relationship now where they commit to  x dollars worth of air space. When an emergency hits, they’re one of those first phone calls you make.

Denver: We had on the show last month the President of Games for Change.  We discussed the innovative nonprofits that were using video games and wearable tech to drive engagement and contributions.  And you happened to be one of those innovative nonprofit organizations– as evidenced by a program you kicked off last October, in partnership with Target stores, called “UNICEF Kid Power.” Tell us how that works.

Caryl: Sure! And our two largest sponsors in UNICEF Kid Power are our founding partners. They are  Target Stores and  Lucas Films Star Wars Force for Change– in Disney. So it has been phenomenal!  Those are two amazing partners, and it doesn’t get much better…

Denver: You got the A list, there’s no doubt!

Caryl: Total A list!  The idea behind the program is:  one in four American children–I read a report– are under-active, contributing to all kinds of health issues here in the United States. While… one in four children around the world, globally, is malnourished, many of them severely malnourished. And we sat in our office, and then we said: “ One in four; one in four.”  There has got to be something we can do…

Denver: There’s a fit there, somehow.

Caryl: …and I wish I could claim personal brilliance… this was not my idea.  But I turned it over to my Senior VP for Innovation, Rajesh Anandan.  He went and met with other folks, and they came back with this idea. At the heart of it, we created a little in-house startup;  we actually created a low-cost Fitness Band for kids. That’s a big challenge because it not only had to be a movement tracker, but it had to be one you could throw at your brother, and it wouldn’t break! Okay? Or, forget to take  it off when you take a bath,  and it will still work. That kind of thing because it had to work for third, fourth and fifth graders. The initial program was a school-based program. The bands are given to children in school. They are in fourth and fifth grade in Title I schools, where 75% or more of the children are on some kind of food assistance themselves. That’s part of our deal with our underwriters in the initial program.

The kids were challenged to meet the minimum number of daily steps. The teacher was given a tablet they swipe to track their stuff, but it is also preloaded with info. on nutrition, on movement, but most importantly– for us– on children around the world and what they were facing… and on philanthropy and giving back. For every 2500 steps the kids walk, they earn a point. The tracker lights up, and it buzzes. It’s wonderful!

Denver: A Fitbit for kids.

Caryl: It’s really fun. And for every 10 points they earn, UNICEF releases a set of ready-to-use therapeutic food to a starving child.

Denver: Oh, what a great idea!

Caryl: So the motivation to the third, fourth and fifth grader in America is:  You get healthy, you will save the life of a child. We piloted the program,  and to date, we have over 60,000 kids in the in-school program. But that wasn’t enough; we wanted 1 million.  Now, we’ve lifted the goal– it’s 2 million now.

We initially set out to have 1 million American children saving the lives of 1 million kids around the world.  We also recognized that it couldn’t be only Title I schools, although there has been something wonderful about it being Title I schools, because these are the kids… and they have written me amazing letters… and they say: “We’re the gets; we’re not the gives.” These are their words… Because we’re the kids whose moms don’t bake a cake for the bake sale; there is no disposable income in my house. We can’t buy the chocolate bars for the sports team, because Mom just can’t write a check.  But we can walk!

Denver: We can take our steps.

Caryl: We can take our steps, and we are the kids who are saving other kids.  And we know what it’s like to go to bed hungry. The stories from these kids… I could fill your whole show! Anyway, we wanted to do more than that. We reached out to Target, and now the bands are available in Target stores. The purchase price also covers one cycle of treatment of ready-to-use therapeutic food. When you buy one at Target, you get access to a password-protected app. Your child is challenged to go on missions.  You, as an adult, have to participate in this program in order for the child to go online because it’s completely COPPA compliant. But you go on a mission; the missions are led by nationally recognized names; Maya Moore did one; Alex Morgan did one; the Star Wars cast just did one. Each mission brings your child to another place in the world. They learn about children around the world; they learn about philanthropy, but in order to complete the mission, they have to take their steps!

Denver: Well, that is intelligent design from start to finish.  Just a great program! The commitment, inspiration and perseverance, Caryl, that you bring to your current role was really shaped very early in your life.  And much of that was surrounding the stories of your mother and grandfather. Share those stories with our listeners, if you would, and the lessons you took away from them.

Caryl: My mom and her brother were put on a ship when she was six, and her brother was four… with a woman whose last name they knew, but whose first name they didn’t know.  They were too young to reference her by first name. They came to this country, unaccompanied by their parents, because the Nazis had invaded Austria. The only way that their lives could be assured was to save them here. So, they came to the United States at a time the US was receptive to their coming, and they were sponsored by a relative here and put into an orphanage on the lower east side of Manhattan, where they lived for several years. And my mother told us that story as kids about this woman who accompanied them to what ultimately saved their lives, and how one person can make a difference.  She ensured that we grew up understanding the responsibility. My mom believed if you’re not part of the solution, you are the problem. You’re not part of the problem; you are the problem.

Denver: Instilled early.

Caryl: Early… and she always had us march…we  kid around… She painted the signs; she put it in your hand.  You went out on the street, and you said what you thought. So, that was Mom. At the same time, my grandfather was on the SS St. Louis, the Voyage of the Damned– which was not allowed to dock anywhere. They had purchased… dearly… documents to enter Cuba.  When they arrived in Cuba, they learned that their documents were fraudulent.  No country would take these people, even knowing that they had fled for their lives. And they were ultimately sent back to Europe, where the majority did perish at the hands of the Nazis.

My grandfather was one of very few who did survive… I knew him, and he really taught us what happens when the world turns its back. So, you got Mom telling you: you’ve got to be out there!  You’ve got Grandpa telling you what happens if you don’t!  I don’t think it’s any surprise that my generation in our family are all in helping professions.

Denver: Yeah!  I can’t think of much better training for your current job than those two lessons.  They’re just absolutely fabulous.

Caryl: And I know that I see the faces of my mother and her brother on every child refugee that I encounter right now.

Denver: A skill of yours that I found to be very interesting… and very central to how you relate to people from different cultures around the world–not to mention your staff–is cooking!  Tell us about your love affair with cooking, and how it impacts your work.

Caryl: My mom was a good cook, and I grew up in a house where there were not written- down recipes; there was a spoon. And so you throw a little of this in, and then you tasted it. And throw a little of that in, and then you tasted it.

Denver: Improvisation.

Caryl: Improvisation. And if you were sad, somebody would cook you something.  And if you were sick, they’d cook you something.  And if you were celebrating, you ate something.   So, I definitely take that to heart, and I find that for me, cooking is really cathartic. I come home at the end of a workday,  and I cook dinner.  That’s what I do.

And my son who’s at college, I bake on Sundays to mail him off something. Any Sunday I’m home, he’s going to get a package because that’s how you show you care.  And that’s how you care for yourself  because it’s a real unwind for me!

Denver: But you also use it in different places around the world. I hear you will just barge into a kitchen for a recipe when need be.

Caryl:  I will!  ‘Cause I always want to understand what I’m eating.!  So, yes, there’s an infamous story in East Germany… about two weeks after the wall came down. I was in East Germany and eating dumplings that I knew I had had as a kid…made by an aunt who’s no longer alive.  And so I did barge into the kitchen and make the chef teach me on the spot  how to make them, I did, yes. And I have done that in other places… And now though, the only difference is: I do write them down and have a great collection! I do have a family cookbook that someday will belong to my kids. And this past year, one of our board members, Hilary Gumbel, put out a phenomenal book. If you have an opportunity, I’d totally encourage you to pick up the book, it’s called: Unichef. The proceeds do go to UNICEF,  and she reached out to some very, very prominent chefs from around the world. They each tell their story, and they each tell what cooking means to them, and they each gave a family recipe in the cookbook.

Denver: Super! Well, speaking of basic principles… as in cooking, with some improvisation thrown on top, that’s pretty much the corporate culture of the US Fund for UNICEF.  And you have one of the great corporate cultures in the nonprofit sector. Tell us how you went about developing it.

Caryl: Well, when I first came to the US Fund, I came as the Number 2,  and it was a lateral move for me. I really took the position because I was so impressed with the CEO at the time, Chip Lyons. He was funding a very healthy, successful organization, and I thought I could learn a lot from him. Three weeks after I got there, Bill Gates offered him a position at Microsoft, and he left me. And I suddenly found myself in a space I’d not worked in before;  I hadn’t been in the international humanitarian space, and didn’t know a lot about the content, but had had a lot of years of experience running nonprofits. And I dismantled Chip’s pyramid and proposed a series of circles.

And we created a senior management team.  I believe its success was based on the fact that we based it on…I used to teach a course in the MBA program called “Leadership and Teams” at Manhattanville College in their Leadership Masters. And I took my own book. We didn’t just declare a team: we brought in a phenomenal coach Mark Sarkady. And he worked with each  member of the team individually; he coached us, and then he sat in our team meetings for almost a year. And if you were acting in a capacity that wasn’t reflective of teamwork, you got called on it in the moment.

Denver: Real-time feedback!

Caryl: Real-time feedback. And we collectively created:  What would the team be?  And we set as a goal–for the remainder of my leadership tenure, anyway,–we wouldn’t set goals only on what we would accomplish, but based on how we would accomplish them. The process and the journey of getting there was as important as the conclusion.

Denver: Very smart.

Caryl: And it’s been phenomenal;  it’s been very exciting and rewarding to be a part of. And I believe it’s why we succeeded in the lean and mean years.  Because when the economy tanked, we were one of the few nonprofits whose income continued to go up. And that’s reflective of the team that came to work every day– even though there weren’t raises– and stayed long hours because we couldn’t hire additional staff.  But we were all in it together, and I think it permeated the message we sent out.

Denver: It really all comes down to the people and how they work together.

Caryl: Oh, and I have really the best professional team I’ve ever worked with.

Denver: Speaking of books, you’ve written a very moving book entitled “I Believe in ZERO.” And that draws on your travels around the world,  what you’ve witnessed, and what you’ve learned in places like Mozambique, Haiti and Bangladesh. And I guess being with that young woman in Sierra Leone really brought home the point that one preventable death is one too many. Tell us that story, and also about your book.

Caryl: Sure.  That day had a profound impact on me personally. We were in Sierra Leone as part of a tetanus campaign.  We had never seen the disease tetanus. In United States, you step on a nail, you get a tetanus shot. You’re going off to college, you get your tetanus shot. You don’t really think about the word “tetanus,” what is the disease… And the Minister of Health invited us to come over to a hospital to see the disease, so we would understand what we were fighting.

So you arrive at a hospital that is a very far cry from what you’re used to in New York City.  No running water, no nursing staff.  Moms sleep on the floor on a mat next to their child on a mat. They go outside and light a fire, and cook a meal, and bring it back in to feed their children. Big blackboard with medications on it, most of which… next to them, there is an” X,”  because it just doesn’t exist… not even a Tylenol for a child in pain. And off behind a curtain in a little corner is a mom whose baby is actually on a little cot-like bassinet, and the baby has tetanus. The baby is 6 days old;  the mom is 18 years old.  She spoke no English. I did not speak her language. And the reason her baby had tetanus is she gave birth at home.  She cut the umbilical cord with whatever was sharp in her hut.

Denver: Or whatever handy…

Caryl: And tetanus, unfortunately, is a spore that lives in dirt; you can’t eradicate this. Yes, you can eliminate it, but you can’t eradicate it. And so she unknowingly infected her child with tetanus. Extremely frustrating to me, because if you immunize women of childbearing years against tetanus, they will pass that immunity on to the child. This is a completely preventable death. Tetanus makes the child supersensory;  you can’t touch the baby because it will hurt her. You can’t sing to the baby, because it will hurt her. You can’t turn the light on, because it will hurt her. So all of those kind of mom instinctive things you do for your own children…you can’t do. You can just sit and watch you child writhe in agony. And so, I sat down next to her, and I just took her hand.  She had no idea who I was because we couldn’t talk to each other. All she knew is:  I was another woman… and another mother.

Denver: Yeah, it was mom talk with eyes.

Caryl: Yeah, and we just sat, and we held hands. While we were sitting there, I could only think about the 70-cent vaccine that would have prevented this. The $3- and-something cents that would have cured this… None of which was available where we were.

And while we were sitting there, I watched the color draining out of her baby’s hand. And I knew her child was dead. And I’d never seen a child die before, and I knew I knew the child was dead… and that she didn’t. And she was still holding my hand, and I knew that I didn’t have the words to tell her her child was dead. So I had to extricate myself and go get a nurse, and I did.  The nurse went in, and I heard that woman scream. It’s a sound…as I’m telling you this story, I hear it.  And I will tell you, it has never left my head. I came back with the phrase: “I Believe in ZERO” because even the death of one child is one too many, and that’s the name of the book. It didn’t change our mission, but it changed the urgency that I brought to the mission.

Denver: It’s a pretty powerful story. Tell us about your website, where people go to find it, what information is there, and what one can do if someone wants to get involved as a volunteer… or a financial contributor.

Caryl: Sure! The website is unicefusa.org.  You can go on that site.  There is a whole section for volunteers and ways to get involved. There’s definitely a way to donate and contribute. $1 buys enough good clean drinking water for a child for 20 days, so every gift counts and makes a difference. We encourage you, please, give and give often, and also get involved. Be part of this; we each bring something to the table that can change the way the world views its children.  We need all of us to be bringing what we bring… and using it.

Denver: Amen! Well, Caryl Stern, the President and  CEO of The US Fund for UNICEF,  I want to thank you so much for being here this evening. The book is “I Believe in ZERO: Learning from the World’s Children.”  It was a real pleasure having you on the program.

Caryl: Thank you, thank you! It was a pleasure to be here.

Caryl Stern, President and CEO of the US Fund for Unicef, and Denver Frederick, host of the Business of Giving

The Business of Giving can be heard every Sunday evening between 6 and 7 PM Eastern on AM 970 The Answer in New York and on I Heart Radio. You can follow us at bizofgive on twitter and at facebook.com/businessofgiving.

We have found a new home! Kindly visit this link in our new website here: https://www.denver-frederick.com/2016/09/20/jacob-harold-president-and-ceo-of-guidestar-joins-denver-frederick/

GuideStar is the largest platform of information about data for nonprofits.  In this segment, Jacob Harold, President and CEO of GuideStar, talks about how both individual donors and nonprofit executives leverage the data that GuideStar curates.  He also discusses the danger of “short-termism”– of thinking everything happens on a quarterly basis. He explains that if you’re trying to build a great company, it takes years or decades… and the same is true for social change.

The following is conversation between Jacob Harold, President and CEO of GuideStar, and Denver Frederick, host of The Business of Giving, on AM 970 The Answer in New York City.

Jacob: I’m thrilled to be here, Denver.

Denver: Some listeners may never have heard of GuideStar. For those who have, they may be thinking: “Oh, Yeah, Yeah. The 990 tax form people.” So, let’s start by having you tell us what GuideStar is, and what you do.

Jacob: You bet!  GuideStar is the largest platform of information about data for nonprofits. And let’s just start by saying:  Why do we even care about having data about nonprofits?  And for me, it’s to address what I call “the elephant in the philanthropic room,” which is simply that some nonprofits are better than others.  Some are able to squeeze more good out of the dollars that they spend. It’s not necessarily that those that are not as effective are bad people, but they haven’t figured out the most effective way to do good in the world.

So the challenge that donors face and that nonprofit executives face…and researchers and government officials… is trying to find excellence in the field, to learn from it… to make sure it gets the resources it needs. And so GuideStar’s mission is to help in that process: to provide the kind of information so that the “stakeholders of social change”–the people who have a stake in the work of the nonprofit sector–are able to make good decisions with their time, and with their money,  and with their attention, with their passion. So, we provide data. And historically that’s mostly been, as you said, from the IRS Form 990, the tax form that most nonprofits are required to file. But we realize that that’s a very powerful foundation of data, but none of us would tell our own story through our 1040. And  we need to supplement that with other kinds of information to tell a richer story about nonprofits. And so that’s what we’re really trying to do at GuideStar right now.  And we’re having some success; we have about 7 million people each year who use GuideStar.

Denver: That’s right. And you really get into the inner workings of all this data and how the whole philanthropic system works. Where did that come from? What kind of background did you have that instilled this into your DNA?

Jacob: In some ways, it came from the dining room table at the house I grew up in. Both of my parents worked for small community-based nonprofits. My mom worked at an AIDS hospice. My dad worked for Catholic Social Services, providing services to the poorest of the poor in our community. And so over the dining room table, I would hear about the struggles faced by those people who are devoting their lives to try and make the world better.  And these were my parents!

And I began to understand that the institutions they worked in… matter,  and the struggles to find funding had consequences for our community. So, after college, in a way I tried to stay in the family business, and I stayed in the  nonprofit sector.  But we all have to rebel in one way or another. So, I rebelled against my parents’ local focus and decided to work on national issues, and I worked on environmental issues. And I had a chance to work for a whole set of different environmental organizations: Green Corps, Greenpeace, Rainforest Action Network. And I got to know dozens of others. And it became very clear to me in my early 20s that some of these organizations were simply far more effective. And it led me to a question: “Well, okay, how are we going to tackle a great challenge like climate change if we’re not sending money to where it can be most effective?” That led me to really start to wonder:  “Well, how do we build a marketplace for philanthropy that will help us achieve a better world?” And that eventually led me to business school, and then to my current role.

Denver: Interesting. You mentioned a moment ago that you have 7 million visitors a year.  Who principally makes up that audience?  And what is the #1  thing that they’re looking for?

Jacob:  When GuideStar was first founded, we assumed that the #1  audience would be individual donors, and they are a critical audience. But it turns out that our single biggest audience are nonprofit executives that are trying to find a partner organization or benchmark themselves against another. I will say that the first thing that usually brings people to GuideStar is salary data about nonprofit executives. I call that the “gateway drug,”  because people come looking for: What does the CFO of this nonprofit get paid? What does the Head of Programs get paid…

Denver: It’s negotiating time for them…

Jacob: That’s right! They may be a donor, but very often they’re actually applying for a job at this organization. And quickly though, they realize there’s a lot of other information here that can answer a lot of other questions. And that leads to much more nuanced analysis.

Denver: It was at the beginning of this year that you gave your nearly 2.5 million nonprofit profiles a facelift of sorts. Actually, it was more like a total makeover. What did you do with them?

Jacob: So as I said before, historically, our primary source of data has been these tax forms.  We all know from filling out our taxes that tax forms– can feel kind of boring.  I think that initially when GuideStar was founded, we just quickly put up the data, and it sort of reflected the structure of a tax form. But that’s not telling the whole story of a nonprofit,  and so we needed to change the visuals of the site, the user experience, the graphic design to reflect  more of what I call a  “multi-dimensional view of nonprofits.” Looking at them from many different viewpoints!  We wanted to say the financial data is incredibly important; it provides a baseline, but it’s not the whole story. So our redesign was really about saying: “Well, there’s the financial data here, but there’s also operational data…and data about people, programs, goals, strategies, photographs and video. We needed to figure out how to display that visually in a way that gave people the whole picture of nonprofits, and not just a partial picture.

Denver: And that’s where the 21st century is. I know that Mark Zuckerberg on his conference call, was talking about the fact that they think Facebook is going to be almost all video in the next couple of years.  So many in the nonprofit sector are there with that dense data– that nobody really looks at anymore, so it’s a great move. Now, nonprofits are asked to complete profiles for GuideStar about their programs and operations, and depending on the level of detail that they’ve put into these profiles, they get recognized at either the Bronze, Silver or Gold level… At least until this past May, when you introduced the Platinum level– which I must say you were almost overly excited about!  What kind of information will the Platinum level require?  And why do you think this information is going to be so meaningful?

Jacob: So as I said, the baseline data we have comes from the Form 990, but we invite nonprofits to come and share additional data to tell a richer story about their work. And about  115,000 nonprofits have added at least some additional data, and about 40,000 of them have reached one of the levels that you mentioned.  Bronze is up-to-date operational data; Silver indicates fresher and more deep financial data; Gold provides answers to questions like: What’s your goal? What’s your strategy?  Describe your programs (in a deep way). And then Platinum is what we call “quantitative programmatic data.” These are metrics…numbers that describe your progress towards your goal.

It could be for a job training program– what is called in nonprofit jargon an “output”– How many people went through your program?  Or it could be an “outcome”–How many people went through your program, and got a job, and kept it for year? The challenge is that the nonprofit sector is so diverse that there’s no single metric that we can use to describe a homeless shelter, an art museum, and an environmental advocacy group. We have to reflect the diversity of the sector.

At the Platinum level, we’ve invited nonprofits to come in and choose metrics that are appropriate to them.  But if possible– where multiple nonprofits are measuring the same thing–we’ve identified that, so nonprofits can more directly compare themselves to each other. And we think this is transformational because it’s the first time that at the field level, we have data that’s really about social change. Not just about the organization itself, but about the impact they’re having in the world… that reflects the diversity of the field, but also reflects the ways the field has a sense of commonality and shared purpose. That said, it’s going to take us years to evolve the Platinum level to a point where it’s truly comprehensive. But we’re very excited about it,  and we’ve had about 1,000 nonprofits so far that have shared about 4,000 metrics and we are looking to have that number climb over the next few years.

Denver: That’s great! Well, it really allows them to benchmark themselves against a similar type of organization… and maybe even see what some of those organizations are looking at that they hadn’t thought about… and saying we need to do that as well! Earlier this summer, we had Perla Ni; the CEO of GreatNonprofits on the program. And they, of course, collect reviews from those who’ve been helped by nonprofit organizations– the beneficiaries, as well as others…donors and volunteers. And we got into a discussion of their relationship with GuideStar–how you worked together to bring numbers and stories together in a way that will really help donors make  more intelligent decisions. You’re a big believer in collaboration and in partnerships… What others have you been working on to serve the public in a better fashion?

Jacob: When we think about building an information system for the trillion-dollar nonprofit sector, it’s very clear that we can’t do it alone.  We have to work with other organizations. GreatNonprofits is a terrific example –where we are able to provide a channel for the GreatNonprofits’  reviews to be shared with many, many more people.   And then, it helps to enrich our profiles as well. So, there are lots of other partners for us. They come both on the data collection side– where we get data, but also on the data distribution side.

There are about 209 partner organizations that are showing our data on their website or in their software– including Amazon.com. Intuit and Google have apps that use our data. The National Donor-Advised Funds, the philanthropic giving vehicle of Fidelity Vanguard, and Schwab all use GuideStar’s data. And so those sorts of partnerships…

Denver: That’s your wholesale partnership there, right?

Jacob: That’s right! Yeah, it really is wholesale. So there’s the retail on the website, and then the wholesale through these partners. And that way, it doesn’t have to be what you would call a “pull strategy”: “Hey, come over to my website” if we have push strategy…pushing the data out to where people already are.

And then there are so many other critical partnerships for us–organizations like BoardSource that are experts in how nonprofit boards of directors work. They’ve helped to inform how we ask questions about nonprofit governance. The same with an organization called D5 that works on issues of diversity, equity and inclusion in the nonprofit sector. We got their advice on how we should most appropriately ask questions about nonprofit staff and board demographics. Our partners at the Foundation Center have the best data on foundation grants, which is a great complement to our work. So we know we can’t do it alone but the partnerships have to be substantive.  And optimally, they need to be automatic too, so the data is flowing back and forth automatically.

Denver: Yes. Exactly. You all do certain things better than others, and if you can join together, it best serves the public. You encourage these nonprofits to be transparent about their operations or finances,… and coming from the school where you want to practice what you preach, you do that by holding a quarterly impact call. Where did this idea come from, Jacob?  And what happens on the call?

Jacob: This was an idea that I think initially came from our former CFO James Lum. We’ve been batting around the question: How do we do a better job proactively sharing with our stakeholders what GuideStar is trying to do.. so that no one’s surprised, so they have an understanding of our strategy…  how they might fit into that, and how it may help them. And we thought about what public companies do.  They have a quarterly earnings call where they share with investors…

Denver: Ah, so that’s it.

Jacob: Basically yes. It was inspired by that, but different in a couple of ways. One is that we’re not just talking about GuideStar’s financial results– which are really just a means to an end, although we do share that. We were talking about our programmatic results:  What’s happened?  How many new nonprofits have come and shared data with GuideStar, for example?  How many people are getting data from GuideStar, or have gotten it in the last quarter? And then, what are we trying to do next?  What are we struggling with?  What mistakes have we made?  What have we learned? I will say the one thing that we’ve been cautious about is: On Wall Street–and here we are in the studio right down near Wall Street–there is the danger, I think,  of “short-termism” of thinking everything happens on a quarterly basis. If you’re trying to build a great company, it takes years or decades, and the same is true for social change. So one thing with the impact calls is we want to make sure that we’re being proactively transparent, but that we’re still thinking in the long term.

Denver: Yeah, and that’s really important.  I think the long term can be lost when everybody wants results and outcomes and begins to design programs that are going to give them the kind of returns and outcomes that will get them funded again. And that’s one of the dangers we have to stay away from.

We’ve been talking about all these different organizations and parties trying to come together to coordinate this information in an intelligent fashion here in the United States… but the nonprofit world is increasingly global.  You have been working on something called the “Bridge Project” to begin to address this. What is the Bridge Project, and what is its purpose?

Jacob: Sure. So the Bridge Project is an attempt to create a unique ID number for every nonprofit in the world…essentially, a Social Security Number or a VIN number. And that’s really important because if different organizations like GuideStar want to share information about a nonprofit that’s in Cameroon, we have to know we’re talking about the same organization.  Having a unique ID helps us do that. It’s a very simple thing, but it’s actually quite profound in our ability to collaborate across an organization like GuideStar… and we mentioned the Foundation Center earlier… which is one of the other partners in the Bridge Project. The other two are Global Giving and TechSoup Global. So, we now have more than 3 million nonprofits in this database that have these unique IDs, and we’re searching for partners to help plug in to that system so that we can expand it over time. Because, yes, we live in a global world!

Now one challenge is that the concept of nonprofit shows up almost everywhere in the world, but it’s always a little bit different. My favorite example is in China; they have something called a GONGO–a government-organized non-governmental organization… which reflects the structure of Chinese Society.

Some of them do very important work. But  as we think about trying to build a global system to understand philanthropy and the nonprofit world, we have to have something that captures commonality through these numbers, but also reflects that diversity. So that’s going to be our ongoing challenge looking forward.

Denver: It would  be a huge step if that could be done. As a nonprofit, you’ve got to go out there and get funding…  what are your sources of revenue?

Jacob:  GuideStar is a hybrid organization.  We are a 501(c)(3) charitable nonprofit, but we do have a business model that allows us to cover the majority of our costs through earned revenue. And so our budget is about $12 million; about $10 million of it comes from earned revenue, and $2 million of it comes from foundations, on average. And we’ve been very lucky to have support from significant foundations like the Gates Foundation, Hewlett Foundation, Kellogg Foundation, Barr, Packard and others. And they like that we’re able to cover most of our costs through earned revenue. But I also like that it’s not 100%.  I like the foundations holding us accountable to our mission, so we don’t just turn into a data company.  We remember that we are a nonprofit that has a social mission. And the foundations constantly remind us of that and force us to make decisions so that GuideStar is maximizing the good for the field.

Now that $10 million of earned income also creates really good incentives because it forces us to be useful for our users.   And they’re only going to pay us if it’s helpful. Now, 99% of our users use GuideStar 100% for free. But there’s 1% who are accountants or foundation program officers or lawyers or bankers or consultants who need additional tools and the ability to download customized databases, etc. And they pay us for access to premium subscriptions.  And then some of our wholesale partners pay us as well, for access to bulk data. But it’s always a tricky balance and it forces us to be as thoughtful as we can be about ensuring that we meet the mission, but also that we pay our bills.

Denver: Let me pick up on your point about the funding that you receive from foundations. Back in May, you and your buddy, Phil Buchanan, the President of the Center for Effective Philanthropy… who was a guest on the show back in the Spring. You led a group of 21 like-minded colleagues who all signed a letter to foundation executives urging them to invest more of their resources in nonprofit infrastructure. What exactly is nonprofit infrastructure?  And what was the specific request you made to these foundations?

Jacob: So, infrastructure is the stuff that helps make a system work. So when you think about society, things like roads or rail or sewers…

Denver: Things we don’t pay any attention to in this country.

Jacob: Exactly. Until they start to go wrong. That’s one definition I’ve heard is that infrastructure is the stuff you don’t realize you need until it goes wrong. And you think about the business world. The business world has an infrastructure:  the New York Stock Exchange, Harvard Business Review, investment banks, etc. Now we’ve seen how sometimes that infrastructure doesn’t live up to what we as a society need it to be. We saw that in the financial crisis.

The nonprofit sector has an infrastructure too:  it’s the training programs at universities that help prepare people to be nonprofit executives.  It’s the magazines and newspapers and radio shows that help to get the word out about what’s happening in the field, what the key questions are, that help people wrestle with the challenges that we face. It’s organizations like The Center for Effective Philanthropy that help foundations learn from their constituents and get better… or like GuideStar. And these institutions are critical for the healthy performance of the nonprofit community. But they’re all a little bit underfunded because people don’t like to invest in this sort of infrastructure. So the 21 of us that you mentioned, initially convened by Phil Buchanan and myself, we asked foundations to devote at least 1% of their grant’s budget to nonprofit infrastructure. That would be a significant leap if they actually did that…

Denver: Sure would.

Jacob: …but…the vast majority needs to go to the work on education, or healthcare, or in environment, or the arts, or whatever issue a foundation is engaged in. But we need that sliver of money to make sure that the underlying systems are there and are healthy.

Denver: Have you been happy with the response?

Jacob: So, it’s been really interesting. I’ve been very happy with the ad hoc response…anecdotal response. Foundation leaders contacting us and saying…”Oh, this is great! Really like it; we’re sharing it with folks. We’re talking to our board about it.”  But it’s too early to know whether it actually has any real impact.

Denver: I know what you’re talking about. Everybody recognizes its importance; everybody wants it done, but everybody wants somebody else to fund it.

Jacob: That’s right.

Denver: Because they don’t want to fund something that other people are going to benefit from,  and they’re hoping some other guy will pick it up. So I think your idea of across the board… and 1%… is the right idea, but as you say we’ll see where it goes.

Of all the topics we have discussed, Jacob, on this show, more than any other has probably been debunking the overhead myth–that misguided notion that you can tell the effectiveness of a nonprofit organization by how much of your donor dollar goes to program, and how little of it goes to administration and fundraising. As a matter of fact, we had Caroline Fiennes on the show–she’s from Giving Evidence based over in the UK.  She cited some data that showed the most highly-rated organizations on Give Well, were, in fact, the ones that had the highest overhead.

You have been a real leader in this from the outset. But let me put myself into a donor’s shoes for a moment, if I can. This overhead number is a really, really nice number. It’s simple; it’s clean; it does what you mentioned a few moments ago.  It allows me to compare that homeless shelter to an art institution,  and maybe.. most importantly, it makes me feel responsible.

Jacob: Right!

Denver: I get the point that you’re making. The question I have here:  Is there another number– or some other indicator– that is nearly as clean or simple,  that I could use to make an intelligent giving decision? Does such an indicator exist?

Jacob: No, it doesn’t!  And the reason it doesn’t exist is that the nonprofit sector is simply too diverse. Just like in the business world, no smart investor is going to only use one single metric to compare the investment into a new startup company– a restaurant versus GE stock. They’re just too different from each other!   Now, that said, that doesn’t mean we shouldn’t look at data.  We need to give up on the idea that there is a single number. I do think that there’s a single “word,” and I will offer the single word which is “clarity.” Is the nonprofit clear about its goals? How is it going to get there?  How does it knows if it’s making progress? And I think that’s where having good data can really help. Does a nonprofit have a good metric that they’ve chosen– on GuideStar Platinum, or wherever– that shows how they believe they should be judged in the unique context of their work? And does that make sense to you as a donor?  Are they clear about why they think the things that they are going to do are actually going to lead to lasting results?

Denver: Is there any effort to try to compare “like” organizations to one another?  When you talk about  the private sector,  you can’t compare them all. But if you look at let’s say, retail stores, it’s always sales per square foot. Are people thinking of doing those kinds of verticals for homeless shelters, for education, for medical philanthropies?  Or,  is that not being thought about?

Jacob: Absolutely!  And I think that could be incredibly valuable to say… “Look, for homeless shelters, there are seven metrics that are really quite relevant. You should look at these, and that will allow you to make smart decisions among homeless shelters.”  Or for art museums… or for international development groups. And we believe that the Platinum level in GuideStar is going to help us gather that data and organize it in a structured way, so that we can look at one subset of organizations at a time.

Now that said, I will just add some nuance here perhaps to complicate things. Think about two different homeless shelters that are both measuring average number of nights stayed at that homeless shelter.  But one homeless shelter focuses on the chronically homeless– people who may have drug addiction problems or mental illness. And another one focuses on the newly homeless–people who just missed a rent check. The second one may want to minimize the average numbers of nights in the homeless shelter. They want to get them back into permanent housing as soon as possible.  Whereas, the first one that’s dealing with the chronically homeless, may actually want to maximize it. So we need to be thoughtful about that unique context.  But even just raising that question… having that data… forces us to be more thoughtful about the work we’re doing, and how to do it better.

Denver: It brings up other questions as well… to use your example.  There may be a homeless shelter that’s not doing that well, but it’s the only one serving a single community.  And if you have do away with that, well, those people are just going to be left high and dry.

You’re a data guy.  Is there any set of data out there that has not been released, but could be released, that would have a profound, positive impact on decision making and problem solving in the social sector?

Jacob: You won’t be surprised that what I dream of is data from individual nonprofits, sharing what they measure to track their own performance– basically the data we’re collecting on Platinum. The challenge, of course, is that it is not one data set.  It’s fragmented across the entire nonprofit sector.

So another answer I’ll give is: government funding of nonprofits. Now, individual levels of government– the federal government, or a given state or municipality, may share data about which nonprofits they’re funding and why. But that is also very fragmented. Government funding of nonprofits accounts for– depending on how you count it– at least $400 Billion a year, and some really good work. But we don’t have that in aggregate to understand how government is outsourcing some of its functions to the nonprofit sector.  And it’s not working!  And I think often the answer is: Yes!;  sometimes the answer is: No! But, how could we get government to share that data at all different levels… in an open format… that will allow us to learn from these investments that we’re making as citizens?  I think, all told, they’re very good investments, but let’s find the data to show that!

Denver: Very interesting. Let me get you out on this: We’re in the middle of a Presidential election.  Thankfully we’re going to pretend to turn the page here and move on to the next one in 2020.  I don’t think we can look really intelligently much more beyond the next four years. What will GuideStar look like? What will the world of nonprofit data look like for our listeners? When I sit down with my computer, or whatever  I’m going to be using four years from now,  and search for information about nonprofits: what information do you hope, and what information do you anticipate that we will be able to get?

Jacob: I’ll start by saying, I think you’re not the only one who’s ready to turn the page on this election.   But I do think that four years from now, we will have enough of this programmatic data–the measurements of actual progress made by nonprofits… against their goals.  And we will have it organized, as you suggested, within the subset–homeless shelters over here, and art museums over there. That’s going to allow us to think about nonprofits in their unique context in a much more powerful way. And I would also say that we’re going to start to have much more global data.  It’s not going to be perfect. It’s going to take more than four years to get to a truly global database of all the work done to make the world better;  That’s going to take decades. But four years from now,  we’ll begin to have linkages with a handful of countries that already have significant efforts. For example, there is a GuideStar in India, that is a separate organization that’s a partner of ours. There’s data on maybe 10,000 of the largest nonprofits…

Denver: It’s a start.

Jacob: And we talk to them regularly to figure out how could we bring our databases together. So I hope that four years from now, we’ll have some really good examples of sharing data across national borders, and that we’re going to begin to have the programmatic data that actually shows how nonprofits are doing towards achieving their mission.

Denver: That would be great!  If people want to get more information about GuideStar, where do they go?

Jacob: So, guidestar.org, and lots of information there: 2.8 billion pieces of data, videos, photos, and lots of fun to explore how all these organizations are trying to make the world better.

Denver: Well, Jacob Harold, the President and CEO of GuideStar. I want to thank you for being on the show this evening. You are not only a great champion for GuideStar, but for the free flow of meaningful information across the entire ecosystem of the nonprofit and philanthropic worlds. It was a real pleasure to have you on the show.

Jacob: Thanks a lot, Denver.

Jacob Harold, President and CEO of Guidestar, and Denver Frederick, host of the Business of the Giving

The Business of Giving can be heard every Sunday evening between 6 and 7 PM Eastern on AM 970 The Answer in New York and on I Heart Radio. You can follow us at bizofgive on twitter and at facebook.com/businessofgiving.

We have found a new home! Kindly visit this link in our new website here: https://www.denver-frederick.com/2016/09/14/roxane-white-ceo-of-the-nurse-family-partnership-joins-denver-frederick/

In this segment, Roxane White describes the mission of the Nurse-Family Partnership, which is to help transform the lives of vulnerable first-time moms and their babies. Roxane outlines how the organization creates a culture of success through mutual motivation.  Through ongoing home visits from registered nurses, low-income, first-time moms receive the care and support they need to have a healthy pregnancy, provide responsible and competent care for their children, and become more economically self-sufficient.

Roxane White, President and CEO of the Nurse- Family Partnership

The following is conversation between Roxane White, President and CEO of Nurse- Family Partnership, and Denver Frederick, host of The Business of Giving, on AM 970 The Answer in New York City.

Denver: Over the last several months, we’ve had on the show the CEOs of the organizations that rate charities–from Charity Navigator to GreatNonprofits. And if you visited their websites to check on how they rated the Nurse-Family Partnership, you would see that it’s been awarded the maximum number of plaudits and stars. And here to tell you why that is the case, is the President and CEO of the Nurse-Family Partnership, Roxane White. Good evening, Roxane, and welcome to The Business of Giving.

Denver: Tell us about the Nurse-Family Partnership (NFP)–what the central mission and purposes of the organization are.

Roxane: Well, what we do is really pretty basic and simple in many ways. We work with moms who are low-income, and we go into the home before they deliver their baby.  We help them deliver a healthy baby; we support the mom to raise a healthy child, and then we help Mom get back on track as well.

Denver: Let me ask you this:  What compelled you to take the CEO job at the Nurse-Family Partnership? I know you’ve been a tireless advocate for fighting homelessness and supporting youth.  Most recently, you served as the Chief of Staff for the governor of Colorado. What inspired you to take on this job?

Roxane: My first encounter with the Nurse-Family Partnership was when I was working with street kids.  I had a young mom who was ready to get off the street, and she was becoming a mom. And I called Nurse-Family Partnership, and I was like: “Yeah, right. Nobody really wants a street kid.” And they took her!  They helped her, and she turned her life around. The second time I was working in child welfare, and I was at an autopsy of a young person who had died. Family had failed: the foster family had failed; government, sure as Hell, can’t raise kids. So,  I was asking our staff,  “What can we do?”   They said, “There’s a program that can reduce child abuse by over 48% and has a track record of doing that.”  And we started working with Nurse-Family Partnership and got much better outcomes for families.

And then when I was Chief of Staff for the governor of Colorado, we were looking at what the heck do we do about Medicaid costs that were completely out of control!  And we brought in Nurse-Family Partnership as a way to reduce the cost to taxpayers of delivering unhealthy babies.

Denver: They made quite an impression on you. Let’s walk through the process a little bit.  Give us a picture of the typical mother you serve–her age, education, race, marital status– things like that.

Roxane: All of our moms are low-income, and all of our moms are at risk for a high-risk pregnancy. So they’re identified by their docs, by pregnancy testing places, by community advocates who say: “Hey, we got a mom here that’s going to deliver a baby.” Often, they are young moms; they may be teen moms. We don’t take any moms generally under the age of 14–but from 14 until about 30. There are moms who are at risk of having a baby born into the ICU unit, a baby being born unhealthy, a mom who’s not prepared to be a mom. So, our most vulnerable moms are the most expensive moms in terms of that delivery. And then we go into the home, and we start working with her.  We’re in the home at least every other week, if not more often before she delivers the baby, to help her deliver a baby on time, at a healthy birth weight.

Denver: Let me pick up on that  teen mom issue– that has always been a big question. Are we making any progress in this country, Roxanne, in getting teen mom birth rates down?

Roxane: We are making huge progress in this country. And one of the things we know is most important when we are working with these moms– is to delay the next birth. Because we know that what we need to help moms do.. is to develop assets. We’ve got to get them back to school;  we gotta get them back to work. And so, not only are we making progress in people not having babies… and getting through school… and getting a job before they have a baby… But when these moms have had a first baby, we’re helping them delay the second baby– which has everything to do with their future, and the child’s future.

Denver: Well, let’s talk about these visits. When do they begin? I know they last until the child turns two years old.

Roxane: We have to be in the home by 28 weeks of pregnancy…

Denver: Okay.

Roxane: …in order to help make certain that we have a healthy baby born. We can have a mom come in earlier than that. Then we work with the mom up until the baby is two-and-a-half years old…with plenty of time to help Mom get career education, school, job back on track, help her find good quality, early childhood education. And then to really attach to that child and learn how to be a good mom. Some moms don’t know how to read to their children and do it in an interactive way… that really does the most for brain development, for example. Moms will see things going wrong with their kids and not understand what’s happening. That’s when we have a nurse who helps look at things like: Do we need to have this child screened for autism?  Do we have a developmental issue, or do we have a parenting challenge?

Denver: Do families generally get assigned one nurse?  Or, are those nurses rotated in and out with the family?

Roxane: It’s generally one mom and one nurse. But each nurse has 25 moms that she works with at any point in time. Unless that nurse says: “You know what? You need a nurse that has a particular specialty.” So, in the case of a Down Syndrome baby, or an autism baby, or a mom that has been using heroin… We might bring in another nurse with more specialty in that area. But we really try to keep that consistent nurse, so that the family develops trust, and she also sees what’s happening over time.

Denver: That makes an awful lot of sense. Are fathers ever in the picture? Are they around?  Or, is this pretty much strictly a relationship between the nurse, the mom and her baby?

Roxane: We absolutely work with fathers, but we don’t have the ability oftentimes to have those fathers in the scene and present. So, one of the things we do is help Mom try to identify the father, reconnect with the father… and see if there are any resources that are safe and helpful there.

Denver: I would imagine that if a registered nurse was coming to my house for two and a half years or so… every two weeks, I would grow pretty accustomed to that and look forward to it. How is it when that relationship ends? I mean, it can be a sweet sorrow as they move on. How is the adjustment… for one and all?

Roxane: Towards the last year and a half, we’re only in the home once a month, or we decrease the amount of visits.  Moms know that it is going to end. And generally what we’re trying to do, is get moms to make a referral of a friend, so that they feel like they have done something really successful. We also have graduations. For many of our moms, it’s the first time they will have graduated for something.

Denver: That’s great.

Roxane: And it’s fascinating to watch them put NFP Graduate on a resume, because they’ve accomplished something. And what we say to them is:  “We want this to be your first graduation… if it’s your first graduation… but you’re gonna do more graduations!”

Denver: For sure! I know that one of your guiding principles is to create positive change for both generations–for the mom and the baby. Are you unique in this regard? How do you go about trying to maintain that balance?

Roxane: It’s amazing… because Dr. David Olds– who founded the program– has been studying these moms and babies now for more than 40 years to see: What is the long-term impact?  Can you really get two-generation change? And one of the things he’s found is that: 18 years after we have been in the home–only with this intervention–the moms are 72% less likely to have been arrested.

Denver: That’s a nice number.

Roxane: Well, that’s because mom went back to work.

Denver: Yeah.

Roxane: Right? That’s because Mom went to school; that’s because Mom developed some assets. So, she sees a different pathway out. We have immediate results for our young people, including a 59% reduction in arrests when the child is aged 15.  Again, long-term outcomes!  And what do we know about arrests? We know that it’s related to:  Was the child able to succeed in school? Were they able to read by third grade? We have significant outcomes every step along the way.  But it’s really fascinating to see that you really can change moms– and her pathway– and you can change the kid’s pathway.

Denver: And, actually, I think they help one another. You talked about something called mutual motivation. What is that?

Roxane: It really is that you start to create a culture of success.  We see parents who have their children back in early childhood education and understand that there’s a difference between just leaving the child with… whomever you’re  gonna leave them with… and early childhood education. And we see the parents start to understand that as well: There’s a difference between a job and a career track. Doing that parallel process with mom and baby…particularly for our younger moms that may have never had that conversation before in their lives…

Denver: It’s interesting, as the baby does better, the mom will do better.  And as the mom does better, the baby will do better.

Roxane: There are families where we have a tough starting conversation… No mom has a child that she hopes ends up in prison. But we have conversations with Mom that if something doesn’t change, it doesn’t look good for her child and her unborn baby.

Denver: Honest conversations.

Roxane: Honest conversations. Real conversations, and “we can change that with you… if you want to. And we can change the prognosis for you and for your baby. It’s gonna take a hell of a lot of hard work, but we’re gonna help you do that work.”

Denver: I know the cost of the program is going to vary depending on what part of the country you’re in. But by and large, on average, what is the cost of a program for a nurse visiting a family for 64 visits or so, over the course of two and a half years?

Roxane: It’s around $9,000 over the course of two years. What’s important to understand about that is that the RAND Corporation has found that for every dollar invested, there’s an average return to the taxpayers of $5.60. Ted Miller just did a follow-up study on that– looking at just the cost in Medicaid, and in health care, and to assess taxpayers– and it was over $6.60.

Denver: That’s fantastic! And I know it is sometimes suggested that you could get this cost down a bit if you did not use registered nurses.  But you believe that they are worth their weight in gold.  Why is that the case?

Roxane:  I’m not a nurse; let me start there and explain to you:  I’m a social worker and a minister in my background. So, I’m in the home with the mom,  and there’s a baby that has burned its hand. And the nurse is looking at the burn…  and the mom’s explanation for the burn…and it’s starting to make some sense. And it looks like it was accident; the baby grabbed a really hot curling iron. But the nurse is able to look at the hand, due some triage with Mom, and we avoid an emergency room visit.

In another example, I’m in a home with the mom that has clearly relapsed and is using substances again. And as a social worker, I’m thinking: “Oh crud, we’re gonna have to get Child Protective Services involved. We’re going to have to do these things. Mom keeps saying she hasn’t relapsed.” The nurse says to the mom: “Let me take your vitals.” She takes the vitals for the mom and then she says: “Honey, your eyes are dilated; your heart’s racing. I know you’re saying nothing’s going on, but your body says something’s going on.” And at the end of the visit, we have mom cooperating with child welfare; we have everybody involved. We have a safe baby, and we have mom headed back  the way she needs to … because the nurse used her medical knowledge to help the mom. Because pre-term birth babies born into ICU are skyrocketing, as are the Medicaid costs in this country, and their overall healthcare costs in this country. Nurses are critical for delivering a healthy baby, avoiding emergency rooms, helping Mom know what to do to get to a full-term pregnancy.

Denver: Interesting! You touched on this before, Roxanne, but the Nurse-Family Partnership–you’re the gold standard, you’re the royalty when it comes to having an evidence-based community health program… How did this get baked into the DNA of NFP?

Roxane: So the founder Dr. David Olds did not go out into the community with this program until he had studied it for more than 20 years in terms of outcomes. And so it is only after really looking at comparison populations in a community…controlling for everything else that was happening in a community…Did Nurse-Family Partnership make the difference in terms of the baby’s future and the mom’s future? And only after he was able to prove that it did over time, did he bring the model into the field.

Denver: You’ve touched on a couple of the outcomes already, Roxanne… Give us a few more of the results you’ve been able to get with this program.

Roxane: A 56% reduction in emergency room visits. Now, think about that for a minute. I worked for a time in government, and I was really tired of government funding things that didn’t work and our dollars being wasted, right?  72% fewer convictions of moms later…as I talked about. An immediate 11% reduction in moms’ use of public assistance within a year.

Denver: Instant payback!

Roxane: Instant payback.

Denver: That’s great. When you look at the number of new moms who are at high risk in this country right now, what percentage of them are getting the benefit of a home-visiting program?

Roxane: Well, we are in 43 states and about 33,000 families’ homes each day. We know we could go to 100,000– and really start to meet the needs of taxpayers and meet the needs of families.

Denver: So there’s a lot more work to be done...

Roxane: There’s more work to be done.

Denver: That’s the tip of the iceberg. Tell us about the fundings…I know that there’s been a $ 1.5 Billion dollar fund that has been established called the Maternal Infant And Early Childhood Home Visiting Program. Tell us about that.

Roxane: So, this is actually one of those times when government really worked for us as taxpayers. It was the first time that the government established that the only programs that would be funded were evidence-based programs. And if you couldn’t prove your outcomes, it didn’t matter how much we liked your name, or how much we thought it was a “feel good” program. There’s no “feel good” in these programs as a starting base; it’s evidence-based. And so that has allowed more families to be served across the country.

There are several home visitation programs. We are the one that works specifically with the highest risk babies, with nurses in the homes. And there are other programs that work more on education and other aspects. So, we try to get the right program into the right family at the right time.

Denver: Fantastic! Picking up on that notion, NFP announced a landmark “Pay for Success” project in South Carolina. Tell us what Pay for Success is… and about the partnership that you have formed with Governor Nikki Haley in the state of South Carolina.

Roxane: So Governor Haley is a leading governor in terms of outcomes and paying for outcomes.  What she established was “Pay for Success.” So if we are not successful in South Carolina, government doesn’t pay us. Novel concept, right? Can we all say “Amen!”

Denver: Absolutely.

Roxane: And so it has allowed us to expand to more than 3,000 new moms, and make certain that a very rigorous evaluation is done with those moms…vs. moms who are not in the program in South Carolina.  Then the government will only pay, over the course of the time, as outcomes are proven.

Denver: You really believe in Pay for Success outcomes and that government should pay for those kinds of programs. Why is that the case?

Roxane: Whether you call it “Pay for Success,” or whether you call it “good government” or you call it “outcomes in government,” my experience running a human service department, and as Chief of Staff for a governor, is that oftentimes nonprofits and other for-profit entities have really good advocates. As a result, things that get funded are not always outcome-focused; they’re not always changing things in our community.  And I believe we should invest in things where we, as taxpayers, get a return on our money that is long-term change.

Denver: Tough to close down programs for some reason, even though they should be closed down.  I was speaking to Jacob Harold, the CEO of Guidestar, and he was saying that the dirty little secret here in the nonprofit sector is that actually some nonprofits are better than other nonprofits… And I think there’s a sense in this country that they’re all deserving because they’re trying to do good work and try to help people. But the fact of the matter is, some are a lot more deserving than others.  I think the sooner people realize that, I think the more we’re going to get for our charitable and our government tax dollar.

Roxane: I completely agree with you,  and I think it is the challenge that will help us establish  confidence again that our government is doing the right thing.

Denver: Very good. We love to close with a story on The Business of Giving,  and you have thousands and thousands of them. So give us one of a mom and her baby who really benefited from the Nurse-Family Partnership.

Roxane: So I’ll tell you a story of this amazing young woman, Oyuni. And Oyuni started out life pretty tough.  She came from a background that didn’t help her in terms of her own skill set and development. She was living on the streets– as is happening across the country with so many of our young people–she started using heroin. And we all know heroin is a pretty addictive drug, and so, she was on the streets when she found herself pregnant.  She’d already made a decision that she was going to have a baby. And fortunately she started looking for some support and assistance, and she connected to Nurse-Family Partnership and got a referral to us.

Denver: Absolutely.

Roxane: After she delivered the baby, she had some pretty severe depression. A key time for a former addict to relapse, right? Because, what do we know happens with things like depression… is that one of the places to go… is to go back to…

Denver: Where you were, yeah.

Roxane: …the substance abuse. So we continue to work with her there.  She ended up breastfeeding her baby; she got support around her depression. What she says over and over is, she didn’t feel judged by the nurse. And that is a critical point– it’s different to tell a nurse that you’ve been a heroin addict than it is to tell a social worker. A nurse addresses it from a medical perspective. Our nurse just didn’t  give up, and kept going into the home, working with her… When needed, they called Child Protective Services together and said she needed to get back into treatment;  we need to get the baby safe. They worked on plans– instead of having this baby end up in child welfare… again very, very expensive long-term… helping the mom get back to work…having a career path. And she now has a two-year-old son and is doing quite well. And if you want to hear her entire story, it is on Story Corps.

Denver: Fantastic! Well for people to learn more about the work of NFP, or to financially support the work you do— so you can go visit more moms and babies– where do they go?  And what will they find?

Roxane: So we’d be delighted to have people join us by going to givetonfp.org. Pretty simple:  givetonfp.org.  There you can help us turn around a mom and a baby’s life and invest in something where there will be real results.

Denver: Well, Roxanne White, the president and CEO of the Nurse-Family Partnership– Thank you for coming by this evening. An ounce of prevention is truly worth a pound of cure, maybe more. And the Nurse-Family Partnership has the scales to prove it!  It was a real pleasure having you on the show, Roxanne.

Roxane: A delight! Thank you so much.

Roxane White, President and CEO of Nurse – Family Partnership, and Denver Frederick, host of the Business of Giving

The Business of Giving can be heard every Sunday evening between 6 and 7 PM Eastern on AM 970 The Answer in New York and on I Heart Radio. You can follow us at bizofgive on twitter and at facebook.com/businessofgiving.

We have found a new home! Kindly visit this link in our new website here: https://www.denver-frederick.com/2016/09/13/andrew-yang-founder-of-venture-for-america-joins-denver-frederick/

“If you are a smart kid in the U.S. today, you’re going to do one of six things in one of six places,” says Andrew Yang, founder and CEO of Venture for America. Learning how to build a business is not one of those things, and Cleveland and Detroit are not among the places.

What Mr. Yang means, as he explains in this segment from the Business of Giving, is that today’s top college graduates tend to gravitate toward a handful of fields (financial services, management consulting, the law) in a handful of cities (New York, Washington, Boston, San Francisco). As did he, going from Brown and Columbia to a Wall Street law firm before realizing it was a bad fit and starting a successful career in start-ups.

Now Mr. Yang brings that experience to bear at Venture for America, a nonprofit he seeded with $120,000 of his own money. In this interview he details how Venture works to develop the next generation of entrepreneurs through fellowships and mentoring and shepherd that budding business talent to cities most in need of an economic boost. He also discusses Generation Startup, an upcoming documentary about the organization, and Venture’s goal to create 100,000 new jobs across the country by 2025.

The following is conversation between Andrew Yang, Founder and CEO OF Venture for America, and Denver Frederick, host of The Business of Giving, on AM 970 The Answer in New York City.

Denver: What would you say about a baseball team that was made up entirely of great field and shortstops? Well, you say they need to get some different kinds of players: someone who can hit, maybe a pitcher or two,  and some people who can play some other positions in the field. Well, my next guest believes that Team America has too many great field and shortstops. So he has dedicated himself to seeing that some of our best and brightest college graduates become engaged in helping to build enterprises in cities across the United States that could really use their talent. He is Andrew Yang, Founder and CEO of Venture for America. Good evening, Andrew, and welcome to The Business of Giving.

Andrew: Thanks for having me; it’s a pleasure.

Denver: Tell us about Venture for America. What is the central mission and objective of the organization?

Andrew: Venture for America is a nonprofit that recruits and trains top college graduates who want to learn how to build businesses. We train them for a summer,  and then we send them to work at early-stage growth companies in Detroit, New Orleans, Baltimore, Cleveland, St. Louis, and other cities around the country that could use an economic boost. Our goals are to help create American jobs through helping early-stage companies grow, and also to train the next generation of entrepreneur.

Denver: Let’s take a look at some of our successful college graduates from some of the very top schools. Is there a default path, Andrew, that they are following– both in terms of careers, and the cities that they gravitate to?

Andrew: Well, I resemble this. When I graduated from college, I didn’t know what to do. So,  I went to law school. My parents thought that was a great idea. And then I came to work here in New York as a Wall Street attorney. And to your point, that’s one of the default paths that our top college graduates have today… and one of the top markets. The default paths today are financial services, management consulting, law school, academia to some extent.  And our talent tends to concentrate in New York, San Francisco, Washington DC, Boston, and a couple of other cities. One joke we have at Venture for America is: if you are a smart kid in the US today,  you’re going to do one of six things, in one of six places.

Denver: Yes!

Andrew: To your point about having a lot of the same sort of player on the field, that’s a pretty apt analogy.

Denver: Yeah. As you’re talking about trying to build and groom these entrepreneurs, I think the words “entrepreneur,” and certainly “social entrepreneur,” weren’t very commonplace a generation or two ago. And I think that today: with the lower barriers to entry, with the internet, and with social media, you can start a business from your dorm room or your home. And we read these stories about these incredible, successful entrepreneurs. I think most people have this assumption that more people are going into entrepreneurship than ever before. Would that be a correct assumption, or not?

Andrew: Well, the statistics tell the opposite story: Rates of business formation among Americans between the ages of 18 and 30 are down about 65%…

Denver: Wow!

Andrew: …over the last 25 years. And if you think about technology, it’s really a double-edged sword. So I’ll give you an example… People think: “Hey! Like now, you can spread the word about your business; you can do all of these things cheaply.” But on the flip side, the internet has taken a lot traditional, small business opportunities and transported them to the cloud, if you will.

One comparison I make is that Kevin Plank –who started Under Armour– which is now a multi-billion dollar company– His first business was selling flowers. Today there is 1-800-FLOWERS and a bevy of online vendors that would make that initial business probably unsuccessful. So, there are a lot of opportunities that have now been taken away.

Technology is also a barrier for many people because a lot of people aren’t coders. I’m going to guess that most of the people listening to this broadcast right now are not coders.  So, for all the talk and hype about:  “Oh, we need to train engineers and coders…” If you look at the ranks of entrepreneurs, the vast majority are non-technical, non-engineers. There has been a lot of industry consolidation at various levels that makes starting a business today actually more rare than it was 25 years ago.

Denver: Yeah, I guess you have to be better than everybody today, whereas before you just had to be pretty good in your own community. Now, you have to be the best of the best. Do you find that young people have a fear of failure?

Andrew: I think that things have changed, even from the days when I went to school, where you could kind of stumble into certain things. Today, very little happens by accident.  So, young people feel like if they fail, they’re not going to get into the good schools. If they go to a good school and they fail, they’re not going to get the good jobs. And so we’re training young people to see failure as a very bad thing. Whereas in entrepreneurship,  there’s a lot of failure that is baked in. To continue your baseball comparison, if you are a Big League hitter, and you hit 300, you’re excellent…which still means you’re not getting on base 70% of the time.

Denver: That’s right.

Andrew: That’s a pretty decent comparison to most entrepreneurship and sales that I’ve seen. No one is going to be selling successfully more than 30% of the time, but our young people today would see that as a signal failure in a lot of contexts. So, along with the fact that everyone is an entrepreneur– which is statistically incorrect and overhyped–there’s also this embrace of failure that we talk about in the entrepreneurship community…but we don’t really talk about…because the people that can talk about their failures tend to be successful.

Denver: That’s exactly right! Sort of a mindset of “Don’t mess up!” That is not the way  to go, but that’s the way we have right now. Well, when you started, or thought about starting, Venture for America, it was largely informed by your experience as having been an entrepreneur–the Good, the Bad — and oh yes! — the Ugly. Tell us about that.

Andrew: Well, I went to law school, and I practiced law for about five months here in New York at Davis Polk. And found it was a very bad fit.  So, then I went out and tried to start my own company. I know firsthand how hard it is to be an entrepreneur in your 20s. My company had a mini rise and maximum fall; it did not work out. And so then the question I faced was what we’re trying to address with Venture for America, which is: How do you get better? If you are to go to a young person and… let’s say that person said: “I really do want to become an entrepreneur, but I don’t know where to start.” How does that person develop? Right now we’re saying: “Go to school; take out  $100K in debt,  and that will be a really good path towards your business training.” What I did is work for a more experienced entrepreneur for four years in a healthcare software startup. And then I worked with another entrepreneur who had started an education company that I then became the CEO of.

And so, the way I developed was by working with the more experienced entrepreneur. And that’s what Venture for America does for its fellows.  We pair them with existing entrepreneurs. Because if you are an enterprising 22-year old, you’re probably still not situated where starting a company is a good idea. At least, it’s not going be a good idea for your investors or your backers.  It might be a good idea for your development!  So, what we do is, we say: “Hey, look, if you want to learn this, let’s have you work with the more experienced entrepreneur for two years. Then, at that point, you’ll have a much better shot at it.

Denver: And when you were the CEO of that educational company– which is Manhattan GMAT–you had a lot people coming in from places like Goldman Sachs and Morgan Stanley, who were getting prepared to take that test…and they had dream jobs! But you found out a lot of them weren’t really all that excited about what they were doing.

Andrew: Yeah, they reminded me.. of me at the law firm, where they had done really well in school.  They’d gotten the jobs that they knew were really competitive. Then they showed up and were like: “Hey, why I am not that pumped about this? Let me take the GMAT, go to business school, get my $100K in debt, and start over.”

I’ve personally taught the analyst at Goldman, and McKinsey, and Morgan Stanley, and I saw this over and over again. So I thought, “Wow, what a weird, elaborate ringer we’re putting so many of our young smart people through!  What would they optimally want to do?  And what should we be asking them to do?”  And those are some of the questions that I hoped to answer through Venture for America.

Denver: And one of the guys who influenced you was someone by the name of Charlie Crowe. Who is he?

Andrew: So Charlie went to Brown, where I graduated from. We met at an alumni event in Providence. Charlie wanted to be a banker in New York…didn’t get the job he wanted.  So, he started a software company in Providence that he’d grown to 100 jobs. And at that time, Providence had an unemployment rate of over 10%. I saw this and said: “My god, Charlie, if you’d gotten that investment banking job, you would have left Providence, and this company would not have existed!” I said out loud to Charlie: “We need more people doing what you did, and less doing what you thought you wanted to do when you were 21 or 22.”

When my company was acquired by The Washington Post in 2009, I thought to myself: How can we create more people like Charlie? That was one of the inspirations for Venture for America.

Denver: And you decided to start that in May of 2011. You took $120,000 of your own money, and you did some bootstrapping. You went around the country and spoke to kids on college campuses… sometimes as many as two at a time!

Andrew: Yeah, those were good times. So we had this press launch for Venture for America. I did put in $120K of my own to seed the organization.  Then I went around calling people I knew and said: “Hey, don’t you love America? Don’t you want to chip in to help start this organization?”  We had a couple hundred thousand dollars in commitments– in addition to my own contribution. And then I went around to college campuses, and I asked young people: “How many of you dream about starting a business someday?” They all raised their hands. And then I said: “How many of you are going to go to a bank, consulting firm, or law school to “learn” about business– if you’re going to eventually do this?” All of them kept their hands up.

Denver: Or raised their other hand.

Andrew: Yeah. And then I said: “How many of you would prefer to go work with an existing startup, in an environment that could really use that help… if we could provide you the training, the network, the prestige, the community, the optionality… that you’re currently seeking at a big professional services firm? And all of them kept their hands up. So we said: “Apply to Venture for America.  It’s going to be very competitive, but if you get in, we will train you. Then we will send you to work at startups and early-stage companies and cities around the country.”

Denver: Well, let’s talk about how competitive it has become over the course of those five years. How many people apply? What are you looking for in an applicant?  And how many are you able to accept?

Andrew: Well, this past year we had about 1,400 applicants from universities around the country for about  170 spots.  So, it’s highly selective. We’re looking for young people that have demonstrated a capacity to contribute. What we’ve taken that to mean is that they’re really good at something. It could be that they’re excellent at school; it could be that they started a business; it could be that they’re an exceptional communicator or content creator; it could be that they’re great on the athletic field. We had the co-captain of the Boston College Lacrosse Team join up, and he’s very, very strong, as you’d imagine. So we’re looking for people that have demonstrated an ability to perform at high levels in a given context… that we think will translate.

Denver: Well, they go on this 2-year journey, and much like the military, it begins with boot camp. That’s five weeks during the summer on Brown University campus. You’ve just finished up your program for this year. What goes on there, and what do you hope the recruits will leave with?

Andrew: Well, we bring in firms like McKinsey, IDEO and the Flatiron School–who are best- in- class at what they do. And then we put the fellows in teams of five or six and assign them competitive, time-constrained challenges. They live and work together; they make fast friends. You can only convey so much knowledge in a particular period of time. What we’re trying to do is give them a sense of action orientation, ability to deliver on tight deadlines in teams– that will end up translating to the work environment.

Denver: So you’re going to place them now in some high-growth companies in cities across the United States that don’t attract a lot of  people, unlike New York, Los Angeles, Boston and Washington. So let’s start with the cities.  Venture for America is currently in what cities?

Andrew: We’re in 17 cities now around the country. We started out in Detroit, New Orleans, Providence, and  Cincinnati in 2012. We’ve expanded to another 13 cities. I was just in Birmingham, Alabama last week. So I can rattle through the cities–you can go to our website–but it’s Baltimore, Cleveland, Philadelphia, San Antonio, St. Louis, Pittsburgh, Charlotte.  It’s pretty diverse. To your point, we’re looking for a few things: one is that the community needs to have a robust nucleus of promising growth companies and early-stage startups. And then it needs to also not be one of the Tier One markets that are already receiving an influx of talent every year.

Denver: Fair enough. And how do you select the companies? I mean, how do you know what companies are going to be right?  And how do you know that a mentor is going to be suitable for one of your VFA fellows?

Andrew: What we do is we spend time in each market. We have a full-time team that meets with executives and CEOs of these startups. We turn down a lot of companies. The measuring stick we use is: Would this be a good development opportunity for a talented and enterprising 22-year old? Then if you go to Baltimore, and you meet with local investors and entrepreneurs, they pass you around very quickly. These communities are very tightly knit. So you can imagine sitting there and visiting various companies.  It’s a lot of fun if you like startups, which I do. But you go and meet teams, and then you get a sense as to what would be the right opportunities.

Denver: And cities have been chasing you. I know that Cincinnati, as an example you mentioned before, really almost insisted that you come to town.

Andrew: Yeah. The mayor of Boise reached out a little while ago. We do get outreach now from cities around the country. We’ve also turned down a lot of markets because some of them aren’t really the right fit for us at this stage, or what we can provide. A lot of communities are looking to build their talent infrastructure, if you will, and it’s invigorating to visit these places. I’ve been to a lot of places I’ve never been before and seen what they’re working on… what they’re building. There are leaders in every community that are very easy to root for.

Denver: Well, let’s talk about your young, budding entrepreneurs. They spend two years at this company. You’ve had enough classes by now that you can track what happens to them. How many stay with those companies…move to other cities… become entrepreneurs themselves?

Andrew: It’s been incredibly successful in terms of the outcomes. Right now, about 25% of our alums co-found, or found a business after graduating– which is really astronomically high.

Denver: That really is.

Andrew:  Another 40%, or so, stay on as managers and leaders at the companies that they worked for in Venture for America– or another startup in their cities. So those outcomes, we think, are incredible. And the most successful of our alums have started companies that are already valued at millions of dollars and employ dozens of people.

Denver: Yes, and those 25% that start up their own companies… you give them a leg up by providing them some potential access to capital!

Andrew: Well, we’d be a pretty lousy entrepreneurship apprenticeship program if we said: “Hey, you want to start a business? Have at it!”  Because the truth is… there’s a mythology that all you need is great determination, passion…

Denver: Yeah.

Andrew: One joke I tell is that: if you’re a young person and you don’t know what to do, and you decide to go to law school like I did, your parents will think it’s a great idea. It’s easy to find, and the government will give you a $100,000 loan.  If you say: “Hey, I want to start a business!”  Parents will think it’s a terrible idea…

Denver: No, they don’t like that at all.

Andrew:… It’s very hard to find, and no one’s gonna give you a $100,000 loan. So it’s no mystery why Business Week projects we’ll have 176,000 unemployed and underemployed law school graduates by 2020. And we will have an equivalent shortage of entrepreneurs around the country. Because we’re systematically incentivizing and encouraging certain things with money.

To your point, we have an accelerator and a seed fund that’s provided this year by UBS to invest in the fellows that want to start businesses. And for every dollar that Venture for America has granted to them directly, they’ve historically gone on to raise $10 from outside investors.

Denver: Very impressive. You’ve made the point– which I think was quite funny– that VFA almost provides parental cover for those who want to become entrepreneurs… because nobody wants their kid to become an entrepreneur…  They’re afraid the kids are going to live in the house for the rest of their lives. But every parent wants their kid to become a fellow!  How can you be against that?

Andrew:  It’s a competitive program; you’ll be hanging out with some of the best people in the country. There are incredible companies, and entrepreneurs that are supportive. And so then parents think: “Wow, my kid has a shot!”

Denver: That’s right. And you’ve also made an interesting point about trying to build the business in those very formative years when you get out of college. Talk a little bit about the brain in development,  and what it means to really to become an operator and start a business.

Andrew: Your brain stays very fluid and plastic through your mid to late 20s. And what young people really respond to are role models. So, when I was with the law firm, I looked around and said: “Okay, who am I supposed to be? I’m supposed to be that partner in the corner office.” If you pair that young person with an operator and a business owner in Baltimore or Cleveland, they’ll look up and say: “Okay, that’s what I’m supposed to be.” And if you work alongside — and I had this experience — a founder, you see what they’re doing; you see the way they think, the way they operate. Then, it rubs off on you. It rubbed off on me. The goal is to have a systematic way for it rub off on lots and lots of people.

Denver: I know, Andrew, you’ve set a goal or an objective of creating 100,000 new jobs by 2025.  I also know we’re in the very early innings, but how are you doing against that goal?

Andrew: We’re about 2,000 jobs in– which I believe is tremendous. And the way you create jobs — I mean, there’s a lot of discussion around this — but the way we at VFA think you create jobs is 1) You help early-stage companies access the talent they need to grow and succeed. And if you ask an entrepreneur what they need, they need one of three things:1) they need money, 2) they need talent,  and 3) they need to figure out their product market fit.

If you invested $100,000 in a young business, the first thing they do is look for someone good to hire. And as someone who’s run a business, I know how difficult it is to find the people that you want to hire. So, if we can solve that problem for these businesses, we can really enable them to grow and hire more people. So Part 1 is: you help these businesses access the talent they need to grow and hire more people.

And Part 2 is:  you train and cultivate a critical mass of your top graduates to themselves become business builders and job creators. And this is not something that happens quickly; it happens over a period of years. Most businesses will take between 5-10 years to grow meaningfully… and most people will as well. My wife compares what we’re doing to planting seeds… it’s like watching trees grow. I will say, some of our young people have grown into real leaders and founders and CEOs much more quickly than I ever could have hoped.

Denver: Well, to your point: human capital really is a great differentiator– not only between companies, but also between cities. So some cities are doing particularly well,  and some cities are just getting by. I think you said once: “What would Detroit be like, if everybody who lived in San Francisco moved to Detroit?” It certainly would be a different city!   In these 17 places you are around the country, are any of those mayors doing any intriguing, or even audacious things to bring additional talent to their cities– in addition to VFA?

Andrew: The most proactive mayor I’ve seen is Mayor Duggan in Detroit. He certainly cares very much about talent. They’ve really gone to great lengths to encourage people to take responsibility for not just their own property, but their neighboring properties. He’s cut so much red tape, it’s phenomenal! You can pay a $50 fee in Detroit and then take over an adjacent vacant lot, and do whatever you want with it!

Denver: Getting things done.

Andrew: On the talent side, I think that there are a lot of cities that are trying to do interesting things. I’m actually going to say– I think what young people are attracted to…is other young people. So, in some ways, there are limitations as to what a public official can do. They can create the conditions for young people to find their community attractive, but you really need some degree of critical mass and momentum to build.  And those things take time.

Denver: Yes. You’ve written a book, Andrew, with a very apt title: “Smart People Should Build Things.” What’s the central message of that book?

Andrew: The first part of the book is pointing out that smart people, right now, are not really building things.

Denver: And you’ve made that point.

Andrew: Yes. We’re sending the majority of our talent to a professional services layer that serves primarily mature organizations. It’s like a lot of icing… and not baking the cake, so I…

Denver: Good metaphor.

Andrew: …document why and how that’s happening. And lot of it’s happening because certain firms just have more resources to recruit and pay. And now those have become the default paths of achievement to many of our young people. And then we talked about what building things would mean–which is working on these early-stage companies around the country…  And that we don’t have enough of our young people taking on that challenge. And the goal is to try and change that. There was a review of the book that was very positive, but said the book could be seen as a promotional vehicle for my organization.

Denver: Good!

Andrew:  Yeah, that was sort of the point. I wrote the book because…”

Denver: Sounds like a successful review. And there are not too many nonprofit organizations, particularly as young as yours, that have a movie coming out! It will be shown in theaters starting  September 23; it’s called “Generation Startup.” Tell us about it!

Andrew: This movie is such a labor of love, not by me or the team, but by this incredible woman Cheryl Houser, who I met over two years ago. And she took it upon herself to try and tell the Venture for America story through film. And the movie is coming out later this month.  It’s a beautiful film. I have seen it. And what I love about it is that it’s the most honest treatment of entrepreneurship I’ve ever seen. It documents the personal ups and downs, the struggles, and the fact that it doesn’t always work out. One of my missions and passions is to try and debunk some of the mythology around startups and entrepreneurship–where you see it, and it’s like a magic trick. And the truth of it is… the opposite of magic. I mean, it can become magic if someone sticks with it for years, soldiers through, and takes on all of the micro challenges that occur day to day. Anyone who starts a business knows what I’m talking about.

But the film follows six of our young entrepreneurs around Detroit for almost two years.  You see them building businesses; you see them trying to succeed in an environment that in some ways is very foreign and difficult for some of them… because many of them are not from Detroit…Now that I think about it, none of them are from Detroit!  And “Generation Startup” as a title… to some of our earlier points… It’s not that this generation is more enterprising than past generations. Statistically, it’s actually the opposite. One comparison I make is that a young person might have a social media account.  But that doesn’t mean they are  starting a business. It’s easy to confuse it. So “Generation Startup,” the title, is more of a call to action; it’s  saying: “Hey, this is what it takes to start a business. Here are young people who are taking on that challenge.  And then, what does that mean in real life? What does that mean on the ground?”

Denver: There are six very personal stories… Tell us one.

Andrew: So, a couple of guys started a chickpea pasta business in Michigan, called Bonza. And you see the early days of them working on the product in their kitchen.  You see them manufacturing it in Michigan in the dead of winter, and then selling it at Eastern Market in Detroit, every weekend on Saturday mornings. So you see their trajectory; you see some of their early pitfalls. That company is called Bonza. The product is very good; my kids like it; it’s high protein, gluten-free pasta. It documents the early days of that business. There’s another really compelling story about a woman named Dextina Booker, who’s an African-American engineer from MIT. She’s actually from the New York area, and she moved to Detroit to work at an investment firm that’s helping revitalize the community. You see some of the personal challenges she grapples with in her new environment as well.

Denver: To learn more about Venture for America, your website would be?

Andrew: Our website is ventureforamerica.org. Again the name of the movie is “Generation Startup.” People tend to find watching the movie trailer more exciting than…

Denver: I did.

Andrew: We’re at ventureforamerica.org. If you, or someone you know, is a talented young person that wants to learn how to build a business, please do apply. We want people from everywhere–all backgrounds, all over the country– to be able to take on the task of revitalizing communities and building businesses.

Denver: Well, Andrew Yang, the founder and CEO of Venture for America… Thank you so much for being on the program this evening. The documentary movie again is “Generation Startup.”  It has received sensational advance reviews, and it will open in select theaters around the country on Friday, September 23rd. So, be sure to catch it! And take that seventh grader, or a high school sophomore along with you when you do. It was a real pleasure to have you on the program, Andrew.

Andrew: It is great to be here. Thank you!

Andrew Yang, Founder and CEO of Venture For America, and Denver Frederick, host of the Business of Giving

The Business of Giving can be heard every Sunday evening between 6 and 7 PM Eastern on AM 970 The Answer in New York and on I Heart Radio. You can follow us at bizofgive on twitter and at facebook.com/businessofgiving.

We have found a new home! Kindly visit this link in our new website here: https://www.denver-frederick.com/2016/09/08/robert-egger-founder-of-the-dc-central-kitchen-joins-denver-frederick/

The founder of LA Kitchen and the DC Central Kitchen, Robert Egger, discusses his initial idea to teach homeless men and women basic cooking skills, and how that idea has blossomed into a program with huge impact— from training unemployed adults for culinary careers, to reclaiming healthy, local food that would otherwise be discarded.

The following is conversation between Robert Egger, Founder and President of LA Kitchen, and Denver Frederick, host of The Business of Giving, on AM 970 The Answer in New York City.

Denver: There are not many founders who would build a world class social enterprise, then one day leave it all behind, move 3,000 miles across the country, and start up another one. But my next guest is not your typical founder; he is Robert Egger, the Founder of the DC Central Kitchen, and now the President and CEO of LA Kitchen. Good evening, Robert, and welcome to The Business of Giving.

Robert: Thanks. It’s a real pleasure to be on.

Denver: Well, from the time you were a kid, you wanted to be Rick in Casablanca, the character played by Humphrey Bogart, open a night club, and change the world through music. But instead, you started the DC Central Kitchen in Washington. So you pivoted, Robert–long before anybody ever heard that word…outside of a few basketball coaches. Tell us how this came to pass.

Robert: Well, I was, as you suggested, a night club guy. I really dreamed–since I was very young– and wanted to be part of the social movements that I grew up watching in the 1960s. I wanted to be part of something, to contribute. As you suggested, man, I thought music was the vehicle, and I still believe it has power.  But I just ended up like a lot of people in the late 1980s.  The issue of homelessness became so “in-your-face” in DC,  but also in every city. I thought  I had to go out and do something. So one night I went out innocently  to serve people on the streets of Washington and encountered the kind of charity model–which is sadly and often times wrapped up in a kind of redemption for the giver, versus the liberation of the receiver. In short, I was serving food that was purchased at the grocery store to people who were standing outside in the rain.

And so I innocently proposed an idea that eventually became the DC Central Kitchen, mainly because all the groups I went to– to try and give it to them– liked everything the way it was. That’s been a benchmark of my career. It’s that sense of: “what we’re doing is great, but it could be better! Let’s always be open to trying something new.”

Denver: Well, tell us a little bit about the DC Central Kitchen: what your business model was there; where you sourced your food; who you hired;  and what you were able to achieve.

Robert: OK. The first time I went out, I purchased food from a grocery store, served the people outside in the rain. So I said: “Hey, look: restaurants, hotels, hospitals, universities throw away a ton of food every night.” And they hate throwing away food; they just don’t want to be sued. So, if you could find a safe, healthy way to get that food…boy, you could serve more people…better food, for less money.

Denver: Yes.

Robert: But I was more intrigued by this idea:  Shouldn’t we be doing something to get people out of the rain and off the street?  So, I also proposed the cooking program, that in effect said: Let’s teach homeless men and women basic cooking skills… and I don’t mean people right off the street. But, let’s try and be part of a system that would start to create an exit door. And restaurants could donate food.  Then they could also help teach,  and would have access to entry-level people who could help them make money! Everybody would win something! That was where it started– this idea of quid pro quo.

Denver: Great idea!

Robert:  Well, I thought so!  I was pretty flummoxed when every charity I went to shot it down, or they thought I was naive.   And maybe I was, but,  nonetheless,  I went ahead and got it started.  I was thinking that I’d go back to running night clubs. But here it is almost 30 years later,  we’re having this conversation.  And the DC Central Kitchen– using essentially recycled food + job training model– has produced about 34 million meals…

Denver: Oh my!

Robert: ..and helped probably, at this stage, maybe 1,500 to 2,000 people to come in off the streets and be part of the solution. It was a fun, really cool run in DC and, of course, the DC Central Kitchen is still rockin’ and rollin’ and thriving and doing tremendous work–almost 12,000 meals a day now.

Denver: So, Robert, how did you know it was the right time to pull up your stakes in Washington and move to where “the future comes to happen”–Los Angeles?

Robert: You know, Keith Richards’ saying, “You’d better walk before they make you run.” And I’d been in charge for a long time. I’ve always tried to be a good leader.  I’ve watched the nonprofit sector, and I’ve observed leaders. There are certain things I saw coming up and thought, “You know, I don’t think I wanna go down that road.” So I was always very careful to diversify leadership, to give lots of people in the organization the opportunity to participate fully, and have their ideas not only heard, but attempted. Had a good board of directors; had a good reserve. The kitchen had been replicated in about 50+ cities, based on DC Kitchen. But then we also had something called “Campus Kitchens.”  There are 60,000 school cafeterias in America that are closed all afternoon, all night, all weekend. “We ought to try and see if we can operate out to some of those.”  I think there are  57 of those now.

Denver:  Well, that’s a wonderful thing you’ve done there.  Sometimes founders try to  make themselves indispensable.  But that was not the case with you, with DC Central Kitchen.

Robert: No. Like I said, I’ve had a lot of benefits,  and I just wanted to use them to show different ways of approach in leadership.  For example, I wasn’t the highest paid person at the DC Central Kitchen, and I’m not the highest paid person here at the LA Kitchen. I’ve always try to experiment with this idea of:  “What is leadership?” Sometimes the things we just mimic maybe don’t serve us the right way.  I’ve just tried to experiment lots of different ways.

But at the same time, I started to really become hyper-aware of how often it’s never really easy for any business. But sometimes nonprofit partners kind of get into a rut of doing the same thing over and over. And I watched as the people who were in need of services shifted. This idea of being flexible and anticipating what’s coming next–I became really good–I like to think I remained pretty good at seeing what’s on the horizon.

And there were two issues that really got me thinking about this next phase for my career which are  a) “Where is the food gonna come from?” And even though we throw away an insane amount of food in America.

Denver: Yes, about 40% I think.

Robert: Yeah, exactly.  And half of that is fruits and vegetables that are cosmetically imperfect.  “Okay, cool! California is a great spot to really pioneer… or be part of this movement… to not only recycle fruits and vegetables, but deeply experiment in the preservation–all the  different ways you can extract great nutrition out of fruits and vegetables; that’s one thing.

But oh my goodness, it’s probably 2002, I did a speech for Meals on Wheels and the National Association, and I was told that there was a waiting list in half of American cities. And I had one of those moments there:  “Wait a second, it’s 2002. The first of 80 million baby boomers hasn’t even showed up yet. They don’t turn 60 until 2006 and you’ve already got a waiting list?” So I became hyper-interested in this issue of aging in America. And come to find out–Los Angeles–even though it’s oftentimes perceived as this temple of youth, it’s actually the largest concentration of older people living in America. Almost 1.65 million people over 65. And like every city, that number is gonna double in 10 years;  and there’s no real plan.

Denver: No.

Robert: I mean, no city in America really has thought about it. In fact, as a country, there hasn’t really been much discussion about what happens–when the largest generation up until the Millennials –when this giant cohort of people..(Many of them won’t have enough money in the bank for the x few years science will give them.) What’s our responsibility to them? How does it work? It’s almost as if we throw away food and people who don’t fit. “If it’s wrinkled, throw it away.”That’s kind of our unofficial motto at LA kitchen: Wrinkled food. Wrinkled people. No waste. Just because something’s got a little wrinkle, doesn’t mean it isn’t nutritious, tasty, desirable, and can’t be part of something bigger. It became something that I  really focused on. This is profound;  it will really test our mettle as a people in so many different ways. So, the quest I’m on right now is: How do you feed more people, a better meal, for less money?

Denver: Yes, I know you referred to it as the “Silver Tsunami.” I ask so many people on this show :  What’s the one issue that really concerns you that we are not talking about?  I’ve never had a single person say: Aging!  And I really do think, like you, it’s the number one issue.  And it’s really not just an issue in this country.  It is a problem around the world that no one is addressing.  So, it is so refreshing to hear that somebody has got this within their sights.

Robert: Well, the baby boomers for all of our foibles,  we still represent the deepest well of life experience in the history of the world. I mean no other generation has been this rich, this free or this educated, ever. And so there’s a great opportunity here. If we look past the surface and realize that there’s a tremendous opportunity here, and it’s an economic essential. We have to keep this generation active and living independently as long as possible. This really puts, I think, a particular onus on the  nonprofit sector to recognize that the productivity we need from this older generation will likely come through volunteerism. Maybe what we need to do is look very, very hard… And actually, challenge our elected officials to see us… not as just the doers of good deeds, but as  tremendous essential partners in channeling the energy, the idealism, the experiences of this generation… to make our community stronger.

Denver: Right. Now, when you came to Los Angeles, you looked at the millions and millions of dollars of service contracts that existed for these senior meals, and you wanted that business. What was the case you made to the LA city officials as to why you should get it?

Robert: Well, I’m in the middle of that right now, and it’s actually kind of exciting, because I think the model we’re developing will not only work here in LA and, of course, you know my history is really trying to use things that exist already…

Denver: That’s right.

Robert: And I’m really good at identifying things that are there… and repurposing them.

Denver: You move the pieces around.

Robert: So contracts are just another example. Yeah, the model was: take food our society throws away, people our society undervalues, kitchens that are unutilized, volunteers that want to be part of something bigger, people we want off the street, chefs who’ll help teach and give them jobs… all that was there. I’ve just taken it  one step further and said, “Well hey, you know, farmers also have food that they can sell you.” And if you go out and buy that cosmetically blemished food at a reduced price, it means you can be very competitive when you go in for a contract. You can actually reinvest the money you might save from the food you purchased into the wages you pay your employees. And then you can turn around to the city and say, “Look, currently with your city contract– which is our tax dollars–you are getting processed meals, made at a low wage.  And profit leaves Los Angeles and never comes back.

Denver: Exactly right!

Robert: So, what we’re saying is: This model — I’ll buy local food; I’ll keep people out of prison and pay a great wage. I’ll produce scratch cook, beautiful, healthy meals every day.  But most importantly, profit never leaves town. And that I think is an economic combination that no mayor in America can resist.

My job is not necessarily to fix the problem, it’s to help society to be brave enough to do it together.

Denver: You have said that you look at LA Kitchen… in fact, all your businesses… as Trojan horses. What are you getting at there?

Robert: Well, if you ask people to talk about homelessness, race, addiction, prison, aging… most people don’t want to talk about it. “No, no,I don’t want to do that.” Or sadly, many people would rather hold on to old stereotypes. For example, if somebody is homeless–it’s their fault. If they’re poor–they’re just lazy. If they’re in prison– they did something to deserve it.

Denver: You’re so right.

Robert: And sometimes you have to help people overcome those fears. Once you realize that the majority of Americans are decent, kind, caring people. They’re just afraid sometimes of new ideas or change. And once you get your head around that, you realize, “Okay, my job is not necessarily to fix the problem, it’s to help society to be brave enough to do it together.” So, a lot of what I’m trying to do–whether it’s a homeless person who can’t see past their life in the rearview mirror, or a felon, or an addict, or somebody coming in the door to volunteer– Often people come in with these barriers: I can’t do that. I can’t talk to that kind of person. And so, I just try and use the kitchen, cleverly disguised as an innocent kind of charitable organization. It’s actually pretty diabolical what we’re doing down there. I mean we’re really trying to purposely lure people into a place where they’ll see things that they thought were impossible.  Or,  they’ll do things that they didn’t think they could ever do. And that’s a lot of what I’m trying to do– is trick people into being the kind of person that they really want to be.

Denver: Right. You’ve always said, you’re not in the charity business, you’re in the bravery business.

Robert: That’s exactly right! I think we get lost sometimes in our charitable work, thinking we can fix the problems.  And it’s beyond us!  There aren’t enough charitable dollars in the world to fix hunger. So,  my job– while I’m trying to do my best to meet an immediate need– is trying to entice, cajole, inspire people to try something new, or be open to change. For example, as I suggested earlier, part of my trip to LA is saying, “Wow! It’s supply and demand. I can get the food I need, and there’s the desperate need here.” But this is also Hollywood, and this is one of the biggest cities in America.  And if I can use this combination… For example, I’m wildly interested in the fact that for the first time in the history of Hollywood, there are so many content providers… you have this rare moment where you’re gonna see a predictable assault, if you will, on the “beauty myth.” More and more older actors will stop and say, “You know what? I’m not going to change myself physically for a role.  And I will dye my hair, but I’m not gonna augment my face to appear young.” And this is a breakthrough moment, because for the longest time women actresses couldn’t get gigs unless they succumbed to this idea of “I’m still beautiful and youthful.”

Denver: That’s right.

Robert: And I think we have this magic moment where we can start to erode that idea, and start to realize that everybody has beauty. And this is a lot of what I’ve been trying to do.   I love the metaphor of taking food– and the slightly blemished produce and sometimes slightly blemished people– and say, “Look, there’s still beauty here; there’s still opportunity; there’s still need.” And so I think there’s a really powerful moment for the American society– where we can start to  look at each other a little bit differently, and realize that everybody has something to contribute; everybody has a gift; everybody has something to bring to the table.

Denver: Just as a footnote to that, I was speaking to the CEO of Trader Joe’s.  He was talking about the blemished fruit and vegetables and said that they would just sit there. And they had the idea one day… in setting up a separate table and calling them:  “heirloom fruit” and “heirloom vegetables. ” He said they just went flying out of the store. So, he took the irregulars and he gave them a nice little name.  All of a sudden,  it changed the perception.

Robert: Yeah.that’s the same thing we’re trying to do at LA Kitchen is say “Wow! Look, boy, if we’re gonna feed a whole lot of older people, we’re gonna have to come up with a new menu. Because we just can’t afford to feed every single person who’s gonna need some kind of nutritional support… everybody can’t have a piece of meat every day.”

Denver: Yes.

Robert:  It’s just not sustainable; it’s not healthy; it’s too expensive. So what we’re trying to do is respectfully and gently start to introduce and explore more of a plant-based diet. Often, nutrition guidelines call for three ounces of protein, and we’ve interpreted that as meat. But what we’re looking at is:  Can we reduce the amount of  animal protein and start to introduce alternate proteins– whether it’s different kind of beans or legumes, tofu, a variety of other things?  But how can we introduce these things– and I’ve never wanted to be a nutritional imperialist and comment what I think is healthy for someone else. But at the same time, we do have a responsibility to try and introduce something that’s going to  keep older men and women active, engaged, out of the hospital, and living a longer life– but more of a full, long life.

Denver: Let me get back to your leadership model for just a moment, because I find part of it to be quite interesting– particularly the 49/51 part of it. Explain to us what is 49?  And, what is 51?

Robert: Well, I’ve alluded to it earlier with this idea that nonprofits can’t fix the problem. I’ve always tried to make the businesses I run or work with stronger, faster, better every day. I never want to get trapped into thinking that my program is somehow the solution. I have to be part of something bigger. My organization has to be part of a larger ecosytem, and I have to contribute to a bigger thing. So, I’ve always metaphorically said: 49/51–I will always give  49% of my energy –and that a full 100% of that 49 will be the daily work I do at LA Kitchen or DC Central Kitchen–but 51% must be asking those larger questions, being part of a bigger discussion.

And that led me years ago to start to ponder– and then challenge– the role that nonprofits play in America, and the way we’re perceived. Because when you really look at it, and I do, there is no profit without nonprofits. I mean, you think about it, what town flourishes… or what mayor can hope to attract a business to relocate to their town or college (students to stick around after they graduate), if that town doesn’t have arts and culture, communities of faith, healthcare, education, clean water… all the kinds of things that nonprofits  do, or contribute to?

Denver: You’re so right!

Robert: So, when you really get down to it , you can’t make money without it. Yet we’re never at the table when budgets are discussed.  We only get what’s left over.  I’ve been very interested in: How do you elect a generation of mayors who show up on Day One… really understanding that nonprofits are major sources of investment dollars coming into the city from outside? For example, nonprofits here in California bring over $44 billion every year into the state from outside.

Denver: That’s remarkable.

Robert: So. if I’m the Governor, I’m looking at the nonprofit differently when I start to realize their potential to bring in investment dollars, their potential to create jobs or, once again, to keep communities economically viable by the work they do making the community whole again.

Denver: Yes,, and I think another source of frustration for nonprofits– and I know that you’ve been a leader in this– is that they can’t lobby or advocate for the things that really, deeply impact the work that they do. Is there going to be any progress made here? Can we make any kind of changes?  Right now, we are sitting on the sidelines and watching the things that are going to impact us.

Robert: Nothing perturbs me more than that log jam. . And I work really hard at that…

Denver: I know you have.

Robert: Because, think about it, I go to work every day,  and there’s a dumpy business across the street that can put whatever “Vote For” sign in their window they want. Yet, if I put a sign in the window, or somebody comes in and says, “Robert, man, you’re a pro, and I really need your advice. Is there a candidate that you think would really contribute to the end of  programs like yours? Is there a candidate that has ideas that would fundamentally decrease the need for charities like yours?” If I say, ” I’m so glad you asked. There is a candidate I really think you should go vote for…” In theory, I’ve just broken the law…

Denver: Yes.

Robert: …as far as nonprofits are concerned. And I think that’s the most undemocratic thing.  Literally, in America, the fact that 14 million nonprofit employees don’t have the ability– or the 1.4 million nonprofits that are supposed to do this kind of work– and if they suggest they will keep our economy flourishing through their work, they’ve been told in effect: “Shut up and feed the poor.”

Denver: Yeah. Or we will take your tax-exempt status away. That’s pretty much what it gets down to….

Robert: Right!  And the reality is:  corporations–whether you want to call us the pejorative: “corporate welfare,”  or just tax breaks to corporations… They get many more breaks than the $300 Billion in annual revenue that nonprofits bring in through donations. So, there really is a wild, unethical double standard going on… in which corporations have First Amendment rights through Citizens United that nonprofits don’t.

Now you can argue all day long whether Citizens United was good or bad. But the point is:  I despise this differentiation–the idea that businesses are better or more equipped to have these discussions than nonprofits are. I’ve written a lot about what I believe are the gender origins of modern philanthropy. This sector grew through the work of a generation–my mother’s generation– that left the home in the 1970s to work because they had to or wanted to. But they were told by the larger society: “You really don’t have any skills; go off and do charity.” And the sector grew from  70,000 nonprofits in 1968 to 1.4 million today.  If you look,  the majority of them are run and have been run by women.

In effect, I’ve always felt that this was a feminized part of the American economy that was unfortunately put in this sexist box of low expectations. The sense of, “Well, look you’re not really a business,  so we’re never going to give you access to capital. We’re not going to allow you to do political work. You’re never going to get credit.” So, what we’re forced to do is be threadbare charities. So I sometimes sympathize with those who would bemoan the lack of innovation within the sector.  The reality is we’re not funded for innovation. We’re funded to do good deeds,  and that must change.

Denver: That’s right. They expect us to act like a business,  but we can’t fund ourselves like a business– which makes no sense. And getting back to your point about the number of charities–1.5 million or so, in a country of just over 300 million people, you believe as I believe: we simply have too many charities. I mean, we have a ratio of one nonprofit for every 200 people. This is almost getting down to a teacher-student ratio. And it’s because of this intense competition for the charitable dollar, there’s  perhaps a false narrative that’s being spun to the American public and to potential donors. What is that narrative?  And do you think it’s doing us a disservice?

Robert: Well, it’s funny. I think we share a frustration that there aren’t more market forces that can shape the sector and get better productivity out of it. Yet,  no one goes into New York or another city and says, “Man, there are just too many dry cleaners; let’s put a moratorium on dry cleaners.” In fact there is the invisible hand of commerce there– that if you’re not a good dry cleaner, ultimately you’ll go out of business.

Denver: Right.

Robert: But what we have here, sadly, after the bust of 2008, charities became one of the growth industries in America. And we can debate whether that’s good or bad, but I do wish that there was some kind of regular media coverage. For example, I’ve lamented for years that there are full pages and sections of newspapers dedicated to restaurants and video games.. When I lived in Washington, for example, non profits represented 26% of the workforce. They brought in billions of dollars because there were local, national and international groups based there. Yet, there was nothing in The Washington Post that talked about them from an investment standpoint. “If you’re going to give to a nonprofit, here is what to look for.”  Nothing about a lifestyle issue if you’re going to volunteer at a nonprofit. Think about it–every year — about 60 million people volunteer…

Denver: Yes!

Robert: And they’re all looking for that spot where they can make a difference. So, whether it’s an investment issue, a lifestyle issue, or an employment issue, the nonprofit sector really gets no media coverage.  $300 billion in annual revenue… yet no real sense beyond the stupid low-administrative overhead story. That’s historically and tragically been the only barometer for success. So I think that’s what’s been missing is– the average citizen is desperate for a sense of what a good nonprofit organization looks like.

We talked about leadership. As an example, having worked with many boards… I’m really deliberate about it,  and I roll off. I do my work,  and it’s time for me to go. You need more blood; you need fresh ideas.  Frankly, I would cringe when people come up with pride and say, “I’ve been on this board for 15 years.”

Denver: Right.

Robert: That’s not a good sign. I wouldn’t be waving that flag.

Denver: No. That’s an organization that’s getting a little stale when you have that going on. And to your point about coverage of the nonprofit sector:  it’s sad to say, but a couple of the major media outlets have dropped their person who covered that sector as they all begin to retrench and try to cut costs. It just seems that this kind of coverage is often the first to go.

Robert: Not only that, but one of the saddest things is that many newspapers realize now that nonprofit scandal sells.  There’s a public that has sadly become cynical, because what you’ve seen is steady drip.  I’ve been concerned about that, because I believe that in the tightening economic belt,  you have to realize nonprofits– for better or worse– have the largest pot of untaxed revenue in America. Whether that’s our revenue annually from donations, or the property that often times sits underneath us,  I know what a juicy target for many legislators this is. There are universities and hospitals which own significant tracts of land in many urban cores.

What you have now are pilot programs– which are a euphemism for fees in lieu of taxes. And it’s this idea of we’re going to ask these organizations to voluntarily contribute their fair share. And it’s like, “Whoa, whoa, whoa time out!” These are nonprofit organizations; they are tax-exempt. If we can’t be involved in the political process, if we can’t have access to capital and these other things, what makes you think that suddenly you can turn around these rules to benefit you– without giving an equal opportunity for us to take full advantage of the rights that other corporations have?

The time has come for a really exciting and long delayed discussion about nonprofits in America. And now for example, are hospitals and universities the same as the LA Kitchen?   Do we need to have a different code that covers these larger institutions? This should be discussed. Should we, as nonprofits, have more of an opportunity to be advocates in our community, just as businesses do? Should be discussed. These are things that I think have been postponed for way too long, and often by the very people who should be at the very forefront of demanding this conversation. And that’s the leadership of the nonprofit sector, whether it’s based in Washington or at the state level. I mean what we’ve had –sadly, at the very moment when our sector needs dynamic, brave, bold leadership– nine times out of ten what we have is a well-intended association president… who may or may not have the funding or the wherewithal to really lead the sector forward.  That’s been a great disappointment for me.

Denver: Yes. One of the radical ideas that you have floated is investment in a nonprofit social enterprise and conceivably have that investor receive an annualized return based on the investment performance…..much as  would happen if you bought stock in Apple or General Motors. Has that idea gone any further,  and is there any energy building around it?

Robert: Well, I toss that out sometimes, particularly in university settings as a  brain teaser out ……if you had given Bill Gates  $1,000 in 1986 when Microsoft went public, you would probably have about $1.5 million at this stage in the bank. But if you had given Muhammad Yunus–who founded the Grameen Bank…Nobel Peace Prize winner who launched microcredit… who has liberated probably 100 million of people out of poverty with small loans–all you would have been eligible for was the one-time tax deduction because you gave it to a charity.

Denver: So well said.

Robert: So it begs the question: Why not an annual tax deduction with increasing value, based on the same rate of return, principles of dividend– if a nonprofit can show economic return? So, imagine that you could say to any normal charity:  if you want to continue to do business the way you always have… right on…but your tax deduction is kind of the traditional model. But if you’re an organization that wants to create a job, wants to keep people out of prison and pay a wage… or if you can show ways in which an investment that you creates a significant economic return…….An example: In DC Central Kitchen or LA Kitchen, our training programs — about 80 -100 people a year go through the program. Those men and women earn over $2 million in salaries and will pay $225,000 worth of payroll taxes… every year. And on top of that, of course, you have the fact that based on recidivism rates, you can determine how many of those men and women statistically might have gone back to prison; how much it would have cost to incarcerate them for one, five, ten years, and the savings realized by not having to do that. So, not only have you saved society money by the lack of men and women going back to prison, but you’ve increased the Treasury–the payroll taxes, or the ripple effect of people spending their money in the economy. That’s just an algorithm. It’s an algorithm and it’s policy. It’s electing a generation of people who come in on Day One saying, “Why don’t we experiment with our tax policy to see if we can spur and incentivize a new generation of nonprofits… like the LA Kitchen… that would do senior meal contracts and reinvest profit.”

What’s to lose in incentivizing the evolution of these kind of programs? If you think about it, we’re kind of  the anti-Milton Friedman. Milton Friedman put out this idea that corporations’ number one job is to get as much profit out, and , in effect,  to put profit before people…

Denver: Maximize shareholder value. That’s been the axiom we’ve all lived by for a generation or two.

Robert: Yeah. These are the kinds of things that you sometimes genuflect to without really stopping and saying, “Wait a second, that doesn’t really make sense.  Frankly as a consumer, that might be fine for the executive of a corporation, but as a consumer, I don’t have to contribute.” So by creating an alternative model– which is what social enterprise is– I lovingly call it Economic Buddhism, it’s just the middle path between .com and .org.

Denver: Right in the middle.

Robert: Yeah. And you get goods and services a la  capitalism. But you get social return on investment. To me this idea of capitalism 2.0 is the future. But that really demands electing a new generation of people who will in effect look at the tax system and say, “You know what? Maybe we’ve been looking at the nonprofit sector the wrong way for far too long.  Let’s open our eyes and see the economy with both eyes wide open.”

Denver: Yeah. I’m going to have you speak a little bit more about that and the “new face of philanthropy.”  I think when you speak to people about it,  they nibble around the edges. But you believe that the way somebody makes their money, and how they spend their money, could in fact be that new face. Tell us a little bit more about that.

Robert: Well, I push it from two fronts. I mean a) You have to look out at the future and realize: Okay, the nonprofit sector has been built on an amazing American economy that was post-World War II boom. And for almost 50 years, America was at the very top and the very pinnacle of the global economy. But as the rest of the world catches up and wants a piece of the pie, what you’re going to see is less and less money that people can contribute to charity. So you can kind of see an arc.

Every year Americans give about $300 Billion a year– which is tremendous– but it’s been flat. So while the sector has grown exponentially…..the giving which is still generous has been flat. And I’m suggesting that there’s an inevitability. When the boomers begin to age out, they’re going to be a lot more fixated on day-to-day survival, as opposed to giving to charity the way they were. They were raised to think that at the end of the year, for tax purposes, you gave. Or maybe for religious reasons. But I think they had the extra money.  As a new generation of Millennials come in, they’re not going to have the extra money. They’re saddled with student loans and credit card debt. They’re having to find housing in an incredibly tight market. So what you’re going to see is a generation of people who won’t  have the same amount of money to give.

At the same time, this generation has been raised doing service. I mean this is one of the most amazing social experiments in the history of the world– 100 million young people doing some kind of good deed before they graduate high school. You’ve got potentially 20 to 30 million of them, I’m estimating, who actually dug it. “Wow! This is great.” And you opened a doorway to people who think, “I don’t have money to give you,  but I can come down and volunteer.” So time is going to be their philanthropy.  I think for  those who kind of got intrigued by the Toms’ one-for-one model and some of these other new models that are really popping up also in food world: “Buy one, somebody else will get one.” … I  think you’re going to see more and more people who will not  genuflect to the idea that “I’m going to give so that on April 15, I can deduct it for my taxes.” I think they’re going to be looking for a very different set of metrics.  And much more importantly, I think they’re going to be very hesitant to fund the never-ending model of charity.  You are really going to have to be able to show–for all intents and purposes–how you are diminishing future need….if you’re going to earn the income of a new generation of philanthropists.

Denver: Yeah, you’re absolutely right.  Let me get back to your dream of running a nightclub. As it turned out, the DC Central Kitchen became your nightclub, and food became your music– which brought people together. And you said that all you ever really wanted to do was put on a show every day. How important do you think it is for a nonprofit organization to want to put on a show everyday?

Robert: When I go to work everyday, I realize that  I can feed people all day long.  That’s great;  that’s good work. But the real power of what we’re trying to do is to entice the men and women who come to volunteer to leave with their eyes a little bit wider open. Again, if they can leave saying, “Wow, I really had these really negative,  understandable thoughts about men and women who have been in prison. But then, I just spent a day talking with this guy next to me who’s in that training program . He taught me all kinds of groovy cooking tips. We did stuff together. This really changes my mind.” That’s at least  what I like to do: I want people to leave enlightened.

When I ran nightclubs, the goal of a great show… I think if you ask any entertainer… you ask Bono, you ask Bruce, you ask anybody, you ask Kanye, what they want is for their audience to leave on an emotional high…but thinking differently, opened up, maybe seeing things differently. That’s what I want to do. I want when people leave the LA Kitchen, I want them to be like, “Wow, that was… I went in there thinking I’m just gonna feed the poor… I’m amazed by their business model. I’m really intrigued by the people I met. I’m really excited about what I was able to contribute today. This really changes my mind about philanthropy; it changes my mind around felons, it changes my mind about me.” And see that’s what I’m after is that kind of trifecta of change. When people really leave saying, “Wow, this  has fundamentally made me reexamine a lot of things that I took for granted before.”

I often say that while we’re feeding people who are hungry through the work we do everyday at the LA Kitchen, there’s a deeper hunger we seek to feed– which is that spiritual hunger everybody has– to belong, to be part of something bigger, to feel like they contributed. I mean if you ask 99% of the people on their death bed, they’re going to look up and say, “I wish I’d done more.”  And that’s what we’re trying to say is: Don’t wait. Today is a great day to begin, you can always come to LA Kitchen. You can always find a place down here where you can make LA a better place for somebody else.

Denver: That’s a great attitude that I think a lot of nonprofits would benefit from having. Robert, to get you operating at peak efficiency, you maintain you need a foil, a nemesis of sorts. Who would be filling that unenviable role for you right now?

Robert: Well….I’ve always tried to go up against… and I haven’t done it purposely…. I just find myself consistently facing the same person metaphorically. And that’s the person who, for all intents and purposes says, “We don’t need to change; everything’s fine the way it is.” And this happened when I first started doing shelter meals. It definitely happened when we started doing school meals, and it’s happening again with senior meals.

Sometimes I underestimate how rigid and how deeply held routines are, how hard it is for people to give them up. And I go back to that fear thing. It’s not because people are bad. It’s just that it’s human nature to find that comfortable spot and stick with it. Consistently throughout my career are people– who stand in front of the people I’m trying to reach– and say to me, “They won’t like this. They won’t like what you’re doing.” And what I’ll politely say is, “Let’s try it. Let’s just try something new. We don’t really have anything to be afraid of.” But I have to respect and understand that for many people, it means that their routine will change; their status quo might be disrupted. And I try to be respectful and understand that,  but you always reach a point where it’s like, “Okay, look, I’ve tried to be polite. I’ve tried to be respectful, but you can’t stand in front of change.  You can’t stop this.”

But I enjoy to a certain extent the politics of social change. How can I through our work help empower, if you will, the recipients to be agents of their own future?  I’ll tell people when we talk about school food,  that the real revolution in school food didn’t come from advocates as much as it came from kids who were going to school in 2006, 2007 and 2008 with cameras that could take a picture. And they could take a picture of their lunch,  and they could send it home to their mom. And mom had a blog. Mom then in 2007-2008 discovered Twitter and realized if she wrote a blog on school food with the picture of her kid’s meal put a hashtag #schoolfoodsucks, that blog went around the  world in about 30 seconds.

Denver: Yeah.

Robert: And so, you had  a consumer revolution in which kids rebelled against the meals, and their parents helped them. And the same thing is going to happen with senior meals. What you’re going to see is an army of older people.  We sadly think them confused and technologically limited.  What you’re going to see now is an army of 50-year olds, 60-year olds pouring on to the internet, wildly sophisticated. They’re going to be nutritionally sophisticated – for heavens sakes — they’ve been raised on the Food Channel. You know what’s wild, man? If you go to the average senior,  or when you ask a 20-year old, or a 30-year old sometimes even the 40-year old: “ Look at those seniors; what generation are they from? Most will take a split second look, and they’ll turn around and say, “Oh man, that’s the Depression. That’s World War II.”

Well no, they’re still around, but these men and women, they were at Woodstock. There’s about to be a big show here in California in the desert and it’s gonna be The Who, The Rolling Stones, Paul McCartney, Neil Young…and they’re all over 70!

Robert: They’re all over 70, in fact I think they’re all over 73. So it makes you realize that the way we  put our seniors in this kind of infantile box– or this 1940’s construct where we’ll play old big band music and we’ll play Shuffleboard. What you’re going to  have is the first beginning of a generation of older people who could actually be really active, engaged, politically engaged. I must admit, going back to our discussion about politics, as much as I’ve been interested in the role nonprofits could play in the political process,  I’ve watched as older people have been manipulated with fear to vote for things– whether it’s Brexit in England or what’s going on now in America. And I’m very interested in: Could there be a bridge built between older voters and younger voters?  Because they really don’t want to see inter-generational kind of warfare going on. That’s what’s coming, unless we really find common ground.

Denver: Yes, you’re absolutely right.

Robert: And one of things I think we can find common ground around is food policy in America. ‘Cause I think older people and younger people are going to have equal interest in clarity of nutrition labeling. What am I eating? Where is it from? There’s going to be a lot of opportunities to build bridges,  and that’s… once again… one of my favorite things to do.

Denver: Yeah. And I think this generational warfare could have some pretty bad overtones too, because the older folks are predominantly white, and the majority of people under the age of five are people of color.  It’s got a lot of implications to it over and beyond just the aging issue.

Let me get you out on this: you consider yourself a bit of an amateur futurist and,  darn, you have a pretty good track record at it! So, beyond what you said already, what else do you see coming? What’s out there just beyond the horizon, Robert?

Robert: Well, I’m mesmerized. We talked a lot about the future of philanthropy. We talked a lot about plant-based foods and the changing demographics. One thing I’m most interested in is women outlive men… and there are more women than men. So what you’re going to start to see… and I became very interested in housing too–is where do older people live? How do they have fruitful lives? And I think, there’s kind of a Golden Girls moment coming on the horizon, where a lot of women are going to start to look at cohabitation. How can we find a sense of a joint support for each other by having five or six women sharing apartments? So I’m very interested in housing policy…

Denver: Fascinating.

Robert: …and how will cities stop and say, “Look, we have got to keep these men and women living independently and as long as possible.”  Ergo, we’re going to potentially have to look at our rules for housing and allow people to co-habitate. Many housing policies are built on that “only a certain amount of non-relative people can live in the same house.”  And for example, this week in LA, they paved the way for homeowners to be able to really build “granny flats” out in the back of their houses. Small little houses…maybe not with all the bells and whistles that you’d expect from a typical code situation, but they’re realizing there’s an opportunity to bust some of the housing needs if we look differently at our traditional history of how we build housing. Who we let live and where. And I just think we have to be very, very aware, because… to your point we discussed it earlier… and we both share a great sense of understanding and trepidation — about the significant social issues globally that aging will place upon us. So, now is the time to be both inclusive, but daring….And those were the two words that should be front and center of every nonprofit’s mission statement.

Denver: Amen! If people want to learn more about the LA Kitchen, get involved, or financially support it. Where do you have them go?

Robert: Couldn’t be easier, man!  lakitchen.org.

Denver: Well, Robert Egger, the founder of the LA Kitchen… and so much more. Thanks for being on the program this evening; it was a real treat to have you here.

Robert: Yeah, right back at you, man! It was a real great conversation. I look forward to another.

The Business of Giving can be heard every Sunday evening between 6 and 7 PM Eastern on AM 970 The Answer in New York and on I Heart Radio. You can follow us at bizofgive on twitter and at facebook.com/businessofgiving.

We have found a new home! Kindly visit this link in our new website here: https://www.denver-frederick.com/2016/09/06/roseanne-haggerty-president-ceo-of-community-solutions-joins-denver-frederick/

In this segment, Rosanne Haggerty, President & CEO of Community Solutions, discusses her organization’s work towards a future without homelessness, in which poverty never follows families beyond a single generation.  Additionally, Rosanne debunks some myths surrounding homelessness— she explains that homelessness is not just a “big city problem”, and that it’s more cost-efficient to get people into a stable homes than to maintain their homelessness (i.e. via shelters).

The following is a conversation between Rosanne Haggerty, the President and CEO of Community Solutions, and Denver Frederick, host of The Business of Giving on AM 970 The Answer in New York City. It has been edited for clarity.

Denver: There are some social problems that, as unfortunate as they may be, just need to be accepted. They will always exist to one degree or another. And one of those problems most people have resigned themselves to is homelessness. No matter what we do, it will never be eliminated entirely. But my next guest is not most people. She is Rosanne Haggerty, the President and CEO of Community Solutions. Good evening, Rosanne, and welcome to The Business of Giving.

Rosanne: Thank you for having me here.

Denver: You have said that the world is full of complex social problems for which no reliable, cost-effective solutions have been found. Homelessness, however, is not one of them. Explain to us what you mean.

Rosanne: All over the country, we’re seeing communities make profound strides in reducing and ending homelessness for good, among people who are chronically homeless–meaning they’ve been homeless for long periods of time– and homeless veterans. We really misunderstood this issue. There is much to be excited about… in terms of what can be accomplished when cities organize their resources properly. That’s the big “Ah Ha!”

Denver: Tells us about Community Solutions. This is now the second organization that you have founded, albeit, related to the first one– which was Common Ground. What is the philosophy of Community Solutions? What are the goals and objectives of your organization?

Rosanne: We help communities solve the complex problems that affect their most vulnerable residents. And we do that by bringing tools from other sectors that have been effective in solving complex problems–from design thinking, quality improvement, data analytics. So, that’s our mission. We have redefined homelessness as a symptom of the larger problem–the breakdown of community systems.

Denver: You started this work back in the early 1980s, and you were exceptionally idealistic back then. You were really hopeful that homelessness was a solvable problem. But what you witnessed was quite disheartening… and gave you a little less of an optimistic outlook. What did you see back then?

Rosanne: When I first moved to New York, homelessness was a newly-defined issue at the time,in the early 80s. I worked by day at a shelter for homeless and runaway young people, and overnight, once a week, volunteering at a church basement shelter for homeless women. And I think in my naïvete, I was of the belief: “We’ll be enough volunteers and shelters–we can nail this!”

Denver: We can lick this thing!

Rosanne: “It’s a new issue; it’s kind of happened on our watch.” And within a couple of months, in both places, I was just appreciating this huge disconnect. I think I had imagined that there was some larger plan, that if we got enough volunteers to staff the shelters, this was all going to work out. But at the Shelter for Runaway and Homeless Youth, the young people could stay for a maximum of 30 days. And I quickly saw the young people I was responsible for–their problems were not 30-day problems. They were permanent problems around housing, jobs, families that had fallen apart… The real complexity was not homelessness, but poverty… that had driven them into homelessness. And yet, we would discharge them after 30 days. No surprise! Most of them would be back 30 days later.

After a few months, I thought, “What exactly are we accomplishing here? This is certainly not something that’s solution-oriented.” And meanwhile, I’m working as a volunteer overnight with women who would be bused to the church basement shelter…They had been lining up for hours and travelling all over the city before being dropped off…They would just sort of stumble in, exhausted. I was able to sit down and speak with a few of them over tea. And it was clear that none of them had any idea how they were going to get out of homelessness. And no one was talking to them about how that could happen. What they knew and had been instructed on was: when and and where to catch the bus to get to that overnight shelter. And so there I was, as a 21-22-year-old, thinking: ”Wait a minute! Nobody’s in charge here! There are a lot of well-intentioned emergency efforts, a lot of people like me who are trying to pitch in, but this is not going anywhere.”

Denver: Well, I think you also witnessed that the resources were available and, just as you said, people had deeply heartfelt intentions. But, the system itself… was broken. How was the system broken?

Rosanne: I’ll start from the vantage point of 2016. Sometimes it takes a while to understand and really see what’s going on. The dots weren’t being connected. There were people who could not solve their housing needs in the marketplace–who needed something other than just affordable housing in many cases–in order to resolve the overriding problem that was making them vulnerable to homelessness.

For instance, in the early 80s, we saw a very significant increase in individuals with mental health difficulties on the street. It was the beginning of the AIDS epidemic. There was the early fallout of the country’s lack of investment in expanding the supply of affordable housing. We were beginning to see the impact of really stagnant wage growth. All of these forces were converging. Yet, we were opening shelters and thinking that was the answer.

Fast forward to 2016: what we’ve realized is needed–not just in homelessness, but in many of these really tough issues that are facing our most vulnerable citizens–is to connect the dots on: Homelessness. Health. Housing. Mental health. Substance abuse. Wage issues. And rather than being overwhelmed by that, we’ve learned you have to gather all the people involved in those issues at the table, and make it simpler for vulnerable people to get what they need. It’s the job of not-for-profits and government to simplify the process of getting people the tools for a basic standard of living.

Denver: As you said, the social welfare system was actually hindering the process of getting somebody who was living on the street into some kind of stable housing. The rules and the regulations were so complex, it required an Einstein to navigate the bureaucracy.

Rosanne: Yes, we saw the problem after a while, and it was us! There was no way– literally no way–we discovered when we started focusing on street homelessness, that people living on the street could actually get themselves into any kind of publicly-assisted housing. They were ineligible for it. So, people ask, “Why do we have homelessness?” Well, we need to look at, “What are the rules we’ve created? What are the barriers that we’ve created in the way of getting this problem solved?” And the tragedy is that good people have unwittingly conspired to create institutions and systems that don’t connect, and are not really grounded in: “How do we help people get what they need as quickly as possible?” So, we’ve ended up in a much more tangled state… that actually blocks progress.

Denver: And although it’s pretty fashionable to disparage the healthcare system, you noted that in working on the issue of homelessness, something could be learned from the healthcare sector. What are some of the strategies and procedures that would be helpful, if adopted?

Rosanne: Our healthcare system–with all its need for improvement–understands that you need to know people by name. You need an individual diagnosis; you need to triage the most urgent cases. It’s never the case that everyone has the same thing, and everyone needs the same level of urgent attention. You understand within the system that generalists and specialists need to communicate with each other. At least those habits are ones, that if we applied them to housing needs, I think we would be in a different place.

And in fact, that’s what we’re seeing in our Zero Campaign: in getting the right configuration of information…person-specific information, in understanding different levels of need and facilitating around person-specific data, that problem solving conversations start to happen with a team able to help communities make progress.

Denver: That’s a very interesting observation, because I think many look at homelessness as a generic problem. We’ve got to “fix” homelessness. We think about that static waiting list you put people on. That’s not the way the healthcare system works, and that’s not the way this system should be working either.

Rosanne: Precisely! I mean, we’d all think it was absurd if anyone who showed up at the emergency room was either given aspirin, or scheduled for brain surgery. But that’s kind of the way we’ve handled things in homelessness.

Denver: You’ve talked about trying to connect the dots, and getting all the players aligned. We have the VA; we have the nonprofits; we have governments; we have the housing authorities. I think a lot of people recognize what’s out there, and we have to have everybody working in unison. But it’s a whole different story to actually get people to do that. They come from different bureaucracies. They have different theories of change. There are egos involved. Share with us the secret sauce of getting this done. How do you change the ingrained habits of how organizations work?

Rosanne: We have found that in just about every community, there are leaders that have never lost the original vision and drive to solve this problem. And it’s always critical to connect with the leader or leaders who can bring a community team together. It minimally has to consist of the Mayor’s office– or whoever controls the health and mental health resources in the community–, the housing authority, the not-for-profits, and the VA.

If you can, get that group at the table to see the problem the same way– which is really about person-specific data. Who exactly is homeless in our community? Who is at elevated risk for prolonged homelessness, or for dying on the street, given the health risks that attend long-term homelessness? And once communities have a starting point– which is real-time person-specific data– they can begin to understand and measure how long it takes that community to pull all of its resources together to get a single individual or a family into a stable home. Then, you’re beginning to move past ideology and all of the methodologies that have surrounded homelessness too.

Actually, we have a pretty clear-cut job to do. “We have this number of individuals who are not going to find their way out of homelessness on their own. How do we pull our resources across these different systems? How do we know we’re doing the job well and getting better at it?”

And so much of this is coaching communities around how they overcome some of the communication and data-sharing barriers. How they actually align their resources… so if someone has the mental health contract… that they’re partnered with someone who is actually overseeing the rent subsidies. How the VA gets involved in working with community systems they often had not worked with before… until the homelessness issue became a priority for the VA. So, it’s really this discipline around putting the pieces together.

And I’d say that maybe the image to think about is: if a community is dealing with a public health threat, i.e. polio, ebola–you would do basically the same thing. Or, there’s a surging hurricane: Who are the most vulnerable? Where are they? What do we need to do? How long is it taking us to do it? Has the situation been resolved? It’s bringing the type of rigor and collaboration we see in disasters into something that’s, frankly, been a slow-moving disaster.

Denver: Yes. Before I get to a couple of your signature programs, Rosanne, I just want to ask you a few questions about some of the general beliefs that people have about homelessness. One of them would be that some people are simply service-resistant: “This is a deliberate lifestyle decision of theirs… They want to live on the street… or they can’t be helped.” Is this true or false?

Rosanne: Well, I had to learn that was not only false, but tragically so. For years, when I was focused on building housing for the homeless, I would walk past individuals in Times Square, Midtown Manhattan and see these poor souls. Not infrequently, I’d call the outreach team saying, “I just saw someone, and we know who she is.” Or “We know who he is; he’s service resistant.” And so, I guess my guilt was sort of discharged… that I’ve made the call. But then one day, one of the service-resistant people–actually, a hospital social worker, called me and said that she wanted to be housed at one of our buildings. In speaking with this woman who’d been homeless over 11 years, she said, “I always wanted help, but with housing! The only thing I was ever offered was a ride to a shelter, blankets and food.” And it was like…

Denver: A light bulb went off.

Rosanne: Total light bulb going off moment! “What if we have just been out there offering what we happened to have…what we think people need? Rather than asking them: “What help do you need to get out of homelessness?” And so, we basically started questioning every assumption we had about: What are the familiar mythologies that surround homelessness? Guess what? Almost every one of them was wrong!

Denver: Incredible. Another myth is that homelessness is a big city problem.

Rosanne: Yes.. Hardly the case. I mean, certainly when you look at the map of homelessness in the United States, homelessness is everywhere. It’s, of course, concentrated in large cities, but no city, no rural area, no county escapes it.

Denver: Another belief I think people have is: We can’t really afford to get these people off the street and put them into housing. The question becomes, “What’s the cost differential between providing housing and providing the services that people need when they’re living on the street?”

Rosanne: Well, the crazy and the hopeful thing is that in cost studies and communities all over the country, it’s been verified time and again: they were spending more money to keep people homeless, than would be required to actually help support them in getting into a stable home… and getting them connected to the health, mental health services or the employment assistance they need.

Denver: Wow, that’s remarkable.

Rosanne: I mean, the numbers are staggering. It’s not even marginal. I think now New York City spends over $40,000 per year to keep a family in shelter. The most robust rent subsidy would result in a fraction of that cost.

Denver: About six years ago, you launched the 100,000 Homes Campaign– in partnership with 186 communities across the country. Tell us how it worked, Rosanne, and what you were able to achieve.

Rosanne: Well, important to know that when we launched it, I think we had maybe 30 communities– mainly our friends– who said, “Okay, we’re with you. This sounds crazy, but it’s the right thing to do.” And it was basically out of this insight: “What if we are looking at the issue wrong? It’s not about all the things we say it is…like we don’t have enough affordable housing; we don’t have enough of this; we don’t have enough of that; people aren’t cooperating. What if the people working on the problem–the not-for-profits and governments– what if it’s about our behavior, and how easy or hard we make it for people to get off the street?”

So, what we did was issue an invitation to communities around the country to join in the effort of figuring out how to work better and smarter– toward a collective target of 100,000 chronic and vulnerable people to be housed in four years. We had tested this. We began with a project in Times Square, got to some proof points where we thought: Here are the key ingredients… And then we worked first with nine, then with up to 30 communities who joined in.

We knew we had some basic ideas that worked everywhere. What was powerful though is that each community that joined improved our original idea. By the end, there were 186 communities involved. It was essentially a giant behavior change in process improvement initiative. And as I’ve mentioned earlier…getting the right players in that community together, using data to actually tell what is going on… “Do we have our arms around this problem; do we actually know who’s homeless, or are we guessing? Do we know how our systems are performing?”

In many ways, when we went to different communities, it was an occasion for groups that had never worked together before to combine resources and intelligence to let the community solve the problem. We were thrilled to see our original assumptions about behavior change, alignment of resources, the discipline of sharing and working at the community level–not as different institutions, but as a team–play out. Those 186 communities together housed more than 105,000 people.

Denver: Wow!

Rosanne: Hats off to the communities, because the hard work happened there. Our team provided the coaching and the data infrastructure, and provided a new community of problem solvers to belong to.

Denver: That’s great. And this is an extension of the “Housing First” concept, would that be correct?

Rosanne: Very much so! And that was a key idea– that housing, without condition, is the first step in enabling a chronically homeless person– or a person with medical vulnerabilities– to actually get on the other side. From a stable place to live…then the mental health and addiction services, and everything else that person might need. First of all, you can find them to offer them services, and then they can be provided consistently. It provides a very proven win for the individual, and a huge win for communities.

Denver: And you just said a moment ago… that it was less expensive for taxpayers to support someone in housing than it would be to care for them on the street. So, what would the cost savings be–for these 105,000 people that you were able to move into housing?

Rosanne: Well, we hired an outside evaluator to look at the cost impact of the first 100,000. The conclusion was that it represented a $1.3 Billion–that’s with a “B”–annual… So that’s a recurring savings…mainly in cost avoidance in the healthcare system, but also in cities that have large shelter systems, and also in the criminal justice system, and in the VA.

Denver: Fantastic! Soon after the 100,000 Homes Campaign was completed, you didn’t sit around too long. You launched something called the Zero 2016 Campaign, and now you’re working with 70 communities. Tell us about the goals and objectives of that initiative.

Rosanne: What we realized with the 100,000 Homes Campaign was that the drive to change the way communities understood and worked on the problem was a powerful and proven insight. But the ultimate objective is not simply to count up and get more people housed, but: How to help communities get to a point where they actually don’t have people in long-term homelessness? How to have a system that can prevent and end individual and family homelessness?

And so, the Zero Campaign is even more audacious. “Who’s in, as far as building a system that can sustainably end chronic and veteran homelessness…and create the local infrastructure that can work all the way down to prevent and end people’s homelessness of every stripe?” But the target for these cities is getting to a sustainable level of chronic and veteran homelessness, and I think six of the cities are already there. And we’re going to have to continue the Zero Campaign past 2016. But these 70 communities are all in, and it’s a powerful thing. It includes four states and huge areas like Los Angeles County. I think it’s an enormous tribute to these local leaders, who are basically putting aside their old programs, their old assumptions, and saying: “What do we have to do to be communities that end this problem?”

Denver: And aside from leading and orchestrating some of these national campaigns, you also get pretty deeply involved in some communities. One of them is Brownsville, Brooklyn, where employment and safety are among the major concerns. Tell us about your Brownsville partnership.

Rosanne: Well a few years ago, as we were getting ready to launch Community Solutions, we were asking ourselves system level questions about what if we work differently and changed outcomes for vulnerable people by making it easier for people to get what they needed. We also asked the question about what causes homelessness. What does the pathway into homelessness look like? The data we have been able to gather–both in New York and Hartford where we worked deeply, but also in communities around the country–point to the neighborhoods of concentrated poverty in our country… where people have struggled the longest, where lives have gone off track early, and where there is huge government investment…

But, sadly, it was not in ways that create opportunity and improve the standard of living for people. It was reactive. And so Brownsville represents one of two efforts to basically get the right people around the same table: residents, government, not-for- profits, businesses, to start looking at how we change the conditions that trap people in poverty.

When we began our work organizing and listening to the community, we heard three things over and over again. 1) For this neighborhood to change, and for people to have different lives, we need to do something around crime. But mainly, we have to deal with the impact of the criminal justice system… so many people involved in incarceration and its effects. 2) We need something for children– to get them on different pathways. 3) And, we need jobs.

And so, we have recruited amazing partner organizations with expertise in those areas. As with our homelessness work, we think it’s the same problem: How do we connect the dots? How do we reduce friction? How do we make it easier for the intentions of our society to create real opportunity? How to manifest it in the outcomes of these programs for low-income people?

Denver: And probably, Rosanne, the best partners you have been able to engage have been the residents of the community. You have something called the Brownsville Hope Summit. Tell us about that.

Rosanne: Well, the 4th Annual Hope Summit is coming up on September 10th, and we move it around each year to basically have a day…

Denver: October last year, right?

Rosanne: It was, and this year the theme is “Live on Livonia.” So we picked some part of the community that’s struggling, has some geographic location. We invite all of the institutional partners, government and residents to come out. We ask: How do we pool our ideas and resources to get something done here?

Denver: I like the way you reframe problems, and that’s always a great way to get some new insights. So, instead of looking at homelessness as a chronic and intractable problem that’s experienced by maybe 1.5 million Americans every year, you began to look at it through the lens: “Hey, over 99% of us have homes!” How did this different prism around the issue change your and other people’s thinking?

Rosanne: Well, we are big believers at Community Solutions in looking at what works. I think maybe we’re just congenital optimists, or people who are very hopeful. But that notion, I think, dates from a couple of seminal experiences early on in our work. I remember when we were operating our big support of housing buildings…my colleagues and I would be tearing our hair out over the couple of tenants:- “Oh! Their struggles!” You’d convince yourself… because you’re always talking about the same problems…that this is impossible. What we learned is: “Hey wait, we’re talking about three people! We have thousands of people who are doing well! Let’s keep some perspective here!”

And then when we started focusing on street homelessness, we realized that while there were dozens and dozens of people we would identify by name on the street, there was only a group of 18 who were homeless every day in Times Square. And when we focused on getting individuals housed, that represented the real core of the problem. And so it caused us to think that life really is organized not around the 80-20 rule, but more like the 95-5 rule. And so, if you can figure out where the problem is most acute, and learn your way… with the participation of the people suffering the problem…into what are some practical things that can move the needle… We have never not seen progress!

Denver: In all that you’ve talked about, you stated three critical things that are necessary to end homelessness. I’m going to ask you to speak to each of them. The first you have already touched upon: Know people by name.

Rosanne: In some ways, it’s the most revolutionary finding of all… that communities that are really getting to sustainable zero on chronic and veteran homelessness.. it’s completely correlated with a by-name list. Do they know each individual who is struggling in homelessness by name, with enough information to help triage them into housing, and get them what they need? Some people will need a lifetime of support; others need help with the first month’s rent.

And if you begin to actually know people by name, it doesn’t only open up the door to solutions, it frankly engages a community in problem solving in powerful ways. Think of the difference between: “We have an estimated x numbers of homeless individuals,” and knowing: “That is the specific individual… John… who has a specific history.” We have seen in communities around the country, people coming out of the woodwork to help, because they know the specifics of that person’s life and that person’s need. So it’s sort of definitive baseline; this is how to solve problems in a complex world.

Denver: And those names change every day, right?

Rosanne: They change everyday. And so, that’s why the real-time nature of the information is so critical to communities.

Denver: The second critical thing, different from how the sector operates, is “to learn by doing.”

Rosanne: Any problem–not just homelessness–but anything that is daunting, really requires a testing and learning. And somehow, we got to a point where… whether it’s a government contract, or a proposal to a foundation, you have to suggest in this big complex, unknown thing, that you already have the answer!

Denver: That’s exactly right.

Rosanne: That’s just not the way the world works. A very wise friend of mine highlights the difference between risk and uncertainty. If you’ve done something before, you can calculate the risk … “Were the conditions right? Do we have enough money? Do we have the right team?” But if something hasn’t been figured out, you’re in a different universe, and you need to create the conditions of support learning, the development of probabilities. It’s going to require a long time to stick with the learning. And this, from the philanthropic and government standpoint, is a challenge I’d like to put out there: Be at the table and the learning; don’t expect that these problems are going to yield to a silver bullet.

Denver: I can’t tell you the number of people I know who have contracts with governments or foundations, and in the midst of them, they’ve learned that it’s not working. But they have to continue because they have an agreement. They have to fulfill it, despite the fact that they know it’s not the way to go any more.

Rosanne: Yeah. It’s like we have all the time in the world to keep going down the wrong path. I think with our team, we have an amazing group that says: “Hey, we’ve got a higher duty to try to get on with things, and do more of the right thing.”

Denver: You’re absolutely right. And the final one: Make success visible to inspire others.

Rosanne: I think, as humans, we don’t believe that something beyond our ideas is possible unless we’ve seen it, touched it, visited it. And so what we’ve learned is how important it is for people who are skeptics, or who just are genuinely unaware of what to do: Share stories; share important graphic information; have them visit your building; have them see that it’s possible to create good, affordable housing that works for formerly homeless people.

And very powerfully, we’ve learned the impact of video… this notion of sharing stories. Information’s critical, and I keep mentioning data. But without the stories, you really don’t grip people with the sense of the possible. And so it’s become, I think, one of our key learnings that communication is an add-on. Communication is core to the mission.

Denver: I’ve been to your website, and I’ve seen some of the before- and-after pictures of individuals that you’ve helped, and they have been amazing. Speaking of your website, if people want to learn more about Community Solutions; if they want to get engaged in some way, or perhaps become a financial supporter, what would you have them do?

Rosanne: Please do come to our website which is cmtysolutions.org.

Denver: Well, Rosanne Haggerty, the President and CEO of Community Solutions. I want to thank you for being on the program this evening. We human beings have a wonderful way of making things quite complicated. It comes as quite a surprise that when all is said and done, the best way to end homelessness is simply to provide homes for people who do not have them! It was a real pleasure, Rosanne, to have you on the show.

Rosanne: Thank you so much.

Ms. Rosanne Haggerty, the President and CEO of Community Solutions, and Denver Frederick, host of the Business of Giving

The Business of Giving can be heard every Sunday evening between 6 and 7 PM Eastern on AM 970 The Answer in New York and on I Heart Radio. You can follow us at bizofgive on twitter and at facebook.com/businessofgiving.

We have found a new home! Kindly visit this link in our new website here: https://www.denver-frederick.com/2016/08/31/interview-transcript-nancy-and-the-american-heart-association/

Heart disease is the #1 killer in this country, but 80% of it is preventable, according to Nancy Brown, CEO of the American Heart Association. In this segment from The Business of Giving, Ms. Brown spells out the different programs of AHA devised to reduce death from heart disease and to improve the cardiovascular health of all Americans.

Nancy Brown, Chief Executive Officer of The American Heart Association

Heart disease is the #1 killer in this country, but 80% of it is preventable, according to Nancy Brown, CEO of the American Heart Association. In this segment from The Business of Giving, Ms. Brown spells out the different programs of AHA devised to reduce death from heart disease and to improve the cardiovascular health of all Americans.

She also discusses how mission-aligned businesses of AHA are generating 9-figure revenues for the organization, and how they and their partners are using crowdsourcing to find “One Brave Idea” to find a cure for coronary disease. Finally, she shares the keys to alignment, passion and camaraderie in a national charity.

Denver: More than one in three American adults suffers from cardiovascular disease. To provide a little context: more women will die from heart disease this year than from all the cancers combined. So, Americans are fortunate that the person charged with leading the oldest and largest volunteer organization dedicated to fighting heart disease and stroke, has created a culture of innovation. In so doing, she has forged some extraordinary partnerships and is increasing the amount of resources available to help better the lives of all Americans. That leader is Nancy Brown, Chief Executive Officer of The American Heart Association, and it is my pleasure to welcome her to The Business of Giving. Good evening, Nancy, and thanks for being with us this evening.

Nancy: Good evening, Denver. Thank you so much for the opportunity.

Denver: So, tell us about the American Heart Association, a little about your history, and more about the mission and objectives of the organization.

Nancy: Absolutely! I’d be delighted to. As you’ve mentioned, the American Heart Association is actually the world’s oldest and largest voluntary health organization dedicated to fighting cardiovascular diseases and stroke. We’ve been in existence since 1924. At the foundation of the American Heart Association’s work is the scientific enterprise of the AHA–coupled with our grassroots presence in communities throughout America–and our presence in 70 international locations. In these,  we dedicate our resources to help make the world a better place for people, and to prevent heart disease and stroke. We are guided by the organization’s 2020 strategic impact goal: which is to improve the cardiovascular health of all Americans by 20% by the year 2020, while reducing deaths from heart disease and stroke by 20% during that same timeframe. So this decade-long goal really is the goal that is the guidepost for the work of the organization.

Denver: Let me ask you a bit about heart attacks. I went around to a couple of my buddies this week, and I said, “Do you know what a heart attack is exactly? How does it differ from cardiac arrest?”  I have to tell you, Nancy, the answers were a little fuzzy; they were a bit uncertain. So give us an abbreviated heart disease 101 course if you would.

Nancy: Sure! I’d be pleased to. So, heart disease is, as you said, the country’s and the world’s number one killer. Heart disease is 80% preventable!  What happens when a person has a heart attack, is that the arteries or vessels leading to the heart muscle generally become blocked. They become blocked from atherosclerosis– which happens as we age, and also happens because of a hardening of arteries in individuals who have high blood pressure. When the arteries narrow, or when the arteries are blocked due to atherosclerosis, the heart muscle is deprived of oxygen, therein causing the heart, in some cases, to have a heart attack. There is another kind of heart attack called a  “sudden cardiac arrest,” which is actually not a heart attack at all.  That is a misnomer. A sudden cardiac arrest happens when the electrical functions of the heart malfunction, and a person’s heart suddenly stops.

Denver: Completely.

Nancy: And that person can be revived generally through CPR or through a defibrillator, if one is available, or if people are trained in CPR. We can come back and talk about the role the American Heart Association has played in that over time. The important thing– if you’re experiencing symptoms of a heart attack or symptoms of a stroke–is to call 911 and get emergency care immediately!

Denver: Are the symptoms different for men and women?

Nancy: Yes, indeed they are. For men, we think of the classic heart attack– a man clutching his chest. Generally, what happens when either a man or woman is having a heart attack is stiffness of the arms, pressure in the chest, sweating. But women also often have jaw pain that accompanies a heart attack, and can also have more nausea, vomiting and shortness of breath.

Denver: And what is” the silent heart attack?”  I hear about them now and then. What is it? How do you know you’ve even had one?  And how common are they?    

Nancy: A silent heart attack is a heart attack, just as I described before, where the heart is deprived of oxygen. Sometimes the symptoms are not as obvious. And it might be a smaller heart attack, but in any case they are often discovered upon medical testing. And people who don’t  get emergency care right away in some cases–perhaps their heart attack is smaller– don’t have a devastating impact from it.  But the message is that anyone who experiences the symptoms of a heart attack…or of a stroke… needs to get emergency care immediately.  Call 911. Get to the emergency room. There are treatments now that were not available before– things that can be done very quickly. For example with a stroke– a person having a blocked artery to their brain–they now can use tPA to dissolve the clot.  There is even a clot retriever now to remove the clot from a person’s brain who is having a stroke.

Denver: So time is of the essence. Don’t be a hero and say, “I’ll just tough this one out.”

Nancy: Absolutely! And if there’s someone in your family at risk of having a heart attack or a stroke, it’s very important to know the warning signs.  And it’s very important to know CPR.

Denver: Let’s talk about a couple of things that contribute to poor heart health. One of them would be sodium, or salt. Now, how much more sodium are we getting in the American diet compared to the guidelines that AHA recommends?

Nancy: The first thing to say about sodium is that the average American consumes 3400 mg of sodium a day. The American Heart Association recommends that Americans consume no more than 1500 mg a day. And the Federal Government’s dietary guidelines suggests 2400 mg a day– which we support because it’s on that journey down from 3400 mg. Most of the salt an individual eats is in packaged and processed foods. And there are many hidden sources of salt. Bread, for example, is a big hidden source of salt. Many food products use salt as a preservative to allow longer shelf life for foods. So, this is why we support people eating whole grains, fresh fruits and vegetables. That’s a much better road for people to go down.

Denver: And one of the things I’ve noticed–having cut down on sodium–is that sodium covered some of the real taste of the food, taste that is actually quite delightful!

Nancy: Thank you for saying that! That’s exactly how we feel about it. If a person consumes more fresh, whole foods, the natural robust taste of vegetables and fruits and whole grains is really quite delightful– without the taste of sodium getting in the way.

Denver: Another big issue of AHA –where you’ve been on the forefront, as was our former Mayor Michael Bloomberg–has been the push against big soda.  And boy, there was a big victory recently in Philadelphia. Tell us about that, and also about some of your other strategies to get Americans to drink less sugary soda.

Nancy: Absolutely! So, added sugar is a large contributor to obesity in this country. And we were very pleased that the Food and Drug Administration has made clear their intentions for food labels moving forward–to call out added sugars not naturally occurring in products. That will help consumers know and understand the amount of added sugar they are consuming.

However, we know that especially youth get the largest percentage of their added sugar intake from sugary beverages. And this is why for over a decade, the American Heart Association has fought to reduce the availability of added sugar drinks for our youth. And most recently, we have recognized that a taxation strategy that allows healthier beverages to be provided to people at less cost than those with added sugar… would be a very important way for us to describe a differential that will make it more appealing to purchase the non-added sugar drinks.

And here’s why this is important, especially as it relates to children and children’s obesity. The average child in this country drinks their age in sugar-sweetened beverages a week. If we look at what’s happening in our country in terms of health statistics, the number of children who are overweight or obese is quite alarming. We see kids today in many states that are faced with diseases that used to be adult diseases: Type 2 diabetes, high blood pressure. This comes from their lifestyle. We recognized at the American Heart Association that one of the most important things we can do is to try to change the environment around people, to give them a chance at a healthier life. As it relates to added sugars in particular, we’re especially concerned about the marketing of these unhealthy beverages to kids and to under-served minorities. This is a big focus of the Association, and one that we intend to really make a flagship of our public policy efforts.

Denver: Are you making headway on that? Are companies beginning to get the message?

Nancy: I think companies are absolutely getting the message. If you look at how hard the beverage companies and their trade association fought the Philadelphia fight, and you see them gearing up. There are 10 places right now that the American Heart Association and our partners are gearing up for valid initiatives that will be prominent this Fall. You see the American Beverages Association and the companies are already concerned. And so, if they weren’t concerned, they wouldn’t be expending those resources. The one thing that I will mention that we are doing at AHA: our board just approved in June a revised policy for our soda tax advocacy initiatives– to focus where we can on a tiered tax structure, versus a flat tax structure. And this tiered structure, we believe, will allow recognition for those products that have removed sugar. We hope it will encourage industry to reformulate products to be able to meet this lower tax threshold.

Denver: Well, looking at childhood obesity, I think about 35% of our children are either overweight or obese.  How do we rank compared to the other developed nations in the world?

Nancy: The United States of America has so much to be proud of, but when it comes to our health statistics, we don’t have as much to be proud of. We are not the healthiest country by far. As a matter of fact, the last survey I looked at from the World Health Organization of developed countries– in overall health– we ranked 16th, or near the bottom of developed countries. And that’s really a problem, but it is also a rallying cry for the work that we do at AHA. We must help people understand that their health is the asset that helps buy them everything else that’s important to them in their life.

Denver: You talked a few minutes ago about The 2020 Impact Goal:  the reduction of death rate by heart attacks and stroke, and improvement in cardiovascular health by 20% across the board, by the year 2020. We’re a little more than halfway through the decade…How are we doing, Nancy?

Nancy: Well, on reductions in death rate, we have achieved so far in this decade a 14% reduction in deaths from cardiovascular diseases. And what’s especially interesting– because AHA is focused not just on the general populations, but on all Americans…we measure our progress among African Americans, Hispanics and Caucasians where there are data sources to support it…We’ve seen an especially promising reduction in deaths among African Americans and Hispanics compared to what we saw the last decade. We’re very pleased with this.  This is 43 years of consecutive reductions in deaths from cardiovascular diseases in this country.

Denver: That’s great news, and I think a lot people don’t appreciate the progress made.

Nancy: It is great news. The problem, as you’ve identified however, is that we are not on track at this moment to achieve the 20% improvement in cardiovascular health as we’ve defined it. And just for your listeners, cardiovascular health is a combination of seven health factors and health behaviors.

Denver: Life’s  Simple Seven.

Nancy: Life’s Simple Seven. So, these are health factors like your blood pressure, your blood cholesterol, your blood glucose. It includes your levels of physical activity, the fact that you don’t smoke, your body mass index, and your healthy diet score. And so, for us to see an improvement in cardiovascular health, in all seven of those–and they’re kind of a bundled portfolio, if you will–we have to see improvement. And so, we have much more work to do in these years leading up to 2020. This is why we have never worked harder in public policy and in inspiring and educating the public to care about their health.

Denver: And I think one of the great footnotes of all this was that 49% of Americans think they have ideal cardiovascular health…when the number is actually…?

Nancy: Fewer than 1% of all Americans.

Denver: That tells you all about human beings that you need to know.  

Nancy: Absolutely, absolutely.

Denver: I also like the way you try to reframe some issues.  I think when we begin to speak to our health provider, there is some negative framing:   “Why are you here today? What’s wrong? Why are you feeling badly?”  And you believe that if you can change it to a more positive framing, we might get different outcomes. That’s a strategy behind your branding campaign “Life Is Why.” Tell us about that.

Nancy: “Life Is Why”  really is the centerpiece of all we do at the American Heart Association. And its intent and purpose is to remind people that their health is their life.  The things that we can do are all about enjoying the things that matter most to people in their lives. When it comes to the healthcare provider in particular, we believe strongly at the American Heart Association that this encounter should be about a physician– or a healthcare provider–talking to a patient about his or her life’s aspiration.  The dialogue should be about how the physician and the individual– together– can create a journey that allows that person to live the best life that one desires. That’s not what happens now. We have a system very much focused on problems, and not about aspirations.  We will continue to work hard to make sure that there are tools and resources and opportunities for that dialogue to change.

Denver: Your tenure at the American Heart Association has really been marked by creating the culture of innovation.  I might add:  that’s not an easy thing to do in an organization that is 90+ years old. And right at the heart of that–right at the center–very visible to everybody is AHA’s innovation Think Tank. Tells us about that, the impact it  has across the organization, and about some of your initiatives.

Nancy: Sure! Happy to do that. The Think Tank that we’ve assembled at the Association is a group of volunteers that come from many aspects of professional life. There are doctors and researchers, of course, but there are marketing executives, business executives, CEOs of health plans, people that know health policy and public policy. And we bring in front of this group things we’re thinking about.  We ask for their ideas about how to make those concepts better.

One example I can give you is that during the economic downturn of  2008 – 2009,  I talked to the Think Tank about the fact that we needed to diversify our revenue sources.  We came up with four or five ideas of how we might take existing things that helped us meet the mission of AHA… to produce a different kind of revenue model for the Association. An easy one to talk about, for example, would be some enhancements we’ve made to our First Aid and CPR programs at AHA. And so, the Think Tank really is a group of people that make ideas that we have… better.  They help us think about how to leverage relationships and how AHA can be a catalyst for things related to science, technology, healthcare and consumerism.

Denver: Well, along those lines, last year,  you embarked upon what is perhaps the biggest investment you’ve ever made in the history of AHA: a program called “One Team. One Vision.”  This is a $50-million partnership between your organization and Google Life Sciences. Tell us how that has developed.

Nancy: Yes! That partnership has grown. It is now a $75 million research enterprise branded “One Brave Idea.”  And here’s the idea behind “One Brave Idea” : We believe that the scientific enterprise needs a new path forward. The average scientist who gets NIH funding, or funding from a research organization like the American Heart Association, spends 40% of their time writing grants for their continuation of funding or for a next source of funding. And what we need to do is to find a cure for coronary heart disease. We know that if the people who are conducting that research are focused on their research–but also worried about where their funding is going to come from–that we weren’t getting 100% of their effort in the game. So, what we wanted to do is to find a way to take the question of funding out of the game.

We wanted to simplify the process and create a more dynamic, interactive research enterprise between the funding organizations and the selected scientist. Google Life Science is now Verily, a subsidiary of Alphabet. AstraZeneca has come aboard, and they’ve contributed $25 million, as has Verily, as has the American Heart Association. We came together on January 14th. We gave a four-week timeframe for interested individuals– who felt that they could come up with the cure for coronary heart disease– to apply to  be selected as the one leader with their vision. We left the application process open only for four weeks. And in four weeks, we had about 350 people apply internationally…

Denver: Crowdsourcing.

Nancy: You’ve got it. And then from that… we have a joint leadership group made up of executives of Verily, AstraZeneca and the AHA. We narrowed that group down to 26;  we did interviews and got additional information from those folks. We narrowed it then down to 10, and we held face-to-face interviews with the 10 finalists at the end of June.  In the coming weeks, we will be announcing the selected recipient of the “One Brave Idea” of research enterprise. Then this individual, and their extended team of people from throughout the world, will begin their journey to find a cure for coronary heart disease. Now, this team is interesting; it’s not your traditional cardiovascular scientist. There are those folks on the team, but there are mathematicians and people who know drug development and physics and…

Denver: A lot of cross- disciplinary people coming together from all over the world, I would imagine.

Nancy: Absolutely!

Denver: Well, you have to call in and let us know who wins.

Nancy: We will do that for sure!

Denver: Another initiative you have is something called the AHA CEO Round Table. And you have a tremendous program around workplace wellness. Who are your partners?  And what are you trying to do with this endeavor?

Nancy: Sure! About three years ago, the American Heart Association created a CEO Round Table, which today has 26 CEOs of some of this country’s largest and most influential organizations, chaired by Henry Kravis, the co-CEO of KKR and Terry Lundgren the CEO of Macy’s. The CEOs come together to share with each other challenges and opportunities.  But the Round Table is really an incubator for new ideas of how to change the dynamic of health and engagement in the workplace. As I often say, we’ve been focusing on health in the workplace–“we” meaning society– for decades. But if you look around you, most people in our workplaces suffer visibly from some of the risks for cardiovascular disease.

Denver: Sitting around all day.

Nancy: And if we can create a new technology-based way to inspire employees to care about their own health, and if we can listen to the CEOs about what’s important to them, we believe we can make a real difference. And at the center of this effort is a new workplace health recognition and achievement program.  We’ve created an index that identifies–both from measurable health outcome results, as well as cultural activities around the company–what are the most important things. And we will be recognizing companies at a gold, silver and bronze level, and also identifying and recognizing America’s healthiest companies by industry category, and by size in this coming year. Those are all activities of the CEO Round Table.

Denver: Great stuff! You have said, Nancy, that one of the biggest IT challenges that faces the healthcare field is interoperability. That is a concept, or at least a word, that not many of us are familiar with.  What is interoperability?

Nancy: Yes. Interoperability is the ability for an individual’s health records to be portable and to be transferred between and among any healthcare provider he or she might see. And so, a person has generally several doctors that they might see…maybe they’ve visited a hospital. In a perfect world–and many are working on this, including our federal government–your records would follow you seamlessly wherever you go. Through this boon of electronic health records– encouraged by variable reimbursement rates for doctors who have electronic health records– if your data follows you everywhere, it hopefully should more accurately indicate what a healthcare provider’s interaction is with a patient. It should also reduce healthcare costs and unnecessary testing. And it also should allow the patient to really be at the center of their healthcare information.

Denver: That’s great.

Nancy: So that’s really a big focus, and something we work hard on in our advocacy…

Denver: You mean, I won’t be getting that clipboard with the pen chained to it?  And have to fill out the same information over and over again?

Nancy: Well, hopefully there will be an iPad that you can fill out, or something to click on. But this is really important for the future of healthcare in this country… that we get this just right.

Denver: You talked a little about fundraising before. In recent years, it has become more and more critical to you because you have a very energetic agenda.  It’s all going to take a lot of money. What is your revenue model?  And what are some of your signature fundraising activities?

Nancy: Sure, the AHA has a revenue model that includes, of course, largely philanthropic support. We are a 501 (c)(3) philanthropic organization. Those dollars come to the Association through events, major gifts, bequests, and gifts from foundations.

Denver: And you’ve done a lot with major gifts from individuals, haven’t you?

Nancy: We have done a lot with major gifts from individuals. Our signature events bring in a good 40% of the revenue of the Association every year. In addition to that, as I mentioned earlier, we’ve diversified our revenue.  We have what we call “mission-aligned businesses” that allow us to meet the mission of the Association, while also generating revenue in our CPR and First Aid training– which this past year generated about a $140 million in revenue to the Association. That’s one example.

Denver: What are the challenges of leading a national organization?  As you know, there can be some tensions between national headquarters and the local chapters and the local affiliates. As a matter of fact, that’s been playing out in some major national health organizations of late. What are the keys to keeping the whole organization aligned and working together in common cause around the mission?

Nancy: I couldn’t be more proud of how aligned the American Heart Association is, and I think that this is a result of a number of things. Probably first and foremost: back in 1998 was when the Association set its first decade-long goal. That goal became a rallying cry for the entire Association.  Every component of the organization rallied together, aligned resources.  We are a very congruent organization; all focus on the same activities, and we are one Association. We previously had 56 separately incorporated affiliates back in the 90s. But since 1998, we’ve been one corporate entity.  

There is great alignment, great passion, great camaraderie between:  the grassroots of the Association, the science of the Association, and the national headquarters of the Association. We’re all working on the same thing, and as I like to say, the most valuable assets that the AHA have are its science and its grassroots.  Everything we do is meant to maximize our effort in those areas.

Denver: Talk a little bit more about that. AHA is a very special place to work. When people talk about the best nonprofit organizations in the country, you’re always on the list. And as matter of fact, when they talk about health-related organizations– whether they are for profit or nonprofit– you’re always on that list as well, most recently in Fortune Magazine. From someone who’s dedicated her entire life to good health, what is the key to creating and maintaining a healthy work culture?

Nancy: I think at the American Heart Association, people are very inspired by the work that we do. People have an opportunity to get involved firsthand in major and significant initiatives that are inspiring. At the center of everything we do, we’re saving lives.  We can see the impact of our lives. We deal with patients in the public, and we deal with families who’ve lost family members. This is very, very inspiring.  And I think the employees of our Association get most of their energy from the fact that they get a chance to work with really amazing volunteers as well.

Denver: Tell us about your website, the kind of information someone will find when visiting it. How can people get involved with AHA?   And also, if people want to make a contribution to financially support your work… What do they do?

Nancy: Well, thank you for that! So, if individuals can visit the AHA’s website http://www.heart.org, on that website, you’ll find a variety of information that can allow you to live a healthier life.  It also gives you great information about how to get involved locally. There’s this terrific ZIP code finder.  You can enter your ZIP code, and it will give a sense of all the local activities– whether they are events, or advocacy priorities, or other programs of the Association. And of course, we would welcome anyone’s donation at donate.heart.org.

Denver: Well, Nancy Brown, Chief Executive Officer of the American Heart Association, I want to thank you for being on the show this evening. You are testimony to the importance of having leaders who are committed to pursuing a long-term vision, and not just short-term needs.  What you’re doing at AHA is certainly evidence of that. It was a real pleasure to have you on the show.

Nancy: Thank you so much! Thank you for the opportunity.

Nancy Brown, Chief Executive Officer of The American Heart Association and Denver Frederick, host of the Business of Giving

The Business of Giving can be heard every Sunday evening between 6 and 7 PM Eastern on AM 970 The Answer in New York and on I Heart Radio. You can follow us at bizofgive on twitter and at facebook.com/businessofgiving.

We have found a new home! Kindly visit this link in our new website here: https://www.denver-frederick.com/2016/08/24/interview-transcript-kate-roberts-of-maverick-collective-and-the-women-centric-model-of-philanthropy/

“Money doesn’t solve problems. People do!” says Kate Roberts, co-founder of the Maverick Collective, an organization that aims to redefine what it means to be a philanthropist.

Kate Roberts, Co-Founder of Maverick Collective

In this interview from The Business of Giving, Ms. Roberts explains how Maverick Collective members invest a minimum of $1 million over three years to pilot an innovative solution for girls and women in the developing world. The organization, co-chaired by Melinda Gates and Crown Princess Mette-Marit of Norway, is an initiative of Population Services International (PSI).

The following is a conversation between Kate Roberts, Co-Founder of The Maverick Collective and Denver Frederick, host of The Business of Giving, on AM 970 The Answer in New York City. This interview has been slightly edited for clarity.

Denver: With the constant barrage of messages, tweets, ads, Facebook posts and the rest, it is extremely difficult for any new initiative to break through and capture people’s attention. But then along comes The Maverick Collective, which has quickly become a hot topic in the world of philanthropy….. and beyond. So it’s a great pleasure to have with us this evening its co-founder, Kate Roberts. Good evening, Kate, and welcome to The Business of Giving.

Kate: Good evening! It’s great to be here.

Denver: The Maverick Collective, which is still quite young, has really captured many people’s imagination. What is it?  And where did the spark of this idea come from?

Kate: The spark of it came from being so impressed with watching philanthropists, such as Melinda Gates, who serves as our co-chair. Coming to the realization that she’s leaving so many of her own resources on the table — and having the smarts, as well as money, to create social change. So, personally, I was really inspired by her journey and the great work that she was doing at the foundation. She then started to mobilize billions of dollars for the issue of family planning. So, that really led us to believe that there is an incredible platform for other like-minded, bold women who really do want to use their skills, their resources and their voice to create change…. rather than just writing a check. Go beyond the check…really get involved and amplify your impact as a philanthropist. And then, of course, the sustainable development goals were announced–very aggressive goals.

Denver: Right.

Kate: And at the heart of all philanthropy–like wealth creation–it is all about impact.  If we’re going to achieve these goals, we need to take an approach where everybody is engaged — Philanthropists, NGOs, governments, the  private sector, the public sector– all effectively working together to achieve these goals.

Denver: And you have another co-chair as well, correct?

Kate: We do. The crown princess of Norway, Mette-Marit. She’s actually the co-founder with me.

Denver: There has been a lot of conversation around girls’ education, women’s empowerment, health issues–which I know that you’re focused on– in the last couple of years. Would it be fair to say that the funding has failed to keep up with the rhetoric?

Kate: It is fair to say. Two percent of U.S. government funding goes to these issues, which I think is a fact that most people don’t know. And, again, in order to achieve these aggressive goals we need to be creative, disruptive.   And we need to redefine what it means to be a philanthropist. Our initiative is really all about ending extreme poverty in our lifetime. That’s ambitious. We want to do it by really focusing on girls and women. And if we do not lift girls and women out of poverty, we will never break that cycle.

So, at the heart of all of this is health…and most of the big problems are preventable. But we really need to innovate around these different health areas in order to identify solutions, pilot them, measure them, and then leverage what we know with our traditional partners–like the U.S. government–to scale these solutions across the world.

Denver: Well as you know, Kate, there are a lot of health problems and challenges  in the world facing girls and women. How do you go about deciding which pilot projects you’re going to focus on?  And what countries are going to do them in?

Kate: Well, first of all, I should say that women make up 70% of the world’s poor, so it’s disproportional. And then you look at what are the pressing issues. What is the ecosystem of a woman? And where do we need to focus? So, we’ve broken the focus impact areas into six focus categories.

Sanitation. Most women are going outside to defecate– which leads to all sorts of disease. But then, it also leads to gender-based violence: men prey on women at dusk when they go outside. So it’s all very much linked–gender-based violence, sanitation.

Then, there are some 250 million women out there who want access to family planning and contraception, and they don’t have it. Sexual reproductive health, family planning, teen pregnancy prevention…we have to get girls in school. And being pregnant by the time you’re 12–which is happening a lot around the world–is something that we absolutely need to prevent in order to keep our girls in school.

Maternal Health. 500,000 women die in childbirth each year, and the cost to the economy–just the sheer opportunity that we have when we invest in women… especially around childbirth.  It will strengthen local communities when you strengthen nations… And then, of course, you empower the world. So there is an economic business sense to it  as well–maternal and child health.

Right now, we’re grappling with Zika, right? We’re all scared of the mosquito.

It used to be about malaria. We’ve eliminated malaria in this country. I think we’re on a fast track to end malaria around the world. It’s simple solutions, right? Putting an insecticide- treated net over a bed which costs about $5. We tested that out. Now, we cover the world in bed nets. So, the end of malaria is in sight.

Of course, Zika is now a new challenge that we have to focus on.  It affects women and their maternity. So, we choose our projects carefully–in partnership with others where we know there is donor interest.  But where there is interest?  We need to fan the flames of an intervention where we believe we can have huge impact. And then once we do, we go back to our traditional partners to scale across the world.

Denver: Right. So, Kate, how does The Maverick Collective work? You and Melinda Gates, and the Crown Princess of Norway–you have gone out and enlisted 14 founding philanthropists. What is the criteria to become a member? What are the expectations and responsibilities that you have to one another?

Kate: Yes. We’re all bold women right now. I say “right now” because very soon, we’ll be inviting men into our group. We all share a common passion for making this world a better place for girls and women We share an interest in global developments, smart global development, strategic global development, and the ability to listen. We have a 3-year partnership together where we really involve the philanthropist — from the very beginning in co-designing the intervention. We choose the right country to do that– and one where we believe we can have the most impact. So that could be in India, or it could be in Guatemala or Botswana. We stretch across 65 countries across the world.

And there is a financial aspect to it. It costs about a million dollars over three years to really have the impact on the ground…and I would say, the sort of ambition to disrupt somewhat. We are changing the way that philanthropy is being done. We’re really turning it on its head. This is not a typical NGO-donor relationship. It’s okay to fail, and transparency is really, really important. We’re transparent with our members, and they get back to us. It’s an open relationship of transparency.

Denver: When you approach these women, you told them you want them to be deeply engaged in these projects–as you just said a moment ago–to co-design these projects. Were any of them skeptical?  Did any of them think that this was just a strategy for you to be able to get them to write a check, and that’s what you really wanted?

Kate: Oh yes! All the time. And I kept saying “No, I promise you. This is how we do it.” And I think if you would have any of these incredible ladies on the show, they will tell you the same thing. They have been told in the past, “Oh, join our board. We want your opinion.” Then they joined the board and realized that they just want the check.

Denver: They want the check.

Kate: And look, people solve problems; money doesn’t. Money is important, but we are really interested in the other resources that a philanthropist brings to the table. Not just money. And I can give you an example.

Pam Scott is a Human-Centered Design champion and specialist. And she’s really helped us to rethink how we design programs. Her initiative is in Tanzania. She is focused on teen pregnancy prevention, and she was out there with a whole team of experts in design. And we really explored together how we could be more effective in designing these programs. And she was leading it…we weren’t. You know, we’re the public health experts. She’s not a public health expert. So, it was a good marriage of talent and resources. And now the program has developed into a three country project across Tanzania, Ethiopia and Nigeria. And in partnership with Gates and SIF, it’s now a $13 million intervention focused on teen pregnancy and human centered design.

Denver: Do you have to wait to be invited to join The Maverick Collective? Or,  if somebody was interested, can they contact you?

Kate: They can contact us, probably best through the website maverickcollective.org. But we choose our members. Not everyone is right for this. And we’re not right for everyone. But we’re strategic. We’re only interested in doing things that we can measure. And we’re only interested in doing things that we can really scale. We take a business approach to how we develop these interventions, and also how we develop our members. It’s a two-way strategy–it’s getting the most out of our members for them to be inspired advocates… and really having the results on the ground.

Denver: From your observations, do you think that men and women approach philanthropy differently?  And, if they do, what would some of those differences be?

Kate: That is such a great question! Well, I’ve mostly… up until now… only worked with women. But what has started to happen– which I think is so exciting — is the husbands have said, “Well, what about me? What can I bring to the table?”

Denver: Turning the tables right.

Kate: Which is exciting, because everything we do, every Maverick Collective intervention, is taking a business approach. So businessmen, for instance, who have been involved in franchising, it’s extremely interesting to us because we have socially-franchised clinics all over the world. We want to take them to a sustainable level. So, yeah, we want some male brain power–those who have been involved in business and would like to use their resources, talent, time, and financial resources to help us solve problems. It’s about problem solving.

Denver: That’s what it gets down to.

Kate: Yep.

Denver: I should mention that Maverick Collective is an initiative of Population Services International–more commonly known as PSI. Tell us about PSI and the important role that they’re playing in this endeavor…

Kate: Well, first of all I should say that PSI is one of the largest health organizations in the world that nobody has ever heard of. We’re in 65 countries. We’ve got about 9,000 employees. We have about a $600 million annual budget. PSI focuses on market solutions for health programs. So we’re obsessed with measurement. Really, our goal is to provide universal healthcare to the poor. So PSI is the implementing partner of Maverick Collective, and they are responsible for providing the results. We tap into their incredible expertise. PSI has been doing this work for over 47 years. Started with a grant from the US government and grew into what we are today. I would say that we are like the DHL of health delivery.

Denver: That’s a good analogy. We talked about Pam Scott’s work in Tanzania. I want to talk about another example of a success… and that was low-cost screening for cervical cancer in India. Tell us how that project developed.

Kate: First of all, cervical cancer is preventable. Yet, millions of women around the world, especially in India, die from the disease every single year because they haven’t been screened. And the technology that we have here in the United States– where we go and get a pap smear every year –which probably costs the health system $30,000 to do it in a lab — those facilities simply don’t exist  around the world.

So, it was discovered through our partners that swabbing white vinegar on the cervix would show an early stage cervical cancer. Literally, household vinegar. Just a swab. Probably costs no more than a cent to do that, and we can detect early signs of cervical cancer. So we decided to pilot this, Kathy Vizas is our champion, who, I have to say, now knows more about cervical cancer than we do. Her evolution as a champion for this issue is unbelievable.

Denver: She’s a daughter of an oncologist, correct?

Kate: Yes, and I think is a frustrated doctor too, deep down. At least… a frustrated NGO worker! Anyway, we piloted her project in India, and we thought that this project would go to the private sector once we proved its results. But, actually, what ended up happening is that the government decided that they were going to take this on, and have now implemented it across India in many provinces.

Denver: Fantastic!

Kate: So for us, we look for these kinds of results. Then, the  private sector taking it on… or the government taking it on…. or both! We just want to deliver the results and then have a sustainable solution for these diseases.

Denver: And that’s the whole point of your business model, as you have said…do the pilot; get the evidence, and then unlock some additional significant funding to help take it to scale. Where else has that happened?

Kate: That has happened also around gender-based violence. So, we all remember the horrific rapes in India–the girl on the bus, the women left hanging from trees after they’ve been raped by policemen after going to the bathroom outside. When it happened, I was at the World Economic Forum. There were many Indian businessmen, and I had never been able to break through to the Indian community of CEOs until this happened.

And then this happened and, I hate to say it, it was a real opportunity for us to develop a big program around gender-based violence. Indrani Goradia is our champion. She’s the most incredible woman. She was born in Trinidad, but has Indian heritage and an Indian family. And she helped us to start this gender-based violence prevention impact project in India. And now, in partnership with USAID– it’s a $10 million program — the largest in India. And we now have gender-based violence projects across the 13 countries, together with PSI. So I’ve watched both the evolution of these incredible women, who are members of Maverick Collective. And the results on the ground have been very quick. So, we no longer see this philanthropic model as a pilot.  It’s working. And we’re really just beginning.

Denver: And when the results on the ground are not that good, you don’t hesitate to share that information with your members…. not only to keep them informed, but also in the hope they can come up with the solution. And that is so different from many other NGOs that, when a problem arises, try to sweep it under the rug because they are afraid if the donors finds out about it, they’re going to end their support. But that has not been your approach.

Kate: That has not been our approach. An example was we had a barrier in Mozambique with one of our members. We really couldn’t get approval from the government to start testing this product. It was a contraception product. And it stalled. So, for six months we were really trying to get those approvals, and we were there hand-in-hand with her along the way. She understood–she took time to really understand the problem and used her time effectively and together we solved the problem.

But I have to say, there’s another really great example of big picture problem solving. Which is male circumcision. We had found out a number of years ago that circumcising African men would be an incredible HIV prevention tool. But none of our partners, and none of our donors, have thought that we would be able to get adult African men into a clinic to be circumcised. Tall order. So we used our own funding…unrestricted funding,,, to pilot an intervention in Zambia. And guess what? It failed. We couldn’t get these men in, and we tried everything. And it took us a year.. kept trying things, kept failing. And then we eventually came up with the messaging that you will be a better lover if you are circumcised. This was the message that really worked. I think we invested $400,000 in this clinic and the interventions–it’s now a $300 to $400 million leading solution across Sub-Saharan Africa. It is one of the leading prevention tools now for HIV. So yeah, it’s risk-taking and innovation…

Denver: Keeping at it.

Kate: It’s keeping at it and using money in the right way. Using private money is so powerful at the beginning stages of solving these problems. But yes, you can fail, and then you have to change course, and you’ll get there in the end. That’s what being a social entrepreneur is all about.

Denver: Fail fast and iterate…and keep on doing it until it begins to work. Another thing that you ask of your members is to become advocates for the issues that they have chosen… and to spread that message of what needs to be done. You just don’t send them out there to do that, you help prepare them. What do you do in this regard?

Kate: We do intense media training. We help our members to write effective op-eds. We come with a whole communication strategy based on who that member is. For instance, Indrani Goradia–she’s in her third year now of doing this–has done TED Talks. She’s testified before the United Nations. She’s worked all over the world with our own employees within PSI to train them to be better advocates. We have a full communication strategy, which is on display at the best conferences. The philanthropist is never to be seen at the conference, right? It’s public health specialists. It’s the same old, same old.

Denver: Same old, same old is right!

Kate: Same old, same old. Where is their empowered philanthropist who has learned by doing? And so, we’re going to shake that up. We’re missing so much opportunity by not focusing on the philanthropist and their smarts.

Denver: You’ve launched some really significant and successful projects in about 14 countries now. Are you thinking of any additional programs or projects… and perhaps going to some countries where you haven’t gone to yet….that you’re seeking funding for?

Kate: Yes, Zika is a little bit similar to Ebola, right? It’s not as ghastly, but it is a real threat. So we’re really looking at how we can prevent people – especially women — from contracting Zika, by helping them to avoid an unintended pregnancy and to make sure that they’re safe and healthy. It’s a real public health challenge that puts expectant mothers and their babies at huge risk. There’s no vaccine. Prevention is where it’s at right now. We really need to focus. So that’s one area.

We are looking at systems of approach to improve maternal nutrition and infant health. Better nutrition for mothers and their newborn babies holds huge potential to end needless deaths in pregnancy. And really, making sure that women have access to the contraception that they need– and really– delaying the first sexual experience for as long as we possibly can. Twelve- year old girls should not be married with three children. Because that brings so many complications, it prevents them from going to school.

Denver: And the cycle continues when that happens. You’ve  got to break that cycle.

Kate: Exactly! It’s about looking at the ecosystem…… and for all of us who have daughters…. I have a little girl. So many of our members have children. We’re also involving them with their parents in this. One of our members has a 16-year old girl, and she  is taking her to Mozambique so they can engage together in this.  We want to make this world a better place for our children.

I really want to stress how important the private sector is.  And anyone who wants to apply their smarts to finding business solutions together with us–with the focus on markets and financing — we welcome you. We have health insurance–that’s something that we’re looking to introduce to some of these developing markets– and financing health through a sustainable lens. We need help thinking through these business solutions.

Denver: For women in the audience, Kate, who really want to become engaged in these issues that impact girls or women — but perhaps not quite at The Maverick Collective level — what advice would you give them?

Kate: Well, my advice always is to learn and find your passion. Understand what your passion is. And there are ways of becoming involved in Maverick, such as through giving circles. If you wanted to bring a circle of women and men together to get behind a project….that would be a great way of engaging. You could also go to psi.org and make a smaller donation if you believe in the mission. We apply the funding to all of these areas. Of course, unrestricted funding is so important.

Denver: It sure is.

Kate: People get worried about funding the light bulbs and the infrastructure, but capacity is so important. Even just investing in a person who is going to do this work–a person like me. Invest in a person. I think that’s one of the best things that the Bill and Melinda Gates Foundation has done: investing in people like me to do this. You might not be building an orphanage and putting your name on it…..but by investing in a person, you will have an incredible, incredible effect!

Denver: I think that message is finally getting out. Darren Walker of  the Ford Foundation was on, and he talked about how they’re increasing their unrestricted support to these organizations. Because that’s the kind of support NGOs can leverage… and you really can’t leverage something that goes directly to a program. The dollar is the dollar, but when you invest in the capacity of the organization, it has a multiplier effect.

Kate: Exactly! I’m glad you’re getting that message out–it’s so important.

Denver: Let me close on this. One of the grand ambitions of The Maverick Collective–  beyond the life changing work that you’re doing to help these women and girls — is to redefine what it means to be a philanthropist. What’s your vision for what a philanthropist is to become?

Kate: My vision will be that you’re not just writing checks…but you’re using your whole self to amplify impact.  When we have inspired, informed philanthropists, they will also inspire other NGOs. They will inspire governments and politicians. They will also inspire other like-minded philanthropists. And if we want to achieve these goals–these extremely aggressive sustainable development goals–in the time frame that we’ve got……

I want to see the end to these diseases in my lifetime. I’m impatient. Our members are impatient, and it’s really going to take a whole movement of inspired advocates to do that. And by the end of this journey with us–the three years that it really takes to implement a solution–they will have gone through the entire process with us and really had a crash course on global development. This is a real opportunity to learn about the issues. And our hope is that they then inspire 10 other people. That is what it  is going to take to move the needle on these issues…

Denver: It’s going to take all of us.

Kate: …Maverick is an important name because it takes an entrepreneur. And Collective is an important addition to that because it’s a Collective of Maverick like-minded, bold entrepreneurs who want to see change.

Denver: Well, Kate Roberts, the Co-Founder of The Maverick Collective… I want to  thank you for being on the show this evening. In addition to the work that you’re doing to better the lives of countless women and girls around the world, I strongly suspect that this women-centric and women-led model of philanthropy will significantly change the way all philanthropy is done in the years to come. It was a real pleasure to have you on the program.

Kate: Such a pleasure. Thank you!

*The Business of Giving can be heard every Sunday evening between 6:00 PM and 7:00 PM Eastern on AM 970 The Answer in New York and on iHeartRadio. You can follow us @BizofGive on Twitter and at Facebook.com/BusinessOfGiving.

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In this interview from The Business of Giving, Lindsay Levin, the Founding Partner of Leaders’ Quest, and the author of Invisible Giants: Changing the World One Step at a Time, discusses how Leaders’ Quest helps build a sustainable, more inclusive world in collaboration with leaders. She shares the philosophy behind Compassion X and tells us remarkable stories of people she has met and the impressive  impact they’ve delivered through their work.

The following is a conversation between Lindsay Levin, Founding Partner of Leaders’ Quest and Denver Frederick, host of The Business of Giving on AM 970 The Answer in New York City. This transcript  has been edited for clarity.

Denver: If you go on to the internet and look for courses in leadership, you will not be disappointed. There are plenty to choose from… whether you want to take them online or in person. But you won’t see too many reviews from those who have taken them that describe their course as “life-changing”  or “transformative”  the way you will for Leaders’ Quest.  It’s a great pleasure for me to have with us this evening the Founding Partner of Leaders’ Quest, Lindsay Levin. Good evening, Lindsay, and welcome to The Business of Giving.

Lindsay: Good evening. I’m delighted to be here. Thank you for inviting me.

Denver: So, tell us about Leaders’ Quest, founded in 2001.  What is its purpose? And what makes it so exceptional?

Lindsay: Thank you. Sure! Leaders’ Quest is really about bridging divides. Our work is about connecting people from very different walks of life, different industries, different sectors,  different countries… and having people learn from one another.

Denver: Well, I want to go on a Quest, okay? So, who am I going to go with? Where across the world are you going to take me? How long does it last? And what will I do when I’m there?

Lindsay: Sure, we do–broadly speaking–two kinds of Quests. The first sort of program you might join us for will typically be one week long. It could take place anywhere.  It could be here in the US; it could be in the Middle East; it could be somewhere in Africa,  Asia, Latin America. For example, our next program is in Kenya. The program after that is in Cuba. The one after that is in Israel,  Palestine, and the West Bank.

You would be with a real mixed group of leaders from different walks of life–people from big corporations, entrepreneurs, social entrepreneurs, people leading nonprofits. It would be a very deliberate mix of people from different countries. And in the course of five or six days with us, you would go out and visit with all kinds of leaders and organizations in whichever country we’re visiting. We would deliberately mix in time spent with businesses, innovators, entrepreneurs, scientists and technologists. Time is spent visiting various communities–grassroots, slums, townships, villages–where people are driving change from the bottom up.

Denver: So I would observe, listen and watch other people make change. How is that going to help transform me?

Lindsay: Well, one of the ways I think about our work is that you can feel like you’re looking through a window. You’re looking out at something else, and you discover that it’s not really a window–it’s actually a mirror!  In the course of having these different visits and different kinds of conversations, it’s very mutual. You’re learning, you’re sharing, you’re asking questions, you’re pursuing the things that really interest you.  And in the course of that, what typically happens  is you start to think about your own life.  You start to think about your own way of leading, your own way of relating to people. And you start to notice different things about how you do what you do.

Denver:  It sounds, Lindsay, a little bit like another organization called Roots of Empathy. It teaches children empathy. In Lesson One, a baby is brought into the classroom on a blanket by his mother. And you observe what the baby is trying to do– the frustrations of reaching a rattle, looking for his mother. As a result, the kids begin to talk among themselves. And changes begin in their behavior– as it relates to bullying, inclusiveness, being kind. In watching somebody else try to make change, you begin to reflect back inward on yourself. It sounds similar to the experience you attempt to provide…Correct?

Lindsay: Right! Exactly!  And one of the reasons I started this was I believe we don’t spend enough time engaging with and getting to know people we may think of as “other,”  or different from ourselves.  So, in my view and  experience,  once you’ve met people from a different country,  a different part of your own town, a different neighborhood–and once you’ve actually talked to them about the things that matter to them–it’s impossible to go back to seeing them as “other.”  You form a connection that changes the way that you look at relationships and life.

Denver: Another thing that I think is distinctive–and you just touched on it–is the sense of self-awareness. I think we spend so much time looking at our external environment–trying to win, get profits…

Lindsay: Right.

Denver:  You really can’t be a great leader unless you are self-aware, correct?

Lindsay: I agree. Self awareness — the ability to cooperate and collaborate. The world, on one hand, is very competitive. But it also needs partnership. It also needs collaboration. And I think today, we need that far, far more than we ever did in the past.

Denver: You started this 15 years ago.. as I mentioned… back in 2001.  Since you began, what we look for and need in a leader has certainly changed dramatically. What are the big differences you have observed?  And how are they  reflected in the way you design and develop Leaders’ Quest?

Lindsay: Right.  I think  the world is changing very fast. That’s not going to slow down–be it  technology, scale,  the numbers of people on the planet,  how we’re all mixed up together — the world is changing very fast. So one of the challenges for leaders is to actually be at peace with that!  To be able to work with vast change, to cope with ambiguity, to cope with uncertainty… And I think for that, you need to be very, very rooted in what you stand for.  You need to understand your own values, what’s important to you.  To have a sense of optimism… see possibility… and work with hope. Those are some of the things that we try to show people… that the world isn’t just newspaper headlines  or what you watch on the internet. The world is full of people trying to do great things every day. And if you connect in with that–and if you build relationships with those kinds of people–you deliver very different outcomes.

Lindsay: I think we’re still at an early stage on that journey. I think it’s a very important transition. I think it takes years, not months or weeks.  In that sense,  I think we’re at an early stage. But I do think that there’s a real acceleration in people realizing that there are some things wrong with the way we do things. Our economic system actually needs to change. Businesses’ role in the world– whether we like it or not– is changing. So what a lot of company leaders are doing… and we spent a lot of time with people working on this

… is figuring out how to respond to that.

How do you put purpose in the core of your business…not as something that you do on Sundays, not as something that you do as a CSR project?  How do you make whatever it is you do,  the products you create, the services that you provide…how do you make sure that you’re doing that with a  sense of social purpose, as well as for financial return? And I also think that in the up and coming generation…people deeply care about being part of something purposeful. I think everybody does.

We all want to do something meaningful in our lives. And it can get a little buried in the hurry, in the mad dash, and in the pressures of day-to-day life. But in my experience, as soon as you  dig a little bit, you find people who really want to do something meaningful… and will give their all, if given the opportunity to do that.

Denver: You are the author of an exceptionally well-received book entitled “Invisible Giants: Changing the World One Step at a Time.” Let’s start with:  What is an “Invisible Giant?”

Lindsay: Well, “Invisible Giants” was my way of talking about the fact that there are many, many, many millions of people doing great things in the world. And when we think about leaders that we admire, we usually come up with a very short list of the most wonderful, famous characters that have populated our past. But in my experience everyday, you can go out and find people in a corner store, in a small business here or a small business there, out in the community… You find people doing good work. And many of them actually end up delivering change on real scale, but are typically unsung heroes. So I wanted to celebrate the idea that people who are sometimes less visible–especially by the way in far flung corners of the world….different parts of Africa or in Asia, or towns somewhere in the middle of America–are doing really good work and are giants in their own field. They have a great deal to share, and others can  learn from them.

Denver: Well, that is inspiring!  I think we sometimes get so overwhelmed with the barrage of bad news that we are constantly fed.

Lindsay: Right

Denver: There are some troubled places and things in the world, but I think the media doesn’t help.  You can very easily develop a sense of hopelessness and say to yourself, “Well, what difference can I make?” So give us an example– to give us hope and inspire us– of one of these invisible giants…

Lindsay: There are a lot examples. But let me pick a man called Naidoo, an Indian gentleman who I met early on in my work. I met him in the city of Bangalore,  and he was working at that time with mentally disabled people. These people had all kinds of mental problems and were from very, very poor communities. No access to medication; no access to doctors typically.

And he created an amazing network of..  barefoot doctors…local people who had some basic training to take care.. in different ways… of people with mental disabilities. Not the same care as full medical care obviously.  But it was an extraordinary network that spread throughout India. And the first time I met Naidoo, I just remember walking into a room… and this wonderful man.. is physically disabled himself.  His smile lit up.  He was just a man of such goodness… his smile really shone out. So I learned a lot from him. I learned a lot from watching the incredible tenderness, compassion and joy with which he engages with people. So he was one of many, many people.

Denver: That’s a great example. And we don’t pay enough attention to mental illness in this part of the world. So I can imagine in that part of the world, it’s never addressed… or rarely discussed.

Lindsay: No,, very tough for people in villages who were in families that  don’t know what to do. They end up literally chaining people up.  So,  it’s really terrible. So a great deal to be learned from those kinds of examples.

Denver: Well, you have a lot of interesting observations in your book. One I thought was particularly interesting was a quote by Lin Lin.  She said, “India is like an injured person lying on the floor. All the wounds are visible and open to the air, and blood is flowing into the ground. But here in China, all our wounds are on the inside.” Now you have spent, Lindsay, an awful lot of time in both of those countries. What was Lin Lin saying there?

Lindsay: Yeah, Lin Lin is a Chinese colleague who I’ve worked with around the world… including in China… but also in India. And she was so struck by what everybody’s struck by in India–which is it’s very vibrant, very colorful, very expressive. The problems of the country you can see absolutely from the moment you set foot off of the plane.

Denver: It’s a bit chaotic.

Lindsay: It is chaotic. And it’s wonderful as well!  It’s got tremendous charm, but huge challenges, and they’re really in your face. You can witness all of that and people talk–it’s a very vibrant democracy. People are talking about sharing their ideas all the time. China feels more closed; it’s harder for foreigners to understand. In my experience there, it really warrants building relationships. As you get to know people there, they do open up. They’ve got a wonderful sense of humor. They care deeply about the same things that we care about. But it’s had a really tough history. It’s still got a pretty closed political system in many ways. And Lin Lin was really talking about that.

Denver: Yeah, they’re very guarded and very tight.

Lindsay: Exactly, exactly. And she was really talking about that. I guess one of my reflections for those of us who spend time visiting China– or wish to visit China– is to  actually take the time and trouble to get to know people. As with everyone–under the surface–we do all care about the same things as human beings.

Denver:  You also were blown away by the amount of building that was going on, and the number of people who were moving.

Lindsay: Right. China is in the middle of an incredible transition. It’s the biggest-ever migration from rural life to urban life. Very, very ambitious. Difficult!  There are many downsides to it,  and there are some upsides too. The scale of change is incredible. One of the things that it certainly has made me think–just in looking at the thousands and thousands and thousands of buildings under construction–is, frankly,  the price on the earth. We have so many of us on this planet today.  How we successfully live together–and plan and grow together– is deeply challenging. And by the way, the Chinese know that. They are smart people–very thoughtful about the problems that they’re having to navigate.

Denver: The people you run into…so many of them are in difficult situations, and their lives are so hard.  They have so little money and so few possessions that they must really be enduring miserable lives……or so we assume!  But in  your travels–from what you’ve observed–that’s not necessarily the case, is it?

Lindsay: No.I think we often look in on a situation and make assumptions.  In my experience, the assumptions are usually wrong. So, I might presume that the solution to problem A is to do one thing.  But I’m usually wrong in that assumption.  So,  it’s really very much about asking the people themselves. People are in all kinds of what we might perceive to be poor communities… I spent a lot of time in slums in different parts of Africa and India… Yeah, life is tough. Resources are short; getting education for your kids is tough; access to any kind of healthcare is tough; access to clean water is tough. But people still have a tremendous sense of community, a tremendous sense of personal agency.  

Some of the most impressive change makers are living in those kinds of tough circumstances. And certainly, I think there’s a great deal that can be learned by everyone, for example,  here in the west about work that’s going on in the east of the planet… or down south of the planet.

Denver: Yes, they’re underestimated. I think somebody was on the show once and said, “Try living on a $1.25 a day, and you’ll find out how innovative you’ll become.”

Lindsay: Right. The entrepreneurship and innovation in slum communities is really extraordinary. And in fact, one of the things that we do with some of the business leaders that we work with is to help them learn from that kind of innovation at the bottom of the pyramid. Because the products and services that will serve the poorest 3 or 4 billion people on the planet are full of ingenuity. And in fact– in my view–that is where some of  the most exciting, interesting markets and opportunities… opportunities to contribute and to grow businesses is going to  come from.

Denver: And I think  one sees even in this country, we’re beginning to finally get a trickle of reverse innovation.

Lindsay: Right.

Denver: Companies like GE are bringing some of those innovations back here, and we never would have done that 10 or 20 years ago…

Lindsay: Well, I want to give a plug to Detroit actually as you raised GE, because we’re just in the middle of creating our first Quest in Detroit. We’re going to be bringing business leaders from around the world to visit Detroit and learn from what’s happening there. Part of it is– the large companies and older companies– are really driving change. A real renaissance is going on there. And at the same time,  there’s tremendous stuff happening in communities at a grassroots level. So, I’m very excited by what Detroit has to share with the rest of the world, and I’ve thoroughly enjoyed the time I’ve spent there.

Denver: I know you did. You noted before that the world is changing at an accelerated rate. I think a lot of other people have noted that as well. But you have introduced this idea that compassion needs to change at the same accelerated rate. You referred to it as “Compassion X.”  What is Compassion X?

Lindsay: Well, Compassion X is really the idea that we are doing a lot of smart things on this planet. We’ve got tremendous technology. We can do all kinds of things that were  unimaginable 10, 15, 20 years ago. And at the same time, we’re discovering more and more about the Earth… and indeed about the universe.

So, there is a fantastic rate of change driven by human cleverness–if you like–human smartness. But at the same time, we actually need to be wise.  We need to invest in being thoughtful; we need to invest in how we relate to one another, how we grow as human beings– what I would call, wisdom. We need to spend time on wisdom.  I think of compassion as being the bridge between the smartness and the wisdom. Compassion is really the ability to look at another person and  imagine myself in that person’s shoes, to recognize that we are all part of the same whole.  Actually, ultimately, my  well-being is completely tied up with your well-being and the well-being of future generations.

Denver: With Compassion X, there are three steps you talked about: One is the work we need to do on the inside– that’s a lifetime journey–and the third step is connecting the dots and bringing it all together. But let me focus on the second step:  “meeting in the middle”  because to tell you the truth, Lindsay, that seems to be the one we’re having so much trouble with right now.

I know you don’t need to agree with someone, but you need to at least listen and respect  a different point of view.  Boy, that’s not going on, particularly in this political season. What insights can you provide there?

Lindsay: Yeah. I totally agree. That challenge of not being driven by–the easy game– going to the extreme and being polarized… and demonizing one another… and assuming that somebody is your enemy because you don’t agree with him or her–there’s far too much of that going on.

In my own belief, I deeply believe in the goodness of people. The majority–by far the majority of us–want to lead a decent life, want to be good to our neighbors, care about the future, care about the next generation, and so on. But it all gets lost in the intensity of life. So the “meeting in the middle” for me is about those of us who can really show you an example of that. It’s about the ability to listen,  the ability to imagine yourself in somebody else’s shoes. When I started Leaders’ Quest, the idea was: if we go and meet each other, we’re changed by that experience. One of the things you can do is get out and meet your neighbors. Go and connect with people on the other side of town. Yesterday, I spent time out in Brownsville, in Brooklyn–meeting with some fantastic people about projects they are running there. And this is just a few stops on the subway…and  a different part of New York… where there are great things going on.

Denver: And you were also with the Chair of the International Steering Committee of OneVoice where you were trying to achieve that “meeting in the middle” between some people on the Israeli and on the Palestinian side.Tell us about that experience?

Lindsay: You know, people are sometime offended when I say this:  but for me, it’s no different–the differences between all kinds of other people. It’s driven by fear. It’s driven by history. It’s driven by good people who care about their own communities and families and have a certain narrative…but have ended up really pushed apart. So the work behind OneVoice was to say: we want to engage with the majority of Palestinian people who actually want to live decently, side by side with the neighbors.  And we want to engage with the majority of Israeli people who also want to live decently, side by side with their neighbors. For that, you have to believe in people. You have to be willing to spend time together. And my experience was of finding lots of fantastic people on both sides of that divide. And if anything, one of the abiding memories is of a deep emotion and passion and care. People are very sad that their populations are in this much pain. So, I learned a lot from that experience and a lot that I brought back into work with other kinds of communities around the world.

Denver: I think you provided some wonderful insights about all the positive things that are happening in that part of the world– which we never hear anything about.

Lindsay: Right.  As with most things, we don’t hear enough about the good stuff. And I think it pushes us into a worse and worse negative spiral.

Denver: Tell us a little bit about your website, where people would go to find it, and what they will find when they go there.

Lindsay: Right. Well, so we’re at http://www.leadersquest.org. You’ll find a lot of stories.  You’ll find blogs, case studies, testimonials. We do a wide range of work. You’ll be able to navigate through that. Lots of images… and I very much hope to meet some of you there.

Denver: Well, some pretty inspiring stuff on the site, I will testify to. Well, Lindsay Levin, the Founding Partner and Founder of Leaders’ Quest… Thanks so much for being  on the show this evening. The book again is “Invisible Giants: Changing The World One Step At A Time.” It really reads very much like a fiction book. It has very descriptive writing and is a very enjoyable read. It was a real pleasure to have you on the show.

Lindsay: Thank you very much! I’ve been thrilled to be here.

Lindsay Levin, the Founding Partner of Leaders’ Quest, and Denver Frederick, host of the Business of Giving

*The Business of Giving can be heard every Sunday evening between 6:00 PM and 7:00 PM Eastern on AM 970 The Answer in New York and on iHeartRadio. You can follow us @BizofGive on Twitter and at Facebook.com/BusinessOfGiving.