Transition from stand-alone nonprofit to embedded program is complex but rewarding
By Valerie Thompson, CVT Volunteer
It’s been just about a year now since Survivors International, based in the Bay Area, was brought under the umbrella of the University of California, San Francisco and the San Francisco General Hospital Trauma Recovery Center. And if you ask Survivors International Program Manager, Cecilia Lipp, the transition has been long and administratively complex. But the trade-off, she says, is that the services currently rendered are seamless.
The lesson learned from the process is how important it is for centers to “continually take a critical look at your model and question the services. As our service capacity and client demographic shifted over time, we hadn’t questioned our organizational beliefs and structure,” she says, which is true of many small non-profits. “It’s hard to step back and forget the emotional attachment to your organization’s service structure. It’s very hard to question; to get beneath those beliefs and really look at what shifting needs the numbers are indicating.”
Prior to the merger, Survivors International was based on a pro-bono networking model with professionals and volunteers from many fields. “We ensured that clients received care, but within our structure, each pro-bono clinician had a certain amount of discretion as to the style of clinical services they provided. The network model was based on the notion that a client could be a client for life, meaning that we never formally closed any cases, but rather welcomed clients to reconnect with services at any point.”
When the center was required to find a more financially sustainable model of operation, they began to look more closely at their client statistics. They looked at how many people actually remained in long term care and found that only 2 percent of the clients did so. “We were surprised that, with a few exceptions, the actual length of time that most clients were in ongoing services was more similar to a short-term treatment model.” These realizations opened them to partnering with centers that provided comprehensive services through a shorter term model, such as the UCSF Trauma Recovery Center. “We now provide interdisciplinary clinical services through a comprehensive case management model. Services here are based in a 16-week treatment model, where patients can be extended when clinically indicated. In a clinic-based model, we now have better clinical management of treatment, better administrative oversight. Though the treatment model is different, we find that the length of time a patient is engaged in services to not be very different from the previous model.”
Survivors International has been completely reorganized. “The pieces that we’ve kept consistent are the name and the fact that we continue to service survivors of torture,” says Ms. Lipp. Survivors International began 20 years ago in San Francisco. It became a model of coordination for a pro-bono network bringing together legal, medical, psychological, public health and human rights expertise. In December 2011 the nonprofit was dissolved and the program was revived in January 2012 as a program of the University of California, San Francisco and the San Francisco General Hospital’s Trauma Recovery Center, funded primarily with a UN Voluntary Fund for Victims of Torture grant, various foundation grants and individual donor funds.
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The new structure allows “an improved system for refugee referral from primary care,” Ms. Lipp says. “All our clinical care is in-house at our welcoming center, located off-site from the University and hospital campuses.” Survivors International has engaged a team of experienced, in-house interpreters “who have come to serve as cultural navigators.”
The new Survivors International structure provides clinicians and administrators with support that “reminds us of why we do this work,” says Ms. Lipp. “The Trauma Recovery Center has an outstanding institution of self-care that I really cherish. We start staff meetings with client successes and staff acknowledgment. Those practices build a culture of hope and help internally ensure the sustainability of services for trauma survivors.”