Amy West, CPA, CGMA

Donors have become much more [sophisticated] … It’s not just the plain vanilla pledge anymore.

A mission to serve: We are a not-for-profit organization, a 501(c)(3) that supports people with developmental and intellectual disabilities, and their families. The operating budget is about $240 million. We employ about 4,000 people, and we operate in the five boroughs of New York City. We receive some federal funding, but our primary source of funding is through New York state. We are one of the largest agencies serving people with developmental disabilities within New York state.

Complexity on the rise: Not-for-profits have become much more sophisticated than they ever were in their fundraising and also in their operations. Donors have become much more [sophisticated], too. It’s not just the plain vanilla pledge anymore. There are many things that go into when a donor gives a gift—the restrictions and huge expectations. We ensure that we understand the expectations of the funders and donors, including the purpose of the funding, any gift restrictions, and any reporting requirements.

Following the rules: Regulatory compliance is very important to us, and we are organized to make sure we follow the rules. Most of our funding comes from Medicaid, and we have a very robust compliance department in which we have a chief compliance officer. Then each of the program departments also has a compliance officer. Then we also have internal controls with respect to our billing department who are just top-notch, very knowledgeable people.

Transition to managed care: Our operating model is changing from a fee-for-service model to a managed-care model. There are so many challenges there. Technology needs to be at a place where we find meaningful information and gather useful information to run our business. It’s just a huge shift for the entire field. To position ourselves in this new environment while continuing to provide the highest caliber of services, we have begun identifying the resources and steps that we will need to take to successfully transition from a fee-for-service model to a managed-care model.

Investing in talent: One of the major challenges in the not-for-profit arena is that it’s difficult to fairly compensate people, and merit increases sometimes don’t happen for a few years. We find nonfinancial ways to incentivize people. We try to make the workplace, while very productive, a fun place to be. I never want to be in a position where I get up in the morning and dread going to work.

—As told to Sheon Ladson Wilson (sheonlwilson@aol.com), a freelance writer based in Durham, N.C.