SEED GLOBAL HEALT Seed Global Health FY13-FY15 Budget Submission and Discussion The attached budget re?ects anticipated Peace Corps eligible Seed Global Health expenses for the three year period ?om October 2012 through September 2015. It is noteworthy that the original three year budget of re?ected several signi?cant limitations. Because the program was completely new, it was dif?cult to anticipate the staf?ng needs that would be required to develop the program successfully. The original budget was developed to support fewer volunteers. The Cooperative Agreement describes 108 in years 1?3. We are deploying 31 in year 1 and anticipate 48 in years 2 and 3 for at total of 127 volunteers. While the budget was modeled with a 3-year constraint of expenses were forced to ?t within that envelope rather than at levels which were realistic ?om the outset. This is evident particularly in staf?ng and travel and the functions they relate to providing. While stipends were conceived to be supported by private philanthropy, it is not a realistic assumption that Seed Global Health could raise private ?mds for basic infrastructure and operations. In viewing productivity and scope of work that has ultimately evolved from the Cooperative Agreement, key tasks have evolved that were not explicitly recognized yet are critical to program success. These can be reviewed in the document ?Program Update July 20 1 3 The variance analysis below focuses on Year 2, FY14. FY15 maintains the same expense base as FY14. In the second year of operations of the Global Health Service Partnership, aggregate expenses of re?ect staf?ng and programmatic costs as described below. The budget is described in comparison to the original pr0posed budget submitted to the Peace Corps in March 2012. It is noteworthy that the original budget re?ected three limitations. The original submission for FY14 was v. this Y14 budget submission which is The variance of re?ects: category variance ($000's] 99.9! wages 41.6.. 159291 Accounting contract 15 Rent and telecom 13 Fringe 31 Indirect costs 4 Other misc. (35) Total 234 Salary and Fringe Variance: The original staf?ng complement lacked suf?cient program support and was weighted toward in?'astructure ?'om Mass General HOSpital (MGH). Through the experience of site selection and recruitment, Seed Global Health has evaluated staf?ng and identi?ed the roles that are needed for success. - Notably, without staff support, the current Chief Medical and Nursing Of?cer positions cannot meet the intense needs of recruitment, site selection, candidate application, and now ?eld support. Each of these roles is now budgeted to have a deputy to share the work of interviewing, ?'equent routine ?eld support and travel, recruitment and program development. - The initial budget did not include explicit staf?ng for Monitoring and Evaluation The FY14 budget submission includes both a senior level consultant and a program support person for this critical commitment of the program. The consultant is budgeted for 55 days per year. - The FY14 budget re?ects a negotiated decrement in MGH staf?ng as experience has clari?ed a lesser level of institutional support than originally anticipated. - Salaries increase 2% over prior year for existing employees. This is consistent with MGH policy. The overall variance in Salary and Wages is an increase of In original In FY14 Employer budget budget Seed Global Health positions submission Chief Executive Of?cer MGH Chief Nursing Of?cer (.5 FTE) MGH Chief Administrative O??icer Seed Program Manager Operations MGH Chief Medical Of?cer (.2 FTE) Seed Admin Assistant MGH Research Assistant Web Support (MGH) Director of Operations and Finance (MGH) Finance Manager (MGH) MGH Senior Adviser (Consultant) Seed Deputy Chief Medical Of?cer MGH Deputy Chief Nursing O?cer MGH Project Manager MGH The ?nancial impact of these changes in absolute terms is an increase ?om to - The ?'inge rate of 37% applies to positions employed through MGH results in an increase ?'om to (variance The ?'inge category includes bene?ts for MGH employees and a modest bene?ts contribution as well as payroll taxes for Seed Global Health employees. The cost of payroll service was initially grouped in ?inge but has been shifted to non-salary expenses in the FY14 submission. - Seed Global Health is actively establishing a bene?ts package in order to be able to hire staff directly. However, several staff (CEO, CNO, program manager) each have joint appointments and shared employment with MGH and this made sense for early hires to the program. This shift would require revisiting the MGH partnership contract. Non -Salary Variance: Non-salary expenses have increased from the original submission of to $33 OK (variance - The principal source of this variance is travel, which grew by The travel budget grew from to including both domestic and international. Travel was initially budgeted extremely modestly in terms of number of trips for recruitment and site support as well as cost per trip. Domestically, Seed Global Health leadership travels to Peace Corps headquarters and quarterly meetings of several Seed staff with Peace Corps colleagues have proven to be invaluable. Orientation is a cost that was not originally anticipated since it was initially planned to be in Boston. - At the advice of the Peace Corps, Seed Global Health has budgeted travel at federal per diem rates for lodging as well as meals and incidentals. These expenses are higher than the modest original budget, but also realistic as advised. The exception to per diems is lower lodging for orientation v. federal rates for Washington, DC. Speci?cally the complement of trips comprising the budget are: Domestic traveI Recruitment 4 overnights each for MDs and RN recruitment (ie Centers for Global Health, conference settings, school settings. This corresponds to Year 1 experience (Johns Hopkins, University of University of California-San Francisco, University of California-Los Angeles, University of Southern California, University of North Carolina-Chapel Hill, University of Chicago, Northwestern University). In Year 2, recruitment may include conference exhibits and other less formal settings. Program Planning 0 day trips for CEO to DC, 12 additional day trips in total for other staff. 0 3 group meetings of 4 Seed Staff to meet in DC with Peace Corps and other partners. In 2013 this corresponded to Site, volunteer and planning meetings. Orientation 4 staff on?site for 12 days. 4 additional day trips for guest lecturers and staff who do not remain on site through the orientation. International travel 0 4 6-day trips to each of 3 countries for both RN and MD leaders. 0 1 additional trip per country?this might be for a special event, to reinforce in- country trainings, and for general support. The accounting contract increases by which re?ects more accurately the expense of an audit. Rent cost and related telecom through MGH increases by to provide workplace basics for the full revised staff complement. - Review of speci?c miscellaneous expenses re?ects decline overall of This includes shifts in Monitoring and Evaluation tools, Orientation costs, IT, communications, dues and subscriptions and other modest variances. Indirect Cost Variance: Indirect costs increase by Expenses on which the indirect rate of 15% is applied includes a subset of salary and fringe, rent, telecom and of?ce expenses. Positions exempt from overhead include consulting roles and the Chief Administrative and Chief Medical Of?cer as listed above. Additional budget risks: - ln-kind contributions are not represented in either the original or proposed budget. In FY13, these included legal services from WilmerHale and brand consulting from SapientNitro. While an FY13 estimate is not yet available, in FY12 contributed legal services were reported at FY12 included signi?cant start up work, therefore lower level of support is anticipated in FY13. Brand consulting fees are not an on?going expense. However an estimate of the value of these services for audit and board clari?cation has been requested. Currently Seed Global Health pays fully for all MGH services and staff. However MGH affords a level of ?exibility that would not be available on the open market. MGH is planning to offer access to electronic resources to all volunteers while they are deployed at sites. These would cost approximately $1000/volunteer representing in-kind support of 0,000 per year. The need for in?country support is absent from the budget submission however success at each site could be buttressed by modest investments to provide parallel teaching resources.