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Business Plan

One foundational step for beginning the process of SANE program development is to create a business plan for your venture. According to research from the SANE Sustainability Project of the National Sexual Violence Resource Center (NSVRC), financial issues are one of the contributing factors to a program's closing.54  A business plan provides the SANE program a realistic overview that includes costs and a timeframe for program operations. 

A business plan is a critical tool for making the argument to hospital- and/or community-based program administrators. It can demonstrate there was thoughtful consideration to financial responsibilities, opportunities for growth in services, and potential challenges to program sustainability. 

A business plan can help an organization describe how it intends to implement its mission and achieve its goals and objectives. The business planning process involves researching the market for the service the organization plans to offer, investigating the resources needed to provide the service, devising implementation and marketing strategies, assessing risk, and determining ways to evaluate success.

Business plans may appear in different formats, but most address the following areas: 

  • The organizational/program summary describes the product or service, its purpose, management, operations, marketing, and finances. 
  • The organizational/program opportunity describes what unmet need the project will fill, including outlining the need and how services will be paid for. This can include community or program benefits and competitors. The plan describes who will be responsible for developing, marketing, and operating the project, and why their backgrounds and skills make them the right people to make the project successful. Implementation of the plan is outlined in detailed descriptions of startup costs, marketing, financials, and operations. 
  • The financial plan should include the costs to launch, operate, market, and finance the business, along with conservative estimates of revenue, typically for 3 to 5 years. In most instances, an outline of how the program will respond if there are problems with implementation is included.

Steps to creating a SANE program-specific business plan include the following (from the NSVRC SANE Sustainability Bulletin Series, Sustainability 101: Creating a business plan for sexual assault nurse examiners by Elise Turner):

  1. Evaluation of care needed
    1. Current costs of providing care 
      • # of cases per year
      • Costs for space used
      • Average time the cases take from sign-in to discharge
      • # of workers that interact with the patient 
      • Categories of workers that interact with the patient
      • Supplies, equipment used
    2. Current billing practices
      • Reimbursement sources for medical forensic exams
      • Reimbursement sources for other services (outside of medical forensic examinations)
      • Current nonreimbursed costs and/or write-off costs
    3. Current standards of sexual assault care in facility (is the care meeting national standards) for:
      • STD prophylaxis
      • HIV nPEP
      • Pregnancy prevention
      • Evidence collection
      • Options for patients for examination
      • Are there any other current staff concerns related to care of this particular patient population?
  2. Cost projection
    1. Personnel-related costs
      • Salary
      • Benefits
      • On-call pay
      • Overtime
      • Administration
    2. Nonpersonnel costs
      • Space rental (based on current community rental costs)
      • Office supplies and equipment
      • Clinic/forensic supplies and equipment and replacement costs
      • Insurance
      • Medications
      • Laboratory costs
      • Internet access, phone/fax, postage
      • Travel costs (for training, education, meetings)
      • Professional membership dues
      • Recruitment, training, licensure, and certification fees
    3. Costs that could be donated or part "matching" funding
      • Exam room space (use current rental cost estimate from above)
      • Copy costs
      • Staff and volunteer time donated
    4. Patient care costs
      • Determine per patient cost based on estimated # of clients to be served (based on current numbers)
    5. Other costs to consider in planning
      • Initial education and training for staff
      • Ongoing training for staff
      • Security if needed for space (particularly important for community-based programs)
  3. Income projection using actual income from billing and payment records. Include the following—
    1. Income from billing sources for payment for the exams
    2. Donated costs from the institution
    3. Donated or existing supplies 
    4. Use of ancillary support service staff if donated
    5. Medicare/Medicaid
    6. Crime victims' compensation
    7. Grants
    8. Other income sources

Once the listed items are compiled, include a one-page summary for the proposal. Update this resource annually based on current information from the program. The business plan can be helpful to use for grant applications and other financial assistance for the program.