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):
Evaluation of care needed
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
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
Current standards of sexual assault care in facility (is the care meeting national standards) for:
Options for patients for examination
Are there any other current staff concerns related to care of this particular patient population?
Space rental (based on current community rental costs)
Office supplies and equipment
Clinic/forensic supplies and equipment and replacement costs
Internet access, phone/fax, postage
Travel costs (for training, education, meetings)
Professional membership dues
Recruitment, training, licensure, and certification fees
Costs that could be donated or part "matching" funding
Exam room space (use current rental cost estimate from above)
Staff and volunteer time donated
Patient care costs
Determine per patient cost based on estimated # of clients to be served (based on current numbers)
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)
Income projection using actual income from billing and payment records. Include the following—
Income from billing sources for payment for the exams
Donated costs from the institution
Donated or existing supplies
Use of ancillary support service staff if donated
Crime victims' compensation
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.