Okay, today we have a brand new guest, Gregor DeBrule, Executive Director of Children's Treehouse Foundation. He's brought to us a conversation about generating revenue with your programming, in particular, licensing nonprofit programs. So hang in there because we're going to hear from Gregor in just a few moments. Before we hand it over, we want to remind all of our viewers and listeners who we are. If we've not met you in our previous thousand episodes, today is 1001. So thank you for those that celebrated with us yesterday. Julia Patrick is here. She is the CEO of the American Nonprofit Academy, and I'm Jarrett Ransom, Nonprofit Nerd and CEO of the Raven Group. We are so very honored to have the ongoing support, investment, belief with these amazing partners. So thank you to Blumerang American Nonprofit Academy, Nonprofit Thought Leader, Fundraising Academy at National University, 180 Management Group, Your Part-Time Controller, Staffing Boutique, JMT Consulting, Nonprofit Nerd, as well as Nonprofit Tech Talk. Again, thank you to these companies. Many of them have been with us from the very, very beginning March of 2020. So thank you so very much. We also want to say, hey, if you've missed any of our previous episodes or you want to go back and listen to the information that Gregor is about to share, we are recording and you can find them here. You can scan that QR code, download the app, and you can find us on broadcast and podcast channels. Okay, Gregor, my friend, that is it for the housekeeping. Now is when we pass it over to you, but I would like to reintroduce you and welcome you back. Again, Gregor DeBrule, Executive Director, Children's Treehouse Foundation, welcome to the show. Yeah, thanks for having me. First things first, congratulations on the thousand episodes. If you were sort of late to the party like I was, being able to go back through the archive and see the quality of the guests and the wealth of knowledge is just astounding. So yeah, it's such a great resource. So congratulations on hitting a thousand. As you mentioned, I'm the Executive Director of an organization called the Children's Treehouse Foundation. We're a cancer support non-profit and what we do is we provide support programming for hospitals to run to help parents and kids when the parent has been diagnosed with cancer. So it's very, it can be very traumatic for the family. Obviously a cancer diagnosis affects the entire family and so we help those families build communication and develop a positive coping strategy and to do that we partner with hospitals. Wow, that is an amazing and incredibly august mission and pretty, it kind of makes me gulp because I think, wow, you think about the patient and that's one thing, but then going through and looking at all the family members, especially children that can't process things as the parents do, what an incredible thing. How long have you been in, has the organization been in service and in talking about that mission? Has that always been the mission to focus on? Yeah, that's always been the mission from day one. The organization's been around for about 23 years. I've been running it for just under two years now and it's always been that. That's always been our mission, is helping children and families. As I said, well, there's a lot of research into the need for a more comprehensive approach to cancer care, a more comprehensive approach to cancer care and a lot of that comes down to looking at the patient as an individual. What are the sources of stress? What are the big issues in that patient's life? If you're a parent, the welfare of your child and your family unit is just about the most important thing that we routinely hear. I'm more concerned about what's going to happen to my child or how do I talk to my child about this than I am with my own welfare or my own survival. If we can help those patients by helping their family and by helping their children, we are helping them with their own cancer treatment. Yeah, I've been there and I understand and it's intense. Part of the thing that we're going to talk about today, and I think Jared and I are so interested in this, is climb. Children's lives, including moments of bravery. If you can explain this program first, then we'll go into the navigation of the licensing, but I really want to get educated on what this looks like. Yeah, so climb. The Children's Treehouse Foundation really exists for one purpose and that's to develop and steward and spread our program. Climb. We have one program that we do and it's Climb. Climb is a six-week art-based, evidence-based program that's, as I mentioned, it's run in hospitals. It's also run online. We run the program online ourselves roughly every eight weeks. And it's designed to have a children's component, a parent's component, a teen component. During those groups, the parents will meet with other parents who are going through sharing this experience. The children are meeting in a group of children who are sharing that experience and the teens are, so each group is sort of separate. So they have a chance to work. You have a chance to sort of bond with others to realize that other people are sharing the same experience that you are and then to work through a lot of the really negative emotions that surround a parent's cancer diagnosis or the cancer diagnosis for the patient. You know, fear, anger, a lot of those things that are really overwhelming. You know, and so we help the kids and the patients. We help the parents sort of parent through cancer. You know, we're not really a support group for the parents, whereas the parent component is really there to support the family.  I have two kids. It's the greatest experiment of all time is raising children. And certainly no one knows how to have cancer. And if you put those two things together, you know, it's incredible, the pressure. And so, yeah, so that's, you know, the program uses a lot of art to help, you know, if you were to try and put kids in a circle, you know, in that kind of, if you imagine like a movie, if they had like a support program, and it was just people sitting around in chairs, you know, it's not going to work very well. So, you know, we use a lot of art to help break down barriers with the children. And the program has been very, very widely received. We run it across the US. We run it internationally in countries like Ireland and Japan as well. It's so fascinating, Gregor. And I remember when you and I sat down and had lunch and you shared with me some of this artwork, and I was just truly taken aback by the magnitude of the image, the message in the image, really going into that. So, I love that someone within the organization saw the opportunity to license this program. So, let's get into the nuts and bolts, the nitty-gritty, right? I like to say, let's nerd out. Let's nerd out over this. How is the climb program licensed? Can you take us through the process or hit the highlights? Because I know we've got amazing viewers and listeners that are likely listening to say, we want to do this, too. Yeah. Yeah. Yeah.  And I think, you know, it's really, it's sort of a symbol of that. Like, if it's a good fit, if it's a good fit. And that doesn't mean that it couldn't become a good fit with some work if it's not a good fit right now. But there's a lot to consider, I think, before you go into it. You know, for me personally, I think it's really important to focus on some of the philosophy of, philosophically, why do we want to do this? You know, I wanted to escape fundraising. That was part of my motivation, you know, is a, sure. I feel more comfortable selling something at the end of the day, really. It's as simple as that. But I don't think that's enough of a reason. Like, oh, we just need, we want more money coming in. That's not really enough of a reason to jump into this. And it's not really enough of a, not really a strong enough foundation. And I think it's really important to that organizations that are considering moving to a licensing structure really spend time to go, why do we want to do this? Is this a good fit for us? You know, how do we know that this is a good fit? And I think, you know, there's, there are a lot of people who, one of the things I've experienced is that there's a lot of people who get sort of squeamish when you start describing nonprofits in business terms. Yeah. And, you know, and that's going to come from a lot of different places. You know, you're going to, you will, you could potentially lose donors who are uncomfortable with the idea of the nonprofits selling something. You know, that's, that's a potential that, you know, that's something that could happen. There's a lot of, yeah, there's not everybody, it hasn't been a big thing, but it's, it's a part of it. And you need to make sure that, you know, internally, the people inside your organization are comfortable with that, with this change, understand the need for it or understand the desire to implement it. And you need to make sure that you, that, you know, yeah, that the other, the other support structures that exist financially, you know, your donors, your grant writers, that this isn't going to be something that's going to interfere with that process, with those processes either. I often think it's a missed opportunity. I think there are so many organizations with phenomenal mission, amazing curriculum, amazing programs, yet we nonprofit leaders rarely take that business savviness and that side to say, hey, we have something good here. And it really could benefit us in long-term sustainability. I mean, for, for me to hear you say, I really didn't want to do the fundraising. I feel more comfortable selling like, yes, let's do this. Like how do we do this? And I think again, it goes back to so many missed opportunities. So you've talked about the philosophical side, which was hard for me to say. And then the technical side, right? So have you, have you touched on the technical side because I'd like to know about how it helps you to generate these funds? Yeah. So, you know, in our case, looking at, when you look at sort of the technical side of setting up a licensing structure, you were talking about developing the infrastructure to deliver something, to deliver some curriculum, some product, right? Do you have that infrastructure in place? Do you have the ability to create that infrastructure and manage that infrastructure? Looking at being able to market yourself, do you understand why your programming is different? Like there needs to be differentiation in the market because you will be competing ultimately with other, potentially you may be competing with other programs or just other ways that the organizations could be spending money. Maybe there's no other, maybe there's no direct competitor for your program, but you're still competing for money within the partnering organization's budget. And then, of course, there's a technical side to the relationship building, sort of developing that pipeline, sort of that sales pipeline, if you will, of establishing these connections and building them, maintaining them, going back, being able to check back in with those organizations. And then, developing pricing structures, developing the contracts associated with the licensing. Man, the delivery model, pricing is quite complicated. It requires a lot of time looking at the market. I think you have to be really cautious about not undervaluing yourself, which I think for our organization was one of the things that was really interesting. When our programs in the past, before we had a partnership model, I think you could say it was cheaper to put our programming into a hospital because at that time we're just paying to train individual staff. So they would say, okay, what's the least number of staff we need to run these programs? So if we said, okay, three, and then they would say, well, can we run it with one and be like, well, not well, but maybe. That's not ideal. And then they would pay for one person to get trained. And in the end, with one person, two people, it's hard to even build the steam to get those programs off the ground. Anyway, as soon as the programs became more expensive, there was suddenly more value associated with it. And so I think it's very, you have to be very cautious about under, like, you know, it's scary to ask for money. It's scary to come up with pricing. There's no, most likely you have, you may have nothing to look at for inspiration. Yeah, you know, in your market, you may be just creating a number out of thin air, you know, but you want to make sure that that number is based on, you know, the most important thing absolutely is that it's that you're profitable, that that amount of money is enough to sustain that program right now. But in addition to as the program grows, because as the program grows, as you develop more licenses, almost certainly the expenses associated with maintaining that program will increase. You know, you have to invest more in infrastructure. I'm curious, when you approach, I'm going to call them your partners, but like the hospitals, the clinics where you provide the program, how do they respond to this side as opposed to you asking for a general donation? I'm really curious how in that conversation, how it resonates with them to say, absolutely, like this is what we want to do. Right. How does that conversation go? I'm really curious, because you're really talking about versus the fundraising. There is no one answer. There is no one answer. The good thing is, is that hospitals are used to spending money on things. And so coming in and having, you know, having a pitch, coming in with a slide deck and a program that is, you know, a product, it's not out of left field for them. It's just different, you know. And in our case, one of the challenges is that nonprofits have tended to shoulder a lot of the load of support programming. And I think that happens everywhere. You know, and I think that, you know, going back to the kind of very quickly to the philosophy of why you make this change is, you know, I believe that we as nonprofit leaders, we part of our sort of obligation is to put the, some of the expectation of this care back to other people. So back to either business, back to society, back to, you know, through legislation, something like that. Right. It would be great if we could put ourselves out of business. You know, that would be ideal if we were able to get other people to take responsibility for the things that we, that we, you know, that we basically address. But it's not always easy, you know, and we had, we've had, we've had not, we've had, you know, certain hospitals who in the past, they had told us we're, you know, we're never going to, we're never going to run the client program. And it was like, well, why not? And they said, because the children are patients. Because it was like, well, yeah, I think you should know that this, I think, do I really have to explain why helping the families helps the patients, I guess. But the thing is, is that a fast forward a few years, we're actually sort of in our contract negotiations or contract talks now with that same hospital. And the difference is time past leadership changed.  And so that's part of it, you know, you're going to come in some, sometimes it's sometimes people are ready for it. They're like, this is what we're looking for something like this. And sometimes you're like, this is the first they've ever thought about this or heard about this. And I think that's, so there's really not a, there's really not one, one answer for that. That is fascinating to me to hear that. And then it's also like, well, duh, like why, why wouldn't you think of this comprehensively, you know, like what's best for the patient likely is an extension of who else and what other things are equally as important to the patient. So that's so fascinating to me. It's riveting.   How have you navigated external help or advice for basically, you know, IP for intellectual property? How has that looked so that you could even go out and start this bold initiative? Yeah.  So that wasn't my doing that wasn't that portion of it wasn't my, it wasn't wasn't what I was responsible for. The contract side of it writing these contracts and, you know, we were fortunate that we have a great attorney on our board who, you know, I'm able to work with to create these contracts. The legal teams from the hospital, obviously, they go to town in the contracts and we go back and forth until we find something we're happy with. You know, we try our best to stand our ground, but obviously we're a lot smaller than a massive hospital system. Yeah, it's fascinating. Do you see that in the two years of your leadership that you have changed your approaches, your documents, the process, and then the second part of that question, what's the time frame when you from the sales to the acquisition of the program and the navigation to the actual licensing process, what does that look like in terms of time? Yeah, we've had we've had we've had hospitals where it's taken a couple weeks and we've had hospitals that have taken longer than six months start to finish. And so it really it really varies quite significantly. And I think that that's, you know, that's that I think that's quite common for that for the, you know, the healthcare industry is to is to look at is to have varied timelines like that other industries it might be it might be a bit different. But going back to kind of making sure that you have the reserves, like, you know, that you that you understand what you're getting into.  Do we have enough reserves to last if it starts taking six months if it takes a year to develop these partnerships, are we going to be able to survive in the meantime? Right? What does that look like? Like what would you advise an organization that wants to, you know, move through this journey, Gregor, what would you advise like a six month reserve, a year reserve? What is that? What does that look like for you know, that's been successful? Yeah, I can give you a little bit of information on like what what it was like for us. You know, we had when I when I took over the organization we had about a just a little bit over a year it's worth of reserves if we turned off all fundraising we turned off all all revenue streams we had about just over a little bit over a year of money coming in and it took it took we're really small organization so we have two full-time staff and everyone else with contractors and we it took you know I would say 10 months roughly to really go in and create all of the infrastructure you know to develop the you know online delivery stuff how do you how do you get files to people all all of this stuff and then to develop the contracts the marketing materials and and during that time you know we said sort of soft launches where we were already talking to hospitals we were fortunate and that this wasn't a new program we had people we had organizations still you know we have social workers who approach us every week saying how can we bring the climb program to our hospital we're fortunate and that we already have a name you know and so we were able to kind of play around with experiment a little bit with our early contracts or our early marketing materials during that 10 months but I you know I do think that it took you know it takes it takes a little while and then and then once you have it and now you're starting trying to sell this then you're looking at some period of time some some number of months before those licenses actually start generating money and so I think a lot of it comes down to what the organization has in terms of human capital that they can apply towards this transition yeah that makes sense and then what about how do you monitor how do you monitor and keep the programming consistent with this licensing what does that look like yeah that's really really important for us you know we our program has been you know researched and published in scientific journals internationally and so we know that if the program is run as manual like as it's as it's written in the manual in the manual we know that the program works but obviously there's a huge concern where once we hand over the materials that you know yeah facilitators could kind of go rogue and make changes that we and we can't we can't therefore you know we can't stand behind that that version of it because we don't we have it may work better for all we know but you know we don't we don't have the research to back it up and our best approach is you know we've we developed our training program you know we make sure that the training program is deep and that it's you know there's enough knowledge checks built in and then we also built into our program so for our facilitators the the professions who are running these programs you know we have like a facilitator dashboard where they they log in they they give us feedback they could they you know weekly so they run those they run those programs six weeks so there's a you know a weekly sort of reporting that they do you know as weekly to say this is how this week went but then at the end of the at the end of the program as well this is how you know and that way we can kind of get the if somebody's feeling like there's a need for a change I would rather hear it from them soon so that we can talk about it with them or maybe we can consider implementing it you know program-wide that chain maybe that's a maybe that's something that that you know we should that we should evaluate but you know putting those systems in place to get that feedback I think is really important I love that go ahead Julie could you share with us how many hospitals you are in or programs you're in and where they are geographically I mean is this is this concentrated in one part of the country or has it just been you know throughout I know I know you have some international correct yeah yeah and actually the program the program was really really successful in Ireland and Ireland you know they have a national health system and so to get the program to be approved for to be run at one facility basically means you have to get you know nationwide approval so the program is basically you know in some senses kind of written into the national health system in Ireland that doesn't mean it's run everywhere but it's it's you know it is an option everywhere but that was unfortunately pre-licensing and so that's not something that generates revenue for us which I think is a huge was a huge missed opportunity in the past here in the US you know we've got programs we've you know we've had programs you know all over the place we you know COVID was was really rough for in-person support programming a lot of our programs stopped at least temporarily but then post COVID there was so much turnover in healthcare some of our trained facilitators who may have been running climb programs at a hospital moved on retired left healthcare and so it's we're still sort of auditing where we stand post COVID but with our partnerships obviously we know those numbers you know we know that you know we know that we've had since our since our launch you know only really in the last couple months we've had 17 new 17 new facilities running climb here in Arizona you know we were able to partner with Honor Health so you know that's not just one hospital and now now they're putting our program system-wide which is really that's the hope is you know if it's good enough for the patients if it's good enough for the families out at you know one facility it should be good enough for the families at the others as well. Amazing you know Jared this has been such an interesting conversation and I just feel like this could be such a foundational change for so many organizations because we see organizations recreating the wheel right as opposed to going out and finding tested and true programming I think this has been amazing Gregor you know we don't have a lot of time I think we could spend hours on this obviously. Yeah I have spent a lot of hours on this yeah. It's really been amazing Gregor De Brule executive director Children's Treehouse Foundation check out their website they have an amazing heat map about where the programs are and to talk talking about what the ecosystem of working within a family looks like the website is children's treehousefdn.org and you can learn more about the work and how they've done it and it's really been an inspirational way to look at a new revenue model that is I think really sustainable and smart been a lot of fun to have you on the nonprofit show. Thank you. Yeah thanks so much for having me and you know I love talking about it so anytime. Thanks Gregor. I really appreciate you sharing I believe you know yesterday as we talked about like the forecast of the future for nonprofits and one of our answers was innovation you know and I do think that while this isn't a new concept for our nonprofit sector and friends it is an innovative concept that many do not consider it hasn't even crossed our you know our brain space our brainwaves and it's time right it's time to lean into these additional ways. I'm a huge fan of earned revenue like when it comes to diversifying your revenue model you absolutely have to do some earned revenue because I don't believe that you know for us as nonprofits we need to give away everything for free we're businesses we need to to run these you know with sustainable models in mind so Gregor thanks for being a champion in this space thrilled to have you here. Thank you so much. It's been a lot of fun hey again I'm Julia Patrick CEO of the American Nonprofit Academy been joined today by the non-profit nerd herself Jared Ransom CEO of the Raven group again we have amazing partners as Jared introduced them this morning or at the start of our broadcast and they include Bloomerang American Nonprofit Academy non-profit thought leader staffing boutique your part-time controller 180 management group fundraising academy at national university jmt consulting non-profit nerd and non-profit tech non-profit tech talk easy for me to say right Jared anyway this has been fabulous a really important message and I think a new strategy for so many people that have invested so much in programming that they know work so Gregor it's been just marvelous having you on so thank you very very much thank you as we end every episode of the non-profit show we want to remind everyone to stay well so you can do well


The dedication, compassion and even artistry that I have witnessed since my husband, Yogi Raj Charles Bates died from a venus thromboembolism, a hospital associated venus thromboembolism in 2012 has just been almost a bigger shock to me than anything else. Every single day, people who have experienced medical harm, whether they've been a recipient of that harm, have lost a loved one because of that harm, or have been in the pathway of helping deliver care and experienced harm in that delivery is a shock that no one, no one wants to have. So people get up every single day to be attentive to ensuring that if you have never experienced a preventable medical event, you never have to. Much like Ty and Carol Moss, who lost their son Nile to a preventable medical error, they have put so much compassion into the music that you are about to hear in the next segment. This is the memorial and survivor segment. And I would just invite you to take a moment if you happen to be multitasking or doing something else while you're listening to this to watch this next segment. When I come back, I'll have the opportunity to speak with Regina Holiday, who has brought her artistry forward to support making this more visible and transparent, so that we can all enjoy safe care together. As I mentioned, Regina Holiday has committed her life's work and her artistry to helping everyone understand how meaningful it can be to talk about medical errors before, during, or after an event. I first learned about Regina a few years ago when I was working with my dear friend Marty Hatley. He was wearing one of her jackets. Yes, I said that exactly right. Regina actually takes and helps people put the stories right on our backs, right out in public so that we can begin to have really meaningful conversations about this very important topic. Regina, thank you so much for being here today. And I would love for you to just tell us a little bit about what inspired you to begin to bring these stories to our backs. Sure. It's a blessing. I am, I'm glad that we created The Walking Gallery. The Walking Gallery of Healthcare has now been around for 10 years. This is our 10th anniversary of the movement. We have over 600 people wearing jackets around the world telling their healthcare stories, and some of them are medical error stories. And it helps the families who have lost loved ones or folks have survived but continue to suffer. Explain things and share their story and help advocate to positive policy change. I actually have a few jackets with me right now. Go ahead. We'd love to see them. So this is one of the jackets. It's sort of dark. It's sort of hard to see, but this one's called spare parts. And it's about Jolene Chambers advocacy. Unfortunately, some individuals who have had limb injuries and they have to have plates and new joints placed in their bodies. Some of them have had wonderful experiences, and some of them have had harm. And a lot of those individuals have often felt like the ranks of healthcare have closed on them and no one wants to talk to them about what's happened to them. So this jacket was about that quandary. My eldest son, he had this jacket, which is a picture of a skull on top of a parking lot kiosk at the hospital. And he asked me to paint that with coins in the eyes and the mouth falling down to the ground because he didn't think you should make a family paid a park when they're watching their loved one die. And that's been a powerful jacket, and it's actually helped change policy in our country where hospital CEOs have come to me and said, Hey, we saw your son's story. We think it's wrong. We can change that. And they did. You know what Regina that reminds me that after my husband died in 2012, I remember after having to walk his body to the more having to try to find my car in the parking lot. It was this moment of just utter disarray. In fact, I left my purse behind. It was so shocking. I was in such shock. So I think your son is really onto something with that. Thank you so much for taking time to be with us today. We really appreciate it and I just, I know for a fact that your work will continue to raise awareness about this and how important it is for us to just be completely engaged in our medical care on behalf of ourselves and on behalf of our patients. There's another gallery that has just emerged for this unite for safe care and the link will be here in the in the video. I invite everyone to go and take a look at that where there are a number of artists who have brought forward the compassion for both art and the compassion for medical errors into one place so go take a look at that as well. Thank you.