Starting an Independent Mobile Clinic

PetFix Northeast Ohio is a state-of-the-art mobile surgery clinic that focuses on curbing pet overpopulation in an underserved area.

The program provides affordable spay/neuter services to low-income owners, feral cat caregivers, shelters and rescues in northeastern Ohio. PetFix works in partnership with local humane societies, rescues and dog wardens. Partners handle many of the logistics including scheduling clinics and collecting fees.

Why We Love This

The founders of PetFix knew that poverty and lack of access to services were two of the main reasons for the uncontrolled breeding of cats and dogs in parts of northeastern Ohio, and wisely engaged local humane societies and other community-based partners in their effort. "They know the area, they know the places to target so it just makes sense," says PetFix founding President, Timotha Sullivan. The innovative collaboration results in a highly efficient and focused spay/neuter service that performs more than 5,000 surgeries a year in remote and impoverished parts of Ohio.

How To Get There

PetFix strongly advises knowing the subject inside and out.

• Study the sources. There are numerous reference guides to mobile spay/neuter clinic operations that can help in the early planning stages, such as "The Guidebook to Mobile Spay/Neuter Clinics" published by Spay/USA. and the Mobile Spay-Neuter Clinic Operations, published by Best Friends Animal Society.
• Cultivate expertise. PetFix was started by a former director of a small humane society with 30 years of experience in nonprofit management and fundraising. She was joined by two veterinarians with experience in both shelter and private medicine. These three, along with a treasurer with strong financial management skills, formed the initial board of trustees.

Step 2: Seek input

PetFix founders organized two major conferences to gather input and feedback. The goal of the first conference was to determine if there was truly a need for a new, independent mobile spay/neuter clinic. The second conference was focused on feedback and cultivation, and took place after PetFix founders had developed a plan. They invited potential clients to critique the program and indicate to what extent they might participate as PetFix partners.

The conferences were "among the most important steps we took," says Sullivan. She says they helped groups that diverged on issues like euthanasia coalesce around what they did agree on – the need for more spay/neuter services. The conferences also helped establish the partner program that allows PetFix to succeed.

Step 3: Write a mission statement and incorporate

After incorporating as PetFix Northeast Ohio, the founders crafted a simple, straightforward mission statement: Ending pet overpopulation by educating the public about the importance of spay/neuter and by making low-cost spay/neuter surgeries easily accessible to those who cannot afford full fees.

PetFix says staying focused on the mission means:

• Staff can avoid being pulled in too many directions or overwhelmed by other compelling animal welfare needs.
• All animal welfare agencies can take advantage of the service regardless of potentially divisive issues.

Step 4: Define your region and services

PetFix ultimately settled on a mobile clinic because it provides the flexibility to:

• Serve geographic areas of greatest need and target human populations generating most of the region's pet overpopulation problems.
• Use a vehicle as a dramatic mobile billboard, promoting spay/neuter and responsible pet ownership.
• Keep animals close to home.
• Interact with owners/caregivers for maximum educational impact.

PetFix chose to limit itself only to spay/neuter surgeries and rabies vaccinations. The services are offered to qualified low-income owners, feral cat caregivers, and agencies offering cats and dogs for adoption.

The founders made the tough decision not to provide wellness exams under any condition. The mission was spay/neuter and they knew they needed to stick to that. PetFix started off serving nine counties in northeast Ohio. This area eventually proved too large and required too much travel, so now PetFix serves seven counties and targets key areas.

Step 5: Apply for nonprofit designation

This step needs to come early in the process since it takes time. PetFix waited eight months for approval. Sometimes the process is much faster, "but it all depends on whose desk your application happens to fall," says Sullivan. PetFix recommends using an experienced attorney or accountant help with the preparation. Forms for nonprofit status are available at www.irs.gov.

Step 6: Set program goals

PetFix started with ambitious goals. The clinic would:

• Be on the road 4 days a week
• Operate 50 weeks a year
• Perform an average of 24 surgeries a day for an annual total of more than 5,000 surgeries.

Achieving these goals proved challenging and took longer than anticipated to meet. "It took us six years to get to 5,000 surgeries a year," says Sullivan. Now PetFix is on the road four to six days a week and averages 22 to 27 surgeries per day. "We've reached our limit," says Sullivan. "We will never be able to increase the numbers of surgeries each year." She adds that of utmost importance is the safety of each animal who comes to the clinic. "Sometimes you have to be willing to celebrate the surgeries you've done rather than focusing on the numbers."

Step 6: Build a budget and raise start-up funds

The start-up budget in fiscal year 2006 for PetFix was $230,000. The bulk of the money came from foundation grants and the rest from individual approaches to major donors. PetFix says it's easier to raise money for a launch than it is to raise operating dollars and recommends raising as much as possible up front. PetFix raised an additional $60,000 dollars during its launch. That money has been "a very important cushion," says Sullivan.

Step 7: Purchase a vehicle

PetFix purchased a fully-equipped demo clinic from LaBoit Inc. of Columbus, Ohio for $170,000, but there are several other reputable manufacturers. PetFix recommends checking them out carefully. "Every inch counts when you are trying to alter as many animals as possible," says Sullivan.

Step 8: Hire staff

The challenges of staffing a mobile clinic are immense. PetFix tried several staffing models before they found a workable fit. Currently PetFix relies on committed part-time personnel. The team includes:

A coordinator to manage the program and handle the often complex scheduling calendar of a mobile unit.
• Three veterinarians, part time. Schedules and workdays vary.
• Two registered veterinary technicians, part time.
• Two drivers/vet assistants, part time.

The rest of the work, including development and finance, is done by members of the board of trustees who donate their services.

Step 9: Develop policies and protocol

The PetFix leadership is always interested in new techniques that might increase efficiency at the clinic but the two veterinarians on the advisory board (with both shelter and private practice experience) have the final say on all issues of protocol.

Step 10: Line up post-operative emergency care

Because the clinic moves on at the end of the day, PetFix won't operate in a community without 24-hour coverage from at least one veterinarian. At discharge, clients:

• Receive detailed going-home instructions including the importance of using an e-collar to avoid self trauma. (PetFix sells e-collars for a nominal fee.)
• Receive a hotline contact number. The hotline is answered between 8 a.m. and 11 p.m. by the PetFix medical team.
• A list of PetFix providers. Providers agree to see clients in an emergency when the hotline isn't staffed or if an animal requires additional care. PetFix pays for complications that are a direct result of the surgery, unless the injury is caused by self-trauma. Other costs are the client's responsibility.

Step 11: Establish an operating budget and determine how to raise operating funds

PetFix calculates annual expenses by looking at expected surgery days per year, number of surgeries per day, employee compensation, and direct and indirect expenses.

About 60 percent of the funds necessary to cover expenses come from client fees. The rest of the funds come from special events, mailed and e-appeals and grants. Partners may pass PetFix fees on to clients or they may raise their own funds to further subsidize the costs. Partners may not charge more. Owners must show proof that they receive or are eligible to receive public assistance or they must be feral cat caregivers. The current PetFix fee schedule is as follows:

• Cat neuter -- $30
• Dog neuter under 50 lbs -- $40
• Cat spay -- $40
• Dog neuter over 50 lbs -- $50
• Feral cats -- $35
• Dog spay under 50 lbs -- $60
• Dog spay over 50 lbs -- $70
• Rabies -- $6. Rabies is required unless proof of vaccination is provided

Powerful Results

PetFix celebrated a double digit increase in 2011, accomplishing 5,093 surgeries. When considering the offspring that might have been produced, PetFix has succeeded in keeping hundreds of thousands of animals from lives of uncertainty over the last six years. Other benefits of the mobile clinic include:

• A growing population of pet owners in northeast Ohio who are able to enjoy their pets without worrying about litters they can't afford.
• Feral cat control. Without the pressure of new litters, feral cat caregivers are able to focus on providing food, shelter and medicine to their colonies.
• Relief to local rescues and humane societies. With the help of PetFix, shelters and rescuers are able to use their limited resources to care for victims of abuse and neglect rather than using most of their time and money dealing with the consequences of uncontrolled breeding.

Some Roadblocks to Watch For

• Initial delays. It took more than a year and a half from the initial assessment conference to the launch of surgeries. Start-up time included outreach, fundraising, and applying for nonprofit status.
• Staffing challenges. The demands of a mobile workplace can take a toll. Several of PetFix's initial hires were lured back into private practice. PetFix now works with a staff of part-time surgeons and vet techs, and the system functions well.
• The different goals of private practice and shelters. Veterinarians that come from private practice may have a different mindset than shelter-based partners trying to free up cage space. PetFix recommends having at least one staff member with experience in shelter medicine to bridge the gap.
• Negotiating challenges and costs that arise in the unlikely event an animal needs post-operative care. Initially PetFix paid for all post-op complications but realized much of the care was a result of self trauma. Now, clients are urged to buy e-collars from the clinic and are responsible for medical costs associated with self trauma.
• Tight quarters. In mobile spay/neuter units, space is at a premium and every inch counts. Some people, even experienced vets, may find they simply cannot work in such tight conditions.
• The challenges of raising funds for a regional spay/neuter program. It's essential to find ways to raise money without cutting into the fundraising efforts of the very humane societies and rescues you exist to serve.

What's Next

PetFix is currently running a capital campaign to raise funds for a stationary clinic, with groundbreaking set for early 2013. The Humane Alliance clinic will be located in Euclid, Ohio on the outskirts of Cleveland and will include transport. PetFix says once the stationary clinic opens, staff expects to triple capacity to about 17,500 surgeries a year and bring services to an where there has been very little.

"It's the hardest thing I've ever done – and I don't regret it for one minute," says Sullivan.

Looking for more resources to help you plan a similar program? Check out these sample forms:

• PetFix care instructions for pet owners
• PetFix medical instructions
• PetFix partner info sheet
• PetFix post-surgery instructions