An HIV/AIDS Advocacy Organization Gets Some Healthy Advice

Visit the community center run by the Latino Commission on AIDS (LCOA) in New York City’s Chelsea neighborhood and you are struck by two powerful images. One is a tribute to the victims of the Pulse nightclub shooting in Orlando, FL, in 2016—the largest mass shooting targeting LGBT+ Latinos in U.S. history. The second is a memorial to the growing number of Latino transgender people who have been murdered in recent years.

The wall hangings are powerful reminders of the community served by the nonprofit, which was established in 1990 as a membership organization to address the HIV/AIDS crisis among Latinos. Its mission includes spearheading health advocacy for Latinos, promoting HIV education, developing model prevention programs for high-risk communities, and building capacity in community organizations. LCOA helps fill a large need: social stigma, poverty, language barriers, lack of access to care, and immigration status combine to deter HIV testing among Latinos, leading to increased infection rates. What’s more, some 22% of the population is without health insurance. The problem has become even more urgent since the start of the COVID-19 pandemic, says Guillermo Chacón, president of LCOA. “The painful lesson we learned from the past two-plus years is how essential it is to invest in prevention,” he says.

LCOA had already done some preliminary work on a plan to provide primary healthcare as part of its offerings, but to further explore this initiative, LCOA’s leadership turned to Morgan Stanley, whose Strategy Challenge pro bono program matches non-profits with rising talent within the firm to help them address key strategic issues. The ten-week program culminates in a presentation to a panel of judges, colleagues and Morgan Stanley leaders who name a winning team.

The Morgan Stanley team representing LCOA—one of nine total U.S. teams—began its work by interviewing members of the LCOA staff, who explained how critical the need for primary care has become. “Their clients were begging for it,” says Ariana Salvatore, a member of the team and an Associate in Morgan Stanley’s Fixed Income Research division. “The staff identified this as the number one additional service they could offer their community.”

The team then interviewed potential medical partners and community organizations, working to develop a model to determine the financial impact of offering primary care. They assessed how much capital would be needed, what sort of staffing would be required, and what income LCOA could reasonably expect from treating primary care patients.

After conducting extensive analysis, the team concluded that offering primary care was not financially feasible for LCOA at this time. The major impediment: treating Medicaid patients would not yield enough revenue to cover LCOA’s costs. The organization would need to cut costs by reducing staff—but that was not a realistic plan, either. In fact, additional staffing would be needed in order for LCOA to offer primary care, along with a more robust technology platform. Adding private paying patients might enhance profitability, but the team concluded this was not a viable option given the population LCOA serves.

It wasn't easy for the Strategy Challenge team to recommend postponing LCOA's expansion plans, knowing how determined the organization was to find a means of offering primary care. “They were pretty far down the road of pursuing this opportunity when we began working with them,” says team member Mary Kelly, a Vice President in the Investment Banking Division’s Global Power and Utilities Group. “So, it was tough to share our conclusions. But they responded really positively and were grateful to us for offering honest advice.”

“We were so impressed with the Morgan Stanley team’s culture of humility, how they took the time to deeply understand our mission over those ten weeks,” says Chacón. “I mentioned to each of them that they left their fingerprints on our DNA for years to come.”

Despite their reservations about LCOA’s plans to offer primary care, the Strategy Challenge team, which also included John Eric Tengco, Vice President, Finance, along with a Managing Director advisor, felt strongly that they needed to leave the organization with a path forward. The team found a consultant to non-profits called Primary Care Development Corporation (PCDC), which offered LCOA twenty hours of pro bono consulting time. In addition, says Chacón, it advised LCOA to look to interim solutions while continuing to explore the feasibility of on-site primary care, such as mobile care vans and telehealth services.

For the Morgan Stanley team members who worked with LCOA, the experience drew on skills that will serve them well in their careers, says Salvatore: “Working on the Strategy Challenge opened my eyes to the non-profit world. It was so interesting to use the skills we developed during our ‘day’ jobs to benefit others. And it furthered my perspective on Morgan Stanley, where our diversity of thought enables us to come up with impactful solutions, whether for clients or to those serving our communities.”