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Executive Summary


  • A Worldwide Problem

      • 18 million cases of blindness due to cataracts
      • 1.4 million babies born with clubbed feet per year
      • 2 million babies born with cleft lip/palates per year

       

      An overwhelming majority of these disfigurements exist in the developing world where there is little or no treatment and where victims often face a lifetime of ridicule and exclusion.

       


  • Solution

    • NextDeserethas partnered with Deseret International to execute an innovative business model that is designed to accelerate Deseret International’s existing program to provide corrective surgeries for cataracts, clubbed feet, and cleft lip/palate. Through Deseret International’s established infrastructure, Next Deseret will increase surgical capabilities exponentially throughout the developing world.


  • BOOT Business Model

    • NextDeseret’s innovativeBOOTmodel encompasses the following steps:

       

      Build: construct small, Western-style surgical centers

       

      Operate:  employ surgeons from developing nations

       

      Own:  allow surgeons to earn ownership in the center over time

       

       

      Transfer: generate enough revenue to fund additional centers


  • Projections

    • Within 10 years, Next Deseret anticipates their BOOT model will enable the following:

      • 240,000+ cataract surgeries
      • 80,000+ cleft lip/palate surgeries
      • 80,000+ club foot surgeries
      • More than 200 surgical centers throughout the world
      • Running balance of more than $10 million to cover administrative and other costs

       

       


  • Start-up Costs

    • Projected cost to build and equip the first four surgical centers is approximately $600,000, which will be funded by Deseret International. Seed funding for Next Deseret will come from the Brigham Young University Social Venture Competition prize money, a contribution by Deseret International, money raised by Next Deseret’s emerging collegiate organizations, and from private donations.


  • Management Team

    • NextDeseret’s management team is comprised of junior and senior university students who are committed to the enterprise and have arranged their school schedules accordingly. As the company grows we anticipate additional management will come from outside sources. 


Investment Consideration


  • Source and Use of Funds

    • Source of Funds

      First prize in BYU Social Venture Competition

      $10,000

      Deseret International funding

      $ 5,000

      From Next Deseret in three stages

      $20,000

      From NextDeseretStudent Chapters

      $ 5,000

      Grant money from entities supporting Social Ventures

      $ 3,500

      Total

      $43,500


  • Use of Funds

    • Stage 1 – May to August 2008

       

      - Raise $4,000 from donors/philanthropists

      - Next Deseret Student Chapter formed at BYU

      - NextDeseret:

                  - Screens doctors for first four surgical centers

                  - Negotiates contracts between doctors and Next Deseret

      - Researches developing nations to determine surgical center need -Ecuador,Bolivia,Nigeria,PeruandUruguay

       

      Stage 1 Cost

      $12,000 - Travel

      $250 - Accommodation

      $300 - Communication

      $150 - Miscellaneous

      Total: $12,650

       

       

      Stage 2 – September to December 2008

       

      - Raise $5,000 from donors/philanthropists

      - NextDeseretcreates organization (volunteers in the developing countries as well as Next Deseret personnel) to manage surgical centers

      - Surgical centers constructed (June-January)

       

      Stage 2 Cost

      $12,000 - Travel

      $250 - Accommodation

      $750 - Communication

      $150 - Miscellaneous

      Total: $13,150

       

       

      Stage 3 – January to April 2009

       

      - Raise $11,000 from donors/philanthropists

      - NextDeseretbrings on student interns (unpaid) to research and analyze surgical needs in the developing world

      - Doctors begin operations in first four beta surgical centers

       

      Stage 3 Cost

      $4,000 - Travel

      $150 - Accommodation

      $1,000 - Communication

      $100 – Miscellaneous

      Total: $5,250

       

      *$5,000 allocated to pay Next Deseret Student team for work on the Social Venture Competition and for the first year of work.

       

      Year-end Total Cost: $36,050

       

      Leftover - Contingency fund: $7,450


The Company


  • The Company

    • Next Deseret was formed in 2006 by Brigham Young University students who assisted Deseret International with fundraising, marketing, and research efforts. The students saw a need for expanded capabilities that would allow Deseret International to provide greater numbers of life-changing surgeries to the poor in developing nations who suffer from cleft lips/palates, club feet, and cataracts.

       

      The Next Deseret team researched the availability and affordability of surgeries for those in the developing world and developed an innovative business model designed to utilize Deseret International’s 20 year historical strengths and provide exponential growth opportunity.            


  • The Need

    • According to research by Deseret International, more than 20 million people worldwide suffer from cleft lips/palates, club feet, and cataracts. These conditions are markedly prevalent in developing nations where poverty and lack of resources often prevent the sufferers from receiving treatment for what is a relatively minor surgery in most first world countries.

       

       

      Deseret International has a 20 year history working with government officials, community leaders, and physicians in developing nations to fund surgeries for cleft lips/palates, club feet, and cataracts. By utilizing in-country doctors and facilities and importing used equipment from first world hospitals, Deseret International has brought the cost of a surgery down to under $20. They have also been able to keep overhead expenses as low as 4%.

       

       

      Through these methods, Deseret International has facilitated an average of 6,500 surgeries per year. A respectable accomplishment, but Next Deseret believes the program can have a much broader reach. Deseret International’s current operating model prevents rapid scale growth and includes inherent risks to sustainability; however, Next Deseret believes these problems can be solved by theBOOTmodel. 


  • The Solution

    • NextDeseret is proposing a unique approach that will exponentially increase Deseret International’s reach and impact. The plan calls for more active economic involvement from local surgeons and community leaders and gives them a vested interest in the success of the surgical center. In addition, the majority of the revenues from the center will remain in the community, providing economic stimulus and helping to increase the standard of living.

       

       


  • The Business Model

    • Under theBOOT(Build, Operate, Own, Transfer) model, Next Deseret will build small, Western-style surgical centers and employ local surgeons who will have the opportunity to earn equity in the center. Doctors can earn ownership of the surgical center through monthly payments derived from for-profit surgeries they perform. The surgeon will also provide contractual non-profit surgeries on behalf of Next Deseret.

       

      Build

       

      Local surgeons will assist Next Deseret in finding a building site that will be accessible to both rural and urban populations. Since the surgical center will benefit everyone in the community, we believe land donation is feasible and will greatly reduce building costs. Estimates have shown construction of each center will be approximately $150,000. Centers can also be equipped at very low cost due to Deseret International’s existing partnership with Globus, a medical supply charity operating in developing nations.

       

      NextDeseretwill finance the construction and equipping of the first four surgical centers through funding and guidance from Deseret International. Additional centers will be financed through the sustainableBOOTmodel.

       

      Operate

       

      NextDeseretwill recruit surgeons with specific training in cleft lips/palates, club foot, or cataracts. Preference will be given to surgeons who are citizens of the developing nation, either currently practicing in the nation or who have moved to a first world country. Many of these surgeons express a desire to practice in their home countries but are unable to afford the soaring capital costs. NextDeseret’s business model, combined with Deseret International’s low costs, will allow a surgeon to return home and establish his or her practice.  

       

      Surgeons will enter into a contract with Next Deseret which outlines the relationship, the business model, and the obligations of both parties. If the contract is breached by the surgeon, Next Deseret may foreclose on the surgical center and offer the opportunity to the next available in-country surgeon.

       

      Own


      Surgeons are given the opportunity to buy up to 75% ownership in the surgical center through a series of reasonable monthly payments. Ownership will encourage the physician to remain at one surgical center, to provide quality care, and to improve the center and its operations. NextDeseretbelieves the contractual relationship with the surgeons will be a major factor in the success of the BOOT model.

       

      Transfer


      Revenue from existing surgical centers will be used to build additional centers in other parts of the world, less 5% which will be allocated to a reserve fund to pay for center supplies and maintenance

       

      As shown in Figure 3, the BOOT model allows for exponential growth in the number of surgical centers. Within 10 years, Next Deseret projects at least 206 fully operating centers throughout the developing world.

       

      Deseret International predicts that each surgical center can perform 50 non-profit surgeries per month once it is operating at peak potential. Within ten years we expect the surgical centers will provide over 100,000 non-profit surgeries per year.

       

      Impacts and Benefits


      NextDeseret’sBOOTmodel will enable over 100,000 life-changing surgeries annually within a ten year period. These surgeries will have a significant impact not only on the patients but on their families, their communities, and their nations as well.

      Social Standing & Human Productivity Potential

       

      What is considered a relatively routine surgery in theUnited Stateswill be life-changing for patients in developing nations. In many of these countries people with birth defects, including club feet, cleft lip/palate, cataracts, or crossed eyes, are considered guilty of some sin that brought on the condition. They are under a social stigma that prevents them from obtaining employment and consequently, they are unable to provide for themselves and become a burden for relatives, government, and humanitarian resources. The corrective surgery frees them from the social stigma and can help them become a fully-functioning, productive member of their community.

      Caregiver Freedom

      The surgeries also release caregivers from the heavy burden of providing physical, financial, and social support for the disabled individual. Both parties are free to join the workforce and become independent.

      Job Opportunities

      NextDeseret’s BOOT model will provide jobs to medical professionals and others in developing nations, thus contributing to the local economy. We anticipate increased employment opportunities for surgeons, nurses, assistants, administrative staff, janitors, pharmacists, security personnel, construction workers, and others. 

      Personal Benefits

      Those with disfigurements such as cleft lips/palates, club feet, and cataracts often have very low self-esteem that can lead to depression and other illnesses. They are often ostracized because of their deformities and may never have the joys of full participation in society. Through these life-changing surgeries, patients are given renewed self-esteem and a chance to experience full social acceptance. 

       


Management & Organization


  • Management & Organization

    • NextDeseretwill visit each surgery site and negotiate the implementation of surgical centers and contracts. With the help of Deseret International, Next Deseret will research areas in the developing world that are most in need of surgical centers specific to cataracts, club feet, or cleft lips/palates. As these areas are designated, Next Deseret will travel to each nation and procure land from local officials, recruit area surgeons, and begin the construction of the surgical center. Next Deseret and members of Deseret International will manage functioning surgical centers from theUnited States.   

       

      One person will be employed to manage the first five surgical centers. NextDeseretwill carefully evaluate the number of personnel needed to manage future surgical centers and will strive to keep costs at a minimum. 

       

      NextDeseretteam members have arranged their schedules so they can perform the necessary work to implement and operate theirBOOTmodel while finishing undergraduate or graduate degrees. Student chapters on college and university campuses will perform research, provide interns, and help manage facilities. Members of Next Deseret Student Chapters may also be candidates for full-time employment at Next Deseret. 

       

       

       

       

       

       

       

       

       

       

       

       

       

       

       


  • Student Team

    • Caleb Manscill

      Caleb has been involved with a number of business ventures. He is currently finishing his undergraduate degree and will travel for Next Deseret to help screen surgeons, negotiate contracts, and manage the building process. He also plans on attending graduate school to earn a Masters of Business Administration.

       

      Levi Belnap

      Levi is an International Relations Major with international experience including in the developing world. His will help Next Deseret launch theBOOTmodel and will work with Michelle Baron to make operations as efficient as possible. Levi plans to pursue a Masters of Business Administration. He is fluent in Italian and Arabic.

       

      Michael Althoff, Student Team Member

      Mike is currently the Vice President for the Marketing Association and is leading a marketing campaign for Deseret International that will give them stronger name presence/recognition inUtah. He plans to help Next Deseret build name and brand recognition worldwide. He is fluent in Spanish.

       

      Michelle Baron, Student Team Member

      Michelle is a Ph.D. candidate for data analysis specifically geared towards growing companies and organizations. Her research and expertise are highly valued as Deseret International continues to grow. She will help Next Deseret perform in-depth research and data analysis.

       

       


  • Deseret International and Board of Directors

    • William Jackson, MD, Chairman

      Dr. Jackson has an anesthesia background and has traveled the world for Deseret International, coordinating its efforts and growing its capacity to provide medical services and surgeries to developing nations.

       

      Doug Jackson, President/CEO

      After experiencing great success in the accounting world, Doug joined Deseret International as the President andCEO. He has had international experience traveling and driving the growth of Deseret International.

       

      Walter Plumb III, Vice President

       

      Patrick Lee, CMO

       

      Board Members

      Rodney Badger, MD

      Angus Belliston

      Branson Call,MD

      George I. Cannon

      Gordon Christensen,DDS

      Ray L. Goodson

      LowellL. Leishman

      Steven H. Mann

      Kristen Oaks

      Louis Pope

      Gary B. Sabin

      Phil Sonntag

      Jack R. Wheatley

       

      Advisory Board

      Doug Beck

      Wayne Chisholm,DDS

      Leon Clark,DDS

      Peter Crawley, Ph.D.

      Clark Crookston,DDS

      Robert Griffin, MD

      Senator Orrin Hatch

      John Jarstad, MD

      Jack Morris

       

      Robert Rhodes, MD


Financial Data & Projections


  • Financial Feasibility

    • As shown in Figure 6, non-profit surgical costs are assessed based on a patient’s economic resources and ability to pay. NextDeseretanticipates the majority of non-profit patients will pay for approximately 5% of the value of the surgery

       

      Figure 6:

       

       

      For profit full-rate surgery fees will create enough revenue to sustain the surgical center, provide an income for the surgeon, and create a return for Next Deseret.

       

       


  • Building and Equipment Management

    • NextDeseretwill allocate 5% of the surgeons’ equity payments for building and equipment maintenance. We expect this fund to increase exponentially as the BOOT model grows.

       

      Figure 7:

       


  • Administrative Costs

    • NextDeseretwill allocate a portion of its monthly surgical center revenues to an administrative fund. The fund will be used to help manage the growth brought about by the BOOT model. The administrative fund can also be applied to unanticipated expenses.

       

      Figure 8:


  • Start-up Costs

    • Projected cost for the first four surgical centers is $600,000 USD and will be financed by Deseret International.


  • Partnerships

    • NextDeserethas partnered previously with Globus Relief and Scojo, existing charities with long histories operating in developing nations. Our partnership with Deseret International comes at a key time when Deseret International, Globus Relief, and Scojo have agreed to create a larger pool of revenue, equipment, and other medical supplies to meet Next Deseret’sBOOTmodel. 

       

      Globus Relief gathers medical equipment and materials that are outdated by first world standards and distributes them to organizations operating in third world countries. Because of Next Deseret’s partnership with Deseret International, Globus Relief has agreed to increase their supply of medical equipment and materials for our needs.

       

       

      Scojo, an eyeglass supplier to developing nations, Scojo has agreed to refer cataract patients to the Next Deseret surgical centers and will maintain a stock of eyeglasses for center patients.


  • Competition

    • Since 1982, Operation Smile has performed cleft lip surgeries on more than 100,000 children in the developing world. However, their operating costs are significantly higher cost than Deseret International - $240 per surgery compared to $19-35 per surgery. NextDeseret’sBOOTmodel will sustain Deseret International’s tradition of low-cost surgeries while dramatically increasing its volume capabilities. In addition, theBOOTmodel uses local surgeons and support staff which will add jobs and strengthen the local economy, while Operation Smile imports first world surgeons and staff on a temporary basis.

       

       

      Aravind is a charity operating inIndiathat works to cure and prevent unnecessary blindness. They employ a business model that is similar to Next Deseret’s in that hospitals must provide services to the rich and poor alike yet be financially self-supporting. However, Aravind’s model focuses primarily on large hospitals located in major cities, making access difficult for those in rural areas. Aravind does not currently offer its surgeons ownership opportunities in its surgical centers.


  • Donations

    • Deseret International will provide the funds to build the first four surgical centers. NextDeseretwill actively seek donations from individuals and corporations and will negotiate the usage of donations that have been allocated to Deseret International. We anticipate that after five years, Next Deseret’sBOOTmodel will sustain the continued building and supplying of additional surgical centers.


Appendix


  • Appendix A - Contract

    •  An important part of the success of Next Deseret’sBOOTmodel is the contract between Next Deseret and the surgeon who will operate and eventually own the majority of the surgical center. Following is the contract to be used.

       

       

       

       

      MEMORANDUM OF AGREEMENT

      KNOW ALL MEN BY THESE PRESENTS:

            This Agreement made and entered into, this ____ day of _______ 2008, by and between:

            Next Deseret (hereinafter referred as “DESERET”), a non-profit humanitarian foundation, with principal mailing address _________________________________________________.

      -and-

      ________________, (hereinafter referred as _______________, a for-profit organization duly organized and existing under the laws of _________, with principal office address at ___________________________________________________________________________. 

      WITNESSETH:

            WHEREAS, DESERET was organized for the purpose of helping the truly needy people of the ________ through: the assistance of dental help, medical help, or educational assistance;

            WHEREAS, [entity name] was organized to administer in the treatment of patients with, among other infirmities, ____________ anomalies in a profit AND not-for-profit enterprise;

            WHEREAS, a [entity name] will operate hospital based services at plot _____________________, and DESERET has commenced construction of a private hospital which will include ____________ services;

            WHEREAS, DESERET has agreed to build, equip, and supply the surgical center for ______________.

            NOW, THEREFORE, the parties agree and obligate themselves, as follows:

      1. DESERET agrees to build, equip, and supply the surgical center and [entity name] is required to follow the financial and surgical repayment of the surgical center. If [entity name] fails to repay appropriate to the contracted agreement DESERET can choose to foreclose the surgical center and transfer potential ownership to another to their choosing. [entity name] shall be responsible for shipment and the safekeeping and maintenance of said equipment, including but not limited to obtaining risk insurance and for the professional maintenance fees in connection therewith;

      2. In consideration of the foregoing, [entity name], its officers and physicians agree to render continuous quality professional medical services to charity patients. It is agreed that they will provide a minimum of percentage according to the transfer ownership agreement. 

      3. If at any time [entity name] decides to discontinue its charitable endeavors, or if DESERET becomes dissatisfied with the relationship, DESERET has the right to take back the items, at its own expense.  At a notice of at least six calendar days days [entity name] will allow the necessary access into the facility; In case of the termination of this agreement each party shall give the other a notice period of not less than five calendar months. 

      4. Disputes between [entity name] and DESERET relating to provisions of this agreement shall be arbitrated. The parties shall each select an arbitrator, and the two arbitrators selected shall together select a third arbitrator. The three arbitrators shall determine the dispute and their decisions shall be binding on the parties. The parties shall divide the costs of arbitration equally between them.

      5. DESERET shall not be liable for liability or damage claims for injury to persons or property from any cause relating to the activities of [entity name]. [entity name] further agrees to indemnify DESERET from any and all liability, loss, or other damage claims or obligations resulting from any injuries or losses.

            IN WITNESS THEREOF, the parties have hereunto set their hands in the place and date first above written.

                                                                  


  • Appendix B - Ownership and Payments

    • The following graph illustrates the rate of transfer for the surgical center from Deseret International to the local surgeon. Deseret International initially holds nearly 100% ownership; however, as the surgeons make their scheduled monthly payments, their ownership increases proportionally. 

       

      The anticipated cost per center is $150,000. Surgeons will be able to buy up to 75% ownership by paying back $112,500 over time. Because of the nature of start-up operations, the scheduled payments begin very low at $50 per month and eventually grow to the maximum rate of $2000 per month over a period of seven years.

       


  • Appendix C - Sources

    • The Ponseti Method of Club foot care: A Vision for the Developing World.  Dr. J. Norgrove Penny, MD, FRCS(C

       

      Global Strategies to Reduce the Health-care Burden of Craniofacial Anomalies.  Compliled by the WHO.

       

      Prevention of Blindness and Visual Impairment: Cataracts.  Compiled by the WHO.

       

      http://www.who.int/en/

       

      http://aravind.org/

       

      http://www.operationsmile.org/

       

      http://www.deseret-international.org/

       

       



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