Feminist Women’s Health Center Case Study

Kwajelyn Jackson, Executive Director

Feminist Women’s Health Center (FWHC) is a reproductive health, rights, and justice organization based in Atlanta, Georgia. Since 1976, they have provided direct services, education, advocacy, leadership development, and movement building with people across all axes of oppression. Their vision is to ensure that all people have the rights, resources, and respect to make empowered, informed decisions about their own bodies and health.

Integrating a reproductive justice framework is ongoing work that has informed and shaped them as an organization. It has led to the development of programs and services that seek to address systemic inequities in healthcare and society affecting women, people of color, immigrant families, low-income and rural communities, and people from the trans and LGBQIA+ communities.

“We are unapologetically a Black woman led, independent, non-profit, multi-generational, multi-racial reproductive health, rights, and justice organization committed to a vision of accessible and judgment- free reproductive health care and access in the South for all who need it.” Kwajelyn Jackson, Executive Director

When beginning work with Tier One Services, Feminist Women’s Health Center was a $3M nonprofit that was losing money due to lack of financial clarity. They had a single person managing multiple financial roles. Because they did not have appropriate financial controls or consistent access to financial data, Accounts Receivable was not correct because they were using journal entries to force the entries to balance. This left money on the table instead of putting the organization in a position to pursue the funds due to them.

After a conversion from QuickBooks Desktop to Xero, the research and analysis provided by Tier One Services resulted in accurate Balance Sheets. Without dealing with spreadsheets, the client freed up time to spend on high-impact moves including fundraising and pursuing justice through the lawsuit in conjunction with Sister Song. The organization is now valued at $4.4M with $450,000 net profit. In addition, by analyzing the financials based on fee per procedure, they have seen a 45% increase in revenue from when Tier One Services started working with them

The last several years under COVID have been difficult for many nonprofits. But the accounting services provided by Tier One Services helped Feminist Women’s Health Center to be more strategic and navigate the crisis successfully. Consistent weekly touchpoints with the team reinforced that processes were in place, working properly, and were being improved. “The frequency of communication makes it feel like a finance department internal to the organization and not like an outsourced service.” Kwajelyn Jackson

During the COVID downturn, Tier One Services worked with the leadership and board to produce cash flow forecasts weekly, enabling FWHC to not only stay open but with no downsizing and no layoffs. The financial information provided by Tier One Services allowed them to better predict how they might fare through changes in revenue. Even in the face of uncertainties, they saw an increase in their overall financial health despite the downturn. Feminist Women’s Health Center received over $1M in grant funds that allowed them to continue providing essential services and create a hazard pay plan for the staff. They managed the gap of increased cost of providing care for patients during COVID, purchased PPE for the staff, and funded their advocacy work.

Legislative Advocacy Program

“The biggest obstacle for me was balancing staying open and serving patients with the idea that I might be putting my staff at risk of harm. I know I cannot guarantee that no one will get sick, whether we close or not, but I am not willing to sacrifice the wellbeing of my staff for the benefit of our community. My staff are my community, and they deserve to be protected at all costs.” Kwajelyn Jackson                                                                               

Services provided by Tier One Services have given Feminist Women’s Health Center a level of financial sophistication they would not have otherwise been able to achieve. Kwajelyn no longer needs to track down information because it’s always available from her Tier One Services financial team. She appreciates having trusted experts that provide data so she can make decisions based on evidence instead of her gut. Learning about Excel techniques, cash flow forecasts, pro forma projections, separation of duties, strong internal controls, and having multiple sets of eyes on the variables have all been very valuable to the organization.

“I’ve learned to be a more transparent leader as a result of having financial information at my fingertips.” Kwajelyn Jackson

Serving as the year-round accounting department for Feminist Women’s Health Center, Tier One Services provided accounting system conversion, process documentation and financial modeling in addition to bookkeeping and bill paying. The development of Daily Intakes based on the patients, abortion funding, and insurance payments were crucial to timely reporting and the ability to make good business decisions.

The accurate reporting and cash flow forecasting provided by Tier One Services gave the organization confidence in their financials. They applied for and received two PPP loans, which were granted and forgiven, allowing them to maintain operations with interruption. Feminist Women’s Health Center’s application for ETRC funds is in process and they are well positioned to access the additional support, which will save the organization half-a-million dollars.

2022 was a difficult year not only because of COVID, but also because of the ruling handed down by the Supreme Court. Scenario planning was essential in Feminist Women’s Health Center’s ability to weather these dual storms. With the help of the Tier One Services team, they imagined what their revenue and staff salaries would look like under multiple scenarios. Because this was in place before the ruling, they were able to retain staff and maintain a consistent commitment to their community. While there were many uncertainties, they were well equipped to pursue additional lines of service and programming opportunities to supplement revenue lost due to restrictions on abortion providers.

“I feel confident enough in our data that we can invest in our people, the people who are necessary to make anything happen.” Kwajelyn Jackson

What does the future hold? Feminist Women’s Health Center began with the mission of providing safe, supportive and non-judgmental abortion and gynecological care services in addition to offering self-help clinics. Today, Feminist Women’s Health Center’s Cliff Valley Clinic provides a range of healthcare services including annual exams, pap smears, STI testing and treatment, HIV testing and counseling, abortion care, trauma survivor abortion care, emergency contraception and family planning. With the support of Tier One Services, they are able to build out a budget that anticipates a small deficit while still providing good financial data to the Board about how they intend to fill that gap.

“Working with Tier One Services has strengthened my ability to communicate our organization’s financials with both internal and external stakeholders. Having a team of multiple people who have clear and complementary roles has freed up my time to fundraise.” Kwajelyn Jackson                                                                                                                                                                                           

Community workshop

Tier One Services is keenly aware of their role in the community and works to advance social justice. Its mission is to help organizations build financial sustainability so they can do more good for more people. By enhancing the financial health and economic power of organizations already working in their communities, Tier One Service helps them make the difference they seek in the world. In their partnership with Tier One Services, Feminist Women’s Health Center has found an accounting firm whose mission supports theirs.

“I tell people if you don’t want to be in the numbers all day but you want to have some trust that there are folks who are managing it with accuracy and care, that is the true benefit of contracting with Tier One Services. I’m really grateful that they have not only been supportive, but advocated on our behalf.” Kwajelyn Jackson