Reproductive Health Clinic

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Executive Summary

Coleman Family Clinic is a nonprofit outpatient reproductive health clinic in Bowling Green, Kentucky providing family planning, gynecological care, annual exams, contraception counseling and STI testing and treatment. Services are limited to what Kentucky law allows, and any discussion of pregnancy options, including referrals, follows state law and legal review. The clinic opens in a 4,800-square-foot leased space. Year 1 revenue is projected at about $430,000, growing to about $776,000 by Year 3. Startup costs are about $270,000.

Company Description

Coleman Family Clinic is a nonprofit corporation founded by Elena Coleman, with a board that includes a physician, a nurse and a community leader. It must hold a Kentucky clinic license and meet the state's requirements before it opens, and its medical director must be a licensed physician. The clinic leases a 4,800-square-foot space with exam rooms, a lab area, a counseling room and a small education room. Services: annual exams, contraception counseling and methods, pregnancy testing and prenatal referral, STI testing and treatment, cervical cancer screening and counseling. Any services related to abortion are provided or referred only as Kentucky law permits and after review by the clinic's attorney.

How we make money. The plan has these income lines: patient service revenue (net collections per visit) at about $88 each, about 1,136 in Year 1; public health and family planning grants at about $1.00 each, about 210,000 in Year 1; foundation grants and donations at about $1.00 each, about 120,000 in Year 1. Pricing is set so each line covers its direct cost and a share of overhead.

Unit economics. In Year 1 direct costs are about $10,224, a gross margin of about 98% of sales. Pay and overhead take most of what is left, so the plan first shows a profit in Year 2. Prices and volumes are set from the assumptions in the appendix and should be replaced with your own quotes.

Problem & Opportunity

Many women in south central Kentucky have limited access to affordable reproductive health care, especially those without insurance or living far from a clinic. They face long waits and travel, and some skip screenings and testing. Teens and young adults want confidential, respectful care.

Products & Services

A clinic that offers affordable, confidential reproductive health care with a sliding fee scale, extended hours and trained staff. Patients can walk in or schedule visits, and the clinic helps patients enroll in coverage. Counseling is nonjudgmental and follows medical standards and state law.

Market Analysis

Bowling Green and the surrounding counties have a university, a growing population and many residents who are uninsured or on Medicaid. Demand comes from young adults, low-income women and patients referred by schools, health departments and community groups.

Who we serve first. Women and young adults in south central Kentucky, especially those who are uninsured or on Medicaid, and patients referred by schools and health partners.

Competitive Landscape

The health department, a few private practices and a hospital system provide some reproductive health care, often with limited hours or capacity. Coleman Family Clinic competes on access, affordability and respectful care. We work with these partners rather than duplicate services.

Our strengths and weak points. Strengths: A board and medical director with clinical and community experience; Affordable, confidential care with extended hours that are rare in the region. Weak points we plan for: Funding rules and state law limit what can be offered and require legal review; A new clinic depends on grants and donations alongside patient fees.

Marketing & Sales Strategy

Partner with the university health center, schools, the health department and community groups, publish clear information about services and fees and ask patients how they heard about the clinic. Outreach materials follow Kentucky law and clearly state what the clinic offers. The first goal is 1,800 patient visits in Year 1.

The first 90 days. Days 1 to 30: file for the clinic license, sign the lease and recruit the medical director. Days 31 to 120: build out the clinic, hire staff and apply for public and foundation funding. Days 121 to 180: open, hold meetings with partner schools and health providers and begin the sliding fee program.

Operations Plan

Each patient has a confidential intake, a clinician visit and written follow-up. The clinic uses an electronic health record, a lab partner and a sliding fee scale with documented income. Staff are trained in infection control, privacy and mandatory reporting. Clinical protocols follow professional guidelines, and the board reviews compliance each quarter. A legal advisor reviews services, signage and referral practices against Kentucky law.

Key resources and partners. Resources: A licensed medical director, a leased clinic, clinical equipment, an electronic health record and trained staff. Partners: The university health center, the health department, schools, a lab partner, a hospital system and community funders.

What we measure. Patient visits, new patients, share of visits on the sliding fee scale, collection rate and cash in the bank.

Risks and how we plan for them:
- Laws and funding rules change. An attorney reviews services, materials and referral practices at least twice a year, and we stop any activity that is not clearly lawful.
- Funding concentration. We apply to several public and private funders and keep patient fees as a growing share of income.
- Public attention and safety. We use trained security measures, confidential records and clear communication with local law enforcement as needed.
- Clinician recruitment. We pay fairly, offer flexible schedules and partner with training programs for nurse practitioners.
- A new clinic has no track record. We start with a few core services, track results and report to the board each quarter.

Legal and ethical review. Because laws affecting reproductive health care change, an attorney reviews clinic policies at least twice a year, and the clinic does not provide any service that is not clearly lawful in Kentucky. Privacy. Patient information is protected under federal health privacy rules, and staff are trained in confidentiality and mandatory reporting. Funding rules. Any public funds the clinic receives are used only for the services those funds allow.

Patient experience. Patients are offered a private check-in area, a visit with a clinician in the same week where possible and clear information about fees before any service. A patient advisory group meets twice a year to tell us what is working and what is not.

Management & Organization

Keisha Chen serves as Medical Director, a role that requires a physician license. Two nurse practitioners or counselors provide clinical care, with a clinic manager and a front desk coordinator. Elena Coleman serves as executive director. A volunteer board oversees finances and compliance, and an outside accountant and attorney support the clinic.

Hiring plan. Elena leads as executive director. A medical director serves part time, a clinic manager and front desk coordinator are hired before opening and nurse practitioners or counselors are added as visits grow.

Outside help. We rely on an outside bookkeeper for monthly reconciliation and tax filings, an attorney for contracts and licensing questions and an insurance agent who reviews our coverage every year. We meet with these advisors at least twice a year and keep notes of what they recommend.

Milestones Narrative

Year 1: obtain the clinic license, sign the lease, equip the clinic, open in month 6 and reach 1,800 patient visits, revenue about $430,000. Year 2: add extended hours and a part-time nurse practitioner, revenue about $626,500. Year 3: add outreach clinics at partner sites, revenue about $776,000.

What the plan's numbers say. Year 1: sales about $430,000, loss about $49,700; Year 2: sales about $626,500, profit about $14,500; Year 3: sales about $776,000, profit about $14,700; Year 4: sales about $869,000, loss about $21,400; Year 5: sales about $942,000, profit about $34,800. The lowest year-end cash is about $66,600.

How we will keep score. Every month we compare real sales to the plan, check the cash in the bank, review the direct cost of each job or product, and look at what customers say. If sales are behind plan for two months in a row, we slow spending and delay hiring until the numbers catch up.

Funding Request

How much we need and how we will use it. Total needed: $511,000. This number comes from the Funding Need Calculator in this plan. It adds up:
- Startup costs of $270,000, listed item by item in the Startup Costs section (the largest are Working capital reserve $80,000; Leasehold improvements for exam rooms and privacy $60,000; Exam room furniture and clinical equipment $48,000).
- A cash cushion of about $241,000. That is the deepest cash dip in the early months plus about three months of bills, so slow weeks do not put the business at risk. Lenders call this "working capital."
- Together that comes to about $511,000 (rounded up to the nearest $500), which is the total we are planning for.
Where the money comes from:
- Founding board contributions and startup grant: $150,000.
- Community lender loan: $361,000.
Kind of funding we are looking for: Community lender loan: $361,000 at 8.0% interest over 10 years, about $4,380 a month. A loan is money we pay back with interest, and the monthly payments are already included in our cash flow.
How we will pay it back. We expect sales of about $430,000 in Year 1, growing to about $942,000 by Year 5. We expect a loss of about $49,700 in Year 1, a profit of about $14,500 in Year 2, a profit of about $14,700 in Year 3, a loss of about $21,400 in Year 4 and a profit of about $34,800 in Year 5. Year 1 is lower than a full year because the clinic opens in month 6 and licensing and enrollment take time. The lowest year-end cash balance is about $66,600 (Year 5), so with this funding the business has money in the bank every year of the plan.
What we are offering the lender: the clinic equipment as collateral and a pledge of grant and donor receipts. As a nonprofit, there is no personal guarantee from the founder.
A smaller first step, if needed. If we cannot raise the full amount right away, we can start with fewer exam rooms and limited hours, partner with the health department for space on set days and expand as funding arrives. Duplicate this plan and lower the buildout and equipment costs to match.
What if sales are slower? We also tested a cautious case where sales come in 20 percent lower every year. In that case the plan shows a loss of about $138,300 in Year 1, a loss of about $135,600 in Year 3 and the lowest year-end cash is below zero, by about $576,700. Cash would run short in that case, so we would cut costs early, delay hiring and talk to the lender before it happens.
All numbers in this plan are estimates. We will update them as real results come in.

Appendix Notes

Documents to attach before you send this plan:

- Nonprofit articles and bylaws and IRS determination letter or fiscal sponsor agreement.
- Kentucky clinic license application.
- Medical director agreement and clinician licenses.
- Insurance certificates for malpractice and general liability.
- Clinic lease.
- Equipment purchase agreements.
- Privacy policy and patient forms.
- Attorney review of services and referral policies.
If you don't have any of this yet, no worries - let's continue.

The assumptions behind our numbers (change them in the Financials section to match your own):
- Patient Service Revenue (net collections per visit): about 1,136 units in Year 1 at about $88 each, costing about $9.00 each to deliver.
- Public Health and Family Planning Grants: about 210,000 units in Year 1 at about $1.00 each, with no direct cost per unit.
- Foundation Grants and Donations: about 120,000 units in Year 1 at about $1.00 each, with no direct cost per unit.
- Pay: executive director $65,000 a year (the same number all five years); nurse practitioner or counselor $92,000 a year (people in Years 1 to 5: 1, 2, 3, 4, 4); clinic manager $52,000 a year (the same number all five years); front desk coordinator $36,000 a year (people in Years 1 to 5: 1, 1, 2, 2, 2); medical director (part-time) $200,000 a year (people in Years 1 to 5: 0.3, 0.4, 0.4, 0.5, 0.5).
- Other yearly costs in Year 1: clinic lease and utilities about $54,000, medical supplies and lab fees about $16,000, malpractice and general liability insurance about $12,000, security and facility safety about $7,000, outreach and education about $9,000, billing, software and accounting about $14,000, legal and compliance review about $8,000.
- Tax rate: 0%.
- Every dollar amount is an estimate. Replace them with your own quotes and research.

Plain words used in this plan:
- Sliding fee scale: prices based on a patient's income and household size.
- Family planning: services that help people plan whether and when to have children.
- Medical director: the licensed physician responsible for clinical care and standards.
- Mandatory reporting: legal duty to report certain concerns such as abuse.
- Credentialing: enrolling with insurance plans so the clinic can bill them.

Startup Costs