The (A) case presents a 2009 critical expansion decision for health care nonprofit Health Leads: whether to expand rapidly while it had momentum, strong advocates, very high demand for its services, and funder support for growth; or whether to postpone rapid expansion and continue working on its model and further prove the company's value to hospitals and clinics. Founded by Rebecca Onie (2009 MacArthur "Genius Grant" Fellow), Health Leads addressed issues at the intersection of health and poverty. The organization operated "Help Desks" in hospitals and clinics to connect patients to essential non-medical resources that could improve their health, such as adequate food, heating, and housing. College student volunteers ran Health Leads' desks, and in 2008 the company helped over 4,000 patients through 20 desks in six U.S. cities. The factors that Health Leads considered in making its expansion decision included: its role as a mission-based nonprofit and its desire to make a national impact; the extremely high demand for new Health Leads Help Desks (up to 500 requests a year); funder growth expectations; concerns about diluting the culture and the brand; and the need for more data to prove the company's financial value to hospitals and clinics. Health Leads also had to decide what expansion would look like if it decided to take that path. Would it mean adding desks in cities in which it already operated or expanding to new cities? If Health Leads expanded, how quickly should it do so? The (B) case describes the company's strategic decision and its impact, and presents the status of Health Leads in the summer of 2013.
