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The unlikely agency president

Jeffrey Sinsebox was not a soccer player and knew nothing of the intricacies of the game, but when his daughters’ travel soccer team was in danger of folding because it had no coach, he did something familiar.
Sinsebox, 39, stepped outside his comfort zone and took on the task, immersing himself in the sport, reading coaching strategy Web sites and watching as many matches on television as he could. His path to the sidelines is just as unlikely as his ascension to the presidency of People Rebuilding and Living In Dignity Inc., a Henrietta-based organization that serves people with disabilities.
Under Sinsebox since 2005, PRALID has grown from a budget of close to $4 million and roughly 130 employees to nearly $7 million in operations and a staff of more than 210. And this happened even though working in services for the disabled was supposed to be a temporary gig for Sinsebox until he could find a job as a teacher.
Growing up, he had always wanted to teach social studies. But his mother worked at Rochester Institute of Technology and he could attend for free, so Sinsebox tried his hand at electrical engineering. He hated it.
When he transferred to SUNY College at Brockport, he had to seek full-time work to help pay his tuition. Because his student-teaching schedule took priority, Sinsebox needed a flexible job, so he began working at a group home run by Heritage Christian Services Inc.
After graduation, Sinsebox had trouble finding work as a teacher, so he picked up another job at CP Rochester, the United Cerebral Palsy Association of the Rochester Area Inc., that would give him health benefits. From there, his path was set.
“I was a service coordinator at CP Rochester, and this really good opportunity came along where my boss’s boss moved into a new job and they gave me the opening for a three-month period,” Sinsebox said. “Up until that point I thought, ‘This is what I’m doing for now to pay the bills, but someday I’m going to get a real job.’ The more I thought about it, particularly when I thought about going to grad school to get my master’s in education so I would have permanent certification, I thought, ‘I’m doing what I want to be doing.'”
Back from the edge
His rise from entry-level service provider to president served Sinsebox well when he took over as president at PRALID in 2005. As a young organization, PRALID still had more resemblance to the small, family-run group of its early days than to a large provider of services.
The organization struggled with its programs and compliance. The staff had been putting so much effort into shoring up the finances that the quality of programs slipped, Sinsebox says. But because he had such intimate knowledge of how residential programs function, Sinsebox knew what it would take to make the necessary improvements.
“When I got here I had to really get down into the programs,” he says. “It also gave me a lot of credibility with our staff. They couldn’t tell me I don’t know what their job is like, because I had already done it and knew what needed to be done, and that made it so much easier to get there.”
Most of the troubles stemmed from the growth path the agency had taken after its founding. PRALID was started in 1994 by the parents of a young man who suffered a brain tumor that caused cognitive and behavioral changes. After going to different agencies in search of services and petitioning the state, they eventually were told that if they created their own agency, they could receive funding.
While they were tenacious and helped grow the organization, Sinsebox says, they were not businesspeople.
“It really was a mom-and-pop kind of agency, and as it grew, it became kind of hard to run that kind of an agency,” Sinsebox says.
PRALID got into regulatory trouble involving Medicaid reimbursements and had to pay $275,000 in a settlement with the state attorney general’s office. In 2004 its debt-to-equity ratio was 29.5 percent, nowhere near the target of 2 percent or less. But after stringing together a few years of surpluses, PRALID has paid off its debt and Sinsebox has focused on reducing overhead and strengthening the programs.
Tanya Griffin, director of quality assurance, said that when Sinsebox arrived, some of the programs were in such poor condition that they were in danger of being closed. Griffin, who also worked with Sinsebox at CP Rochester, says his renewed attention to the regulatory issues that had caused PRALID’s setbacks helped turn it around.
“He worked tirelessly at training the staff and hiring new staff who were knowledgeable of the regulatory components, so we could stay open and improve the quality of services across the board,” Griffin says.
In shifting the focus to quality, no expense was too minor to be cut. Sinsebox sought out efficiencies that were small, such as eliminating paper cups for the drinking fountain, and large, such as his decision to forgo public relations campaigns. The focus was to cut out any bit of excess and pour the savings into services.
Take the case of a man who lived in one of the organization’s group homes. He was diagnosed with a terminal condition last year but did not want to leave for a hospice, so PRALID brought in the staff and equipment that enabled him to stay where he was. It cost $70,000 to $80,000 in all.
“You never want your finances to dictate the decisions you’re making,” Sinsebox says. “When it comes to paper cups or coffee, that’s way less significant than the service you’re providing to individuals. That’s been the big focus of mine.”
Taking away coffee and withholding paper cups might sound like the acts of an office despot, but Griffin insists that Sinsebox is anything but that. Many of the organization’s projects keep employees in the building for 12-hour days, and dealing with clients who may be injured or in emergency situations can weigh on them. It is his humor and bright attitude that make coming to work pleasant, Griffin says.
“The things we deal with on a day-to-day basis aren’t always positive, but in dealing with serious situations he always has a positive outlook,” she says.
Even as he dives into his work, Sinsebox tries to maintain a balance in his life. He volunteers as a fundraiser for the Juvenile Diabetes Research Foundation and with Flower City Habitat for Humanity Inc.
Sinsebox, who lives in Henrietta with his wife, Maureen, and daughters Paige and Grace, is also an avid outdoorsman, working his way through hiking all of the high peaks in the Adirondacks.
Picking the spots
To conserve its resources, fundraising also has taken a more minor role at PRALID. The agency brings in $10,000 to $15,000 each year with small events, but Sinsebox says expanding those efforts would not be cost-efficient.
“Fundraising is a struggle for me because people go out to a golf tournament and pay $125 for a ticket, and after all its bills the agency gets $20 of that,” Sinsebox says. “Now you’ve paid someone for 10 months to help organize that or paid a consulting agency.
“There are agencies that fundraise very well, but for many, if it’s not done correctly it’s an exercise in futility.”
The focus instead is on building relationships in the community. PRALID puts out a newsletter and has held a picnic at Frontier Field to build long-term relationships with the families it serves. That could lead to what Sinsebox regards as the serious fundraising money, large donations and bequests.
Because the agency is smaller and newer than some other service providers, Sinsebox has to pick his spots.
“I think the bigger agencies invest a lot of time and effort into selling themselves and have the staffing required to go everywhere and be everywhere,” Sinsebox says. “You have to pick the things you think are most critical.”
The approach has come with a price, Sinsebox says. PRALID provides the same services as larger or more well-known agencies, but its decision to stay out of the spotlight means it sacrifices name recognition among consumers.
“It’s hard to look at another agency saying ‘We’re the premier source’ of doing something, when we’re doing it as well,” Sinsebox says. “I’m more of the philosophy that if you do the right thing and do it long enough and well enough, you’ll earn your reputation regardless of how much flash you have.”
One of PRALID’s greatest strengths is its relationship with its board of directors, Sinsebox says. Unlike some organizations whose board members know more about the mission statement than the balance sheet, Sinsebox says, PRALID has directors who were always attuned to its difficulties and aware of what it would take to emerge.
“When I came here, the board was already so plugged in, probably from the troubles that had already occurred,” Sinsebox says. “It was always my hope to have an open relationship with the board, give them full disclosure of what is going on. It makes the agency work a lot better to have this seamless flow of information.”
Chairman Patrick Rogers says Sinsebox is in frequent communication with the board and sends administrators to board meetings to update members.
Because board members have financial expertise and stayed closely involved, Rogers says, PRALID had strong financial management even when there were problems with programs and regulatory matters. It was the selection of Sinsebox as president that allowed the organization to turn its focus to making operational improvements.
“Our finances have always tracked pretty well. We hoped for growth and maybe didn’t achieve it, but we didn’t want to grow until our operations were at a level where consumers are being cared for and our fundamental mission is being accomplished,” Rogers says. “The way it was being run before really didn’t allow for the combination of taking care of consumers while looking for ways to grow, and with Jeff we have that.”
Despite his restraints on spending, Sinsebox still sees much room for PRALID to grow in the changing landscape for non-profits.
One opportunity is in the nursing home transition and diversion waiver, a state program designed to help people in nursing homes or at risk of being placed there to remain in the community. The waiver helps provide supports such as home health aides and environmental modifications that transform homes into proper facilities for their care.
Because PRALID has no state or national affiliations, it has the ability to grow its services without limitation. The organization has grown its services in Buffalo and Niagara Falls, especially for environmental modifications.
“Two years ago we were doing about 30,000 of those e-mods, and this year we’re doing over half a million,” Sinsebox says. “At the rate it’s growing, we should be doing more than a million or better in another year or so.”
As for the lengths he goes to in trimming excessive spending from the organization, Sinsebox says he believes he is simply ahead of the curve. With more scrutiny ahead for non-profit organizations as state funding and revenue in general are under pressure, the new reality will be paring as much as possible rather than simply looking for more money, he says.
“It’s starting to become more that way because it’s going to have to,” Sinsebox says. “The responsive agencies used to just go to their legislators and ask for more money, but the path we’re on is unsustainable. We need to find ways to do things more efficiently.”
Unlikely successes
His own background and expertise could be an indicator of this new reality for non-profits. More of a mechanic than a car salesman, his focus on the nuts and bolts of the operation could be the template for more leaders of organizations, he says.
“I think at non-profit agencies across the board, the way it used to be was you were a fundraiser or a diplomat or a politician, but not an operations person,” Sinsebox says. “I think that flew for decades. In addition to those things you need to be savvy with the way the programs are run operationally.”
The savvy is coming along for Sinsebox. This year he completed a master’s in communication at SUNY Brockport, improving the skill he calls both his “biggest asset and biggest liability.” The degree helped him represent PRALID better, drawing on the times when he can command a room full of employees during a training session. It also reduced the chance of “saying just the dumbest things,” which he admits he sometimes does.
Whatever strengths he developed in earning the degree, Sinsebox recognizes it only makes his resume that much more unlikely.
“The most logical thing for me to have done would be to get an MBA, a master’s in health care administration or perhaps public administration,” he says. “But I didn’t have a ton of interest in those programs-not that they’re not good and worthwhile.”
Griffin believes it is because Sinsebox learned about health care systems in a day program rather than a classroom that he is such a good leader. Having worked in direct care, he was able to diagnose operational problems better than a leader who started at a management level, she says.
“I think the difference is Jeff worked his way from the ground up,” she says. “When there’s a crisis or an unusual situation, he’s able to step in and do a thorough analysis of whatever the problem is. Because he’s worked in those settings and positions, he is coming at it from a practical perspective.”
Or it might be that Sinsebox just has a knack for doing things the unconventional way. The girls on the soccer team he coaches would probably agree: In his second year as coach, he has guided them to a 7-1 record, best in the league.

Jeffrey Sinsebox
Title: President, People Rebuilding and Living in Dignity, Inc.
Age: 39
Education: B.S. in history, secondary social studies certification, SUNY College at Brockport, 1992; M.A. in communication, SUNY Brockport, 2008
Family: Wife Maureen; daughters Paige, 10, and Grace, 8
Residence: Henrietta
Hobbies: Outdoor activities, coaching and soccer
Quote:”You never want your finances to dictate the decisions you’re making. When it comes to paper cups or coffee, that’s way less significant than the service you’re providing to individuals. That’s been the big focus of mine.”

rbj@rbj.net / 585-546-8303

07/24/09 (C) Rochester Business Journal

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