NKF: Meeting the Challenge Together

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NKF Meeting the Challenge Together

• John Davis
• CEO, National Kidney Foundation, Inc.
• February 6, 2008

2008 Executive Leadership Conference
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Agenda

• The Big Picture Re-Defining Our Challenge
• NKF Breaking News
• Program Updates Announcements
• Progress in our transition to Divisions
• NKF is Meeting the Challenge Together

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BREAKING NEWS!

• A New Study in the Journal of the American
  Medical Association re-calculates the number of
  American adults with chronic kidney disease.
  Based on this new data, NKF can report that the
  current number is
• 26,000,000

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Re-Defining Our Challenge

• That is a 30 increase in the number of direct
  NKF constituents
• The increase has occurred since 2002
• And, gt 400,000 Americans are now on dialysis
• Medicare alone is now spending gt 20 Billion
• And, gt 75,000 Americans are waiting for kidneys
• That number has doubled since 1996
• 13,937 kidney transplants were done in 2007
• Nearly 50 of transplants are from a living donor

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Re-Defining Our Challenge

• All organizations seeking funds from the
  pharmaceutical industry must cope with increased
  scrutiny and regulatory challenges
• Public Policy Challenges Continue
• Much unfinished business from last session of
  Congress
• New conditions for coverage for ESRD facilities
• 9th Scope of Work for Medicare Quality
  Improvement Organizations
• Honest Leadership Open Government Act of 2007

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Re-Defining our Challenge

• Increasing Competition for Attention Donors
• We intend to fight harder for our rightful share
  of the publics money and awareness
• Number of health-related messages increasing
• NKF and CKD must compete with pharmaceutical and
  insurance companies, government, hospitals and
  other not-for-profit organizations
• Leading the fight for attention is 9 Billion
  companies spent on medicine advertising last year

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Re-Defining our Challenge

• We Must Have A Unified and Focused Approach
• NKF signature fund raising programs must grow
• ? Kidney Cars ? NKF Golf Classic ? Kidney Walks
• Continue to increase corporate support for
  programs ? Kidney Learning System (KLS) ? KEEP ?
  Guidelines
• New major increased focus on individual
  contributions
• ? Online Giving ? Individual Gifts ? Planned
  Gifts
• Continue high-quality cost effective local
  special events

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Re-Defining our Challenge

• The Time Is Now
• We are making the necessary investment in
  resources, people, structure, strategy to be more
  effective so we can meeting these new challenges
  and fulfill our mission
• We have our Strategic Plan in place strong
  leadership to guide us
• We have a shared mission, need a shared vision to
  be successful
• We are helping more and more of you with your
  organizational needs
• That should help free you up to focus on fund
  raising and program improvement strategies

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Re-Defining our Challenge

• Building for the future includes
• Hiring new high level professionals
• John Brown, Training Director
• Larry Geiger, VP for Marketing
• Kelly Robertson, Internal Marketing Director
• Chief Financial Officer
• VP for Development (Individual Giving)
• Web Site Editor
• Recruiting Director

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Re-Defining our Challenge

• Building for the Transition to Divisions
  includes
• Joan Shepard Lustig, Senior VP
• Lauren Bruce, Transition Services Manager
• Stephanie Shipman, Field Services Manager
• Petros Gregoriou, Field Services Accounting
  Director
• Vice President for Divisions
• Plus outsourcing various technical functions
• NKFs Call Center
• Data Base Management

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Re-Defining our Challenge

• In addition to new staff in New York, NKF has
  added nearly 60 people to its staff as a result
  of Affiliates becoming Divisions.
• This brings our staff numbers to nearly 200. We
  anticipate being at about 250 by year-end.
• That nationwide cohesive team will bring new
  focus to meeting our challenges. Were very
  excited about the way we can work together to
  meet our challenges.

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BREAKING NEWS!

• NKF Kidney Cars revenues for the current year
  are running 33 higher than last year!
• Car donation rate has reached gt40,000 annually
• Improved Search Engine Ranking
• Improved online marketing, pricing program
  efficiencies is having positive impact on the
  amount per car
• New Drop-off Option
• Nationally sponsored program

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Fund Raising and ProgramImprovement Strategies

• NKF Golf Classic National Championship at Pebble
  Beach got rave reviews
• "It was a once in a lifetime golf experience. It
  was awesome and well organized. The weather was
  fabulous all in all a great trip, thanks!
• "We had a fabulous time. I don't think any of us
  wanted to leave. It was a terrific golf
  experience! Thanks to the National Kidney
  Foundation for making it possible.
• Pebble Beach will again be the site for the 2009
  NKF Golf Classic National Championship

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Fund Raising and Program Improvement Strategies

• At Pebble Beach NKFs Saturday night auction made
  a Record Breaking 75,000
• Over 80 tournaments scheduled for 2008
• NKF benefits from both NKF Golf Classic and
  Cadillac Invitational events
• Sponsors include Ping, Golf Digest, Adidas, and
  Pebble Beach Resorts.
• New Golf Club Donation Program Kidney Clubs

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Fund Raising and Program Improvement Strategies

• NKF New Golf Donation Program
• Kidney Clubs
• Golfers can either donate clubs at an NKF event
  OR directly through the new donation website on
  their own at any time
• Donations are received and payment is forwarded
  directly to NKF Affiliates Divisions
• Working with 3balls.com a leading internet
  retailer of used/like-new brand name golf
  equipment

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Fund Raising and ProgramImprovement Strategies

• 88 Kidney Walks in 2007 with 40,000 walkers
• 3.5 Million in 2007 50 growth from year before
• Our goal is gt 5 Million in 2008 and 15 Million
  soon
• Largest Walks in NKF Divisions Serving Greater
  New York and The Delaware Valley broke attendance
  fund raising records!
• Currently expanding marketing support
  initiatives to strengthen program and national
  brand

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BREAKING NEWS!

• KEEPs 100,000th participant was tested on
  November 15th in Los Angeles.

Aura Lemus, Inglewood, CA
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Fund Raising and Program Improvement Strategies

• 60 KEEP events are planned for World Kidney Day
  and throughout March
• 2008 KEEP goal is to increase KEEP participation
  to over 3,500 per month
• Global KEEP Expansion is progressing
• KEEP Annual Data Report
• New format, coming in April (AJKD supplement)

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Fund Raising and Program Improvement Strategies

• KEEP in 2008
• Revised Screening Questionnaire
• Longitudinal Program launch
• Additional Follow-Up with participants for cohort
  maintenance
• Additional Tests
• HDL, LDL and Hemoglobin A1c (HbA1c)
• Educational follow-up programs launched
• Expansion into Alaska and Puerto Rico
• KEEP event quality has improved since October

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CKD within DM and HTN is the new paradigm for
public health and the NKF
HTN
CKD
DM
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NKFs CKD Message

• Cardiovascular disease is the number one killer
• Chronic Kidney Disease multiplies CVD risk
• For every CVD risk factor (Diabetes,
  Hypertension, Dyslipidemia, Anemia), clinicians
  must test for CKD
• The patients are sicker
• Risk factor levels are higher
• Control is worse and treatment is more complex
• Outcomes are worse
• Costs are higher
• With CKD, patient management is different
• Treatments are available and effective today

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NKFs Message in Stage 4 CKD

• Stage 4 CKD is an asymptomatic clinical event!
• We can slow progression in Stage 4
• We can reduce the incidence of bad events that
  occur in Stage 4
• We can reduce the severity of Stage 4
  co-morbidities
• We can improve the coordination of care in Stage
  4
• We can prevent
• Death
• Cardiovascular events
• Loss of cognitive function (in aging)
• Kidney failure

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Fund Raising and Program Improvement Strategies

• More CKD patients identified and treated
• NKF KEEP program
• CDC NKF state detection programs
• Increase awareness and enhance providers ability
  to detect and treat patients
• Help providers and payers address the problems of
  diabetes, cardiovascular disease and CKD
• Better outcomes

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BREAKING NEWS!

• As of April 1st, KEEP will have a new central
  laboratory serving all Affiliates and Divisions.
  NKFs new lab partner is

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Fund Raising and ProgramImprovement Strategies

• Quest is the nation's leading provider of
  diagnostic testing, information, and services
• gt30 regional laboratories in key US markets, with
  over 2,000 patient service centers
• More than 41,000 employees
• The worlds largest private database of clinical
  test results
• Quest tests more than 150 million people a year
• Multi-dimension partnership that will build KEEP

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Fund Raising and Program Improvement Strategies

• Rationale for change to Quest
• More OPPORTUNITY
• They have size, scope reach
• Physician interaction
• Opportunity to engage Quest in educational
  programs and other activities
• Opportunity to involve Quest employees in KEEP
  events
• Will make change as seamless as possible fully
  operational by April 1

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BREAKING NEWS!

• At the request and initiation of KEEPs
• Primary Sponsor, Amgen, NKF is launching the
• KEEP Affiliate/DivisionDevelopment Fund

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Fund Raising and Program Improvement Strategies

• The KEEP Affiliate/Division Development Fund
• Founding Sponsor is Amgen
• Other sponsors will be solicited
• Grants will be made by NKF through applications
  available to Affiliates and Divisions
• Grant criteria focused on doing new things
• Expansion of the KEEP program in an Affiliate or
  Division territory, not for simply holding KEEP
  events
• Establishing KEEP in new areas
• Making KEEP events regularly scheduled and
  longitudinal

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Fund Raising and Program Improvement Strategies

• Amgen will not fund any grant requests for KEEP
  from NKF Affiliates Divisions
• Amgen will continue to consider program and event
  grant requests as long as they do not relate
  directly to KEEP
• Other sponsors have requested such a program and
  their funds will be added to the pool
• All funds must be awarded to Affiliates or
  Divisions, NKF will not retain any of the money
• Applications available March 1
• First Awards will be given on April 1
• Funding in 2008 will exceed 500,000

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Fund Raising and Program Improvement Strategies
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Fund Raising and Program Improvement Strategies

• On World Kidney Day, March 13th, NKF will hold
• Nearly 50 KEEP events around the country
• Major events in New York
• Closing bell at NASDAQ stock exchange
• Times Square jumbo-tron, NKF public service
  message
• Grand Central Terminal mini screening and
  awareness
• Major events in Washington DC
• Congressional Kidney Caucus Briefing Reception
• People Like Us patient advocates visit members
  of Congress
• In Los Angeles -- KEEP it Hollywood mini
  screening for celebrities media

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Fund Raising and ProgramImprovement Strategies

• World Kidney Day Media/Promotion plans include
• Satellite media tour featuring Steven Cojocaru
  (Cojo) of ET
• Dear Abby letter
• CNN feature with Dr. Sanjay Gupta
• Extensive coverage in major dailies, national
  magazines on the Web
• Editorials in all major nephrology journals
• Interview on Tom Joyners morning show
• Great local events planned
• Kidney Awareness Night at a Miami Heat game
• Kidney Awareness Night at a Denver Nuggets game

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www.kidney.org/news/wkd/local
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Research

• RESOLVED that, due to projected growth in
  organizational strength and resources through
  transition of many Affiliates to Divisions, the
  National Kidney Foundation will commit to
  doubling its research program funding over the
  next five years.

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NKF National Budget Research Spending
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Fund Raising and Program Improvement Strategies

• Other Program Improvements
• Hope Street
• One of NKFs best received patient education
  programs
• Used in nearly all US dialysis units
• Supported by both Large Dialysis Organizations
• Funded through June
• New funding actively being sought
• KLS educational programs growing and being tested
  in collaboration with Affiliates/Divisions

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KLS CME/CE Activities

• Over 22,500 Learners and growing
• 45 Non-Nephrology Clinicians

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Fund Raising and ProgramImprovement Strategies
NKFs Take Action Network is growing rapidly!
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Fund Raising and ProgramImprovement Strategies

• The Take Action Network
• Now has more than 3,000 volunteers
• 7,634 messages sent to Congress in 2007
• Can now reach every Senator (100) and 423 of 435
  U.S. Representatives with constituent views
• Network has grown by almost 30 since October
• All of your Board Members should be included
• We all should encourage our own Members of the
  House of Representatives to join the
  Congressional Kidney Caucus

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Fund Raising and ProgramImprovement Strategies

• NKFs Public Policy Successes in 2007
• Revised FDA label for EPO to be consistent with
  KDOQI 
• Norwood Living Organ Donation Act allows paired
  donation
• CKD quality measures added to the Medicare
• Increased appropriation for CKD Program at CDC to
  2 million
• Proposed 4 cut in dialysis payment not enacted

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Fund Raising and Program Improvement Strategies

• NKFs Public Policy Priorities for 2008
• Passing the Kidney Care Quality and Education
  Act
• Securing Medicare payment for education at CKD
  Stage 4
• Validating bundling of payments for dialysis
  services before a new bundled payment system is
  fully implemented
• Building and increasing funding the CKD Program
  at CDC

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Fund Raising and Program Improvement Strategies

• NKFs Public Policy Priorities for 2008 (cont)
• Improving access to early transplantation
• Extending immunosuppressive drug coverage for all
  who have had a Medicare covered kidney transplant
• Enhancing use of the Medicare Medical Nutrition
  Therapy Benefit
• Maintaining a focus on kidney disease in the
  development of Healthy People 2020
• Continuing the prohibition against the purchase
  or sale of organs for transplant

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Fund Raising and Program Improvement Strategies

• NKFs Public Policy Priorities for 2008 (cont)
• Removing the financial disincentives for living
  donation
• Increasing funding for kidney research at NIH
• Increasing funding for the FDA to assure patient
  safety while improving access to new drugs
• Building the membership and activities of the
  Congressional Kidney Caucus
• Utilizing People Like Us (PLU) to focus NKFs
  public policy program on patients

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BREAKING NEWS!

• UNOS has announced its intention to change the
  system for allocating deceased donor kidneys.
• Time on dialysis will no longer be the criteria
• Additional life years added by the transplant
  will become the main factor
• Serious implications for our patients
• Change is expected by the end of 2008

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NKF 2008 U.S. Transplant Games

• Pittsburgh, PA
• Venues
• University of Pittsburgh
• Carnegie Mellon University
• David L. Lawrence Convention Center
• Soldiers and Sailors Memorial Hall
• Heinz Field

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U.S. Transplant Games

• Part of Pittsburghs 250th city anniversary
  celebration
• VIPs/Celebrity Presence
• PR coordinating celebrity appearances and media
• Pittsburgh Pirates Organ Donor Awareness Night
• Expect Largest Games 5K Working with OPO on
  outreach to local workplace partners for
  corporate team participation

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NKF Spring Clinical Meetings
NKF 2008 Spring Clinical Meetings April 2-6,
2008Gaylord Texan, Dallas, TX

• Debut of a special track for NKFs new Council
  of Advanced Practitioners (Physician Assistants
  and Nurse Practitioners)
• A total of 323 abstracts were submitted for
  CM08, compared to 285 in CM07
• Over 90 exhibits expected
• Goal is to exceed CM07 registration numbers
  (over 2,500)

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BREAKING NEWS!

• NKF announces that it will develop and launch a
  new marketing campaign in 2008 that includes, for
  the first time ever, paid broadcast and print
  advertising nationally and in key markets around
  the country.

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Fund Raising and Program Improvement Strategies

• NKFs new advertising
• Development effort headed by Fitzgerald Co., a
  McCann-Erickson company best known for Coca Cola
  Classic television advertising
• First step was research on NKF and CKD awareness
• Development of creative brief well underway
• Creative concepts and plans to the Board in April
• Pilot test of ad campaign by 3rd Quarter 2008
• Anticipated NKF investment could be
• 1,000,000

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BREAKING NEWS!

• Three more NKF Affiliates have voted to join the
  Transition to Divisions with votes in the past
  week. And, more votes are schedule in February
  and March. Joining the movement this week are
• NKF of Upstate New York
• NKF of Kansas and Western Missouri
• NKF of East Tennessee

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NKF Coast-To-Coast
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NKF Coast-To-Coast Direct Service Areas
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NKF Coast-To-Coast Direct Service Areas
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NKF Coast-To-Coast Direct Service Areas
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NKF Coast-To-Coast Direct Service Areas
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NKF Coast-To-Coast Direct Service Areas
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NKF Coast-To-Coast Direct Service Areas
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NKF Coast-To-Coast Direct Service Areas
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NKF Coast-To-Coast Divisions
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NKF Coast-To-Coast Divisions
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NKF Coast-To-Coast Divisions
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NKF Coast-To-Coast Divisions
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NKF Coast-To-Coast Divisions
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NKF Coast-To-Coast Divisions
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NKF Coast-To-Coast Divisions
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NKF Coast-To-Coast Divisions
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NKF Coast-To-Coast Divisions
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NKF Coast-To-Coast On Deck?
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NKF Coast-To-Coast On Deck?
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NKF Coast-To-Coast On Deck?
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NKF Coast-To-Coast On Deck?
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Transition to DivisionsFrequently Asked Questions

• What about our money?
• In this structure, Divisions and NKF share the
  same finances. Plan for next years budget to
  equal this years. Growth will come at about the
  same ratespending income go up together
• What about our autonomy?
• Division Boards (and Regional Boards) will still
  make priority decisions, develop the budget,
  evaluate staff performance, set goals and speak
  to and for the public

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Transition to DivisionsFrequently Asked Questions

• Will our local programs continue?
• We will not take away the traditional programs
  you have runCampsResearch Programs Patient
  Assistance Funds Symposia . Local priorities
  will be set by the Division Board, local revenue
  will support them, they will continue
• Will we be forced to do National programs?
• We believe KEEP, patient service and education,
  organ donation awareness and public education are
  part of a balanced program for Affiliates and
  Divisions beyond and within those elements, you
  decide

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Transition to DivisionsFrequently Asked Questions

• Will we just be fund raisers?
• No, NKFs corporate culture is very program
  oriented. Programs that benefit patients, their
  families and people who care for them are
  critical to success.
• Will we only have to do NKF fund raisers?
• No, again we believe Kidney Cars, golf and walks
  are important building blocks in a balanced fund
  raising programs. But, local priorities and
  doing what works will be local decisions.

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Transition to DivisionsFrequently Asked Questions

• What about our staff?
• At the transition, Affiliate staff become part of
  the National Staff
• All Affiliate CEOs and Executive Directors will
  become either Division Presidents or Regional
  Vice Presidents
• Only in the largest Affiliates with purely
  bookkeeping or personnel staff will a staff
  reassignment/transition be considered
• There will be at least a six-month transition
  period
• Management will be professional and consistent

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Transition to DivisionsFrequently Asked Questions

• Will this benefit Affiliate staff members?
• Market-based competitive salaries determined by
  objective data analysis
• Access to the NKF health and life insurance
  program (highly rated, family coverage, cost
  effective, flexible), includes short and long
  term disability coverage
• Paid Time Off Program
• Pre-tax Flexible Spending Accounts
• 403b Retirement Plan based on NKF contributions
• Tax deferred individual retirement plan
• Longevity incentive (for every 5 years 1.25 of
  salary)
• Time spent at the Affiliate will count

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Frequently Asked Questions

• Will Division President and Regional Vice
  President positions be good jobs?
• They will be very similar to Affiliate CEO and
  Executive Director jobs, without the
  administrative burden focus on doing programs,
  raising money, working with volunteers raising
  public awareness
• Salaries will be performance-based with an
  incentive compensation plan to reward achievement
  of goals (agreed upon by NKF, Division or
  Regional Board, the Division President or
  Regional Vice President)
• Additional tax deferred retirement plans will be
  offered
• Extensive training personal development
  opportunities will be offered at NKFs expense
• Compensation and benefits review and competitive
  analysis by Clark Consulting, Inc. and NKF
  Compensation Committee
• Performance-based job security

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Transition to DivisionsFrequently Asked Questions

• Will this be good for our Affiliate?
• Yes, here are some of the reasons why
• Financial security
• NKF marketing and brand identity
• Help Desk operation for IT, HR, PR
• Continuity of local programs priorities
• Additional NKF resources
• Elimination of legal regulatory liability
• Assurance of legal regulatory compliance
• Retained voice in NKF priorities and plans

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Statements You Will Never Have to Worry About,
Again!

• Hello, Im from the IRS
• When I get elected Chairman, were going to do
  everything my way
• Im a prominent doctor, Ill decide myself who
  gets our research grants
• Your staff gets paid more than theyre worth
• Lets hire whoever is cheapest
• This is notice of a legal proceeding in which you
  are named as defendant

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Transition to DivisionsFrequently Asked Questions

• Will this be good for NKF?
• Yes, here are some of the reasons why
• Consolidated resources and operations
• Expanded data base of potential donors
• Program delivery through a consistent plan
• Economies of scale in administration, program,
  fund raising and capital expenses
• Greater ability to provide more help to more
  patients and fulfill NKFs mission

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Transition to DivisionsFrequently Asked Questions

• What will NKF be able to do differently?
• Provide better ROI to national sponsors
• Conduct better donor solicitation programs
• Provide cost-effective back office support
• Implement a comprehensive training program
• Improve intra-organization communication
• Launch a real NKF Planned Giving Program
• Fund better research

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Transition to DivisionsFrequently Asked Questions

• Can NKF live up to all its promises?
• Yes, and here are some of the reasons why
• This is a total organizational commitment made
  by the Board, volunteer leadership, medical
  leadership and staff
• Funds have been identified
• Staff is being added (short term increase in
  administrative costs taken into account)
• Communication and training are being enhanced
• All commitments made to date have been met

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Transition to DivisionsFrequently Asked Questions

• How do we define successful?
• We will measure the growth, fund raising
  experience, program delivery and visibility of
  our Divisions. That assessment will come after
  their first two years as a Division. Affiliates
  success will be measured just like we measure the
  success of Divisions. They wont have to meet a
  higher standard, just keep pace with the growth
  of the Divisions.

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Progress in our Transition to Divisions

• Continuing to strengthen and build our national
  brand
• New advertising
• Combining Division National databases,
  including extensive on-site IMIS training
• IT upgrades in Division offices, including
  training
• Staff professional development opportunities
• Additional volunteer training
• Convio implementation
• Automation of HR systems

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Progress in our Transition to Divisions

• Other benefits coming for divisions
• Real-time financial statements by May 1
• Increased Marketing Communications
• New VP doing needs assessment across the
  organization immediately addressing Web site,
  Membership, Professional Meetings, KEEP
• More regular internal communication Introduced
  Foundation Focus, more frequent e-Kidney
  newsletters and Division/National calls
• Paper-less resources for staff expense reports,
  insurance and payroll documents and real-time
  personnel information

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Progress in our Transition to Divisions

• More training to include
• Career Development for Program Fund Raising
  staff at Divisions
• Staff and volunteer leadership training
• Walk/Golf Academy enhancement
• Updated On-boarding for new employees
• IMIS Convio (basic, intermediate, advanced)
• Expanded general training
• Internal/external customer service
• Individual performance improvement
• Organization procedures, systems policies

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2009 Executive Leadership Conference

• February 4 7
• New York City

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