THE NEW HAMPSHIRE SPAY/NEUTER PROGRAM: Lessons From The First 10 Years
by Peter Marsh
In New England, we sometimes speak of people who didn’t know each other growing up but went through the same changes as having gone to different schools together. All of us working to bring about a world where every companion animal has a loving home are going to different schools together. We go through many of the same things, with the same dream, just in a different place. The more we are able to learn from each other, the faster our dream will come true.
The New Hampshire spay/neuter program is a good example. In the early 1990s, a group of us worked to put together programs that would end the killing of healthy or rehabilitatable cats and dogs in our shelters. After speaking with advocates from one end of the country to the other, we found a New Jersey program that had been among the most successful in reducing shelter overpopulation. So we contacted the people who had worked to put this program together and designed our program to take into account all they told us about what had worked well for them and what had not. This article itself is an example of building on the work done by colleagues because it adopts the same “What Worked, What Didn’t” format. It is written to share with others what we’ve learned from operating our program for the past ten years.
1. Targeting a Program for Low-Income Pet Caretakers.
The best decision we made was to target our program to a population that had not been served in the past: cats and dogs living in very low-income households. In part we did that because this approach had succeeded in New Jersey. Even more important to us, in the 1980s we had operated statewide open access programs through which anyone could get his/her cat or dog sterilized for about half of the usual cost. While these low-cost programs seemed to keep the problem from getting worse, they weren’t able to make it a whole lot better, which is what we were determined to do. Year in and year out, we continued to put about 12,000 cats and dogs to death in our shelters.
Now we know why a low-income program is so important. It turns out that if you don’t provide a way for people living in poverty to be able to sterilize their pets, a much higher percentage of their cats and dogs remain sexually intact, which ultimately leads them to be admitted to shelters or migrate to freeroaming colonies. Even if you have good low cost programs, the copayment remains beyond the reach of the very poor and, at some point, you “hit the wall” and can’t make any more progress. That’s what happened to us. As soon as we provided poor caretakers with a program they could afford in 1994, the drop in shelter admissions and deaths was dramatic (see graph 1).
Targeting helped us in two other ways that proved critical to the program’s success. First, it made the program cost effective, which in turn has made it possible for us to secure and maintain public funding. And it allowed us to gain the broad support of local veterinarians, who had told us for some time that they would work with us on any program that helped people who genuinely needed it.
2. Using Dog License Fees as a Source of Revenue
You learn a lot when you have to generate enough revenue to keep a program operating month in and month out. Not only does the revenue source have to provide enough funding for the program, it has to provide it in a steady stream. Any time that a program has to be cut back or shut down due to a lack of funds — which has happened to us for several months over the years — it suffers a setback.
Almost all of the funding for our program comes from a small surcharge on dog licenses issued throughout the state. Dog licenses have to be renewed every year in New Hampshire, so the license surcharge gives us a steady and predictable source of income. The main disadvantage is that the program’s income becomes dependent on how many caretakers comply with the licensing laws. At first, the $2 surcharge didn’t bring in enough revenue to operate our program throughout the year. Instead of trying to get the surcharge increased, the Pet Overpopulation Committee that oversees the program took steps to have veterinarians send copies of all the rabies certificates they issued to local licensing officials. This simple procedure has increased the number of licenses issued by more than fifty percent. The $2 surcharge generates about 25 cents for each resident of the state every year, enough revenue for us to operate our program year-round. The other revenue source we considered, a specialty license plate, typically generates about 5 cents per resident each year.
A dog license surcharge, then has provided us with an adequate and annualized source of revenue. But our situation is not ideal. Applying the surcharge across the board, to both sterilized and unsterilized dogs, allows us to keep the amount of the surcharge small (an important consideration in New England) but it is not very progressive. A more sensible design would be to increase the amount of the surcharge substantially — say to $10 — and apply it only to unsterilized dogs. This procedure would not only provide enough revenue for the program, it would also give people an incentive to have their dog sterilized.
3. Establishing An Oversight Committee
A legislative committee was set up to oversee the program. I had real doubts at first that the committee would accomplish a great deal. There was concern that the diverse makeup of the committee — which by law included groups that had opposed setting up the program in the first place — would create a legislative gridlock. I was dead wrong.
Over the years, the Pet Overpopulation Committee has become the program’s champion and advocate. A good example is the work of municipal officials and veterinarians on the committee to increase the rate of compliance with dog licensing laws, mentioned above. More than that, the committee has become a place to address problems that arise and help the program adapt to changing times. Every program may need such a benefactor, if it is to thrive.
4. Using Public Assistance Programs to Determine Eligibility.
As soon as you begin to operate a neutering assistance program (if not sooner), you become jealous of the funds spent to administer it. Every dollar spent is not available to pay for sterilizations. So it’s important that the program’s eligibility criteria be easy to understand and apply. It also needs to reliably identify the people who genuinely need help and not saddle participating veterinarians with a great deal of paperwork.
We’ve found that the best way to accomplish all of the above is to use people’s eligibility for public assistance programs as the way to decide if they are eligible for our program, too. Using the New Jersey program as a model, we selected seven public assistance programs with very low-income limits, which has worked out well for us. It has allowed us to “piggy-back” on the work that the administrators of human service programs have already done. Over the years, the state veterinarian has streamlined the administration of the program to the point that administrative expenses take up less than fifteen percent of the program’s budget. In recent years, targeted low-income programs operated by Maddie’s Fund have simplified the eligibility determination process even more by selecting eligibility for a single program — Medicaid — as the standard, allowing their programs to be administered even more cost effectively than ours.
5. Establishing A Dedicated Account for Program Revenue.
Looking back, I believe the second most important developmental milestone that our program passed, after its birth in 1993, was the establishment of an earmarked or dedicated account for program revenue three years later. Before that, all the revenue from the dog license surcharge was deposited into the state’s General Fund and the program was dependent on periodic appropriations through the legislative budget process. Any funds that were not spent by the program at the end of a fiscal year were returned to the State Treasury. All of this made the program’s financial base very shaky.
Getting legislation passed to put the dog license revenue into a dedicated fund changed everything. The law sheltered the program from changes in the economic and political climates. It’s a two way street, though. The independence of being ” off-budget” means that the program must be shut down if the funds in the account are depleted. So far, though, having dedicated funds has been a good trade off for us and probably should be the goal of every publicly funded program.
6. Operating the Program Through a Network of Private Veterinarians.
Veterinary services are delivered in our program through a statewide network of participating veterinary hospitals. This has proven to be one of its greatest strengths. More than 70% of all the veterinary practices in the state have joined the program, making it much more accessible to caretakers than if the services were delivered through widely-scattered low cost clinics or a mobile unit. And accessibility is critical to the success of a low-income program because transportation
to and from the veterinary hospital is often a great barrier.
Using a network of existing veterinary hospitals has also proven to be cost effective, in large part because it takes advantage of the infrastructure that is already in place instead of paying to duplicate it by creating new clinics. The average subsidy paid by the program is about $60.00 per surgery, almost exactly the same as that achieved by Maddies’ Fund low-income programs, which are also operated through a network of private veterinary hospitals.
Taken together with the targeted design, which has steeply driven down the number of shelter admissions, and the low administration costs, operating our program through private veterinarians has helped our program be a good investment. Neutering subsidies have more than paid for themselves. Every dollar spent on the neutering program in its first seven years has saved $3.15 in reduced impoundment costs (see graph 2).
What Didn’t Work
1. Offering Neutering Subsidies to Encourage Shelter Adoptions.
From the beginning our neutering program attempted to reduce the shelter death toll by attacking it from two directions: neutering subsidies for low-income pet caretakers were designed to reduce the number of cats and dogs coming into shelters while subsidies for shelter adopters aimed to increase the number going out. We hoped that our shelter adoption rate would increase substantially if potential adopters could get shelter animals sterilized for a $25 (now $30) copayment.
Unfortunately it hasn’t worked out that way. While the shelter adopter’s program has proven to be very popular with adopters and veterinarians, the shelter adoption rate has only increased by about 20% over the past ten years. Subsidies for the low-income program have proven to be a much better investment. While each program costs about the same to operate every year, more than eighty percent of the drop in shelter deaths has come from a steep decline in shelter admissions and less than twenty percent from an increase in placements.
Not only has the shelter adopter’s program proven to be not very cost effective, by now it is somewhat regressive. It is designed to provide funding only for sterilizations that take place after an animal has been adopted. When our program was set up ten years ago, neutering before- adoption programs were quite rare. By now, they have proven to be the best practice. And they are probably a better investment than a shelter adopters’ subsidy program.
2. Not Subsidizing the Cost of Presurgical Immunizations in our Original Low-Income Program
In its original design, our low income program subsidized only the cost of the surgery. If presurgical immunizations were required for any cat or dog that was sterilized through the program, the caretaker had to pay the full cost. This proved to be a significant barrier. We discovered that almost a third of those who had applied to the program and been found eligible failed to follow through and have the animal sterilized. When we followed up with them to find out why, many said they could afford the $10 co-payment for the surgery but the extra $25 – $30 for required shots had put the surgery out of reach.
Once we recognized this barrier, we modified the program to include the cost of shots in the subsidy and increased the co-payment to $15. This has increased the average subsidy by about fifteen percent but has put the program within the reach of those caretakers that we need to reach the most.
3. Using a Complex Fee Structure for Payments to Veterinarians
In our program, participating veterinarians are paid eighty percent of their usual and customary fee for all services they provide through the program, as long as the resulting charge is below the annual fee caps set by the State Veterinarian. To set the caps, each participating veterinary hospital submits a fee schedule every year and the statewide average becomes the cap. The fee structure was designed this way so that we could take into account the variation in costs that veterinary hospitals in different parts of the state had to pay for expenses such as labor and rent. Now it seems to be a needless administrative expense and an extra burden for participating veterinarians. While a wide variation of veterinary expenses may make a design like this necessary in a large state, a small state or county would probably be better served by a single fee structure such as the one used in the Maddies’ Fund program.
I wish I could say that we knew all along how successful our program would be. It didn’t happen that way, perhaps because so many other things we tried had not worked out as well as we had hoped, perhaps because so many animals had been put to death in our shelters for so long. I can’t say, either, that we decided to try to get funding for a targeted low-income program because we thought the veterinary community would support us. We hoped so, but that wasn’t the main reason. We were interested only in saving lives and would have worked to get this program started even if the vets hadn’t been behind us.
And I can’t say that we wanted to have the program because it would save tax dollars. It just worked out that way.
A targeted low-income program allowed all of these things to come together for us and it can for any community. Perhaps it’s luck, perhaps Providence, but all the pieces of a low-income program fit together.A targeted program allows you to get the support of veterinarians, which makes it possible to get public funding. This allows you to provide big enough subsidies to make the program affordable for the people you need to reach the most and to pay vets fairly, which ncourages their broad participation and makes the program accessible. All of which makes the program effective in reducing the number of animals who entered shelters and saves tax dollars. But best of all it saves lives.
August 25, 2003
Solutions to Overpopulation of Pets
24 Montgomery Street
Concord, NH 03301
Reprinted from Paws to Think, Autum 2003, Vol. 2, No. 4, with permission from The Pet Savers Foundation,
59 South Bayles Ave. Port Washington, NY 11050-3728
The Pet Savers Foundation
59 South Bayles Ave.
Port Washington, NY 11050-3728