This case focuses on the challenges of keeping a collective impact program—the Tackling Youth Substance Abuse (TYSA) program on Staten Island—focused and effective over time, a problem faced by many collaborative community-based efforts. The TYSA program was founded in 2012 as a cross-sector collaborative response to the alarming rates of substance abuse on Staten Island, using a collective impact framework.

In the four years since its founding, TYSA had accomplished a great deal. But by October 2016, when the case opens, many of the original members of TYSA’s steering committee—most of whom had been high-level decision-makers in their organizations—were delegating their spots to mid-level staff who were not empowered to make organizational decisions. In addition, TYSA’s early successes against prescription drug abuse were increasingly overshadowed by a growing opioid problem on the Island and by a continuing culture of alcohol abuse by underage teens. A subtler challenge was that, in the Staten Island community, TYSA was over-identified with Adrienne Abbate, TYSA’s Project Director, herself; how could TYSA shift the community’s perception to demonstrate the program’s value beyond its leader?

Project Director Adrienne Abbate decided to pull TYSA’s executive leadership and staff together to discuss strategies to reinvigorate the program and to sustain the momentum they had fought so hard to create.

Physician Moka Lantum was ready to try his hand as a social entrepreneur, aiming to improve healthcare for an underserved population in rural Kenya, where access to clinics was difficult, curable diseases flourished, maternal and child mortality rates were high, and dangerous counterfeit drugs flooded the market. Lantum began to develop a technological solution that could address multiple public sector healthcare problems through a single IT tool, ZiDi, a cloud-based system that could process a wide array of information, from individual patients and their symptoms to drug supplies, the utilization rate of individual clinics, or staff absenteeism. 

Lantum and a Kenyan partner incorporated MicroClinic Technologies Inc. (MCT), launching ZiDi in August 2012. Lantum’s goal for MCT was to demonstrate that ZiDi could improve maternal and child health in rural clinics and dispensaries, and persuade the government to buy it. Over the next two years, ZiDi proved useful, and MCT won endorsements and awards—but no government contract, not even a request for proposal (RFP). By August 2014, the slow pace of government decision-making was threatening MCT’s existence. Lantum had to decide: stay the public sector course or diversify into an uncharted market segment with its own unknowns?