Waitlist Zero — Planning Grant

Although it is not currently one of our main focus areas, we have identified advocacy around increasing organ donation as an area with potentially outstanding “room for more philanthropy.” In particular, we see no substantial organizational capacity devoted to finding and promoting ethical, safe, and politically plausible ways to provide benefits for kidney donors, which could have sizable health benefits while saving the healthcare system money.

Thomas Kelly and Josh Morrison, who are considering starting an organization to advocate on this topic, approached us to consider funding their work for a planning period of 4 months. The brief proposal they submitted is available here.

Thomas is a political science graduate student who is planning to donate a kidney this fall, while Josh is a kidney donor and lawyer who worked at the Alliance for Paired Donation until leaving to work on this project full time.

“Thomas Kelly—Thomas is a PhD Candidate in Political Science at UC Berkeley where he studies American politics. His current research focuses on lobbying and advocacy, particularly the differences in lobbying between public and private providers of government services. He completed his BA in Economics and Political Science at the University of Michigan in 2010. He is planning to donate a kidney to start a “chain” of kidney donations in Fall 2014.
Josh Morrison– Until recently, Josh was General Counsel and Director of Strategic Initiatives at the Alliance for Paired Donation, a leading innovator in living kidney transplantation. He also serves as Co-Chair of the Transplant Recipients International Organization Youth Circle. Prior to that he worked as a life sciences attorney at Ropes & Gray, a law firm in Boston. He received his B.A. from Columbia University and his J.D. cum laude from Harvard Law School, where he was an editor of the Harvard Law Review. He is the co-author of a forthcoming article in the Journal of Law and Contemporary Problems, State Organ-Donation Incentives Under the National Organ Transplant Act. He donated a kidney in December 2011.”

This is an area where GiveWell staff have an unusual level of personal interest and engagement. Senior Research Analyst Alexander Berger donated a kidney and publicly argued for incentives for kidney donors in 2011. Along with GiveWell Research Analyst Howie Lempel, he has been informally advising Thomas and Josh as they’ve started the planning process (for several months before they approached us for funding), and he is (personally) a financial supporter of the project. Alexander and Howie have social relationships with Josh and Thomas based on their informal advisory relationship, and Josh has stayed at Alexander’s house when he visits San Francisco.

The proposal requests $50,000 to pay Josh and Thomas to leave their jobs and spend four months developing a plan for an organization to develop and promote policies that would use public benefits for kidney donors to eliminate the waiting list.

“It should be possible to provide public benefits to donors, perhaps along the lines of the GI Bill, so that their gift are valued as a public service while not being treated as a commodity. Doing so should allow patients to feel comfortable asking their loved ones to donate and bring enough donors into the system so that no one will need to die because they couldn’t find a transplant.
In spite of the potential benefits of these policies, we are not aware of any concerted efforts by major existing organizations to develop, promote, or ensure the passage of such policies. We would like to spend September-December of this year conducting research and developing a detailed plan to launch an organization focused on remedying the shortage. We aim to generate a strong theory for how to achieve the desired policy change, to test and refine it based on feedback from leaders in the field of transplantation and people with nonprofit and advocacy leadership experience, and develop a detailed plan for the resources (human and financial) required to succeed. We have already raised $20,000 from “friends and family,” and we would be able to leave our full-time jobs and dedicate our time fully to this project for the proposed 4-month period with further outside funding of $50,000.”

The key deliverable from the project would be a detailed plan for such an organization, including a convincing theory of change and an assessment of the human and financial resources required to execute it;

“We aim to generate a strong theory for how to achieve the desired policy change, to test and refine it based on feedback from leaders in the field of transplantation and people with nonprofit and advocacy leadership experience, and develop a detailed plan for the resources (human and financial) required to succeed.”

we also hope to see evidence of support or buy-in from relevant constituencies (e.g. funders, patients, transplant groups). They have applied for 501(c)3 status for an organization they’ve created called Wait List Zero, but an I.R.S. decision is still pending, so the funds they are requesting would go through Save Lives Now New York, which would act as a fiscal sponsor.

“We have applied for 501(c)3 status as Wait List Zero, but while that application is pending, we have an agreement to receive fiscal sponsorship from Save Lives Now New York Foundation, Inc.”

While it is generally difficult to assess what would happen in the absence of a grant, we see this case as unusually clear: GiveWell staff have spent a substantial amount of personal time discussing and investigating the issue, and believe there are no other institutional funders devoted to this space and no organizations serving the role that the one envisioned in this proposal hopes to serve. We do not think that the project considered here would happen in the absence of a grant from us.

Our primary reasons for making this grant are:

• The project is aiming to address a problem that we think is under-resourced and reasonably important. We see this project as overlapping substantially with the work that we would want to do internally if we were to investigate this cause more deeply, and Alexander and Howie’s high level of personal involvement means that we expect to be able to learn from the project with a limited commitment of official GiveWell time.
• A fairly small planning grant gives us the opportunity to learn more about the potential returns to an advocacy organization working on this topic, and about Josh and Thomas, without committing to supporting the resulting effort.
• Providing early funding for an organization often seems to contribute to its success disproportionately to the amount of money involved, especially when a funder has personal knowledge of the recipients. (We certainly feel that this characterizes our experience at GiveWell.)

We would consider this grant minimally successful if it leads to a substantial increase in our knowledge of the field and a clear decision about whether or not we see the plan that is developed as being worthy of support, even if the answer is no, since we see it (to a large extent) as buying ourselves valuable information. That said, the grant could still readily fail if we don’t learn enough to be able to make an informed decision, and it would clearly be preferable that it result in an outstanding giving opportunity.

Based on these considerations, Good Ventures decided to grant $50,000 to support the project.

Because Alexander and Howie are personally involved as advisors, we expect to have an unusually high level of informal engagement and follow-up for this grant. We do not expect all of that to be public, but our minimal expectation is that the project’s formal output will be shared publicly (including here) and that we will do a (potentially brief) formal writeup at the conclusion of the grant period reflecting on what we learned.

Read more:

• Project Proposal
• Summary of a Conversation with WaitList Zero

Sources