Pro Resources

Starting a Facility from Scratch

This is a living document. Please share your feedback, ideas and stories.

What is Starting a Facility from Scratch?

This refers to creating a new facility to provide veterinary care that is not physically part of the shelter or a partner facility. The facility may be linked to a shelter or completely stand-alone.

How Organizations Can Begin

Setting Goals

When considering a project of this nature, it’s very important to have a clear idea of goals and what success will look like. It’s essential to assess unmet needs in the community, before embarking on a new project. Then set goals, based on the needs and what services you are best able to provide. Avoid duplication of effort and cost, and avoid competition for the same donor dollars.

Community Assessment

What does the community need and want?

A core principle is “nothing about us, without us”. Historically, many assistance projects have been chosen and implemented without community consultation and engagement. This is an outdated and sometimes harmful approach.

Where are the needs greatest?

Economic and geographic factors are the greatest barriers to accessible veterinary care. Access maps of your community or region to determine which areas are most in need. Veterinary practices can be mapped to identify “veterinary deserts”. (Here’s how).

What needs are already being met?

Identify existing resources in the area of interest, such as boarding, food banks, groomers, veterinary clinics, pet stores, dog training, human social services and funding opportunities.

Where are these services being provided?

It’s really helpful to map existing services.

Are there opportunities for partnerships and collaboration?

For example, can you work with or near complementary services such as grooming and pet supplies?

An example of a Community Assessment document can be found here.

Missing Services

What services are lacking in the community of interest?

Preventive “wellness” care?
Spay/neuter facility?
Full-service veterinary care?
Low cost/subsidized care?
Urgent/emergency care?

Service Delivery

Important considerations are:

Frequency of services
Physical structure – “pop-up” or MASH style clinics in parks, tents, church halls or permanent fixed clinic
Existing or new facility
Funding model
Barriers to care – these should be considered when deciding how to deliver services:
- Income/economics
- Transport
- Language
- Location
- Culture/belief
- Education

Who Will Access Services?

The goal of community-based veterinary care is to remove barriers to care and allow people to access services with dignity and agency.

A question that must be considered at the outset is whether or not to screen for financial need. Needs-based services are common, but this may not be the best model.

Model	Pros	Cons
Needs-based model	Restricts service to those who need it most Limits client base Seems “fairer” to staff, funders, local veterinary clinics	Can negatively impact dignity and agency Can be administratively onerous How to manage situations where need is stated but no proof is available?
Open-to-all model	Open, accessible model More welcoming, less implicit judgment Inclusive of those in the middle who don’t qualify but can’t afford typical private care Sliding fee scale can help to generate income Less administrative burden	Case load could be overwhelming Could serve those less in need to the detriment of those with greater need Pushback from the veterinary industry; perception of competition

You will also need to address philosophical questions beforehand, such as whether the clinic has a requirement that clients spay/ neuter their pets, or how to manage clients who refuse vaccination at the time of spay/neuter surgery.

A model that focuses on education and partnership rather than prescription and judgment is preferable.

Services

What Services to Offer (and Not Offer)

Community veterinary care programs struggle with the scope of service offerings. Some choose a “wide and shallow” approach (vaccination, microchips) while others choose “narrow and deep” (for example, fundraising for orthopedic surgeries). This decision will be very different for different organizations, but it’s important to be clear at the outset what services will be offered.

Constant ad hoc decision-making on a case-by-case basis is inefficient, confusing, inconsistent and fraught with moral and ethical dilemmas. This is particularly problematic when dealing with frequent events. A clear, well-communicated set of service offerings will prevent confusion and disappointment among clients and decision burn-out among staff. Of course, every system must have the flexibility to deal with outliers.

A written list, defining scope of care available in the program, is highly recommended. Decision trees can be useful and efficient supplements to such lists. This is an example of an algorithm for decision-making.

Consider Building the Services in Stages

The facility could start at a level that requires the least resources and staffing, and build to a full-service model, if desired and as resources allow.

Many other parts of this guide also split up facility requirements, equipment and so on into stages, to allow organizations to build in a modular way.

Stages	Includes	Pros	Cons
Telehealth/ Telemedicine	Phone/video consults +/- dispense medication if allowed	Inexpensive Non-veterinarians can manage some calls Time-efficient	Technical barriers on client side Regulatory restrictions in some jurisdictions Limited to hands-off services
Preventative Care: Vaccinations, microchips	Wellness checks Client education Vaccines, microchips +/- parasite control	Protects large numbers of animals Inexpensive service provision Low cost to clients Public health benefits (rabies)	None (other than not a full service model)
Preventative Care (including vaccination and microchips) with Heartworm Testing/Prevention	Above plus heartworm testing and preventives	Protects large numbers of animals Inexpensive service provision Low cost to clients Public health benefits (rabies) More complete medicine	Few (other than not a full service model) Heartworm testing can require more staff and can be challenging in a park or outdoor setting What to do with positives?
Spay/Neuter	Pre-surgical counselling Pre-surgical exams Surgery Follow-up care	Population control - reduces shelter intake Keeps animals in their homes Welfare and longevity benefits to animals Highly efficient models readily available (ASPCA/Humane Alliance)	Expensive to set up Staffing costs relatively high Higher risks Access to emergency care needs to be arranged in advance
Basic Sick Care	Diagnostics Medication Client education	Meets an unmet welfare need Meets an unmet client need	Difficult to decide what to treat and not treat Need to decide whether to treat one-offs only or chronic care; this can be an artificial and alienating decision for the clients Potentially expensive to set up, depending on offerings and regulations
Owner- requested Euthanasia	Counseling Euthanasia procedures Handling of remains	Meets an unmet welfare need Low-cost option for clients Offers staff an opportunity to truly support and comfort	Requires controlled substances Requires policy framework Privacy requirements if owner is present Emotionally draining for staff
Extended Sick Care	Diagnostics Medication Client education Follow-up care	Meets an unmet welfare need Meets an unmet client need	Higher costs Higher staffing requirements and expenses; requires advanced equipment (e.g. X-ray machine)
Advanced Surgery	Surgeries beyond routine spay/neuter +/- dental extractions	Meets an unmet welfare need Meets an unmet client need	Higher skill level needed; more advanced equipment needed (e.g. ortho pack, suction, cautery) More resources needed for post-operative care and follow-up
Urgent or Emergency Care	Provision or arrangement for this level of care Provision or arrangement for after-hours care	Meets an unmet welfare need Meets an unmet client need Short-term intervention not requiring ongoing management; high impact for individual animal and family Fundraising might be easier for high-profile cases	Cost per case can be very high Higher costs in general Higher staffing requirements and expenses Additional facility requirements for isolation/ICU