Breath of My Heart Birth Place

What it reported doing in 2024

In 2024, navi pin haa un mu or breath of my heart birthplace (bmh) completed its third year of restructuring as an indigenous-led organization under a co-director model. The rapid growth in our budget and team has been a byproduct of our organizational focus on increased capacity and expanded services. Our intention is strategic growth rooted in a community- and provider-centered model that continues to sanctify our connection to the integrities and lifeways that we collectively hold. In the last year, weve supported the ongoing integration of our perinatal community health worker and the roles related services. Now, all of our clients receive a comprehensive needs assessment and assistance with their medicaid application as part of the intake process. Additionally, bmh collaborated in successful policy and advocacy work with significant contributions to legislative work supporting doula reimbursement, midwife pay parity, and birth center facility fee pay parity. Breath of my heart increased capacity through further development of our internal structure. We began work to revise our internal policies, procedures, and board by laws to enhance role clarity and to better support a positive workplace culture. We hired additional support staff, including a medical biller, a clinical director assistant, and a food distribution assistant. We are continuing to recruit an additional third midwife and our student midwife apprentice program is also progressing as we finalize our student handbook and stipend policies. In 2024, we maintained all of our programs and increased capacity, including increasing our hours of no cost direct services including our same day appointment clinic. Expanded access assists in the provision of pregnancy testing, medicaid presumptive eligibility qualification, and pregnancy services. We provide early and open access to pregnancy care with providers in rural and tribal communities, which is critical for ensuring early access to prenatal care. We continue to coordinate referrals for care that are outside of our scope and maintain a body feeding rate of 100% initiated feeding at birth. Our food distribution program has significantly increased in response to food access issues in our community. We provide regular distribution to over 35 families per week with half of those distributions delivered directly to families homes. We were able to secure access to several local farmers for fresh produce. We are providing postpartum food and herbal support for indigenous and low income families, with a focus on supporting local farming economies and nutrition through traditional foods. We continue to provide diapers and baby supplies for young parents. This service ensures access to essential items and reduces their need to shop frequently because of cash-flow problems. Our young parent advocate continues to support and provide resources and information to young parents both directly and in collaboration with other community health advocates. The program is completing a needs assessment project to inform how best to structure supporting young parents within bmh programs. The young parent advocate works closely with our perinatal community healthworker to individualize young families' needs as both clients and community members. Our policy advocacy work continues, with responses to the changing medicaid and department of health landscape. Through regular stakeholder meetings with the department of health and other community collaborators, we successfully advocated for medicaid reform to be inclusive of fair and equitable reimbursements for midwives and doulas. We remain mobilized and ready to advocate for reproductive health issues on local, state and national levels alongside coalitional collaborators and community partner organizations. We are grounded in our local birthing ecologies and continue to nurture their continuance. In the last year, we established a community herbal apothecary that allowed us to increase our

Financial Efficiency

• Mission deployment rate: 46.3%; rating input score 46
• Program expense ratio: 76.9%; rating input score 77
• Fundraising efficiency: $81.93 raised per $1 spent on fundraising; rating input score 84; 84th percentile among comparable filings

Transparency & Controls

• Consistency checks: 100%; rating input score 100; 63rd percentile among comparable filings
• Pay-setting controls: Limited
• Foreign activity oversight: Limited
• Grant itemization coverage: Limited
• Major donor itemization: Yes; rating input score 100
• Related-party transparency: Limited

Accountability

• Independent voting board: 100%; rating input score 100; 63rd percentile among comparable filings
• Governance controls: 8 of 8 controls in place; rating input score 100
  • Conflict-of-interest policy: Pass
  • Whistleblower policy: Pass
  • Document-retention policy: Pass
  • CEO compensation review process: NotApplicable
  • Other executive compensation review process: Pass
  • Form 990 shared with the board: Pass
  • Board meeting minutes documented: Pass
  • Audit committee oversight: Pass
  • Independent financial-statement audit: Pass

Sustainability

• Operating margin: 39.8%; rating input score 89; 89th percentile among comparable filings
• Total-asset coverage ratio: 1.15; rating input score 42; 42nd percentile among comparable filings
• Liabilities to assets ratio: 0.02; rating input score 79; 79th percentile among comparable filings
• Officer compensation ratio: 15.7%; rating input score 18; 18th percentile among comparable filings

Growth

• Program expense growth: 33.3% per year; rating input score 100; 94th percentile among comparable filings
• Revenue growth: 35% per year; rating input score 100; 95th percentile among comparable filings
• Asset growth: 25% per year; rating input score 100; 90th percentile among comparable filings