Hepatitis B Initiative of Washington Dc

What it reported doing in 2025

2025 marked 20 years of HBI, and a journey of growth, learning, and intentional evolution. In 2025, HBI conducted over 10,000 free health tests, reaching and screening more than 3,000 individuals across the communities we serve. We began as the Hepatitis B Initiative, focused on raising awareness and providing screenings for a critical health issue affecting underserved populations. But over time, it became clear that testing alone was not enough. Communities were navigating far more than one condition. We saw chronic disease, hypertension, cholesterol concerns, diabetes, metabolic health challenges, infectious diseases beyond hepatitis B, and broader barriers such as housing instability, stigma, addiction, language access, and lack of insurance. The work had already grown beyond hepatitis B. Our name had not. So we made the decision to evolve the organization into the Health Betterment Initiative, to reflect the reality of what our communities needed and what we were committed to addressing. That evolution was not just about identity. It was about impact. In the early years, as was common across many nonprofits, services often stopped at delivery. Screening was provided, but follow-through required resources many organizations could not sustain. Management consciously decided that if HBI If HBI was going to be an effective public health nonprofit, we could not stop at testing. We had to invest in outcomes. That meant building systems that ensured individuals were not left behind after their first interaction with us. Over time, we developed the structured linkage-to-care model that defines HBI today, connecting individuals from screening to real medical follow-up, treatment engagement, and sustainable care. This included: Follow-up support Insurance navigation Targeted outreach to high-incidence populations Engagement strategies for individuals experiencing homelessness or navigating substance use recovery Because meaningful public health work is not a one-stop service. It requires investment, of time, resources, and commitment, to move individuals from awareness to action. Today, HBI addresses a broad range of health priorities, including: Hepatitis B and C HIV and syphilis Vaccine facilitation Hypertension and cholesterol Diabetes and metabolic health, including MASH and MASLD Tuberculosis awareness Alzheimers and dementia education Our approach is guided by population insight and supported by structured data management through our data manager alongside ongoing education for our Community Health Workers led by education coordinator. We are also honored that HBI was selected once again to serve as an insurance navigator through the Virginia Marketplace, helping individuals affected by job loss and economic instability regain access to coverage and sustainable healthcare. Because sometimes what people need most is not another program. It is access. After 20 years, HBI continues to evolve grounded in the belief that improving health requires more than services. It requires systems. Investment. Trust. And a commitment to ensuring no one is left behind. It is an honor for our CEO, Sandra Marrero-Ashford, MPH, MPA, MA to lead this work, and to celebrate this milestone alongside our dedicated team and the communities we serve.

Financial Efficiency

• Mission deployment rate: 70.7%; rating input score 71
• Program expense ratio: 75.2%; rating input score 75
• Fundraising efficiency: $87.43 raised per $1 spent on fundraising; rating input score 83; 83rd 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: Limited
• Related-party transparency: Limited

Accountability

• Independent voting board: 0%; rating input score 0; 6th percentile among comparable filings
• Governance controls: 3 of 8 controls in place; rating input score 38
  • Conflict-of-interest policy: Pass
  • Whistleblower policy: Fail
  • Document-retention policy: Fail
  • CEO compensation review process: Pass
  • Other executive compensation review process: NotApplicable
  • Form 990 shared with the board: Fail
  • Board meeting minutes documented: Fail
  • Audit committee oversight: Fail
  • Independent financial-statement audit: Pass

Sustainability

• Operating margin: 6%; rating input score 47; 47th percentile among comparable filings
• Total-asset coverage ratio: 0.24; rating input score 12; 12th percentile among comparable filings
• Liabilities to assets ratio: 0.15; rating input score 30; 30th percentile among comparable filings
• Officer compensation ratio: 6.9%; rating input score 46; 46th percentile among comparable filings

Growth

• Program expense growth: 18.5% per year; rating input score 100; 77th percentile among comparable filings
• Revenue growth: 17.5% per year; rating input score 100; 79th percentile among comparable filings
• Asset growth: 11.9% per year; rating input score 100; 61st percentile among comparable filings