COMPLIANCE ISN’T THE GOAL. IMPACT IS.
The Determination of Need (DoN) Process.
ALTO helps health systems turn the Determination of Need process into a powerful tool for building trust, visibility, and lasting community partnerships.
The Determination of Need (DoN) is a Massachusetts state regulatory process overseen by the Department of Public Health (DPH). Its purpose is to ensure that major healthcare capital projects—like building new facilities, purchasing expensive equipment, or making significant structural changes—provide public benefit and advance health equity in the communities served.
The DoN process isn’t just about compliance. It’s about strengthening community partnerships and ensuring meaningful investment. When undertaken strategically, it can become a powerful mechanism for demonstrating leadership, accountability, and authentic commitment to health equity.
Too often, though, health systems approach the DoN as a transactional requirement, resulting in community voices not being fully heard, funding opportunities not designed for maximum community impact, and communications focused on reporting rather than building engagement and trust.
At ALTO, we help health systems do more than check the boxes. We turn regulatory obligations into strategic opportunities by aligning investments, messaging, and partnerships that build trust, visibility, and measurable impact in the communities you serve.
How we can help
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Community Engagement.
Recruit and organize Community Advisory Boards (CABs).
Facilitate and manage CAB meetings to ensure a community-driven process.
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Funding Strategy.
Design Requests for Proposal (RFPs), Letters of Intent (LOI), and one time investments. Manage Allocation Committee to ensure fair review and awards processes.
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Communications.
Craft announcements, press releases, social media posts, and awards messaging to build engagement & trust.
Capacity building for awardees including communications toolkits and message development support.
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Media Relations.
Develop targeted media outreach, briefs, pitches, and talking points to ensure the right audiences are reached.
Major announcement event planning.
Why ALTO?
We bring deep, hands-on experience guiding Massachusetts Determination of Need (DoN) and Community Health Initiative (CHI) projects of every size, from small community investments to the largest DoN in the Commonwealth’s history.
We have worked inside one of the nation’s top ranked hospitals and health systems, alongside community partners, and in collaboration with the Massachusetts Department of Public Health officials and other regulatory agencies. That experience allows us to bridge policy, operations, and communications so that every DoN process is both compliant and community-centered.
We help organizations turn complex requirements into clear strategies that build trust, visibility, and measurable impact. Our team can manage the entire DoN process from start to finish or step in to strengthen specific components as needed.
