COMPLIANCE ISN’T THE GOAL. IMPACT IS.
The Determination of Need (DoN) Process AND BEYOND.
ALTO helps turn the Determination of Need and other funding processes into powerful tools 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, 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. And this challenge isn’t unique to DoN. This same pattern can occur when foundations, health systems, and other funders move quickly to distribute dollars without a clear strategy for engagement and storytelling.
At ALTO, we help 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 & Support
Recruit and organize Community Advisory Boards (CABs).
Facilitate and manage CAB meetings to ensure a community-driven process.
Capacity building for awardees including communications toolkits and message development support.
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Funding Strategy
Design Requests for Proposal (RFPs), Letters of Intent (LOI), and one time investments.
Manage Allocation Committees to ensure fair review and awards processes.
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Communications
Craft announcements, press releases, social media posts, and messaging to build engagement & trust.
Strategic Storytelling: Months and even years after awards are made, craft stories of real world impact that inform and inspire communities, funders, and regulators.
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Media Relations & Events
Develop targeted media outreach, briefs, pitches, and talking points to ensure the right audiences are reached.
Major announcement events and receptions, press event planning and execution.
Why ALTO?
We bring deep, hands-on experience designing and facilitating major funding strategies including 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 funding 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.
