You do not need to know exactly where to begin. Start by identifying what matters most and the next practical step.
We help organizations that care for people understand what is happening, make responsible choices, and turn those choices into work that boards can govern, executives can manage, staff can carry, and participants can access and trust.
Our role is to strengthen the organization that delivers the service, not to direct clinical practice. We do not provide medical advice, diagnosis, treatment, licensure, legal, or clinical compliance consulting.
Services
Eight services. Start where you need us.
Sirianno & Associates provides the eight services shown below. Choose the area that matters most to your organization.
Every assignment has a clear focus. We also take a 360-degree view of your organization—considering the connections among leadership, governance, funding, communications, and mission that influence the work. Our recommendations address your chosen priority with the whole organization in view.
Eight consulting areas
Start with the greatest need. We’ll bring the whole organization into view.
Explore the service areas in detail. Each one is a distinct area of expertise and a clear place to begin.
1
Strategic Planning & Implementation
“Demand is growing, community needs are changing, and we need clear priorities that our board, executive director, and staff can use.”
Clarify present reality, make consequential choices about mission and services, and build a substantial working plan with priorities, owners, measures, and first actions.
“Our board cares deeply about the mission, but we need clearer roles, stronger decisions, better meetings, and a more productive partnership with the executive director.”
Clarify authority, expectations, structure, and governing routines so the board can focus on mission, strategy, resources, risk, executive support, and public accountability.
“Funding is uncertain, too much depends on a few sources, and we need a practical plan for grants, contracts, donors, and unrestricted revenue.”
Connect financial reality, government and foundation funding, philanthropy, earned revenue, partnerships, and leadership responsibility to a more resilient revenue strategy.
“I need a confidential, experienced perspective on a consequential decision, leadership pressure, workforce question, or what should happen next.”
Support executive directors, board chairs, development leaders, and senior staff with practical counsel, role clarity, priorities, and disciplined follow-through.
“People who need us cannot always understand or find us, and our communications are not building the trust, participation, referrals, or support we need.”
Clarify how participants, families, referral partners, funders, donors, and the public understand the organization, then strengthen its story and communications priorities.
“People may qualify for our services, but finding, reaching, understanding, or staying connected to them is harder than it should be.”
Examine access, referrals, partnerships, communication, and the organizational experience surrounding services so people can navigate them with dignity.
This work addresses access, communication, coordination, and organizational experience—not diagnosis, treatment, or clinical protocols.
Participant access and experience journey map
Barriers to awareness, entry, and continued participation
Alignment is something a well-designed process creates.
1
Understand
Gather the evidence and perspectives needed to see the situation accurately.
2
Reveal
Make strengths, constraints, differing perspectives, and underlying causes understandable.
3
Choose
Frame the real options, tradeoffs, priorities, and decisions.
4
Build
Create the agreed working documents: a substantial plan or roadmap, decisions, responsibilities, required resources, measures, and first actions.
5
Learn
Use the working documents to review implementation, test assumptions, and make necessary adjustments.
We create a trusted process that transforms uncertainty, competing perspectives, and unrealized possibilities into clarity, shared direction, and practical action.
Organizational Strength Review
When you know something needs to change but are not sure where to begin
The Organizational Strength Review gives board and executive leaders a trustworthy account of the organization as it operates today. It is especially useful when service demand is rising, priorities compete, board and staff perspectives differ, the executive director is carrying too much, funding is uncertain, workforce pressure is increasing, or a significant opportunity requires decisions before a full strategic plan can be completed.
What it examines
Connections across the whole organization, with detailed assessment focused on the areas agreed in scope. Evidence may include documents, financial and operating information, confidential interviews, participant and partner experience when appropriate, and relevant external conditions. This is a developmental organizational review, not an audit, accreditation, personnel investigation, clinical review, legal review, or scientifically validated index.
Timing and investment
Usually six to eight weeks. Typical fixed-fee investment: $15,000 to $22,500.
Confidential board, staff, and selected stakeholder listening
Organizational Strength Brief
Priority classification showing what to protect, repair, build, decide, or learn
Leadership decision meeting and Decision Record
Three to five near-term priorities with owners, resources, first actions, and review dates
90-Day Transition Plan
Four ways to work together
Eight services. Four clear engagement scopes.
The eight services identify where help is needed. These four options establish the depth and breadth of the work. Every assignment considers the connections across the whole organization, while detailed work stays focused on the agreed scope.
Independent Leadership Counsel
$2,500
“I need experienced help thinking this through.”
Structured counsel, written recommendations, and follow-up support for executive directors, presidents, and board leaders.
Focused Consulting Engagement
Beginning at $12,500
“I know the area that needs work.”
A defined assignment in any service area, with exact deliverables, timing, and fixed fee established in the written proposal.
Organizational Strength Review
$15,000–$22,500
“We need to understand what is holding us back and what deserves attention first.”
A diagnostic assessment that considers connections across the whole organization. Detailed assessment focuses on the areas agreed in scope and produces priorities and recommendations.
Integrated Strategic Direction
$25,000–$40,000
“We need shared priorities and a coordinated plan across the organization.”
A coordinated strategic assignment spanning multiple service areas, with shared priorities and an actionable plan.
Independent Leadership Counsel is prepaid when the engagement is booked. For larger engagements, the standard schedule is 40% on booking, 30% after the evidence and listening stage, and 30% on delivery. The final schedule is stated in the written proposal.
Travel or specialist expenses are included only when agreed in the proposal. There are no surprise charges. Major fixed-fee engagements include eight hours of implementation counsel during the 90 days following delivery.
A focused engagement may address Fundraising & Sustainable Revenue or Brand, Communications & Public Trust, as well as any other service area. Full executive search, facility design, campaign execution, brand redesign, and other specialist responsibilities are defined and priced individually in the written proposal.
You do not need to choose an engagement before contacting us. We’ll help establish the right scope.
The practice draws on more than 30 years of organizational leadership and advisory experience, including nonprofit executive leadership, governance, fundraising, communications, institutional growth, and work involving healthcare and health-related institutions. Our role is to strengthen the organization delivering the service. We do not advise on medicine, diagnosis, treatment, individual cases, licensure, or clinical practice.
A complimentary 30-minute conversation helps establish your situation, fit, and a sensible next step. Detailed analysis and written recommendations begin with a paid engagement.
