Nick Rees has guided the Buckeye Ranch through growth, and growing pains.

When Nick Rees left a 24-year career at Kroger to join the Buckeye Ranch as vice president of development in 2003, the nonprofit had an annual budget of about $19 million. By last year, that figurehad grown to $32.8million. "We've nearly doubled in size," says Rees, who became Buckeye Ranch's president and CEONovember 2009 and has overseen a significant expansion of services.

Whether handling day-to-day operations or organizing fundraisers such as Taste of Dine Originals or the upcoming Rally for the Ranch, Rees is a hands-on leader with a two-part focus: to serve all of the children who need the organization's help and "to not have a waiting list, because needing help and waiting is the worst feeling in the world," Rees says. "What if your child had attempted suicide, the hospital she needed mental health care, and you had to wait three months to get it? What would you do? How could you sleep at night? I don't want families to have to go through that. The only way to meet demand, and eliminate the waiting list, is to grow."

The Buckeye Ranch is a 52-year-old organizationthatprovides treatment and support services to children with behavioral and mental health problems.Last year, helped more than 1,600 Ohio children and their families through residential treatment centers, outpatient and home-based counseling and treatment programs, foster care and the Permanent Family Solutions Network, which provides visitation space and support services to children still living with their own families. The nonprofithas offices and centers in Columbus, Grove City, Newark and Cincinnati. It serves children in about 40 Ohio counties and is one of the largest providers of foster-care services in the state.

Buckeye Ranch began when a philanthropic group known as the Women's Juvenile Services Board set out to raise $100,000 to open a center for troubled boys. They raised the money bit by bit, selling fruitcakes and buckeye corsages as fundraisers, and built the Argo House residential treatment center on a patch of farmland in Grove City in 1961. The first year, the program served 10 boys.

They hired Dr. Les Bostic, a therapist who at the time was working within the juvenile justice system. He led the nonprofit (called Buckeye Boys Ranch until 1994) for nearly four decades, overseeing a significant expansion in both physical facilities and the number of children the program could serve. He retired in 2000. was instrumental in augmenting the residential treatment centers with an equestrian therapy center and programs such as horticulture and art therapy.

Rees, the third chief executive (he succeeded Rick Rieser, who held the job from 1997 to 2009), has also left a mark on the organization. Last year, Buckeye Ranch took over the Rosemont Center in Linden, which had served troubled youth for nearly 150 years, when it fell on hard financial times. "We weren't even looking to expand when they called us, but we took it on because it's an area where there aren't enough services, and if they shut down the need would be even greater," says Stephen Richard, Buckeye Ranch's executive vice president of programs and services. "We're building up the programming there."

Like Rosemont, not all of Buckeye Ranch's recent growth has been of its own volition.There is more need for mental health care than there resources, Richard says. "Funding is becoming more and more of a challenge, even moreso in the last two years. We've already absorbed one foster care agency and grew even bigger than we expected to because somebody needed to step in when that agency closed."

The economic downturn in the early 2000s and the recession of 2008 "caught a lot of nonprofits off-guard. They weren't prepared, so they went bankrupt and closed," Rees says. "When other agencies closed up, there was still a need for those services. Counties were looking for people to provide them, and we were ready. Luckily, we had planned for the rainy days so we weathered that storm."

Budget Balancing

In 2012, fees for service accounted for 72 percent of Buckeye Ranch's revenue. Medicaid reimbursements accounted for 22 percent. Two percent came from the Alcohol, Drug and Mental Health Board of Franklin County, and 5 percent came from miscellaneous sources and contributions. Volunteers play a small role, in part because of the Health Insurance Portability and Accountability Act of 1996 that govern patient privacy, Richard saysLast year, 583 volunteers donated a total of 2,332 hours, mostly doing administrative work and physical improvements such as painting.

The organization's growth and nearly $33 million annual budget can mask the challenges health-re nonprofits face. "Every year, our costs are greater, but Medicaid reimbursements haven't gone up in a decade," Richard says. "Our community-based programmingand all mental health outpatient and home-based programs lose significant money every year. We're just blessed that other programs produce some surplus we can use to cover that."

Government programs such as Medicaid-which most clients use-"reimburse you for seeing the children," Rees says. "Starting up, maintaining and adding buildings isn't covered."

Fundraisers help fill that gap, but they only account for about $2 million of the annual budget, Rees says. "All ofthe fundraising money this year goes into unrestricted funding to be used as the ranch needs it. It helps offset the services where we lose money, which is most placesunfortunately."

Buckeye Ranch has several signature fundraisers: the annual Taste of Dine Originals, which featur food from locallyowned restaurants; selling personalized bricks in the reflection garden on the main campus; the annual Buckeye Ranch Bash, which was held at Nationwide's headquarters earlier this year; and Rally for the Ranch, a auto show and banquet. There is also an ongoing capital campaign to raise money for upkeep.

Still, "I worry about there not being enough money every night," says Stephen J. Smith Sr.n attorney and member in the Columbus office of Frost Brown Todd, who has been a Buckeye Ranch board member and volunteer for nearly 40 years. His involvement began in the early 1970s, when his neighbor, Bostic, walked over and said, 'I need a little help.' Next thing I know I'm on the operations board."

Smith now chairs the holding company board, one of several boards that oversee the organization. The Buckeye Ranch Foundation and Buckeye Ranch Holding Company also own the nonprofit's land and real estate, as well as a small portfolio of investments. In 2010, the most recent data available, investments generated about $80,000-up from $28,000 in 2009

"We are very austere in how we run the ranch, but there will always be new needs, whether it's programming or new roofs," Smith says. "The corporate community has been very generous, but we don't get a lot of small donors. You need the people who send $5 or $25 just as much."

The organization lacks small donors in part because people don't understand what it does or all the services it provides, Smithsays.

Rees agrees. "People are confused about what Buckeye Ranch is," he says. "We're building awareness from almost nothing. Even kids who have success stories here don't usually tell people because of the stigma [of mental illness]. It makes fundraising difficult. People will not donate to something they don't understand."

In addition, mental and behavioral problems aren't issues that tug at people's heartstrings and, therefore, their checkbooks, Rees says. "People think it's poor parenting or they bring it on themselves, rather than what it is: a physical issue within your body, just like a chronic illness such as diabetes."

'Never Settle'

Despite the challenges, Rees says he mission to stay waiting-list free keeps him motivated. "Les Bostic told me there was never a year that he didn't worry about the money, but we got by for 50 years.I'm our internal lobbyist, and I stay as close as I can to my congressmen, trying to protect funds for these kids."

More and more nonprofits are turning to the business sector to tap talent. "The world of nonprofit management has become more complicated than it was 20 years ago," Rees says. "You have to understand HR issues, legal issues, government funding mechanisms, marketing and advertising."

Rees spent 24 years in advertising and community relations the Kroger Co., where he had a close relationship with Buckeye Ranch. Kroger sponsored the Buckeye Tennis Classic; the professional tournamentraised money for the nonprofit from about 1970 to 1984 and drew big-name stars such as Arthur Ashe and Jimmy Connors. "I helped put together the tournament, plan advertising, parties and banners for the event," says. Kroger also supported other Buckeye Ranch events, and it was tradition for a local Kroger manager to serve on the board.

When the vice president of development post came up, Buckeye Ranch approached him. "I was flattered but wasn't looking for a job," Rees says. "I loved my work at Kroger, but the more we talked about it, the more the timing seemed right. My wife and I were ready for a change."

Change is also what keeps the ranch moving forward. "We all share the belief that we'll never settle," Richard says. "We are good at what we do, but we're always looking for something else that we can or should be doing, and for new opportunities to provide the best care for our kids."

"We're constantly thinking about how we grow, where there are clients, how we can be less reliant on one particular county and serve more kids," Rees says. "We think we do a heck of a lot for the kids we serve, at least as good or better than everyone else in our business, so why wouldn't we want to serve more children?"

Denise Trowbridge is a freelance writer.