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Part of the Babson Entrepreneurial Leader Collection. MDSC is a 501(c)(3) organization, professionally staffed with a mission to ensure individuals with Down syndrome are valued, included, and given opportunities to pursue fulfilling lives. Though dedicated to the families of Massachusetts, MDSC is gaining recognition as an innovator and being called upon to train and support organizations in other parts of the US and world. When the case opens, MDSC's executive director, Maureen Gallagher, is departing a strategic planning retreat. She and her Board members have come up with an exciting list of strategic initiatives, including areas for potential service expansion. However, current initiatives and needs of its steadily expanding community were beginning to overwhelm the current operational model. MDSC had the know-how, the ideas, and the drive to do more, but this operational reality would constrain further service expansion. In addition to specifying three overarching directives and four specific strategic initiatives to support these directives, the board also determined that MDSC would move to a state-of-the-art approach to support its growing list of state-of-the-art services. The approach would include a revamped operational model built upon an updated digital platform. With these changes, MDSC would be able to scale its services to families, increase its donations, and win more grants to help sustain the organization's good work. Though there is consensus in the vision, there are questions regarding the steps this small, resource-constrained organization should take to make this vision .