In 2003, a few years after the Bill & Melinda Gates Foundation began implementing its small schools reform agenda, the Chancellor of the New York City Department of Education (DOE) announced a plan to replace large failing high schools in New York City with 200 small schools. In short order, the foundation and the Chancellor became partners with city labor unions, several other foundations, and several intermediary organizations in carrying forward this initiative. This study examines the role that intermediary organizations, the groups responsible for distributing grant funds and starting and advising new small schools, played in the Gates Foundation initiative. The study is part of a collaborative evaluation effort funded by the foundation and led by MDRC that included the Academy for Educational Development (AED) as well as Policy Studies Associates (PSA). Together the three groups, through four studies, aimed to clarify the characteristics, implementation, and impact of the New York City small schools initiative. In this study, PSA presents intermediaries' various approaches to school design and capacity-building, answering four descriptive questions: (1) What expertise did intermediary organizations bring to the small schools initiative?; (2) What were the key features of their school designs?; (3) What pressures and supports did intermediaries apply to encourage implementation of the school designs?; and (4) What challenges constrained their efforts to establish schools that prepared youth for college and careers? They also answer an analytic question: Did intermediary approaches to reform reflect the complexity of the challenge as it has been described and understood over the recent history of school reform? In carrying out this study, PSA researchers conducted 70 open-ended, hour-long, individual interviews with 53 leaders of 18 intermediary organizations (executive directors and senior staff). They also analyzed intermediary reports to the foundation and their online program materials (such as start-up manuals, curriculum guides, databases, evaluations). A summary of key findings and conclusions follows. Appended are: (1) Study Respondents; and (2) Summaries of Intermediary Organization Planning Processes, School Designs, and Support for Implementation. (Contains 9 footnotes and 9 exhibits.) [This paper was prepared with Erickson Arcaira, Stephen Coleman, Elizabeth Reisner, Troy Scott, Tandra Turner, and Yvonne Woods. For the executive summary, see ED510237.]