What a difference five months makes. Oie Osterkamp recalls that evening in June 2002 when he strode across the stage of an Albuquerque ballroom to shake the hand of Inc.'s editor and accept his award. Osterkamp's company, the Raleigh, North Carolina-based Job Strategies, was a thriving professional employer organization that placed and managed workers in companies across the Southeast. "We were asked to be on boards, talk to groups," Osterkamp recalls fondly. "It was a pretty cool time."

Not long after, Osterkamp and his partners noticed that their health-insurance provider, which covered the workers they placed in customers' companies, was slow making payouts. Ultimately, the insurer refused to make good on $350,000 in medical claims. "Our attorney said, Send a letter to all your customers saying what happened, and give them the number for the insurer if they want to try to arbitrate," says Osterkamp. "It was the right decision. But it wasn't the moral decision."

Instead, Job Strategies paid 100 percent of the claims out of its own operating accounts. "Our bank didn't like that very much," says Osterkamp. "They tightened the reins, and that started a financial spiral." The dot-com bust, which engulfed the company's high-tech clients, finished the job. The partners sold Job Strategies to a friendly competitor for a price that exactly equaled their debt.

Osterkamp's marriage went down with the business. "I had no job, no prospects, nowhere to sleep," he says. Camping in his former business partner's extra bedroom, Osterkamp recalled his mother's advice: "Whenever you feel bad, go serve somebody who has it worse than you." So he started doing missions for his church and eventually founded a nonprofit to plant educational programs in the poor villages of Honduras. He wrote and published an inspirational book, Being a Sharefish in a Selfish World.

A regular income was more elusive. Osterkamp did business development for an office-supply firm until it laid him off. A consulting gig with a pharmaceutical company ended with the entrance of a new CEO.

Then, last November, a board member for the Ronald McDonald House in Durham asked Osterkamp to recommend someone for executive director. Reading the six-page job description, Osterkamp realized "this is what I was designed and built to do." He assumed the position in February.

"You couldn't pay me enough to do something other than this," says Osterkamp. "I've gone from success to significance."