Northeast Ohio Behavioral Health, Ltd.

Strategic Plan

July 1, 2008 – June 30, 2012

Table of Contents

I. Executive Summary:

Northeast Ohio Behavioral Health, Ltd. (NEOBH) has continued to demonstrate clinical expertise in the mental health treatment of children, adolescents, adults and families. Our organizational philosophy requires us to seek excellence in our treatment methods, the satisfaction of our clients, and the professional growth of our staff. NEOBH has never tried to “be everything to everybody.” It has recognized its strengths and its limitations, and has focused on the provision of mental health counseling services within the scope of outpatient intervention, while expanding the availability of services for specialty populations. NEOBH shall retain a focus on the provision of outpatient mental health services for the next four years (July 1, 2008 through June 30, 2012), and shall continue to seek opportunities to fill niche specialty areas that are underserved within the community. NEOBH will additionally seek opportunities to move its services into the community, and will effectively utilize technology toward the efficient delivery of services and the enhancement of staff communication.

The following Strategic Plan documents our assessment of our organization, and plots a course for the future of Northeast Ohio Behavioral Health, Ltd.

II. Authorization:

The 2008-2012 Strategic Plan was approved by the NEOBH Advisory Board on October 23, 2008.

Robin Tener, Ph.D. Robin Tener, Ph.D.

NEOBH Advisory Board Chair Executive Director

III. Mission and Vision:

A. Mission Statement:

By living in accordance with our personal values and principles and the ethical standards of our professions, we continuously strive to provide high quality counseling services in a safe, therapeutic environment to a clinically diverse population while honoring the dignity and worth of each person that we serve. Our intent is to instill hope, promote positive change, and help our clients to reach their full potential regardless of their sex, race, religion, sexual orientation, country of origin or economic circumstance.

B. Practice Philosophy and Values:

The following goals have been identified as core principles for the operation of Northeast Ohio Behavioral Health, Ltd.:

• To treat each of our clients with dignity, respect, courtesy and kindness. This respect of our clients is an expectation of all staff members, regardless of the context in which they are interacting with our clients.

• To engage in the continuous problem-solving necessary to facilitate a smoothly functioning environment in which all staff can work together in a spirit of harmony and cooperation. It is recognized that such an environment is essential for the efficient delivery of services.

• To attract and support highly qualified, motivated personnel who are proficient in the skills essential to their positions and who are dedicated to a high standard of professional behavior.

• To achieve a practice environment that will allow us to meet the needs of our clients while recognizing the need for continued professional growth and personal fulfillment.

• To strive toward the most effective integration of changes in public policy, funding and accreditation requirements and needs of the service population without sacrificing the quality of the services we provide to our clients.

IV. Organizational Profile and History:

A. Brief History of NEOBH:

NEOBH was formed in 1999 via the combination of the for-profit private practice organizations of four different Managing Partners/Members. Over time, three of the four partners separated from NEOBH, with the last separation occurring at the end of 2004. Many challenges were encountered during this five year period, not the least of which was differing Partner/Member interest in the pursuit of COA accreditation, and differing Partner/Member need for this accreditation, based on the service population needs of branch offices managed by various Partner/Members of NEOBH. In October of 2003, the Ohio Department of Mental Health (ODMH) mandated national accreditation of all Community Mental Health Centers within the State of Ohio by September of 2006 in order to achieve Deemed Status and maintain ODMH accreditation. At the time this ODMH rule was enacted, only one of the remaining two Partner/Members of NEOBH managed branch offices with contractual Medicaid agreements with local Mental Health Boards. COA accredits organizations as a whole; therefore, it was necessary for an additional business separation to occur, and this was managed in an orderly fashion by the conclusion of 2004. The Operating Agreement of NEOBH was subsequently revised to reflect numerous COA requirements related to this document.

NEOBH currently has one managing Member, and has continued to function as a Limited Liability Company. The pursuit of COA was the responsibility of this sole Member. The pursuit of re-accreditation remains the responsibility of the sole Member of NEOBH, who also acts as the agency’s Executive Director. This has represented a significant challenge.

B. Description of Programs and Services:

Northeast Ohio Behavioral Health, Ltd. is a Mental Health agency that seeks to provide quality mental health services for adults, adolescents, children and families. It is certified by the Ohio Department of Mental Health to provide three basic services:

• Individual Counseling/Psychotherapy

• Diagnostic Assessment

• Community Psychiatric Supportive Treatment (aka Case Management)

NEOBH creatively utilizes these three services to address the assessment, treatment and case coordination needs of unique populations, with an emphasis on underserved populations.

C. Description of Service Population:

Within its defined population of adults, adolescents, children and families, NEOBH additionally provides services to the following target groups:

• Children and adolescents in the care/custody of the Stark County Department of Job and Family Services (Stark County Office)

• Children and adolescents in the care/custody of Summit County Children Services (Summit County Office)

• Foster parents caring for children in the care of Summit County Children Services and the Stark County Department of Job and Family Services

• Parents of children/adolescents whose children are in the care/custody of either the Stark County Department of Job and Family Services (SCDJFS) or Summit County Children Services (SCCS)

• Adults, adolescents and children with brain impairments due to accident or injury

• Children and adolescents who are documented or suspected victims of sexual abuse and/or sexual exposure

• Adults, adolescents and children who are deaf or hearing impaired

• Children and adolescents who demonstrate difficulties with attachment and bonding

• Adults who require psychological assessment prior to bariatric surgery

• Adolescents with histories of trauma who are on probation with the Juvenile or Family Court

• Children, adolescents and adults who require psychological assessment to determine an accurate diagnosis and an appropriate treatment direction

• Children, adults and adolescents who are trauma victims, due to exposure to or the direct experience of traumatic events

• Families requiring assessment pertaining to divorce/custody matters, visitation and child placement disputes

• Parents who require focused attention toward the development of parenting and child behavior management skills

• Adults, adolescents and children diagnosed with Autism Spectrum Disorders

• Adults, adolescents and children who are Mentally Retarded/Developmentally Disabled (MR/DD)

• Children and adolescents whose mental needs are best addressed by services delivered within a school environment

• Adolescents with histories of trauma who are incarcerated in either Residential Treatment or Community Corrections facilities

V. Organizational Mandates:

A. External Mandates – Ohio Department of Mental Health (ODMH):

NEOBH must adhere to the following external mandates related to the production of Outcomes and Outcomes measurement:

NEOBH is required to provide Outcomes data to the Ohio Department of Mental Health via two prescribed tools:

• The Ohio Youth Scale – Worker, Parent and Youth (over age 12) versions

• The Adult Form A – Worker and Client Forms

The Adult Form A is administered under the following mandated schedule:

• At Intake

• Every Six (6) Months

• At Termination

The Ohio Youth Scale is administered under the following mandated schedule:

• At Intake

• Every Three (3) Months

• Annually

• At Termination

ODMH further expects Outcome data to be utilized within the treatment planning process and audits charts for this element during annual Medical Necessity Audits and Year-End Financial Audits that are conducted for ODMH by The Stark County Mental Heath and Recovery Services Board and by an independent auditor.

NEOBH is mandated to participate in Medical Necessity and Year-End Financial Audits and must produce documentation on demand. It is additionally mandated to pay all fees related to the work performed by the independent auditor.

ODMH additionally requires providers to complete a Behavioral Health Module (MACSIS) under the following schedule:

• At Intake

• Whenever there is a change in the demographic status of the client

• At Termination

ODMH also provides NEOBH with mandates regarding the reporting and management of Client Rights and Client Grievances. ODMH mandates regarding Client Rights and Grievances supercede the criteria that may be established by accrediting bodies, such as COA.

B. External Mandates - The Stark County Mental Health and Recovery Services Board (Stark County MHRS Board)

The Stark County MHRS Boards provides NEOBH with additional mandates regarding data collection, financial reporting, provider agency planning projects and client outcomes production that change from year to year, dependent on Board membership and focus. NEOBH is mandated to respond to Board requests for data and project involvement, per contract.

C. External Mandates – Professional Codes of Ethics:

NEOBH is bound to the ethical codes of its respective professional disciplines, and expects its employee to adhere to published professional standards. Upon hiring, NEOBH Clinical Staff members are asked to attest to their willingness to uphold the ethical standards expected of their profession.

D. External Mandates – Employment Policies:

NEOBH provides each employee with an Employee Handbook that describes its personnel policies. Per State Employment Law, NEOBH is mandated to obtain an employee signature on policies related to Sexual Harassment, Confidentiality, Drug-Free Workplace and Anti-Discrimination.

NEOBH also adheres to state standards regarding employee qualification for the provision of health benefits, exempt versus non-exempt employment status and qualifications for inclusion in the NEOBH 401(k) Plan. It adheres to federal laws regarding Equal Employment Opportunity and Family Medical Leave.

E. Internal Mandates:

NEOBH adheres to internal mandates regarding the measurements of certain aspects of the performance of the organization. Thus, we have identified the primary questions that can be applied to a variety of areas of function within the organization:

1. The Appropriateness of a given policy, procedure or method of doing something

2. The Effectiveness of a given policy, procedure or method

3. The Quality with which the organization applies/follows through with a policy, procedure or method of operation

NEOBH has chosen the following three areas of Management as its PQI Focus:

1. Risk Management

2. Financial Viability/Income Stability

3. Expansion of Services

Program/Service Delivery Effectiveness:
As an additional internal mandate, NEOBH has adopted the following widely accepted Indicators to assess its collection of information connected to service delivery:

1. Accessibility: Is the client able to access necessary services?

2. Availability: Is the service that is needed by the client available at NEOBH?

3. Efficiency: Is the service delivered in a fashion that is maximally efficient, from start to finish?

4. Continuity: Are services smoothly transferred between clinical staff, or between agencies?

5. Safety: Is any aspect of service delivery unsafe or is client safety compromised in any way?

6. Timeliness: Are services carried out in a timely fashion?

7. Respectfulness: Do clients and referral sources perceive NEOBH as a place where they are treated with respect by all NEOBH staff with whom they come into contact?

VI. Critical Issues and Challenges:

NEOBH identifies the following issues and challenges as it embarks on the fulfillment of Goals and Objectives within its 2008-2012 Strategic Plan:

1. Fiscal Limitations: NEOBH exists within a system of shrinking resources at the state, federal and local level. As a for-profit organization, NEOBH cannot rely on grants and foundation funding. NEOBH must earn its income “one client at a time.”

2. Increasing External Mandates: NEOBH must effectively manage these mandates, which are directly connected to its contracts with funders. However, these “unfunded mandates” have a definite cost for NEOBH that affects its capacity to provide resources needed for program development and enhancement within the organization.

3. The Development of a Quality Workforce: NEOBH operates offices within a geographical area that has more than college/university program dedicated to the training of mental health professionals. Yet, the basic skill set of new graduates has been found to be lacking in several regards, thus making it imperative that NEOBH provide adequate training and supervision, often beyond the point of independent licensure.

4. Integration of Best Practices: NEOBH must demonstrate its commitment to the integration of additional Best Practices that are related to its clinical populations.

5. Limited Management Resources: NEOBH remains a for-profit fee-for-service organization that cannot afford to employ many personnel that occupy management positions. Even the Executive Director contributes to the generation of direct service income. However, this model limits the growth and promotion of NEOBH and requires the Director to assume many tasks that are delegated or otherwise distributed within larger non-profit organizations. This includes the accomplishment of COA Re-Accreditation by the Spring of 2010.

6. Increasing Level of Pathology and Chronicity within the Client Population: NEOBH has noted the heightened level of distress and violence present within the community and its effects on the functioning of the adults, children, adolescents and families within its service population. This has required NEOBH to creatively utilize its prescribed areas of Service Delivery (Diagnostic Assessment, Individual Counseling and Case Management) to create programs and services that can meet the needs of an increasingly difficult population.

Long-Term Plan 2008-2012

Mission-Related Goals and Objectives

Goal A: NEOBH will continue to provide high-quality, non-medical mental health services to children, adolescents, adults and families.

Objectives/Strategies:

• Create Performance Quality Improvement (PQI) Projects that address issues related to the implementation of Best Practices as these are identified

• Monitor the results/analyze the data set produced

• Create and disseminate implementation strategies based on results

• Respond to survey and data requests from the Ohio Department of Mental Health (ODMH) regarding Performance Improvement efforts

• Participate in Outcome Studies as required by ODMH

• Integrate Outcome data in treatment planning (Chart Review), training (Orientation and Training Modules) and program planning efforts (pre and post-testing)

Responsible Parties: PQI Committee, in conjunction with the Executive Director and the PQI Officer

Goal B: NEOBH will seek to attain the highest level of client/consumer satisfaction.

Objectives/Strategies:

• Monitor Client Satisfaction on a monthly basis

• Provide feedback to agency staff and Advisory Board regarding specific areas of concern, as well as positive feedback received

• Make concrete changes based on client feedback in any applicable area of NEOBH operation

Responsible Parties: PQI Committee, in conjunction with the Executive Director and the PQI Officer

Goal C: NEOBH will assess service gaps and the community assessment of service needs, as well as community satisfaction, and will respond to this information within the content of its Annual/Short-Term Plan.

Objectives/Strategies:

• Gather data regarding Community Satisfaction on a yearly basis

• Gather data regarding Community Needs Assessment on a yearly basis

• Create and disseminate the appropriate surveys, tabulate responses, and provide data to the Advisory Board and agency staff

• Execute additional planning efforts and make programmatic changes based directly upon the data received

Responsible Parties: Executive Director, with appropriate input from the PQI Committee, NEOBH staff and the NEOBH Advisory Board

Goal D: NEOBH will create a practice environment conducive to the needs of our clients and to the professional practice of our clinical and office staff members. NEOBH will pursue any feasible option for off-site treatment of clients that will expand its operations.

Objectives/Strategies:

• Yearly evaluation of the status of the leased space utilized by the Cuyahoga Falls/Summit County office location of NEOBH, including the degree to which present office locations meet the needs of agency staff and fits referral patterns

• Reduce office space within the Stark County Children’s Network of Stark County

• Increase delivery of services at Multicounty Juvenile Attention System

• Expand services into specialized and/or selected school environments.

Responsible Parties: Executive Director, with input provided by the Business Manager and agency staff, with additional consultation provided by the NEOBH Advisory Board

Goal E: NEOBH will support, attract and retain highly motivated and highly qualified personnel within all areas of its operation.

Objectives/Strategies:

• Continue to participate as a provider of Continuing Education Units (CEU’s) for the Ohio Counselor and Social Worker Board

• Offer in-house staff training opportunities, at least yearly, regarding skills and topics pertinent to professional and ethical practice

• Sponsor at least one community-wide workshop per year

Responsible Parties: The Executive Director will maintain the necessary approvals for CEU provision through the Counselor/Social Worker Board Office of Continuing Education. The Director will also obtain staff feedback regarding topics of interest, and will utilize PQI data in order to further identify areas of needed skill improvement.

The Executive Director will plan and execute “in house” workshops at least yearly, with the Annual Staff Training Event maintained as a primary source of staff training.

The Executive Director will organize other formal and informal staff trainings as needed to address staff training requirements outlined by accrediting bodies, consumer need and licensing body standards.

The NEOBH Business Manager will perform ongoing assessment of staff training needs within the clerical staff, and will address training required as a result of changes in technology, including software and hardware connected with data information systems, the reporting requirements of funding sources, and the management of clinical records.

Goal F: NEOBH will achieve and maintain re-accreditation by the Council on Accreditation (COA). It will obtain accreditation prior to May of 2010, and will continue to implement the organizational changes created by the certification readiness process, in preparation for re-accreditation.

Objectives/Strategies:

• Completion and creation of all procedures, organization structures and documentation necessary for the Administration and Management Narratives required for the Self-Study

• Continuous education of the clinical, clerical and business management staff regarding changes in policy, procedures and performance expectations

• Budgeting of COA-related fees and expenses

• Correction of any areas of deficiency noted via the progressive completion of the COA Eighth Edition Standards

• Preparation for the site visit, including the preparation of Clinical Staff, Support Staff and the NEOBH Advisory Board.

Responsible Parties: The Executive Director, with the cooperation of the PQI Committee, the Business Manager and the NEOBH Advisory Board

Goal G: NEOBH will expand its involvement in self-pay and contracted services markets, while maintaining its contracts with local Mental Health and Recovery Services Boards.

Objectives/Strategies:

• Establish and maintain working relationships with Mental Health Recovery Services Board staff, as well as Provider Relations representatives from Managed Care entities

• Participate in Clinical Chart Audits/Medical Necessity Audits as required by ODMH/Mental Health Recovery Services Board contracts and Managed Care contracts

• Utilize internal Clinical Chart Audit results to enhance the efficiency of internal operations and create programmatic changes

• Utilize “niche” practice areas as a means of entry for NEOBH clinical staff to provider panels and contracted services (i.e. MRDD clients, children in the custody of Child Protective Services, children exposed to trauma, children with disrupted attachment, etc.)

• Provide Mental Health Recovery Services Board staff with all required reports and clinical documentation per contract requirements

Responsible Parties: The Business Manager and the Executive Director will share responsibility for the identification of potential Managed Care contract expansion and marketing of specialty areas. The Business Manager shall be the person primarily responsible for compiling and sending staff application packets, and checking these for accuracy. The Executive Director will pursue contracts with community entities (i.e. Family/Juvenile Courts and Child Protective Services) that utilize areas of NEOBH clinical expertise.

Goal H: NEOBH will maintain financial solvency and meet all expectations regarding accurate and timely financial reporting.

Objectives/Strategies:

• Meet all deadlines for the submission of data necessary for the completion of the Annual Year-End Audit

• Meet all deadlines regarding the submission of Quarterly and Annual financial reports to the Stark County Mental Health and Recovery Services Board

• Provide Management Reports to the Executive Director and the NEOBH Advisory Board for use in planning and analysis of the Agency’s financial position

• Implement all recommendations made within External Audit Reports/Management Letters

Responsible Parties: The Business Manager of NEOBH will supply Quarterly and Annual financial reports to the Stark County Mental Health and Recovery Services Board Staff, the Executive Director and the NEOBH Advisory Board.

The Business Manager of NEOBH is responsible for the collection of data necessary for these reports, as well as well as the collection of additional financial data required for the Annual Year-End Audit. The Business Manager shall work closely with the Auditor.

The Executive Director will review all data presented, and will ensure that financial audit recommendations are implemented by the Business Manager.

The NEOBH Advisory Board will review and approve all financial reports, and will provide recommendations and consultation concerning the financial position of the organization.

Goal I: NEOBH will reformulate its policies and procedures and will refine existing and create new program practices so that these will meet one or more of the following Quality Indicators selected by NEOBH:

• The practice/procedure is an Established or Emerging Best Practice with proven clinical effectiveness. Where no specific “best practice” has been identified, NEOBH will document the rationale for the selection of procedures/practices utilized.

• The practice or procedure satisfies consumer need for a specialized service or services provided to a specific population, resulting in increased client satisfaction.

• The practice, policy or procedure is cost-effective. It increases attention to client needs by reducing unnecessary staff and administrative effort.

• Improved access to services in a timely fashion is enhanced by the practice, policy or procedure.

• The practice, policy or procedure is efficient. It increases the opportunity for the appropriate and targeted delivery of services.

• The practice, policy or procedure leads to improved outcomes regarding client functionality and/or a decrease in problematic symptomatology.

• The practice, policy or procedure is ethically, morally and/or legally responsible. It safeguards the client, staff members and/or the organization from undue risk.

• The practice, policy or procedure enhances the clinical expertise of NEOBH staff.

• The practice, policy or procedure provides monitoring of care and adherence to legal and/or professional standards of clinical care and organizational functioning via appropriate oversight.

• The practice, policy or procedure provides effective communication and collaboration with the System of Care that is needed by the client and responds to the Levels of Care within that system

Objectives/Strategies:

• Conduct a review of all existing policies and procedures and revise and/or re-define in terms of Quality Indicators

• Add new policies and procedures in accordance with identified needs and COA standards

• Examine existing clinical practices and related literature to determine Best Practice elements present or needed.

• Where no Best or Emerging Practices exist, define and defend the rationale for clinical practices utilized

• Utilize appropriate consultation (i.e. legal) to ensure proper adherence with applicable laws and regulations

• Utilize Performance and Quality Improvement (PQI) data and Outcomes Data to internally benchmark NEOBH performance and create plans for improvement

Responsible Parties: The Executive Direct will conduct a review of existing policies and procedures, as well as a review of specific clinical practices utilized at NEOBH.

NEOBH staff members engaged in treatment of niche populations will provide rationales and descriptions of approaches used to meet the needs of these clients.

The PQI Officer will design PQI projects directed toward the enhancement of Outcomes for specific clinical populations/diagnostic groups.

The NEOBH Business Manager will define and revise office billing and clerical procedures in terms of how these meet one or more Quality Indicators.

Goal J: NEOBH will invest in technology that will enhance the efficiency of its operations.

Objectives/Strategies:

• Respond to client and staff feedback regarding needs for improved technology, such as voice mail, web-based information regarding the organization and use of the internet to expedite the transmission of information

• Conduct a needs assessment to determine where the best value can be obtained with the assistance of technology

• Prioritize equipment purchases/replacements in terms of staff efficiency

Responsible Parties:

• The Executive Director will review purchase options via research and consultation completed by the Business Manager.

Appendix A:

Description of the Strategic Planning Process

NEOBH employs the following steps in its Strategic Planning Process:

1. Examination of the level of accomplishment of Goals and Objectives contained within previous Long and Short-Term Plans

2. Critical analysis of barriers encountered toward the fulfillment of Objectives contained within Short-Term Plans

3. Solicitation of input from NEOBH Staff regarding possible future agency direction, referral patterns, and client priorities/needs noted

4. Use of Client Satisfaction Survey data, Community Survey data and Staff Survey data to identify stakeholder interests and concerns

5. Consultation with the NEOBH Advisory Board regarding trends noted in the above data resources, within financial reports and within the Strategic Plans published by entities that provide funding for NEOBH services

6. Draft of Strategic Plan submitted to NEOBH Advisory Board

7. Consideration of Advisory Board reaction and the inclusion of Board input toward refinement of the Strategic Plan

8. Re-Submission of the Strategic Plan to the NEOBH Advisory Board as an Action Item within the Agenda of the Board

9. Dissemination of the Strategic Plan to NEOBH Staff

10. Dissemination of the Strategic Plan to the Stark County Mental Health and Recovery Services Board, via inclusion in Provider Plan

11. Dissemination of the Strategic Plan to stakeholders, in summary form, within the Annual Report

12. Posted availability of the Strategic Plan to clients and additional stakeholders

13. Posting of Strategic Plan on the NEOBH Website

Appendix B:

Assessment of Strengths and Weaknesses

Strengths:

• Committed agency staff, with low to moderate turnover of clinical staff. Several clinical staff members have been employed for more than seven years

• Variety of experience base within clinical staff (i.e. university professors, agency program directors, chemical dependency agency) as well as varied professional backgrounds (counseling, social work, psychology) results in a rich clinical atmosphere conducive to different points of view and the sharing of ideas

• Establishment of “niche” specialty areas, particularly within the child and adolescent service population

• Strong community reputation regarding the provision of services to complex cases, including those involved with the Court system

• “Hands on” leadership that appreciates and experiences the clinical challenges of client work as well as the complexity of the business environment

• High level of expertise (in house, and consultative, via audits) regarding financial reporting requirements and expense allocation

• Implementation of computerized billing programs, with opportunities for expansion

• Committed Advisory Board members with areas of expertise that NEOBH can draw upon

Weaknesses:

• Small size of the agency creates centralized leadership and requires numerous administrative roles to be performed by the same staff members versus distribution of duties and responsibilities

• Lack of psychiatric services, limited both by the availability of such services and the cost of obtaining psychiatric consultation

• Varied schedules of staff members/inclusion of part-time staff make it difficult for the clinical staff to meet together as a single unit

• Limited space in some office areas has made expansion of some programs more difficult

• Single billing location requires close coordination between office staff in various clinical office locations

• Complexity of “paperwork” requirements due to the mandated requirements of funding sources has required diversion of clinical staff attention and reallocation of very limited clerical staff resources.

Appendix C:

Assessment of Community Needs/Environmental Scan

Existing Community Services:

At the present time, Child and Adolescent Service Center (CASC) in Stark County and Child Guidance/Family Solutions in Summit County are considered the primary providers of mental health services to children, adolescents and families in their respective counties. These agencies have a wide array of services, including psychiatry and case management, in addition to traditional outpatient counseling. NEOBH serves a significant number of children and adolescents via its Medicaid-only contracts with the Stark County Mental and Recovery Services Board (Stark County MHRS Board). NEOBH is able to bill out-of-county Medicaid units through this single Board contract and via participation in the Heartland Behavioral Health billing transmission system. Although its contracts with Managed Care bring forward referrals for adults, adolescents and children, the child/adolescent focus of NEOBH has drawn referrals from sources with this population emphasis, such as pediatricians and family practitioners.

NEOBH competes with other private practitioners in the community for the private/fee- for-service client market. It does not compete with adult Community Mental Health agencies (such as Portage Path Community Mental Health Center/Summit County, and NOVA Behavioral Health/Stark County) for Medicaid-only clients. Indeed, these agencies serve a more demanding adult population who frequently require psychiatric services as well as central pharmacy and case management services.

At this time, NEOBH plans to enhance its operations by the provision of additional services, principally Community Psychiatric Supportive Treatment (aka case management). NEOBH has moved its service delivery out into the community (i.e. within specialized school and youth criminal justice environments) and recognizes that the populations within these environments require case coordination, community linkage and outreach in order to enhance progress toward Individual Service Plan goals. NEOBH has also moved toward the provision of services to niche populations (juveniles on probation, deaf and hearing impaired and MR/DD clients) that also require services outside of the realm of traditional mental health treatment.

NEOBH has considered adding child psychiatric services in the past, but the continued high cost of hiring this type of specialist, in comparison to the amount of potential utilization, prohibits further consideration of this possibility. Thus, NEOBH will not market it services to chronically mentally ill clients that require this treatment component.

NEOBH plans to maintain an emphasis on “niche” specialty areas, particularly those needed within the child/adolescent/family clinical populations. These include the following:

• Child sexual abuse assessment

• Assessment and treatment of incarcerated youth reactive to trauma

• Psychological evaluations

• Custody Assessments

• Trauma Assessments

• Trauma Treatment, utilizing Best Practice methods, such as Trauma-Focused Cognitive-Behavioral Treatment (TF-CBT) and Prolonged Exposure Treatment (PET)

• Intensive Parent-Child Intervention (IPCI)

• Parent Education and Skill Training, via use of “The Incredible Years”

• Parenting Evaluations

• Bariatric Assessments

• Family intervention for youth on probation

• Attachment and bonding treatment

• Counseling services for MR/DD clients

• Assessment and counseling services for Autism Spectrum clients

• Counseling services for Deaf and Hearing-Impaired clients

Identified Service Gaps:

The referral patterns of NEOBH strongly indicate that NEOBH is the primary choice for the above-listed services within both Stark and Summit Counties. This is particularly true regarding child sexual abuse assessment services, as well as abuse/neglect or dependency cases involving the Stark County Family Court. NEOBH has received increased attention from the Summit County Juvenile Court and Summit County Children Services regarding requests for the assessment of children, adolescents and parents.

Accessibility

NEOBH continues to experience a high demand for assessment and treatment services, particularly within the Stark County office, and particularly within the area of Parenting Evaluations. Accessibility for these two specialty areas has been limited by clinician availability, but is improving.

In contrast, the Summit County Office appears to offer more possibilities for Managed Care and fee for service clients (such as Custody Evaluations), as well as specialized consultation for children and adolescents with Autistic Spectrum Disorders, such as Asperger’s Disorder. The expansion of services to these clients is currently limited by the availability of staff with the appropriate expertise. The hiring of staff with the appropriate specialized skill set has remained a priority for NEOBH. Further, NEOBH recognizes that its expansion of services toward other underserved populations (such as MR/DD clients) requires the acquisition of staff that has interest and skill in the delivery of service to this population.

Appendix D:

Data Sources Used Toward Strategic Planning

NEOBH utilizes the following data collection instruments toward the development of its Strategic Plan:

• Community Survey

• NEOBH Staff Survey

• Client Satisfaction Survey (Youth and Adult Versions)

Appendix E:

NEOBH Advisory Board Member List and Profiles

Revised 11-09

Short-Term Plan July 1, 2008 – June 30, 2009

Goal A: NEOBH will continue to provide high-quality, non-medical mental health services to children, adolescents, adults and families.

Objective 1:

• Create at least two Continuous Quality Improvement (CQI) Projects that monitor agency performance utilizing Outcomes Data

Objective 2:

• Create one CQI Project based on an area of Best Practice and/or a social clinical population (i.e. Outcomes with trauma victims)

Objective 3:

• Revise PQI Plan and PQI Committee Membership in accordance with 8^th Edition COA Standards

Responsible Parties: PQI Committee, in conjunction with the Executive and Clinical Director and the QA Officer

Goal B: NEOBH will seek to attain the highest level of client/consumer satisfaction.

Objective 1:

• Communicate Client Satisfaction to staff on a quarterly basis

Objective 2:

• Make at least two changes in procedure, etc. based on data received from Client Satisfaction surveys

Responsible Parties: PQI Committee, in conjunction with the Executive Director and the PQI Officer

Goal C: NEOBH will assess service gaps and the community assessment of service needs, as well as community satisfaction, and will respond to this information within the content of its Annual/Short-Term Plan.

Objective 1:

• Make and document responses to Community Satisfaction where the respondent provides data that makes it possible to respond

Objective 2:

• Execute at least one programmatic change based upon the data received from the Community Satisfaction Survey

Responsible Parties: Clinical/Executive Director, with appropriate input from the PQI Committee, agency staff and the NEOBH Advisory Board

Goal D: NEOBH will create a practice environment conducive to the needs of our clients and to the professional practice of our clinical and office staff members. NEOBH will pursue any feasible option for off-site treatment of clients that will expand its operations.

Objective 1:

• Conduct an assessment of the Cuyahoga Falls/Summit County office location of NEOBH, including the degree to which present office location meets the needs of agency staff and fits referral patterns

Objective 2:

• Examine utilization patterns within office space within the Stark County Child Advocacy Center and Children’s Network of Stark County

• Revise service provision at Multicounty Juvenile Attention System to improve profit margin

Responsible Parties: The Executive Director, with input provided by the Business Manager and agency staff, with additional consultation provided by the NEOBH Advisory Board

Goal E: NEOBH will support, attract and retain highly motivated and highly qualified personnel within all areas of its operation.

Objective 1:

• Provide at least one training events that gives staff Continuing Education Units (CEU’s) for the Ohio Counselor and Social Worker Board

Objective 2:

• Investigate and implement at least one opportunity for outside training and continued internal cross-training of support staff

Responsible Parties: The Executive Director will maintain the necessary approvals for CEU provision through the Counselor/Social Worker Board Office of Continuing Education. The Director will also obtain staff feedback regarding topics of interest, and will utilize QA/PQI data in order to further identify areas of needed skill improvement.

The Executive Director will plan and execute workshops at least yearly, with the Annual Staff Training Event maintained as a primary source of staff training.

The Executive Director will organize other staff trainings as needed to address staff training requirements outlined by accrediting bodies, consumer need and licensing body standards.

The Business Manager will perform ongoing assessment of staff training needs within the clerical staff, and will address training required as a result of changes in technology, including software and hardware and data information reporting requirements of funding sources.

Goal F: NEOBH will achieve and maintain re-accreditation by the Council on Accreditation for Children and Family Services (COA). It will obtain accreditation prior to May of 2010, and will continue to implement the organizational changes created by the certification readiness process, in preparation for re-accreditation.

Objective 1:

• Revision of PQI plan and implementation of all PQI expectations per COA

Objective 2:

• Complete Procedure Manual for support staff functions

Objective 3:

• Complete review of 8^th Edition Standards toward a Task List re: areas/policies requiring revision

Objective 4:

• Review policies and procedures in accordance with the above review

Responsible Parties: Clinical/Executive Director, with the cooperation of the CQI Committee, the Business Manager and the Advisory Board

Goal G: NEOBH will expand its involvement in self-pay and contracted services markets, while maintaining its contracts with local Mental Health Boards.

Objective 1:

• Establish a working relationships with Mental Health Recovery Services Board staff, and clarify expectations in light of changes at local, state and national levels

Objective 2:

• Evaluate existing contracts re: cost/benefit

Responsible Parties: The Business Manager and the Executive Director.

Goal H: NEOBH will maintain financial solvency and will meet all expectations regarding accurate and timely financial reporting.

Objective 1:

• Examine all areas of cost for potential savings and justification

Objective 2:

• Compete the Annual Reconciliation Audit without payback

Objective 3:

• Comply with expectations for the submission of financial reports to the Stark County Mental Health and Recovery Services Board

Objective 4:

• Implement all recommendations made within External Audit reports/Management Letters

Responsible Parties: The Business Manager of NEOBH will supply Quarterly and Annual financial reports to the Stark County Mental Health and Recovery Services Board Staff, the Executive Director and the NEOBH Advisory Board.

The Business Manager of NEOBH is responsible for the collection of data necessary for these reports, as well as well as the collection of additional financial data required for the Annual Reconciliation Audit. The Business Manager shall work closely with the Auditor.

The Executive Director will review all data presented, and will ensure that financial audit recommendations are implemented by the Business Manager.

The NEOBH Advisory Board will review and approve all financial reports, and will provide recommendations and consultation concerning the financial position of the organization.

Goal I: NEOBH will reformulate its policies and procedures and will define existing and new program practices so that these will meet one or more of the following Quality Indicators selected by NEOBH:

• The practice/procedure is an Established or Emerging Best Practice with proven clinical effectiveness. Where no specific “best practice” has been identified, NEOBH will document the rationale for the selection of procedures/practices utilized.

• The practice or procedure satisfies consumer need for a specialized service or services provided to a specific population, resulting in increased client satisfaction.

• The practice, policy or procedure is cost-effective. It increases attention to client needs by reducing unnecessary staff and administrative effort.

• Improved access to services in a timely fashion is enhanced by the practice, policy or procedure.

• The practice, policy or procedure is efficient. It increases the opportunity for the appropriate and targeted delivery of services.

• The practice, policy or procedure leads to improved outcomes regarding client functionality and/or a decrease in problematic symptomatology.

• The practice, policy or procedure is ethically, morally and/or legally responsible. It safeguards the client, staff members and/or the organization from undue risk.

• The practice, policy or procedure enhances the clinical expertise of NEOBH staff.

• The practice, policy or procedure provides monitoring of care and adherence to legal and/or professional standards of clinical care and organizational functioning via appropriate oversight.

• The practice, policy or procedure provides effective communication and collaboration with the System of Care that is needed by the client and responds to the Levels of Care within that system

Objective 1:

• Conduct a review of all existing policies and procedures and revise and/or re-define in terms of Quality Indicators

Objective 2:

• Add new policies and procedures in accordance with identified needs

Responsible Parties: The Executive Direct will conduct a review of existing policies and procedures, as well as a review of specific clinical practices.

NEOBH staff members engaged in treatment of niche populations will provide rationales and descriptions of approaches used to meet the needs of these clients.

The PQI Officer will design PQI projects directed toward the enhancement of Outcomes for specific clinical populations/diagnostic groups.

The NEOBH Business Manager will define and revise office billing and clerical procedures in terms of how these meet one or more Quality Indicators.

Goal J: NEOBH will invest in technology that will enhance the efficiency of its operations.

Objective 1:

• Examine feasibility of online charting, cost/benefit

Responsible Parties:

• The Executive Director will review options via research and consultation completed by the Business Manager.

Assessment of Human Resource Needs

The assessment of human resource needs is an ongoing process. At this juncture, NEOBH does not plan to appreciably expand its operations within the next four years; nevertheless, it is possible that opportunities for collaboration may occur. At the very least, NEOBH can expect to continue to require the following staff resources:

Clerical Staff:

• Front Desk/Charge Data Entry

• Transcription

• Billing

• Billing Follow-Up

• Outcomes Data Processing

• Filing and Chart Closure/Data Entry

Business Management:

• Bookkeeping, Payroll, Financial Reporting

• Supervision of Office/Billing Staff

• Managed Care Linkage and Follow-Up

Clinical Staff:

• Licensed Professional Clinical Counselors

• Licensed Independent Social Workers

• Licensed Psychologists

• Psychology Assistants

• School Psychologists

NEOBH will continue to engage in the use of contractors and outside consultants to assist with the following areas:

• Legal Consultation

• Computer Network/System Consultation

• Office Maintenance/Routine Repairs

• Certified Public Accountant/Annual Financial Audit

• Certified Public Accountant/Tax Preparation

Demographic Profile – Stark County, Ohio

POPULATION/2003 Estimate: 377,519

INCOME DATA/YEAR 1999

Annual Household Income (Median): $39,924

Per Capita Money Income: $20,417

Persons Below Poverty Level (Percentage): 9.2%

GENDER DATA/YEAR 2000

Female Persons (Percentage): Male Persons (Percentage):

52.0% 48%

RACIAL/ETHNIC DATA/ YEAR 2000 (Percentage)

Caucasian: 90.3%

Black or African-American: 7.2%

American Indian and Alaskan Native: 0.2%

Asian: 0.5%

Native Hawaiian/Pacific Islander: 0

Other Race Reported: 0.3%

Two or More Other Races Reported: 1.4%

Hispanic or Latino: 0.9%

White/non-Hispanic or Latino: 89.7%

Total Minority Population: 10.5%

LANGUAGE DATA/YEAR 2000

Foreign-Born Persons: 1.8%

Language Other than English Spoken at Home: 4.3%

Spanish Spoken at Home: 2.2%

German Spoken at Home: 2.1

AGE DATA/YEAR 2000

Persons Under 5 Years of Age: 6.4%

Persons Under 18 Years of Age: 24.8

Persons 65 and Older: 15.1%

Median Age: 38.2 Years

RELIGIOUS AFFILIATION DATA/YEAR 2000

Largest Religious Bodies Number of Congregations Number of Adherents

Catholic: 30 77,490

United Methodist: 59 23,046

Independent/Non-Charismatic: 4 16,070

Evangelical Lutheran (ELCA): 26 12,247

Church of Christ: 18 10,074

United Church of Christ: 21 9,073

Presbyterian Church/USA: 13 5,534

EDUCATION DATA/YEAR 2000/Persons 25 and Over

No High School Diploma: 16.6%

High School Graduate: 41.2%

Some College, No Degree: 18.9%

Associate Degree: 5.3%

Bachelor’s Degree: 11.9%

Master’s Degree or Higher: 6.1%

VITAL STATISTICS/YEAR 2000

Births/Rate per 1,000 Population: 12.3

Teen Births/Rate per 1,000 Females, 15-19: 40.5

Marriages/Rate per 1,000 Population: 7.6

Divorces/Rate per 1,000 Population: 4.3

Demographic Profile – Summit County, Ohio

POPULATION/2003 Estimate: 546,773

INCOME DATA/YEAR 1999

Annual Household Income (Median): $42,304

Per Capita Money Income: $22,842

Persons Below Poverty Level (Percentage): 9.9%

GENDER DATA/YEAR 2000

Female Persons (Percentage): Male Persons (Percentage):

51.8% 48.2%

RACIAL/ETHNIC DATA/YEAR 2000 (Percentage)

Caucasian: 83.5%

Black or African-American: 13.2%

American Indian and Alaskan Native: 0.2%

Asian: 1.4%

Native Hawaiian/Pacific Islander: 0

Other Race Reported: 0.3%

Two or More Other Races Reported: 1.4%

Hispanic or Latino: 0.9%

White/non-Hispanic or Latino: 83.0%

Total Minority Population: 17.4%

LANGUAGE DATA/YEAR 2000

Foreign-Born Persons: 3.3%

Language Other Than English Spoken at Home: 5.6%

Spanish Spoken at Home: 3.2%

German Spoken at Home: 2.1%

Other Language Spoken at Home: 0.3%

AGE DATA/YEAR 2000

Persons Under 5 Years of Age: 6.6%

Persons Under 18 Years of Age: 25.0%

Persons 65 and Older: 14.1%

Median Age: 37 Years

RELIGIOUS AFFILIATION DATA/YEAR 2000

Largest Religious Bodies Number of Congregations Number of Adherents

Catholic: 40 121,602

Independent/Non-Charismatic: 6 21,950

United Methodist: 45 21,083

United Church of Christ: 21 11,148

Evangelical Lutheran (ELCA): 14 6,912

Episcopal Church: 11 5,924

Presbyterian Church/USA: 16 5,825

Lutheran Church/ MO Synod: 12 5,643

EDUCATION DATA/YEAR 200/Persons 25 and Older

No High School Diploma: 14.3%

High School Graduate: 33.6%

Some College, No Degree: 21.7%

Associate Degree: 5.3%

Bachelor’s Degree: 16.7%

Master’s Degree or Higher: 8.4%

VITAL STATISTICS/YEAR 2000

Births/Rate per 1,000 Population: 12.9

Teen Births/Rate per 1,000 Females, 15-19: 41.7

Marriages/Rate per 1,000 Population: 7.3

Divorces/Rate per 1,000 Population: 4.0