presented by jane blatz david charron ashley illuzzi manish kulkarni meghan lafferty
TRANSCRIPT
Child & Adolescent Treatment Services: HR Strategy Proposal
Presented by Jane Blatz
David CharronAshley Illuzzi
Manish KulkarniMeghan Lafferty
What Success Look Like?
ANSWERChild & Adolescent Treatment Services' vision is to be the best outpatient children's mental health agency in our community. Being the best means providing the highest quality treatment, highly-skilled staff, ongoing workforce development, child-friendly facilities, so each child thrives and feels hopeful.
CATS in a Brief
Who: 75 years promoting emotional well being for families & children
What: Treated 2,746 clients in 2012Where: Across Erie CountyHow: 6 Programs, 135 Full-Time StaffWhy: Roughly 1 in 4 children will
experience a diagnosable mental health problem, 79% who need services will not receive them (AJP, 2002)
Purpose & Stated Goals
CATS REQUEST
Evaluation Tool Last assessed over 5
year ago Over correction of
subjective measures Challenge to pay for
performance bonus
OUR GOALS
Overall HR Strategy Performance
Management System Update Evaluation Tool Update Evaluation
Process Review Recognition and
Reward System
Evaluation Tool Proposed Changes
CURRENT
Behavioral
Manager Driven
Vague
Subjective
Ratings Developed by Primary Manager
PROPOSED
Blended
Employee & Manager Input
Clear
Measurable
Ratings Calibrated with All Managers
Clinician Evaluation Lifecycle
Management Set Goals
Employee Set Stretch
Targets
Midyear Review
Employee Self
Evaluation
Managers Evaluation
Managers Calibrate Ratings
Employee Ratings
Delivered
Rating Calibration
Employee evaluations completed Together Managers use guidelines to apply
ratings Managers propose how to distribute any raise
or bonus
Identifying the game changing performers across programs and locations
Identify areas of internal strengths and weakness across the organization Provide areas for training & development Areas of consideration for HR strategy
Motivation Findings
ASSUMPTIONS
Everyone wants a bonus
Vacation time is valued
Additional Training as a bonus
FINDINGS
Majority prefer a raise
Majority afraid to take time off as it impacts performance numbers
Training mostly happens during personal time, not additionally motivating without raise
Motivation Findings * PLEASE ADD IN HERE WHAT ELSE YOU THINK THEY SHOULD KNOW
ASSUMPTIONS
Kudos Program Motivates
FINDINGS
Kudos Program Demotivates & disrupts workflow
Managing Staff Performance is Crucial to Success
Personnel Cost,
5,911,056,73%
Operating Expense,
2,186,401 , 27%
Our Approach
Analyze Performance
Evaluations Employee
Satisfaction Surveys Customer
Satisfaction Surveys Meetings
Senior Leadership Six-Sigma Team
Focus Groups Clinicians Managers
Explore Workforce
Management Models Non-profit
Management Systems
Strategy Maps Company Goals
Initial Findings
Problematic Staff Evaluation Tool & Process
Chasing the All Important STAT Differentiating Quality vs Quantity Motivation and Performance Misalignment between Strategy and
Goals
Evaluation Tool & Process Findings
Results are Positively Skewed Unclear Evaluation Scale
Measures “Do-Able” not “Deliverables” Hospital Example: ▪ # of patients treated vs. % of lives saved, improved
Overemphasis on a single indicator “Stat” is 10% of the evaluation, 90% of the
focus Only Measures Past Performance
Data is subjective and difficult to use for future decision making and change
Measures “Do-Able” not “Deliverables”What Does 8 Stats Say About Quality of Care?
Compare this to Multiple Measures?Client keeps all appointments, but school reports increase in truancy Cancels often due to
lack of outreach reminders
After 2 years, has received $2,000 in unbillable services because she doesn’t have state ID
Cancels often due to lack of transportation
Customer Survey: Parent 90% satisfied with service, gives specific praise to clinician
Maximize Margins and Mission
DOLLARS$ 0 1 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33
Cost per Session
Reimbursement Per Session
Issue: “Different Programs Have Different Reimbursement and Impact”
Understand trade-offs in program portfolio in terms of impact and financial results
Strategy 1: “We should cut costs”
Cost cutting has limited benefit in a lean organization, will it decrease service quality?
Strategy 2: “60% productivity is the target”
What about cancel/fail, unforeseen events, different program reimbursements, and costs?
Strategy 3: “We must expand in order to remain financially stable.”
Expansion is costly and what about serving those on the waitlist first?
Motivation and Performance
End GoalProviding Quality
Customer Service
Training
Knowing
what to do
Motivation
Wanting to Do it
“Money will make me happier, but not work harder, I already work hard.”
“There is no money for training”
“When we taught other school workers what we know, we understood it better ourselves”
“I love feeling appreciated”
Is CATS Retaining “Highly-Skilled” Staff?
2012201120100%
2%
4%
6%
8%
10%
12%
14%
16%
18%
20%
CATS Turnover is Higher Than Expected and Grow-ing, but Who is Leaving?
CATS Turnover Rate
National Turnover Rate for Social Service
Use Findings to Develop Strategy
Problematic Staff Evaluation Tool & Process
Chasing the All Important STAT Differentiating Quality vs Quantity Motivation and Performance Misalignment between Strategy and
Goals
Developing Strategy
CATS has three goals:1. Quality2. Sustainability3. Expansion
We looked at these 3 goals as a guideline for the strategy map
Strategic Goal #1
• Provide the best possible service to customers
• People-focused organization• Focus more on giving the best
treatment rather than quantity• Not give as much emphasis
on stats
Quality
Strategic Goal #2
• Reduced overhead • Greater amount of funds for raises and employee recognition
• Less worry about day to day financial sustainability
Financial Stability
Strategic Goal #3
• Eventually grow in terms of both services offered and number of people served
• Have a well known brand that people choose to go to because of its reputation
Expansion
StrategySetting the Corporate Objectives
CATS OVERALL MISSION
1. To be the best evidence-based mental health prevention and treatment organization in western New York.
2. To be financially sustainable
3. Expand services beyond Erie County
Strategy Map
Resource Perspective
Process Perspective
Financial Perspective
Client Perspective
Information Capital: 1 organization, many different teams.
Organizational Capital: Importance of Databases, Scheduling & Billing
Human Capital: 73% of entire budget – 100% of the work
Customer Management:High Customer Satisfaction Crucial, 30% Avg cancel/fail (10-50% range)
Innovation: Sufficient
Operations Management: Needs improvement
Cycle Time (See More Clients)
Quality (Critical)
Price Selection ServiceFunctionality
Partnership: Schools & Private Practice
Brand: Accreditation
Reduce Cost Structure: Not Enough Info
Increase Asset Utilization: Must achieve >60% work productivity
Increase Customer Value: Set by insurance
Expand Revenue Opportunities: Grants & Programs at 50% of income
Operational Efficiency Revenue Growth
Service AttributesImageValue
Network
OVERALL MISSION
To be the best evidence-based mental health prevention and treatment organization in western New York.
To be financially sustainable in the long-term
To expand our services and expertise to those who need them
Financial Sustainability & Social Impact Map
(150,000) (125,000) (100,000) (75,000) (50,000) (25,000) 0 25,000 50,000 75,000 100,000 125,000 150,000
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
UnivDBT
FFT
East
PCIT
West
South
Lancaster
CAC Prg
ICM Prg
SCM Prg
Other DMH
Oth Non-DMH
Foundation
Child and Adolescent Treatment Services Financial Sustainability & Social Impact Map
* Bubbles Sized According to Annual Program Expense
Social Impact 4=Excellent
3=Above Avg2 = Below Avg
1 = Low/Not Relevant
(Loss) /Profit
Detailed Logic Model
Logic Model Components
Building a leadership brandOptimizing human capitalDeveloping talentShaping organization & communication practices
Driving performance
Building a Leadership Brand (Doables)
Walking tour, skip-level meetings & focus groups
Ongoing HR and strategy meetings Ongoing middle management
meetings Reward dinners and luncheons Supervisory meetings
Building a Leadership Brand (Deliverables)
Addressing employee satisfaction Corporate strategic plan Strategic plans by middle managers Addressing top performer turnover Supervisory meetings ensure
compliance
Leadership Outcomes
Shorter -Term
• Consistent face-to-face interaction
• Sense of unity and teamwork
• Employee satisfaction
Intermediate
• Cross program collaboration
• Up-to-date performance management process
Longer-Term
• Staff collaboration
• Meeting performance goals
Optimize Human Capital
Hire an HR coordinator to work with staff and clinicians
satisfaction & performance understanding of bottlenecks Ability to focus on:
Reports New training & development Recruitment plans
Optimize Human Capital
Restructure data management system
time spent on data analysis by 50%
ease of use
Optimize Human Capital
Hire staff that add both impact and economic value
profit impact
Optimize Human Capital
CURRENT
Behavioral
Manager Driven
Vague
Subjective
PROPOSED
Blended
Employee & Manager Input
Clear
Measurable
Developing Talent
Senior leaders participate coaching
and providing leadership training both for themselves
and for middle managers
Employees receive stat credit for
participating in training
Employee engagement/satisfacti
on increases, productivity and other
performance improves
Management and employee
performance scores improve
Shaping Organization & Communication Practices
Mentorship Program for New Hires Inter-Program Collaboration
School Education Seminars External Pilot Programs
DBT and UB School of Social Work Mastery, Autonomy, and Purpose (Drive, by Daniel
Pink)
Mastery – In House Training Autonomy – Staff Set Their Own Reach
Targets Purpose – Celebrate Impact Frequent & Often
Driving Performance
New Evaluation Tool
Evaluation Process Proposed timeline
Goal Setting
Evaluation Process
Senior Leadership Annual CATS Presentation Review▪ Evaluate CATS goals
Adjust goals Quarterly reviews▪ Meetings with middle managers
Quarterly staff appreciation events
Evaluation Process
Middle Managers Performance evaluation meetings Compensation meetings Coordinate strategic initiatives Quarterly Meetings▪ Receive and give coaching with senior leaders▪ Set team goals▪ Coach front line staff
Evaluation Process
Front Line Personal goal setting Quarterly team meetings▪ Best practices▪ Coaching & development with middle
managers
Goal Setting
Align new evaluation process
results with company goals
Company Goals Campaign
-Serve 3,000 children-10 controllable
actions-Measurable deliverables
Program Goal Development
-Support company goals
Identification of Botteneck
Implementation (next steps)
Recommendations
Summary of Logic Model
Building a Leadership Brand
Employee satisfaction
through improved
communication
Development of corporate
strategic plans
Developing Talent
Clinician coaching &
training
Performance scores
improvement
Shaping Communication &
Organization Practices
New hire mentorship programs
Cross-program collaboration
Summary of Logic Model (Contd.)
Use of measurable metrics
Manager as well as employee driven
Optimizing
Human Capital Evaluation
process
Goal setting
Driving Performanc
e
QUESTIONS