Providing solutions for successful living for individuals with challenges since 1976

Published June 2016

Workforce shortages a major concern for CRSI leaders

Three areas of financial concern for CRSI continue to be healthcare costs, lack of workforce availability and increased overtime. CRSI is thankful that more citizens are receiving healthcare with the passage of the Affordable Care Act, but is concerned about the budget impact. The cost of employee healthcare has increased annually by about $400,000. This increase is not reflected in Medicaid reimbursements to the agency nor has Medicaid rates increased in nearly ten years, resulting in less resources for staff wages and benefits.

With unemployment rates hovering around a low 4% in most counties served by CRSI and stricter hiring

requirements imposed by government regulations, the available workforce is greatly reduced. Fewer qualified applicants result in costly overtime increases that are also not reflected in Medicaid reimbursements. For example, overtime has been held to about 5-6% annually for the last twenty years. In 2015 it reached 15%. This workforce challenge has also forced CRSI to refuse providing services in some counties due to lack of staffing. We have not experienced this depth of workforce shortages in my over thirty years in the field of disabilities, however, CRSI is aggressively promoting sign-on bonuses, rewarding referrals from staff and using other incentives to find and hire qualified employees. We are also very aggressive in expressing concerns about these issues at the local, state and federal levels; and will continue doing so in 2016.

In 2015 we focused on culture change by addressing communication between departments and discussing policies, strategies, changes and future departmental needs. Quarterly meetings became training and informational sessions for directors and managers. A group of dedicated employees also participated in the “Good Life” program and will continue to spread the positive culture message throughout the agency in 2016. Training refinements continued in 2015 with a focus on how to make training more beneficial, efficient and energizing. Managers are encouraged to empower and enable staff input. Exit surveys are now used to evaluate reasons why people leave the agency and discover areas where we can improve. 2016 continues to be a year of change as we strive to meet the needs of our current and future customers while working within a budget largely determined by legislative decisions that impact the way we do business. With the DD and aging populations increasing, there is concern for individuals needing future services. Of note are the successes and improved depth of services within the Behavior Support Department, resulting in an increase in behavior services. An increase in services brings with it a need for an increased workforce. Coupled with an improving economy, the provider sector has a difficult time attracting caregivers for minimal dollars. In light that we are now in the beginning phases of a biennium budget, it is very important for all stakeholders - individuals, families, guardians and caregivers - to support state budget initiatives to increase wages. I would like to express my sincere thanks to all of the direct support employees who work extra shifts to cover unfilled hours. Without this dedication and commitment we would not be able to serve people who deserve high quality services and continuity of care.

Chief Executive Officer

President

Page 2 2015 Annual Report

QUALITY

SATISFACTION

Identifying the needs of the customer and meeting those expectations with QUALITY services and a professionally trained staff...

Striving for customer SATISFACTION while providing supports that are accessible, successful, appropriate and considerate of the diversity of customers and the community…

Clark County: Participants in the 2015 Strive@CRSI program

work under a contractual workforce training agreement with

Gordon Food Services at the GFS distribution center in

Springfield. The company pays each individual minimum wage

and CRSI pays the job coach who accompanies them to the

job site.

The key to delivering quality services is an exceptional workforce that is dedicated to meeting the needs of individuals served. In 2015 CRSI management introduced the “Attitude of Gratitude” program to honor well-deserving employees for outstanding performance and commitment. Each month, multiple employees are recognized from various regions served and one employee on the list is honored as Employee of the Month.

2015 Employees of the Month

January Amanda Sparks

Support Manager Madison/Franklin Region

February Christy Cottrell

Program Specialist Clark County

March Ella Williams

Support Manager Allen County

April Michelle Burgoon Support Specialist Auglaize County

May Crystal Fordney

Support Specialist Auglaize County

June Katja Walker

QDDP Champaign County

July Jessica Rutherford Support Specialist Madison County

August Kimberly Ream

Support Specialist Champaign County

September Ernest Awuah

Support Manager Franklin County

October Amanda Lawrence Support Specialist

Clark County

November Crystal Van Horn

Executive Assistant Allen County

December Jodie Freistuhler Support Manager Auglaize County

Allen County

Page 3 2015 Annual Report

Developing trust with customers through HONESTY and RESPECT while interacting with customers and one another in a professional, fair and caring manner...

Sharing ideas, direction and resources; and promoting TEAMWORK to resolve issues, encourage Self-Advocacy, and promote f lexibility and growth within a changing environment for customers and staff...

Paulding County: Since 1991, the Ohio Provider Resource Association (OPRA) has annually recognized direct support employees that demonstrate outstanding service and achievement in the DD field and whose work significantly impacts the lives of individuals with developmental disabilities. Team Paulding County is one of two Ohio winning teams for its outstanding medical advocacy that can only be achieved by a group of direct support professionals who are exceptionally dedicated to the people they serve.

HONESTY AND

RESPECT

TEAMWORK

Clark County

Shelby County: Included in their person-centered plans for

individual services are Carl Banks’ desire to attend a baseball

game and Ricky Cook’s wish to attend a

sporting event.

When the Shelby County Board offers

each gentleman a chance to attend a

Dragon’s game, they both are excited to

go. They are accompanied by CRSI

support staff.

Miami County

Champaign Co. Defiance Co. Miami Co. Auglaize Co.

Logan County: A wedding-themed fashion show put on by the Aktion Club, which is the only service organization for adults with disabilities. It has more than 12,000 members worldwide. These two Belle Center housemates volunteered as models for the 2015 fashion show.

Behavior Support Behavior assessment provides planning, training, consultation and support services to persons with developmental disabilities; assisting in achieving effective services and building skills for staff and family members in order to handle behavioral and crisis situations.

Community Based Residential Support CRSI provides services for individuals with developmental disabilities who live in their own homes or with roommates or family, using staff supports that allow for individual choices and decision-making.

Consumer Advocacy CRSI's proactive, consumer-driven philosophy is enhanced by the Consumer Advocacy Department; staffed by individuals who can, due to their own circumstances, easily relate to the needs of consumers served. CRSI actively participates in advocacy issues on the local, state and national levels. Customer satisfaction surveys assess services provided. The staff works closely with the Quality Assurance Department to ensure that CRSI follows-up with any reported concerns or requests resulting from consumer satisfaction surveys.

ICF/IID CRSI has eleven residential shared living settings or intermediate care facilities for individuals with intellectual and developmental disabilities (ICF/IID), where individuals are supported with medical, transportation, tailored programming and other intermediate services which are available to meet the more specialized health needs of individuals with developmental disabilities.

Management Services In partnership with County Boards of DD and other agencies, CRSI provides both program and fiscal services such as fiscal oversight, management of direct support programs, ancillary services and more.

Medication Administration Training This comprehensive course is conducted by qualified and experienced nurses who provide CRSI direct care professionals with safe medication administration training in compliance with state regulations. Training is also available to employees of other providers.

Remote Monitoring CRSI has entered into a whole new world of providing support services for individuals with developmental disabilities. Remote monitoring is one of the newest options for consumers who choose not to have staff present or who wish to have staff present less frequently.

Strive @ CRSI Strive@CRSI engages youth and adults with developmental disabilities in person-centered training on independent living, work readiness skills and community involvement. We inspire people to discover the working world by offering meaningful job experiences leading to employment in the community.

Strive - To Achieve Your Goals. Your Choice. Your Success. Our Support.

Transportation Services CRSI provides non-medical transportation for individuals enrolled in Individual Options, Level One, and Self–Empowered Life funding waivers to get to and from a place of employment or to access adult day support, integrated employment, supported community or enclave employment transportation, and/or vocational habilitation.

Quality Assurance The Quality Assurance Department maintains CRSI’s high level of quality care through peer review, program evaluation, staff training, service utilization analysis and monitoring for compliance with all rules and statutes that govern CRSI services.

Page 4 2015 Annual Report

CRSI

SERVICES

Williams County

Enjoying a car show, thanks to her direct care staff.

Clark County

Involvements with nature, social interactions, sensory skills and learning new capabilities are just some of the experiences enjoyed at the Strive camp for children with developmental challenges.

Advocacy...

Consumer Advocate John Hannah receives accolades after his panel presentation on the subject “The Risk of the HCBS Rule: Sibling Perspective” at the ANCOR annual conference. The rule expects people with disabilities to have full access to the benefits of community living and services. Hannah is a full-time consumer advocate, with CRSI since 1995.

Our Customers... are the most important. They are not dependent on us - we are dependent on them. They are not an outsider in our business - they are a part of it. We are not doing them a favor by supporting them...they are doing us a favor by giving us the opportunity to do so.

Page 5 2015 Annual Report

OUR

CUSTOMERS

Fulton County

Champaign County

Madison

County

Champaign

County

Allen

County

Mercer

County

Allen

County

Auglaize

County

Van Wert

County

Miami

County

Paulding

County

Williams

County

Allen County 2450 Mandolin Drive

Lima, Ohio 45801 (419) 229-3200

Auglaize County 13101 Infirmary Road

Wapakoneta, Ohio 45895 (419) 738-9511

Also serving Mercer, Van Wert

Clark County 2030 N. Limestone Street Springfield, Ohio 45503

(937) 324-3113

Also serving Clinton, Greene, Warren & Butler

CRSI’s role in the COMMUNITY: providing integration, collaboration and service delivery...

Franklin County 1350 W. 5th Avenue

Suite 230 Columbus, Ohio 43212

(614) 481-5550

Logan County 1600 South Main Street

Bellefontaine, Ohio 43311 (937) 592-3599

Also serving Hardin, Union, Marion, Morrow

Madison County 117 W. High Street, Suite 104

London, Ohio 43140 (740) 852-3850

Also serving Fayette, Pickaway

Miami County 405 Public Square, Suite 373

Troy, Ohio 45373 (937) 335-6974

Also serving Shelby, Darke, Preble, Montgomery, Hamilton

Defiance County 1911 Baltimore, Suite 103

Defiance, Ohio 43512 (419) 784-0886

Serving Northwest Ohio

Lucas County 151 N. Michigan St.

Suite 317 Toledo, Ohio 43604

(419) 243-6814

THE

COMMUNITY

REGIONAL OFFICES

Page 6 2015 Annual Report

CRSI employees excel at community service. Judy Coy, support manager in London was awarded Volunteer of the Year by the Madison County Special Olympics.

Building blocks in the community

Participating in Special Olympics, playing softball, bowling, vacationing, dancing, and supporting a favorite team is all part of CRSI’s efforts to integrate consumers with the community by building blocks of understanding, communication and education.

Health Fair hosted by CRSI is held annually in September... FREE AND OPEN TO THE PUBLIC

@ CRSI 2015 Knox and Seneca Counties: Construction in 2015 included this brick, one story in Tiffin, a home for six individuals who are moved out of state-run institutions and into group home environments. As part of state downsizing of institutional living services, CRSI is chosen by the Ohio Department of Developmental Disabilities (DODD) to build three homes in Knox County and three homes in Seneca County in order to provide services for a total of thirty-six people with developmental disabilities.

Madison County

Champaign County

Page 7 2015 Annual Report

2015 EXPENSES

$.76 of every dollar spent is spent on staff wages, taxes, benefits and training.

2015 REVENUE

CRSI generates revenues in excess of $36 M. Eleven ICF/IID locations accounts for 29% of all revenue. In residential settings, over 67% of all revenues generated is from services provided to 591 individuals.

Corporate Office 1150 Scioto Street • Suite 100

P.O. Box 29 • Urbana, Ohio 43078

Phone: (937) 653-1320

Fax: (937) 653-1321

c r s i - o h . c o m

Member of the following Chambers of Commerce: Bellefontaine/Logan Co. Defiance/Defiance Co. Eaton/Preble Co. Findlay/Hancock Co. Greenville/Darke Co. Lima/Allen Co. London/Madison Co. Marysville/Union Co. Piqua/Miami Co. Sidney/Shelby Co. Springfield/Clark Co. Troy/Miami Co. Urbana/Champaign Co. Wapakoneta/Auglaize Co.

A message to employees and persons served Ed Corwin, Chair

Board of Trustees

On behalf of the entire Board of Trustees I want to acknowledge and thank every CRSI employee for your dedication and loyalty to the people served by CRSI. It is you who makes it possible for CRSI to offer the services needed by each individual served. Whether you provide direct care or administrative support, it is not often an easy job and your time and commitment is greatly appreciated. I would also like to express a big thank you to every individual who chooses CRSI as your provider. It is an honor to serve you. Every decision made and opportunity offered, every modification in service,

adjustment in staff, or the start of something new is made with you in mind. We listen to you and adjust to your needs in partnership with you, your family or guardian, the County Board of DD or any other advocate on your behalf. We listen and it is our goal to be able to meet all of your needs and choices. “Empowering You” is not only part of the CRSI name, it is also part of its mission and philosophy that is governed by the Board of Trustees. We, as a board, continue to be very proud to voluntarily serve you and play a role in your success as well as the growth and success of CRSI.

CHAIR: Edwin Corwin, Urbana (24)

VICE CHAIR: Dr. Richard Dietz, Urbana (18)

SECRETARY: Mary Ann Metherd, Urbana (34)

TREASURER: Jeff McCulla, St. Paris (28)

CURRENT TRUSTEES:

Jerry Schlaegel, Urbana (31)

Alice Schlemmer, Troy (20)

Rosemary Saunders, Piqua (20)

Terry Howell, Urbana (18)

Phyll is White, Vandalia (16)

Christine Glessner, Urbana (16)

Dr. Dan Stowe, Mechanicsburg (12)

Phil lip Edwards, Urbana (8)

Jorja Woodward, Piqua (5)

Joanne Petty, Urbana (4)

Brian Nicol, Urbana (2)

Todd Michael (1)

Richard Meyer (1)

Ex-Officio Members:

Ed Kauffman, Piqua (16)

Administration:

Than Johnson, Chief Executive Officer

Scott DeLong, President

CRSI’s goal is to provide the best individualized services and assist customers in pursuit of a valued

and meaningful life.

Board dedication Years of service represent a combined total of 274 years of dedication.

BOARD

ACTION

Two new trustees joined the board in 2015.

Todd Michael

Richard Meyer

CRSI’s principle opportunity to contribute is the Bill Butler Champaign Open, in support of needs and wishes for those served by CRSI.

Page 8 2015 Annual Report