Meet Our Newest Team Member!

Please help us give a warm welcome to our newest team member, Dave Branding, PhD!

With more than 40 years of administrative, executive leadership and board governance experience in a variety of health and human service organizations, integrated delivery systems and health plans, Dave has served as a provider, purchaser and funder. He specializes in achieving and maintaining accreditation, improving risk management practices and creating supportive accountability systems.

Working at CARF International for more than 12 years, Dave has led more than 120 accreditation surveys across 40 states and provinces as an administrative and program surveyor, team leader and report-writer for the Behavioral Health, Opioid Treatment Program, Employment and Community Support and Business and Services Management Network standard manuals. He also serves on CARF’s appeal and review boards.

In addition to administering several million dollars in grant funding, he has delivered dozens of conference program presentations and participated in more than 20 statewide and national policy and practice improvement initiatives.

Dave earned a Doctorate in Education and Master of Arts degree, along with a certificate in transition planning, from Southern Illinois University. He received a Bachelor of Science in Psychology from Central Michigan University.

We are thrilled to have Dave on our team!

Is Your Organization Staying Competitive in Today’s Environment?

In today’s increasingly competitive environment, health and human service organizations often struggle to distinguish themselves. Providing high quality services is a given, but to establish your brand, you must demonstrate that you make a difference in the lives of those you serve.

Some critical factors that can help maintain your organization’s competitive edge include earning national accreditation, reporting on service outcomes (not just outputs) and recruiting and maintaining a qualified, well-trained workforce.

Accreditation

Achieving accreditation affirms that child welfare, behavioral health, employment and community service organizations meet or exceed professional-grade quality standards in service delivery. It also gives clients and other key stakeholders an appropriate tool for effectively evaluating service providers.

Organizations that earn accreditation reach beyond minimum licensing standards and make a long-term commitment to strong governance, program consistency, outcome measurements and continuous improvement throughout their agencies.

Accreditation requires organizations to undergo an objective review by an independent accrediting body. The designation signifies that agencies effectively manage their resources and enhance the quality of life of the population served.

Individuals and families increasingly regard the accredited status of an agency as an important factor when considering where to seek services.*

Performance Improvement and Reporting on Outcomes

With detailed digital data available just a few clicks away, health and human service organizations are being held accountable for measuring service outcomes – not just outputs. This new development requires the collection and analysis of relevant data to discover trends and patterns. The key is to make improvements (or expand upon achievements) where necessary.

Outputs are quantifiable data points related to the numbers of people served, frequency of home visits made, time in care and other common variables. However, outputs measure the impact that services have on the lives of those in care or treatment, including knowledge transferred, behaviors changed, improved homelife stability and other revealing and quantifiable data points.

In fact, all organizations seeking to gain and maintain accreditation are required to record and report outcome statistics as part of their performance improvement programs. Compiling performance indicators in a transparent, easy to understand manner will help service providers connect with clients, families and donors in a meaningful way and, in turn, allow them to be more competitive.

In the nonprofit arena, the relationship with donors has been forever transformed by technology and the unyielding desire for increased information that supports educated giving decisions. Providing reports on outcomes can also help non-profits tell their story and compete for hard-won donor dollars.

Qualified Workforce

Recruiting and retaining a well-trained, qualified workforce is the key to providing high quality services, reducing operational and programmatic risk, maintaining an organization’s reputation and contributing to institutional stability.

To attract talented employees, agencies should institute standardized recruiting procedures, conduct primary-source verification of education and licensure, perform background checks and review criminal history records for those individuals who work directly with vulnerable or at-risk people and develop effective onboarding processes.

In the health and human service field, top-quality employees aim to work for nationally accredited entities, an achievement that demonstrates your organization’s commitment to quality and to investing in its workforce.

It is easier to retain a qualified workforce by focusing on training, staff satisfaction, professional development and transparency. Investing in your people will foster a more stable workforce and enhance the quality of provided services – all of which helps make your organization more competitive.

Summary

Implementing steps to retain your organization’s competitive edge takes time and effort, but think about the alternatives: If you neglect the opportunity to continually improve, your reputation will ultimately suffer.

Earning national accreditation provides a framework for improving operations, measuring and reporting on outcomes, recruiting and supporting employees and providing quality services – which help maintain your organization’s competitiveness in an ever-changing environment.

For assistance preparing for national accreditation, or with any of the items mentioned in this article, please contact us at Info@AccreditationGuru.com.

* See our article on using accreditation as a marketing tool for more information.

Team Member Highlight – Carol Smith

Carol started her accreditation career in 1980 when she implemented a substance abuse outpatient and prevention program for the State of Michigan Office of Substance Abuse Services. For more than a year,
Carol prepared the agency for its first national accreditation survey and began implementing policies and procedures during a time when the behavioral health field lacked clearly defined standards. After
achieving accreditation, she became a consultant and specialized in helping agencies navigate the CARF and The Joint Commission accreditation processes.

Carol has an extensive career in the field of accreditation, specifically with CARF. She has been a CARF surveyor for 28 years and has served on several ISAC’s (International Standards Advisory Committee) to help revise and develop new standards. She has provided training on accreditation topics both to an international audience and to new CARF surveyors and is a content editor of survey reports, and serves on the CARF accreditation appeal board.

Carol spends free time with her husband, her pug, and two cats in northern Michigan. She enjoys walking on the beach, traveling, gardening, reading and spending time at her winter home in southeastern Florida.

We are happy to have Carol on the Accreditation Guru team!

Team Member Highlight – Tracy Collander

Tracy Collander

Tracy first became familiar with the accreditation world when she began working for Gateway Foundation in 2007.  Gateway Foundation is accredited by The Joint Commission, and she became familiar with TJC behavioral health accreditation during her 6 years as executive director for Gateway Aurora.

Her knowledge of accreditation became much stronger as she became Executive Director of The Joint Commissions Behavioral Health accreditation program, as she had the opportunity to work closely with the accreditation team, behavioral healthcare leaders, and advisory members.  Now that she is back in the field, she continues to value accreditation as a road map to leading a safe, high quality organization.  She believes this is critical for engaging a team that is invested in providing the best care possible to people in need.  Her Joint Commission experience has been so valuable to her as a leader – it reinforces her resolve to provide the best possible leadership to her team in support of the care that people deserve to receive.

She enjoys spending time with her two teenage boys, husband, and dog.  Her boys are both involved in sports, so much of their free time is spent cheering on their baseball/basketball teams locally or on the road.  When at home, they love watching movies together or hanging out with friends.

She also enjoys outdoor activities – gardening, walking her dog, running, golfing…boating when they have a chance to get to a lake… hiking when she visits her brother in Oregon or sister in Arizona…and skiing when it snows in the Midwest or when they travel to visit her siblings.  Both her husband and Tracy are from big families, so there is often a birthday, holiday, or other event to celebrate as well!

When she has downtime, she loves to read (or listen to books on Audible when driving), particularly suspense books, historical fiction novels, and leadership books.

We are happy to have Tracy on the Accreditation Guru team!

The Advantages of Accreditation

Some human service agencies view accreditation as a luxury. Others see it as a hassle. Yet the benefits are undeniable.

Achieving national accreditation announces to the world that your organization strives to be the best it can be. That’s hard work, but the process sets you on the course for long-term greatness.

Attempting to cultivate a culture of excellence and reach lofty goals enhances your reputation, but accreditation also offers more practical benefits: it’s a reliable way to increase revenue and decrease costs, objectives that are valued by almost every human service agency.

Accreditation Requirements

Due to the advent of the Family First Prevention Services Act (FFPSA), many child welfare organizations that provide residential, out-of-home care and seek federal government funds are required to be accredited, a mandate that takes effect beginning in October of this year (though states have the option to delay the process for up to two years).

Several states also require that various types of service providers become accredited as a qualifying step toward earning their license or receiving higher reimbursement rates.

Culture of Excellence

Without question, accreditation signals to potential funders and clients that your organization adheres to high standards, internal cohesion and exemplary service delivery.

Other benefits include improved internal and external stakeholder communication and enriched staff training programs that, in part, lead to enhanced services to clients.

The results of a questionnaire sponsored by the Council on Accreditation affirm these assertions:

* 94 percent of respondents agree that the process “improves transparency and accountability”

* 86 percent contend that it “improved outcomes for the people they serve”

* 90 percent acknowledge that it “improved their quality of services”

Gaining accreditation from a prominent agency also demonstrates your commitment to reach beyond the minimum licensing standards and maintain strong management, program consistency, financial controls, outcome measurements and continuous improvement.

Financial Incentives and Quality Improvement

Beyond the cultural benefits to earning accreditation, there are more practical reasons to seek this distinction. According to The Joint Commission, a prominent accrediting agency, the accomplishment beefs up your bottom line by increasing reimbursement rates, in part by reducing paperwork preparation time.

Accreditation forces organizations to focus on quality improvement and measure outputs and outcomes of deliverables, which both funders and stakeholders are increasingly demanding.

Planning service offerings and maintaining meticulous documentation can attract additional recognition and funding sources from governments, foundations, grant makers and individual donors.

It also boosts referral volume. The Joint Commission contends that other positive outcomes include an increased “ability to work with a broad array of clients” that improves “an organization’s ability to participate in referral networks, thus potentially increasing the value of referrals.”

The Joint Commission further found that “payers want to work with organizations that provide high quality services, which helps elevate their brand” and pay public relations and marketing dividends.

Accreditation decreases risk due to the development of management plans, which in turn lowers liability and insurance costs. Data collection, an increased effectiveness of care and improved intake billing also streamline costs.

A recent study sponsored by CARF International, another accrediting body, compiled startling statistics demonstrating that CARF-accredited programs experienced a 26 percent increase in persons served annually, a 37 percent increase in conformance to quality standards and a 37 percent increase in annual budget dollars programs from before their first survey as compared to their latest survey.

Accreditation in Action™

“The accreditation and re-accreditation process helped us raise the bar for our staff and the population that we serve,” said Hughes Johnson, managing director of compliance and performance improvement at Memphis-based Youth Villages, which operates in 14 states across the country, shared his organization’s experiences with accreditation.

“It’s a tough process with a large number of standards, but it helped us develop a defined policy that holds us accountable.”

According to Elizabeth Carey, president and CEO at Starr Commonwealth, which offers programs for children and families in Albion, Michigan, her organization is dedicated to “performing at the highest levels for the children, families and communities we serve.” Therefore, “achieving and maintaining accreditation is a critical factor to ensuring high quality.”

The Payoff

Many human services agencies claim that they adhere to upholding high ethical and client service standards.

Far from being a chore, achieving accreditation has become a necessity for all human service organizations participating in today’s competitive environment. In addition to sending a definitive sign that quality and consistent professionalism permeate your organization’s culture, it offers tangible benefits that pay dividends every day.

For more information or for assistance with becoming nationally accredited, contact us at info@AccreditationGuru.com.

Are You Measuring Your Service Outcomes? You Should Be!

According to a recent study in the International Journal for Quality in Health Care, “what cannot be measured, cannot be improved.”

With detailed digital data available just a few clicks away, non-profits are being held accountable for measuring their service outcomes. In fact, all organizations seeking to gain and maintain accreditation are required to record and report outcome statistics as part of their performance improvement programs.

For example, while The Joint Commission has always required organizations to assess outcomes of care, treatment or services, organizations are now required to accomplish this through the use of a standardized tool or instrument.  By utilizing “measurement-based care,” The Joint Commission “believes these standards enhancements will help accredited customers meet the growing demand to demonstrate the value of their services and increase the quality of the care, treatment, or services they provide.”

For health and behavioral service providers, the focus on process – or fee-for-service arrangements – is obsolete: the new priority centers on positive patient results, which must be documented.

This approach rejects fee-for-service reimbursement, where “individual providers are incentivized to order more tests and procedures and manage more patients in order to get paid more, regardless of patient outcomes,” according to the New England Journal of Medicine.

Value- and performance-based models aim to rein in ballooning costs. The outcome-based orientation is partially designed to help lower spending.

Another broad goal is to improve care and help patients efficiently navigate the health care system. Collaboration and customized services are replacing the top-down model, where experts determine the procedures and patients follow along.

Many major insurance companies are reorienting their reimbursement schedule to reflect this data-driven model. According to national accrediting body CARF, Cigna, Aetna and U. S. Healthcare plan to increase value-based payments to as much as 90 percent of all reimbursement spending in the next few years.

Beyond private insurance companies, state and federal mandates are also pushing patient care toward outcome-based services.

The Centers for Medicare & Medicaid Services (CMS) has begun implementing value-based changes, for example. Under Section 223 of the federal Protecting Access to Medicare Act, moreover, the Substance Abuse and Mental Health Services Administration initiated a pilot program in eight states to introduce value-based outcomes in certified community behavioral health clinics.

The program includes technical specifications and data-reporting templates requiring the collection of 21 measurable data points.

Participating states are mandated to “collect and report on encounter, clinical outcomes, and quality improvement data,” according to CMS. “The statute also requires annual reporting by the states that will entail collection of data which can be used to assess the impact of the demonstration program.”

In addition, fee-for-service reimbursement is being replaced by the prospective payment system (PPS), which is based on the quality of care rather than services provided.

Another new initiative implemented by CMS, Bundled Payments for Care Improvement, links “payments for the multiple services beneficiaries receive during an episode of care.” Acute care hospitals, skilled nursing facilities, home health care agencies and inpatient rehabilitation facilities, “enter into payment arrangements that include financial and performance accountability for episodes of care.”

CARF reports that state regulators are also spurring the shift toward performance-based models and criteria by promoting prevention and methods that consider social determinants of heath.

“The future is undoubtedly in favor of providers that can implement strong performance management practices,” according to CARF. Agencies that reorient their practices in this new direction will be well-positioned to achieve and maintain accreditation status.

Contact Accreditation Guru to help put your organization on course to thrive in this brave new world of outcome-based measurement.

Meet Our Newest Accreditation Guru Team Member

Viviane Ngwa

We are happy to announce that Viviane Ngwa — a Clinical Social Worker, is joining Accreditation Guru as our newest Accreditation Consultant!

Viviane Ngwa
She comes with leadership experience in the provision of services to individuals with intellectual and developmental disabilities, services to youth with juvenile probation involvement as well as extensive experience in child welfare and behavioral health service structure across many states.

Viviane is a current member of the Board of Directors of Family Focused Treatment Association (FFTA) and a past Board President. She was also a member of the Board of Trustees of the Council on Accreditation (COA) where she currently serves on the Standards Committee and the Board Development Committee. She has been a COA Peer Reviewer Team Leader and a Hague Evaluator for many years leading numerous accreditation site visits across the United States and Canada.

Viviane is a wonderful addition to our growing team!!

Meet Our Newest Accreditation Guru Team Member

Tracy Collander

We are happy to announce that Tracy Collander, LCSW a nationally regarded accreditation expert, is joining Accreditation Guru as our newest Accreditation Consultant! A former executive with The Joint Commission, she brings deep knowledge and experience to her position as accreditation consultant.
Tracy Collander
A leader in the behavioral health field for more than 25 years, Tracy has amassed extensive experience in child welfare, addiction treatment, psychiatric inpatient treatment, and community mental health services.

Her credentials include serving as executive director of behavioral health, Linden Oaks at Northwest Community Healthcare, and as executive director of the Behavioral Health Accreditation program at The Joint Commission, one of the largest accreditation agencies in the country.

Tracy is a wonderful addition to our growing team!!

Succession Planning – It’s Not All About You

At some point, every organization will face the challenges of a change in leadership. Though many of these transitions are anticipated – like when a CEO or board chair retires – other times, agencies are faced with the task of filling an unexpected opening.

Nonprofit organizations are known for doing their best to provide stellar services to those in need while working with limited funding and, often, fewer human resources personnel than the typical for-profit company. It’s the nature of the business.

The key to making any leadership change a seamless process for staff and clients alike is to thoughtfully develop a succession plan along with intact, actionable policies that will guide your decisions and help your organization Prepare for Greatness!™

Avoid Service Disruptions by Developing a Plan

Planning ahead is essential – before potential shake-ups take up valuable resources. Always include the executive leadership staff and the board of directors in succession planning and its implementation. Get them onboard for developing an emergency transition plan that outlines the delegation of responsibilities and authority in the event of an unplanned vacancy or leadership disruption.

For planned leadership transitions, map out an appropriate timeline for a smooth transition. This also helps ensure that a proper support system is in place for new leaders, including mentoring opportunities and well-defined goals for the individual and the organization as a whole.

Getting buy-in from the principal people in the organization helps keep everyone focused on developing the most beneficial policies. Make it an organizational goal to support new leadership, allowing him or her to develop a personal comfort level and lead with confidence.

Though obvious, it bears repeating: Communication is paramount. Throughout the entire transition process, it is essential to maintain fluid lines of communication within all levels of the organization.

Develop a Process to Ensure Smooth Transitions

If your organization puts policies into place, they should be thoughtfully analyzed, planned and reviewed – just as agencies do for budgeting, daily operations, strategic planning and other essential functions.

Ensure continuity by developing a list of potential leadership successors based on the ability to enhance and capitalize on individual strengths and effectively match the best candidate to the most appropriate position.

Because nonprofits must generally do more with less, it is beneficial to create ample opportunities for staff and board members to cross-train and/or broaden their leadership skills so that there are several individuals at the ready to step into larger roles with more responsibility when the time comes.

Give special attention to developing your organization’s group of talent. Concentrate your valuable resources on educating and strengthening the skills of your agency’s leadership candidates to build a reserve of exceptional contenders when the time arises.

When compiling your candidate list, be sure to consider challenges such as maintaining an adequate amount of staff diversity, recruitment of a wide range of individuals who provide the skills your agency will need in the future, and long-term employee retention.

Another potential affliction for nonprofits is Founder’s Syndrome, where an organization’s founder or other long-employed leader feels that no one will be able to do all of the work required and/or care more about the mission and staff than he or she does. If a founder refuses to partake in succession planning the entire enterprise can be jeopardized when he or she leaves – or dies. It is up to the board to assert its oversight and prepare for the inevitable transfer of power if the entity is to survive.

Consider Best-Case and Worst-Case Scenarios

Incorporate various situations into your planning. It is easier to prepare for a months-long, anticipated CEO retirement than it is when a key employee takes a job at another organization without warning or requests a leave of absence for several months to care for a stricken parent or recover from an injury.

Consider whether installing an interim leader into a management position would be of greater benefit to your organization than quickly placing someone in a position just to get it filled. This is especially important for the highest-level positions in the agency where it may be beneficial to seek outside candidates for consideration.

And, of course, thoughtful and timely communication before, during and after the transition of leadership positions supports the success of both the individual and your organization as a whole so that the focus will remain on what you are all there to do – fulfill your mission of serving others.

With proper planning beforehand, the stress of selecting a high-level replacement and transitioning that person into the job will be much easier to accomplish. By implementing these tips and instituting a process, you can help your organization Prepare for Greatness!™ when faced with potentially disruptive personnel changes.

 

Time is Tight: Seek Accreditation Now for QRTPs [as Mandated by the Family First Prevention Services Act]

The new Family First Prevention Services Act (FFPSA) has generated many questions about the timing of when each state will decide to implement the regulations and, in turn, when the new category of residential settings called Qualified Residential Treatment Programs (QRTPs) are required to become nationally accredited. Accreditation for qualified residential treatment programs has thus become a hot topic for such centers.

FFPSA is changing the face of child welfare by authorizing federal dollars to support prevention services for children identified as being in “imminent risk” of entering foster care. It also shifts the focus from relying on congregate or group care settings to keeping children in family-like atmospheres – specifically foster family homes.

Under FFPSA, with limited exceptions, states will be able to dedicate federal Title IV-E funding for children’s care maintenance payments in a residential setting after the first two weeks of placement. Approved settings, including the new QRTPs, must use a trauma-informed treatment model and employ registered or licensed nursing staff and other licensed clinical staff who are onsite according to the treatment model and  available 24 hours a day and seven days a week.

The law institutes other requirements related to formal assessments of children that ensure the appropriateness of the placement, family engagement and aftercare support for at least six months post-discharge. For additional information, visit: http://www.ncsl.org/research/human-services/family-first-prevention-services-act-ffpsa.aspx

States’ Decisions – To Delay or Not Delay?

FFPSA specifies that to be considered as an official QRTP, the program must be licensed and accredited by a Department of Health and Human Services-approved accreditation agency: Commission on Accreditation of Rehabilitation Facilities (CARF), Joint Commission on Accreditation of Healthcare Organizations or Council on Accreditation (COA) by October 1, 2019, unless a state requests a delay for up to two years.

States are presently weighing their options to request a delay or “opt-in” to comply with the new restrictions regarding reimbursement. States must submit their request to the HHS Children’s Bureau by November 9, 2018 if they intend to delay the effective dates of certain provisions in the Family First act. However, states may still change their decision after their plan has been submitted, so nothing is definitive at this point – except that QRTPs will need to become accredited.

A number of service providers are opting to wait and see if their state will delay the effective dates with the hope that this will provide additional time to become nationally accredited. However, a delay in accreditation for qualified residential treatment programs is a gamble on the service provider’s future.

“I recommend that non-family-based care providers like group homes or residential programs who wish to become a licensed QRTP, begin the process of accreditation now,” said Leslie Ellis-Lang, Managing Director, Child and Youth Services at CARF. “It is the safest action.”

Accreditation for Qualified Residential Treatment Programs

Most service providers require 12 to 18 months or more to become nationally accredited. With the initial effective date of October 1, 2019 one year away (unless a state delays enactment), there is still some time to complete the process.

To meet the FFPSA deadline, organizations must consider the time necessary to:

  • Select an accrediting body
  • Secure budgetary allotment and board approval
  • Develop accreditation-required plans, including an organization-wide strategic plan, among others
  • Prepare standards-compliant policies, procedures and protocols
  • Implement accreditation standards (both CARF and COA require six months of conformance with standards before an onsite survey may take place; Joint Commission does not require this “look back”)
  • Make operational, service delivery and facilities improvements, as necessary
  • Prepare staff and board members for the accrediting body’s onsite survey

Accreditors’ Efforts and Deadlines

Under such a sweeping federal mandate as FFPSA, thousands of organizations throughout the United States will apply for accreditation at the same time, which can strain the capacity of the accrediting bodies.

The good news is that each of the three (presently) approved agencies (CARF, COA, Joint Commission) have been proactively preparing for this onslaught of new applicants by increasing their operational staff and adding surveyors to conduct the onsite reviews.

Yet each accrediting body has its own timeline, based on when applications are due and the scheduling of onsite surveys. Regardless of which body is selected, an organization should generally estimate that it will take at least 12 months to achieve accreditation.

In order to complete the process and receive accreditation by October 1, 2019, organizations must submit their application and deposit by the following deadlines:

CARF:

CARF recommends that organizations choosing to use the 2018 Child and Youth standards for their survey and wanting to be notified of their outcome prior to October 1, 2019, should submit their application by December 31, 2018.

COA:

COA’s application deadline for organizations working toward the October 1, 2019 benchmark is November 19, 2018.

Also, in October 2018, COA will provide an application fee refund (in the form of a credit against future fees) for organizations that are mandated by FFPSA and are pursuing accreditation for the first time. An organization must complete its initial application by October 3 and fully execute an accreditation agreement by October 31, 2018 in order to receive this benefit.

The Joint Commission:

To complete the accreditation process and receive a Joint Commission accreditation award by October 1, 2019, organizations are “strongly encouraged” to submit an application and deposit by December 31, 2018 with a request for onsite survey (“ready date”) of no later than April 1, 2019.

Regardless if a state decides to opt-in or delay the FFPSA regulation and requirement for QRTPs, all service providers are strongly encouraged to begin the road to national accreditation as soon as possible. No matter what a particular state decides to do, the mandate is here to stay. Don’t gamble on your organization’s future!

 

Accreditation Guru is available to assist in the accreditation for qualified residential treatment programs, child welfare and behavioral healthcare organizations nationwide as they navigate the road to accreditation in an efficient and streamlined manner. For more information, contact us at Info@AccreditationGuru.com.