How Accreditation Supports Mergers and Acquisitions

Since 2018, there has been significant merger and acquisition activity in the behavioral healthcare field, but why? Individuals are becoming more aware of healthcare issues; there is less stigma about seeking help for mental health struggles; and more effective treatments are now available. This has created increased demand for and use of mental health and addiction treatment services, as well as channeling more funding towards meeting the demand and growing need. Not only this, but as individuals, including professionals, gain understanding of the link between mental and physical wellbeing, more integration of physical and behavioral health care is occurring. So, where does accreditation come in?

There are a number of accrediting bodies that work to ensure providers of substance use disorder treatment and mental health services meet specific, nationally accepted standards, including The Joint Commission, CARF International, Council on Accreditation (a service of Social Current) and others.

Accreditation requirements (standards of safety and quality of care) center around three main areas: documentation, facilities, and people. Documentation standards focus on written plans; polices and procedures; clinical records; and personnel files. For people, standards address not only the care of the persons served, but also those that provide it. Facility standards ensure that the physical environment where care is being provided is safe, healthy, and therapeutic for everyone within. All these standards create stability within an organization, which is a favorable factor in M&A activity.

Achieving accreditation also gives a behavioral health organization a framework for growth and management of their internal resources. It helps to standardize clinical processes and documentation and provides an external validation of the quality of services provided. Accredited organizations will often see increased efficiencies from improved practice consistency, tightened administrative practices, and an increased emphasis on risk management. Because of accreditation requirements, organizations will inevitably have a broader view and a more detailed approach to risk mitigation and risk management than they’re doing on their own.

For an investor looking to acquire a service provider, seeing that a facility is accredited can provide peace of mind. Accreditation indicates that an organization has gone through the work to create a strategic plan, comply with legal and regulatory requirements, and has implemented quality monitoring practices. All of which assist with due diligence, both on the administrative and clinical sides. Investors can also be assured that the facility’s finances are well managed, as accreditation speaks to sound financial management practices. There are even a number of reports that say accreditation reduces staff turnover, which can save an organization money and maintain a high-quality workforce.

Another part of due diligence is examination of litigation and claims history of an organization. Have there been any lawsuits filed or any pending? What is the frequency and severity of claims? Are there identifiable patterns and trends? What steps were taken to reduce the chance of reoccurrence? Accreditation supports this type of investigation by helping to maintain a positive history by proactive identification of risk and finding ways to mitigate or eliminate it where possible. Secondly, it encourages a performance improvement process that requires collection and analysis of key data and then taking action for improvement. Additionally, accreditation promotes a safe and healthy physical environment with requirements for emergency and disaster planning.

If your organization is going through a merger or considering accreditation, you are not alone! Accreditation Guru operates nationwide and provides a number of services to guide you through the process, such as:

  • Individual accreditation consultation
  • Mock surveys
  • Development of accreditation-compliant plans and policies
  • Risk assessment
  • Strategic planning facilitation
  • And more…

If you would like to have a conversation, please feel free to contact us via our website or schedule a free Zoom consultation with one of our experts.

For more information or questions about the contents of this article, please write Peggy Lavin @ peggy@accreditationguru.com.   This post contains original content and was written for Accreditation Guru, Inc. Use of this copy is permitted with credit and reference within the same body of copy to Accreditation Guru, Inc.

Accreditation – A Solid Foundation for a CCBHC

The Certified Community Behavioral Health Clinic (CCBHC) model has seen rapid uptake in the last decade because it improves the quality of life for individuals with behavioral health needs. It does this by improving community-based access to behavioral healthcare, regardless of an individual’s ability to pay, which is important. Studies have shown that, in the U.S., one in five adults have a mental illness, but fewer than half received treatment in the past year. In addition, individuals with behavioral health needs often have poor physical health outcomes due to a lack of physical health care access, so the CCBHC model integrates and coordinates physical health services for this population. In order to meet this mission, CCBHCs receive enhanced Medicaid funding that allows them to provide more services as well as services that are not always reimbursed, like community outreach and partnerships.

In 2002, eight community mental health clinics formed the first CCBHC pilot. The number of CCBHCs has now grown to over 400 operating in 40 states. More states are considering adopting this model now that the program has gone nationwide. “Certified Community Behavioral Health Clinics help connect Americans to easy-to-access, comprehensive mental health and substance use disorder treatment and supports in their own communities,” said Miriam E. Delphin-Rittmon, Ph.D., the U.S. Health and Human Services Assistant Secretary for Mental Health and Substance Use and the leader of SMAHSA.

But becoming a CCBHC can be complex. Agencies may need to expand services and hours, hire staff, and determine how and where to integrate physical health care into their operations so they have the capabilities they need to meet the qualifications. CCBHCs are nonprofit organizations or units of a local government behavioral health authority, including tribal government. They must directly provide (or contract with partner organizations to provide) nine types of services, with an emphasis on the provision of 24-hour crisis care and substance use disorder treatment, use of evidence-based practices, care coordination with local primary care and hospital partners, and integration with physical health care.

Some of the key expectations for certified community behavioral health clinics are closely aligned with the accreditation requirements of the national accrediting bodies. These include:

  • Advancing integration of behavioral and physical health care
  • Coordination of care, treatment and services through care coordination/case management
  • Delivering services based on individualized plan of care/treatment by well-trained, competent staff who match culturally/linguistically to the population(s) served
  • Providing patient-centered, trauma-informed, recovery-oriented best practices in their care, treatment and services
  • Enhancing quality to improve outcomes for individuals served
  • Collecting, reporting, and tracking data
  • Continuous quality improvement.

Because national accreditation requirements contain standards of care for addressing these same CCBHC criteria, achieving and maintaining accreditation with Accreditation Association for Ambulatory Health Care (AAAHC) CARF International (CARF), Council on Accreditation (COA), or the The Joint Commission can provide a solid foundation for a  behavioral health care clinic’s journey as a CCBHC. Through compliance with accreditation requirements, organizations will have a roadmap to follow for addressing many key CCBHC components. These areas are then assessed by surveyors/reviewers during on-site or virtual site visits, providing validation of good practices and potential feedback that can generate further enhancements.

Recognizing this solid foundation, SAMHSA encourages accreditation for a CCBHC by an appropriate, nationally recognized organization such as AAHC, CARF, COA, or The Joint Commission. SAMHSA’s intent for a CCBHC is to improve access to and quality of mental health and addiction care, treatment and services for all persons in need. This intent is reflected in the mission of each of the national accrediting bodies: AAAHC, CARF, COA, and The Joint Commission.

Accreditation Guru has experts who can provide consulting to assist organizations throughout the CCBHC accreditation/reaccreditation process. Recently, AG was proud to partner with BestSelf Behavioral Health, a CCBHC, in their achievement of accreditation through COA. BestSelf provides outpatient, integrated behavioral and physical health care using evidence-based practices. Its programs and services include education and vocational supports, mobile mental health and substance use disorder services, homeless outreach and housing, community and school-based programs, and coordination with law enforcement and medical, mental health and child protection professionals. “COA accreditation has allowed BestSelf to focus on quality and maintain best practices as well as operate our Opioid Treatment Program,” says Rebecca S. Steffen LCSW-R, Vice President of Quality Improvement & Accreditation.

We would love to discuss your clinic’s accreditation needs, click here to contact us.

  1. The National Council for Mental Wellbeing, CCBHC Success Center, 2021 Impact Report, https://www.thenationalcouncil.org/wp-content/uploads/2021/08/2021-CCBHC-Impact-Report.pdf?daf=375ateTbd56 (October, 2021)
  2. National Alliance on Mental Illness, Certified Community Behavioral Health Clinics, https://www.nami.org/Advocacy/Policy-Priorities/Improving-Health/Certified-Community-Behavioral-Health-Clinics (October, 2021)
  3. The National Council for Mental Wellbeing, CCBHC Success Center CCBHC Overview, Success Center, CCBHC Overview, https://www.thenationalcouncil.org/ccbhc-success-center/ccbhcta-overview (October, 2021)
  4. Substance Abuse and Mental Health Services Administration, Criteria for the Demonstration Program to Improve Community Mental Health Centers and to Establish Certified Community Behavioral Health Clinics https://www.samhsa.gov/sites/default/files/programs_campaigns/ccbhc-criteria.pdf (October, 2021)

For more information or questions about the contents of this article, please write or call Jennifer Flowers @ Jennifer@AccreditationGuru.com / 212.209.0240.   This post contains original content and was written for Accreditation Guru, Inc. Use of this copy is permitted with credit and reference within the same body of copy to Accreditation Guru, Inc.

Engaging and Evaluating for Board Effectiveness

Nonprofit leaders and board members often ask about ways to maximize and maintain board member engagement. Furthermore, they ask about how to evaluate the board’s ongoing effectiveness. While there are a number of areas that go into developing an engaged and effective board, some of the initial key steps are outlined here.

How Do We Maximize and Maintain Board Engagement?

Build Teamwork to Make the Dream Work

It starts with having the appropriate people in place; without this thoughtfully constructed team of individuals, it becomes impossible to achieve a group that is able to work together cohesively and strategically.

In addition, how many nonprofits have members who have been on the board together for years and have never really gotten to know one another? Imagine how much more effectively a group like this could have guided their organization toward its mission had they been governing as a team rather than as acquaintances coming together for meetings, or to merely fill a seat at the table.

To maintain an effective board, there must be an atmosphere of mutual trust and respect among the members and the agency’s executive leadership team. Board members who enjoy interactions with one another and the organization have a higher level of trust and respect that will likely lead to quality participation and regular meeting attendance.

Ensure Commitment to the Nonprofit’s Direction

One of a nonprofit’s most valuable assets is its board of directors. To create this value, a board must be diverse, dedicated, and eager to assist your agency in fulfilling its mission.

Board members should not only be committed to the agency’s mission, but they should also be willing to support the nonprofit’s needs and understand what is expected of them as an actively involved member.

Clearly Communicate Involvement Expectations

Aligning expectations on both sides ins critical. Leadership needs to clearly understand what each member can and is willing to provide in terms of skills, time, and financial support (this means both direct giving and/or helping to raise funds) and successfully match those to the needs of the nonprofit organization.

The appropriate level of board involvement will depend, in part, on the size of the organization and its stage of development. A newly formed nonprofit or grassroots advocacy group will often require an “all hands on deck” approach, whereas a more advanced organization may focus more on maximizing the board members’ network of contacts and fundraising efforts. In either case, the legal and fiduciary oversight responsibilities of the board of directors must be considered priority.

Hold Effective Meetings

Meetings should be a positive use of the board members’ time. Discussions should allow for open debate and questioning, and time should be spent on strategic goal advancement, while not be mired in minutia or the detailed operations of the organization. For example, if a board is reviewing, debating, and approving agency procedures, they are operating on a micro-management level. The board should remain focused only on policy approval and developing and fulfilling strategic goals. There should also be an agreed-upon decision-making process to keep meetings moving forward, ultimately resulting in more effective meetings.

Plan for and Respond to Challenges

Developing and maintaining an effective and unified board requires consistent effort and a desire from each member to keep the interests of the agency first and foremost. This can become exponentially more challenging when starting out with ineffective or frustrated board members. It is important to be on the lookout for warning signs of disengagement or disenchantment as well as any new power struggles. Plan ahead about how you may prevent and handle some of these challenges.

Nonprofits often struggle with how to appropriately dismiss board members from their responsibilities when this becomes the necessary course of action. However, it can be done with time, thoughtful planning, and action. To plan for these situations, there is an entire process that must be in place to identify and recruit diverse, committed, new members. (contact us for additional information).

How Do We Measure Our Effectiveness?

In today’s competitive philanthropic environment, it is essential to regularly measure the functionality and influence of your nonprofit board and determine practices and strategies that will strengthen its impact. Conducting a thoughtful board assessment is a solid place to begin.

The following questions may help to better inform a board assessment:

  • Does each member of your board feel engaged and involved in the oversight of your organization on a regular basis?
  • Is your board directly involved in setting fundraising goals, and are they actively involved in the fundraising process as required by your nonprofit?
  • What are your board’s three greatest strengths, and how have these contributed to the overall success of your nonprofit?
  • What are your board’s three most significant weaknesses, and how have these held your nonprofit from operating at its optimal level?
  • Does your board culture encourage and welcome open discussion of issues, even when members are not in agreement?
  • Is there a mutual level of respect among all board members?

Developing relationships, establishing expectations, heading off potential challenges, and assessing board effectiveness are just some of the activities that will help foster an engaged, cohesive board of directors who can effectively contribute to fulfilling your nonprofit organization’s mission. For information on any of these questions or other ways to take your board to the next level of engagement and effectiveness, please feel free to contact us.

For more information or questions about the contents of this article, please write or call Jennifer Flowers @ Jennifer@AccreditationGuru.com / 212.209.0240.   This post contains original content and was written for Accreditation Guru, Inc. Use of this copy is permitted with credit and reference within the same body of copy to Accreditation Guru, Inc.

The Alliance’s New “Operations Support Services”

As a partner of the Alliance for Strong Families and Communities, Accreditation Guru is excited to share with you their new and game-changing “Operations Support Services” offering for the nonprofit sector. This offering is intended to help leaders address provision of operations support services related to human resources, finance, administrative operations, and more. This is available to ALL nonprofits in the United States, not just Alliance member organizations.

Across the country, daily tasks, ranging from detailed budget reports to regular donor stewardship, siphon limited energy and resources that could be better directed toward program implementation. Because dollars available for overhead functions are particularly scarce, nonprofits should look for smart ways to maximize these resources. For organizations that cannot cost-effectively sustain internal capacity and expertise in administrative functions, the gap will continually widen and plague their abilities to focus and execute on their missions.

The Alliance is dedicated to helping community-based organizations (CBOs) bolster their approach to risk management, improve the effectiveness of fund usage, and understand the benefit of shared services—all of which allow for an increased focus on mission and people served. The “Operations Support Services” offering was created to help fulfill the five identified “North Star” initiatives in the landmark report, “A National Imperative: Joining Forces to Strengthen Human Services in America,” by the Alliance for Strong Families and Communities and the American Public Human Services Association.

By partnering with the Alliance, CBOs can outsource various financial and administrative duties for which internal capacity and resources may be limited. As part of this new venture, the Alliance also is offering competitive and robust benefits packages, enhanced retirement planning services, and comprehensive EAP and work-life services to their employees at a reasonable cost, regardless of their size. In addition, the Alliance’s unemployment tax program combats hidden expenses, avoids claims volatility, and enables better management of cash flow and claim tracking.

The Alliance has established many strategic partnerships to facilitate provision of operations support services that can be customized for any size nonprofit:

  • Flexible accounting and bookkeeping assistance delivered directly by Alliance staff
  • Comprehensive, competitively priced group health insurance packages offered via industry
    leaders that cover thousands of companies and hundreds of thousands of lives
  • Employee assistance and work-life services from FEI Behavioral Health, the Alliance’s
    social enterprise
  • The ability to provide a wide range of retirement plans and planning services to employees,
    with the added value of no administrative fees
  • A cost-effective alternative to the state unemployment tax system
  • Access to group purchasing savings programs

“Along with our expertise in human resources, finance, and administrative operations, it is our intent to enhance and expand our support services to help leaders address needs related to fundraising and development; marketing, public relations, and communications; and information technology,” explains Lenore Schell, Alliance senior vice president of strategic business innovation.
For more information, visit the Alliance’s website.

Annual Plan is Strategic Plan’s Greatest Tool for Success

Most nonprofit organizations have (or should have!) a long-term strategic plan, one that they have spent a great deal of time and resources to develop. By engaging various staff, board members and stakeholders, the strategic planning process can be an effective way to identify strategies that will support the organization as it strives to fulfill its mission. As stellar as the strategic plan may be, however, unless its strategies are methodically put into action, the plan itself becomes inconsequential to the agency’s operations.

Generally speaking, a strategic plan covers a three-to-five-year period (most common is three years) – which in today’s real-time, fast-paced operating environment can seem daunting to even the most seasoned nonprofit leaders. This is where an annual plan can become a strategic plan’s greatest tool for success. First, it is essential to understand the difference between the two. A strategic plan clearly defines the organization’s mission, lays out a vision of what it wants to achieve over the next few years, and defines several strategic priorities designed to guide the agency toward mission fulfillment. This is the framework for what is to come. An annual plan – or work plan – is staff-driven, designed with specific objectives, outcome measures, and areas of responsibility (including timelines) in order to provide the day-to-day guidelines needed to ensure the strategic goals are ultimately met.

We’ve gathered these key considerations to help create a valuable and effective annual plan:

  • Be sure annual planning remains an inclusive process for everyone involved, including internal and external parties; when people feel personally connected they are more likely to take ownership and responsibility for the tasks at hand
  • List only the strategies to be implemented during the coming year; this keeps focus on the short-term as well as laying out a manageable, rather than overwhelming, plan for the next year
  • Break down annual strategies into smaller goals that are assigned to specific areas or individuals, including due dates and follow-up procedures
  • Expect that future events will often cause the need to reevaluate and perhaps even change the course of part of the plan; being ‘at the ready’ and adaptable to unforeseen events will only help to move both plans forward!
  • Annual plans may also incorporate other regular planning processes, including review of the technology and information management plan, financial planning, human resources planning, etc.
  • The annual plan is precisely the place to be specific; use a variety of tools here that will highlight the details of the plan’s successes and shortcomings, such as metrics, measurements, or any other analytical tools that are relevant to evaluating the plan’s overall goals