Annual Report

FY2009

EXECUTIVE SUMMARY

by Susan D. Buchwalter, Ph.D., President/CEO

JULY 2008 - JUNE 2009

The Counseling Center touched the lives of approximately 11,200 people in fiscal year 2009 – approximately 7% of the population of the Wayne and Holmes County area.

The Counseling Center is a private, not-for-profit corporation that provides a comprehensive range of behavioral health services to a wide variety of community residents. The main office is located on Benden Drive in Wooster; but the agency operates out of seven locations across the two county area. The initial FY09 operating budget was $6.2 million.

Many of the services provided by the Center are specifically purchased by the Mental Health and Recovery Board (MHRB), and provided to those individuals with either limited resources or with more severe, persistent problems. Other parts of the Center’s service array are targeted toward those with less chronic conditions and are funded with a combination of public dollars and private revenue from insurance, Medicare and the clients themselves.

The Center began the year with a staff of 124 individuals (106 full-time equivalents) which included 4 part-time consulting psychiatrists, 1 certified nurse specialist with prescriptive authority, 5 doctoral level psychology staff, 56 counselors or social workers, 2 nurses, 28 paraprofessional assistants and 28 business and support staff. The total staff included approximately 30 independently licensed mental health professionals and encompassed over 1000 years of combined mental health experience.

The Center is certified by both the Ohio Department of Mental Health and the Ohio Department of Developmental Disabilities, and all mental health services are nationally accredited by CARF. In addition, the Center serves as a qualified local provider for a number of regional and national health insurance companies.

The Center’s mission states that the organization is

“dedicated to enhancing the mental health of individuals, families, and

groups through a comprehensive range of prevention, treatment and

rehabilitation services, designed to meet individual needs.”

In the recently completed fiscal year, the Center made significant strides toward that mission. Some of the Center’s efforts in each area are summarized below.

PREVENTION SERVICES

Prevention services at the Center include such activities as suicide prevention, child assault prevention, early childhood mental health consultation, specialized programs for parents who are divorcing, support groups for families with a mentally ill relative, school-based services, family support services, and specialized training or education on a variety mental health issues.

In FY09, the Center’s prevention programs:

reached approximately 7,320 individuals with some type of mental health consultation, education or prevention service
touched 924 adolescents in 8 different high schools and one middle school with depression awareness and suicide prevention programs and specifically screened 400 students for depression, identifying 69 who were referred for additional services. Of those screened, almost 3% reported that they have thought “seriously” about killing themselves.
provided information or educational presentations on mental health to over 1,300 persons
assisted other community professionals in dealing with the mental health needs of their own clients by providing 1,187 hours of consultation
reached 320 parents with a divorce education program designed to reduce the impact of divorce on their children. Ninety-three percent of the participants subsequently described the course as providing them with helpful strategies for dealing with their children
implemented an early childhood mental health program providing training and consultation to local childcare centers after which 100% of the trained teachers reported experiencing improvement in the teaching techniques that they were using in their classrooms
provided an intensive evidence-based parenting program to parents with an out of control adolescent after which the parents reported a statistically significant decline in negative behavior including a reduction in arguing, yelling, rule breaking and fits of anger, and an increase in the youth’s reported ability to control emotions and stay out of trouble
assisted a number of mental health support groups, including a support group specifically for Amish families with a mentally ill family member, a children’s group for Amish children with a mentally ill parent and a group for survivors of suicide
located school-based therapists in four local school systems, resulting in a reported reduction in acting out behavior and with the majority of the students passing their classes and being promoted
provided paraprofessional family support aides to clients referred by the Family and Children First Councils in both Holmes County and in Wayne County to assist in maintaining school attendance and family stability. At the end of the year, 100% of the students in the Holmes County program and 95% in the Wayne County program avoided out-of-home placement

TREATMENT SERVICES

Treatment services provided by the Center include: individual and family counseling, medication assessment and monitoring, crisis intervention, and diagnostic assessment. Counseling is provided at offices located in Wooster, Rittman, Orrville, and Millersburg and is available for adults, children, adolescents, families, and couples. Typical problems include depression, anxiety, child behavioral difficulties, marital distress, interpersonal problems, and sexual or physical abuse. Crisis intervention services are available 24-hours a day and focus on short-term intervention, suicide prevention, screening for possible hospitalization and referral to other appropriate services. Assessment services are provided to every person who seeks ongoing assistance from the Center; and, at times, to other organizations or individuals who have a specific need. Medication is provided to clients who need this additional support to deal with their current symptoms.

In FY09, the Center’s treatment programs:

provided a diagnostic assessment to 1,627 different individuals who sought on-going mental health services
provided individual counseling services to 2,028 different persons, with a customer satisfaction rating of 95% and a reported improvement in symptomology of 93%
intervened with 1,397 different persons who contacted the Center for crisis intervention – an increase of 18% in requests for emergency assistance
provided psychiatric assessment and access to psychotropic medication to a total of 1,579 different clients
accessed over $500,000 in actual medication or indigent medication program assistance to help clients who could not otherwise afford their medications
maintained a caseload per psychiatrist that was more than double the national average
arranged 108 public hospital admissions, involving 83 different persons, and assisted with 329 private psychiatric admissions

REHABILITATION SERVICES

The Center’s rehabilitation services are designed to assist those adults and children in the community who are affected with more severe and persistent mental health problems. Specific services offered in FY09 included: community support services (which focus on helping clients to live successfully in the community), social and recreational support, home-based family intervention, employment services, and residential care.

In FY09 the Center’s rehabilitation programs:

provided 55,196 units of community psychiatric support to adults with severe mental illness, and an additional 23,489 units to children or youth
achieved excellent customer satisfaction in programs targeted to severely emotionally disturbed children with 97% of those who received home-based services and 95% of those receiving community psychiatric support rating their services as good, very good, or excellent.
documented statistically significant improvement in symptoms and functioning for children and youth participating in the home-based intervention program and noted that 86% of the children and youth who completed the program were still in their homes nine months after the conclusion of services and 100% were still consistently attending school
received a national Best Practice in Customer Satisfaction Award from the Mental Health Corporations of America for the services provided by the Partial Hospitalization program
placed and supported mentally disabled persons in securing paid employment in such fields as nursing, sales, food service, construction and landscaping

OTHER SIGNIFICANT ACCOMPLISHMENTS

In addition to the specific program accomplishments noted above, the Center also:

provided 160,480 units of mental health care
managed 3,894 different cases and maintained an active caseload of 3,205 per month
processed 2,211 admissions – an average of 184 per month
completed a referral source satisfaction survey in which 82% rated their satisfaction with the Center as good, very good, or excellent
documented statistically significant change in system distress, quality of life, financial status and empowerment for adults who used Center services; and statistically significant change in problem severity and level of functioning for children and youth, as measured by the Ohio Department of Mental Health Outcomes system
completed the installation of an electronic scheduling software, automated the case closure process, improved the collection process for doubtful accounts and implemented program specific quality improvement initiatives in each service area
completed a client satisfaction survey in which 95% rated their overall service satisfaction as good, very good or excellent; 93% reported that services were helping them deal with their problems; and 98% indicated that they would refer others to the Center
administered a staff satisfaction survey in which 92% rated the Counseling Center as a good place to work
successfully renewed the organization’s certification by the Ohio Department of Mental Health

SPECIAL CHALLENGES

While the Center experienced significant clinical success during the year, the agency also faced a number of difficult challenges as noted below:

funding reductions from the Center’s primary payer – the MHRB – led to the closure of three key programs during the year, including Employment Services, Partial Hospitalization and Social/Recreational Services. These closures, and other funding changes, led to the termination or temporary lay off of 20 staff positions including: four social workers, two program managers, three drivers, two rehabilitation aides, two family resource specialists, three job coaches, two family support aides and one early childhood mental health educator

twelve of the twenty specific services offered by the Center failed to meet their expected annual productivity targets due to program closures, difficulty in recruiting appropriately trained replacement staff and an unexpected amount of family/medical leave among clinical providers

key services continued to have a waiting list which ranged from 107 to 283 and averaged 217 persons – an increase of 53 (32%) from the prior year

operating revenue was not adequate to cover operating expenses and the unreconciled and unaudited financial reports for the year suggest that the organization will end the year with a loss

SUMMARY

Despite the challenges of significant service demand, increased administrative requirements, funding reductions and the constantly changing health care environment, the Center continues as a positive and dynamic organization, committed to providing quality mental health care and excellent customer service to the residents of Wayne and Holmes counties.

Outcome measures and customer satisfaction surveys reflect that the individuals who use the Center are positively impacted in their lives – whether their problems are short-term and acute, requiring only limited intervention, or long-term and chronic with ongoing needs for rehabilitation and support.