I Thought You Would LIke to Know-

Much is happening and I thought I would use the Sounding Board to catch you all up on many of the changes and upcoming activities in our agency. 

Update on the New Oasis Center:    While many staff are aware of our plans for the new Oasis Center this project has been stalled for the last few weeks.  Here are the details- several weeks ago I was contacted by the State of Connecticut and asked if we would be interested in sub-letting a building that was soon to be vacated by  the Department of Developmental Services.  This building, located at 932 Bank Street, was used by DDS to run a day program very similar to our Social Rehabilitation program.    Since this building would allow us to improve service delivery by providing great space I quickly indicated  that  we would certainly be willing to  sublet that space.   There was much work necessary to develop the sublease and get the necessary approvals.  The process was going well but was stalled by the  State of Connecticut  Office  of Policy and Management.  Despite the fact that the sublease had been developed the  State of Connecticut’s own lawyers, OPM decided it would not give the necessary final approval on the sub-lease!  The process looked like it was hopelessly stalled and that we might lose the building.  Enter Ms. Deborah Heinrich-  Connecticut's recently appointed advocate for  CT non-profits.  (Ms. Heineich was appointed  to a cabinet level position by  Governor Malloy to assist non-profits http://www.ct.gov/malloy/cwp/view.asp?A=4010&Q=471320.)    I called ms Heinrich and filled her in on the details of this project and  the difficulties we were having with OPM.  Once Ms. Heinrich  understood the issues she immediately advocated on our behalf  with OPM and it now appears that  we will shortly have our lease and all the wonderful plans that have been made by Claudia and her staff can go forward.  I am cautiously hopeful that we will be able to move the Social Rehab and Employment programs into their new space early in February.    Keep your fingers crossed!

Management Team Additions:  As our agency has grown it has been obvious that additional expertise in technology and finance were necessary to assure that we maintain our leadership positions statewide- I am pleased to report to you all that there are two new senior managers joining our team.   Mr. Heath Bish joins our agency as Director of Technology and Information Systems.  While the agency has been well served by Mike Reynolds for many years our use of technology has grown exponentially over the last several years and the need for leadership in our acquisition and use of technology has been clear.   Heath will be with us full time beginning February 7^th and will assume responsibility for and supervision of all aspects of our technology use.  

Val Kent joined the agency in 2009 as a staff accountant.  Her work has been exceptional and she has been promoted to Associate Fiscal Director to provide additional expertise in the myriad Department of Labor and other regulatory  requirements that govern the operation of  non-profits here in Connecticut.  Val will focus her work on  payroll and benefits and accounts payable.   Please join me in welcoming Heath and congratulating Val!

New Funding : We continue to pursue additional funding streams to help us meet our mission to seve those with severe and persistent mental illness.   We were recently notified that we have been awarded a competitive grant by Access to Recovery to provide additional employment services to our clients.  This grant was written by Melissa Dunbar and Jessica DeFlumer-Trapp.  Well done Melissa and Jessica!

Reconfiguration of State Street Office Space:  As many of you know Emily Reynolds  is on a 6 month family leave and during that leave, her office will be used by Marie Salvemini as an Intake Office.  Tracey Hauser has moved to the Marie's office and Heath Bish is now in Tracey’s office.

35th Anniversary:  This year marks the 35^th anniversary of the founding of First Step/Sound Community Services.  In honor of the agency, the clients and the staff, our Board of Directors is planning a series of activities to celebrate this milestone.    The first of these activities will by a fund-raising lunch at the Dogwatch Cafe in  Stonington.  It will be followed by a client and staff art exhibit at the TseTse Gallery ( http://www.tsetsegallery.org/ )on State Street.

 I will provide more information about 35th Anniversary activities once the schedule  is finalized but I do hope you will join the Board of Directors in as many of these activities as possible.   Two of our staff members, Sue Himes and Sue Smith, have volunteered to work with the Board of Directors on the 35th Anniversary activities.  If anyone is interested in joining the committee planning the 35th Anniversary activities, please  give me, Sue Himes or Sue Smith a call.

And finally  a word about-

Snowmegeddon:  This has clearly been the very worst winter I have experienced since joining First Step and we are only 1/3 of the way through the winter!  It has always been my belief that since we serve the  very neediest in our  community, we should keep our agency open during periods of inclement weather whenever possible.  And while at times we have delayed the opening of our agency, until this winter our agency we had NEVER failed to open due to weather.  More than two feet of snow in many areas of the state simply made it impossible to open our day and outpatient programs.   I do want to thank and acknowledge the commitment of all staff members who have made it in over the past few weeks to provide services to our clients even when the weather has been terrible.  And of course a very special mention to our residential staff members who have operated their programs in spite of the weather. Thanks to all!

Be well!

Francis Church and Us

Before joining Sound Community Services I spent many years teaching at Rhode Island College in Providence.  Rhode Island College is best known for its School of Education and its Master level Counseling Program.  As a faculty member in the Department of Counseling and Educational Psychology I taught the first course that aspiring teachers were required to take - Educational Psychology- as well as the first course in the professional sequence for aspiring counselors- Introduction to Counseling.  Since both of these courses were usually the first step students took as they entered teaching or counseling I always spent some time encouraging them to explore their suitability and motivation for choosing teaching or counseling as a profession.

While teaching these courses, and keeping in contact with my students after they entered the field, I had the opportunity to watch many counselors at various points in their careers. And as I taught new students and advised those who had graduated, I observed that  that the students who went on to become excellent teachers and effective counselors had certain personality characteristics in common.  The first and most important of these characteristics is optimism. Teachers and counselors must first believe that people can learn and change through the experiences that they [the teachers/counselors] provide.  The second essential characteristic I observed is a belief that most people are, at base, good- that not only people can change, but that they also want to change for the better.  Without these beliefs guiding practice, teaching or counseling is an empty exercise- it is play-acting, without real meaning or substance.

It has been a difficult year for us- funding has been in question for most of the year, the State of Connecticut has required radical changes in our case management program, and further funding cuts are projected for FY12, and with all the stress these things have caused-I had almost forgotten what I had learned about optimism and the belief in the underlying goodness of people. Almost forgotten until I ran across an obscure reference to the work of Francis Pharcellus Church, a 19th century writer and newspaper man.

Let me tell you a bit about Mr. Church.  Church served as a war correspondent reporting on the activities of the Army of the Potomac during the Civil War. I was so very surprised by his war correspondent experience that I spent a beautiful fall afternoon last October at The Library of Congress Main Reading Room researching some of the dispatches filed by the New York Times correspondents as they reported on the some of the most horrific battles of the Civil War including Antietam, Chancellorsville, The Wilderness, Fredricksburg and Gettysburg. These were some of the bloodiest battles of the American Civil War.  In each of these battles there was terrible loss of life and in the case of Gettysburg in particular thousands of soldiers, horses and mules went unburied for days in the unbearable July heat of a Pennsylvania summer. The report of the battle in the New York Times spoke of unbelievable horrors and one can only imagine the sights, sounds and smells that Mr. Church experienced as the Army of the Potomac engaged Lee and the Army of Northern Virginia in the summer the spring and summer of 1863.

It is very hard to believe that living through such experiences would result in anything but a totally demoralized and pessimistic individual.  But not so,  and despite the more than one hundred and fifty years that separate us, Mr. Church  must have been very much like us.  We, as did he, see and hear about terrible things every day.  We see our clients ravaged by mental illness and substance abuse.  We work with clients who have been subject to horrific trauma, we work with clients abandoned by their families.  And yet we continue on with our work- we do believe that the work we do, the skills we teach, the support we provide can and will make a difference in the lives of those we serve.  We share an important characteristic with Mr. Church- optimism and the belief that good resides in all people.   

Mr. Church’s most famous and most remembered writing is not the retelling of a horrific Civil War battle, but rather a letter to a little girl. His optimism and belief in the goodness of all seems particularly appropriate during the Christmas season.  Here is the  letter and his response to the letter Mr.Church received when he worked as an editorial writer for the New York Sun.           

           
Dear Editor,

I am 8 years old. Some of my little friends say there is no Santa Claus. Papa says,   'If you see it in THE SUN it's so.' Please tell me the truth; is there a Santa Claus?

Virginia O'Hanlon.

115 West Ninety Fifth Street.

VIRGINIA, your little friends are wrong. They have been affected by the skepticism of a skeptical age. They do not believe except [what] they see. They think that nothing can be which is not comprehensible by their little minds. All minds, Virginia, whether they be men's or children's, are little. In this great universe of ours man is a mere insect, an ant, in his intellect, as compared with the boundless world about him, as measured by the intelligence capable of grasping the whole of truth and knowledge.
Yes, VIRGINIA, there is a Santa Claus. He exists as certainly as love and generosity and devotion exist, and you know that they abound and give to your life its highest beauty and joy. Alas! how dreary would be the world if there were no Santa Claus. It would be as dreary as if there were no VIRGINIAS. There would be no childlike faith then, no poetry, no romance to make tolerable this existence. We should have no enjoyment, except in sense and sight. The eternal light with which childhood fills the world would be extinguished.
Not believe in Santa Claus! You might as well not believe in fairies! You might get your papa to hire men to watch in all the chimneys on Christmas Eve to catch Santa Claus, but even if they did not see Santa Claus coming down, what would that prove? Nobody sees Santa Claus, but that is no sign that there is no Santa Claus. The most real things in the world are those that neither children nor men can see. Did you ever see fairies dancing on the lawn? Of course not, but that's no proof that they are not there. Nobody can conceive or imagine all the wonders there are unseen and unseeable in the world.
You may tear apart the baby's rattle and see what makes the noise inside, but there is a veil covering the unseen world which not the strongest man, nor even the united strength of all the strongest men that ever lived, could tear apart. Only faith, fancy, poetry, love, romance, can push aside that curtain and view and picture the supernal beauty and glory beyond. Is it all real? Ah, VIRGINIA, in all this world there is nothing else real and abiding.

My very best wishes to you all this holiday season!

Gail         

---

What We Call the Begining is Often the End

Emily Reynolds, Programs Director will shortly begin a six month leave of absence.  I am sure our entire agency will miss her and  we wish her well as she and Hayden  welcome their first child into the world.   She has asked me to share her thoughts with you on this upcoming “transition.”

Gail

T.S. Eliot wrote, “What we call the beginning is often the end.  And to make an end is to make a beginning. The end is where we start from”. 

This concept certainly resonates with me at this time as I am faced with knowing I have about 10 work days left before I embark on a life changing experience many of you have already experienced, ‘parenthood’. For those of you who do not know, I am pregnant and due to have a baby girl on or around January 3^rd 2011. I am filled with a mix of excitement and fear. The excitement of meeting this little person and beginning the next chapter of my life and the fear of the unknown, how and when will she arrive, will I be able to handle it, how will I balance being a good parent with all my work responsibilities, am I planning on being away too long, have I left enough direction and guidance for the staff at Sound Community Services and I could go on and on.

As a clinician, I recognize this is all a part of transitioning, something many of us go through at many points throughout our lives. The simple truth is, we come to beginnings only at the end.

Over the years I have gotten to know many of you and have been reflecting back on many of you as individuals and the transitions you have gone through such as: marriages, divorces, babies, children starting kindergarten, teens beginning to drive, sending kids off to college and facing “empty nest”, death of loved one’s & colleagues, aging parents, sick and/or disabled children, new homes, chronic illness and so much more.  I probably did not acknowledge your transitions enough, but I did often think about each of you when I knew change and transition was upon you.

Transitions in life can be best described in three stages: Endings, The Neutral Zone and The New Beginning. When we think of “endings” we often think of something very final and many of us fight the process, not recognizing that the ending is actually the first act. I will work really hard to maintain that perspective on my last day before leave, my goal will be to embrace my ending or last day and return for a new beginning with an enhanced perspective. 

The Neutral Zone is often thought of as an in between state of mind or being, that period where we have completed the ending but the new beginning has not yet begun.  The Neutral Zone is a time to examine and understand our current situation and a time to begin to make sense of the transition we are experiencing, a time for inner-reorientation and realignment of self. How often have we all gotten so caught up in the “doing” and living life in fast forward that we forget to appreciate the process and meaning behind what we are doing and why. The Neutral Zone is about re-orienting to one self. It is a stage we often want to reverse and go back to ‘what was’, though ‘what was’ can never really be again, or we want to fast forward and get to the new beginning but then we have never really fully transitioned. For me, the time between my last day of work and the birth of my daughter will be the neutral zone, it will be a time where I will need to “let go” given all the technology we have to keep me connected and a time to prepare for my new role and begin getting oriented to my “self”, a self that is not defined by career and my professional role. My sense is I will have a lot of work to do while in the neutral zone!

With every ending however, is a new beginning. My new beginning will be in my new role of “motherhood”.  A role I look forward to and yet in the same respect, fear. A new beginning I will have time to acclimate to and practice, but a beginning that will also face many more transitions throughout life.

It is probably fair to say our culture does not take the time to embrace the life transitions we are all continuously experiencing. I have found myself reflecting on lots of things these days, things I know about many of you, as well as my own personal and professional transitions since beginning my employment here in 2003. I would be remiss if I did not also acknowledge the organizational transitions we have endured together; the ending of First Step and IBH and the beginning of Sound Community Services and all the work that was done to facilitate a successful merger. Our transitions in service delivery & treatment modalities, transitions in how we run our organization from operational perspectives, our transition from an affiliation organization to an achievement focused organization,  our transition from paper to electronic record keeping, our integration of technology into our service delivery and our never ending transitions around physical location and office space. I certainly think we have been successful in many of our endeavors and while I would certainly tackle things differently if I had to do them again, we did survive and we continue to succeed. Each and every one of you was an integral part of the transitions this organization has made since our merger in August of 2005. There are days when the change seems endless but each and every one of you continues to demonstrate your commitment to those we serve, and it is those we serve that drive me to want to continuously focus on improving and doing things better.  

During my leave I hope to self orient in new ways and return to my role here at SCSI with a new and improved world view. It is an honor and privilege to know and work with each and every one of you. I know as I transition out for a period of time, you will all carry on and continue serving those who depend so much on us.

My very warmest wishes to you all, wishes for a safe and peaceful holiday and a new year full of health and happiness. 

Emily

Be Well!

A New Place to Call Home

Seven years ago the then Board Chairmen Ed Samul welcomed me to First Step as Executive Director.  On that very first day he gave me an "assignment."  My very first "assignment" was to find the agency a new and permanent home- a home that would provide a comfortable and welcoming place for clients as well as staff.  At the time the entire agency rented a very old 3 story building on Green Street.   The Oasis Center occupied 400 square feet or so on the ground floor.  The MIRP and Basic Skills Program occupied dark and dank basement rooms that were prone to flooding.  Staff offices occupied the 2nd and  3rd floors of the building with 4 or more staff per office. There were no computers for clients, no adult education program, no elevator, no outside area for gardening and limited parking for agency vehicles. Heat and air conditioning were spotty at best.   And while I usually find old buildings charming, there was nothing charming about the Green Street building. 

It has been seven years since I got that first "assignment" and I have spent much time, as did the previous executive director, looking for a permanent and suitable home for our agency.

The merger of Integrated Behavioral Health and First Step presented an opportunity to leave Green Street.  All of our programs were consolidated at State Street- the home of our merger partner Integrated Behavioral Health. Soon after space became available at 21 Montauk and some administrative staff were re-located to allow for the  expansion of our Outpatient programs. And while the Montauk and State Street buildings have provided  good office space for clinicians, line staff and administrators the space occupied by the Oasis program is less than desirable. The space is small and cramped and poorly ventilated. Programming is difficult and there is no space for staff offices. Staff and clients have had "to make do" with just a small portion of the State Street 2nd floor.

Through a collaboration with the Department of  Developmental Disabilities we will be able to finally provide a home for our Social Rehabilitation Program. I am so very pleased to tell you that early next year the Social Rehabilitation Program and Employment Services will move to their own 4000 square foot building on Bank Street very close to our Montauk Avenue site.  This building has been used by the Department of Developmental Disabilities to house a similar program and as a result the space is perfect for our programs.  We imagine a building that will have dedicated programming spaces as well as a "Great Room" with comfortable home like seating to encourage socialization. There will be a dedicated classroom space that will house our Adult Education program and other skill building programs.  The building also contains a full kitchen, laundry room and showers that will be used to support Basic Living Skills   and MIRP programs. The building also has an outdoor patio area perfect for barbecues and space for raised beds for gardening.

Over the next few weeks Don Hazzard, Property Services Director and Claudia Olson, Social Rehabilitation Program Coordinator will be planning the relocation with the goal of being fully moved in by early January.  And of course there will be a ribbon cutting and Open House celebration  that all are invited to! I hope to see you there to celebrate with our Oasis colleagues and clients!

Be Well!

How Do We Learn?

If you were to ask me to list the core values of our agency, I would identify training and staff development as  integrally important to the work that we do.   The training that we either bring into the agency or we participate in at the local, state and national level assures that we are fully informed and up-to date on the best practices in the field.  

Here at Sound staff development takes many forms-  we train at department meetings and management team meetings; we  provide eLearning access to all staff and require a minimum of 30 hours of training yearly; we require that all managers attend at least one  state or regional conference annually; we support staff obtaining advanced degrees through tuition reimbursement; and senior managers are encouraged to attend  at least one regional or national conference annually.  

Recently as part of ongoing staff development Jessica DeFlumer-Trapp and I attended the Open Minds Technology Conference  http://www.openminds.com/ in Baltimore.  This week she joins me as a guest blogger and discusses some of the “take-aways” from that conference.  She also informs us about the changes that  have been implemented in the case management programs through her participation as a  State of Connecticut Recovery Champion.

Gail

This month, I attended the Open Minds Technology Conference in Baltimore; this is a yearly national conference that addresses technology as it relates to and enhances behavioral healthcare.  One of the speakers made a comment about change that resonated with me.   The comment was to the effect of, “Mental health went unchanged for so many years [with regard to diagnosis, understanding, treatment] that people often selected to work in this field BECAUSE they didn’t expect things to change.”  This is an interesting commentary on both the field and the people who work in it; these days, however, it probably feels like change is ALL that happens.  Budget cuts, funding shortages, and uncertainty at the state and federal level has lead to feeling as though we are constantly on a treadmill- the belt keeps coming no matter how fast you run.  It may feel like you’re running BECAUSE of outside sources, but what should be recognized is that many of these changes and initiatives are being implemented with an eye on what is best for the staff, community, and people that we serve. 

“Case management” is a term that broadly encompasses the care that people receive in a community setting.  Over time, the idea that a person is a “case” to be “managed” has been phased out, and is being replaced with more recovery-oriented language- “community support”, “service coordination”, and “care coordination”.  The old model of the case manager’s role-  assuring that their clients were still alive, were taking their medications, were staying out of trouble- is going the way of the dinosaur.  Now, in order for states, the Federal government, and managed care organizations to acknowledge and fund the work being done in the community, skills-building work MUST be demonstrated.  The days of “forever” case management are over.  Now, persons served in these programs should expect to be admitted, develop necessary community living skills, and be discharged.  Re-admittance to the program is not considered a treatment failure; it is simply viewed as a need for additional support and education before we send the person back on their way to continue their recovery.

Connecticut launched the initiative in March 2010 to take Case Management and revamp it to a Community Support model.  All agencies that were impacted, throughout Connecticut, had to appoint a Recovery Champion to lead the charge.  This person is responsible for heading the team that will implement the change, creating some enthusiasm and energy for new work being done, and serve as a point person state-wide for discussing and bringing feedback to DHMAS and the Office of the Commissioner, about what really works in our organization.   At this time, I serve as the Recovery Champion for SCSI; I attend meetings by phone and in person twice a month, and provide feedback and data to DHMAS and OOC.  This affords me the opportunity to see how truly innovative SCSI is, with regard to our ECR, use of technology, and implementation of best practices in Community Support, including concurrent documentation, skills development, and productivity requirements.  The truth about a major systems change is that it is never as easy as it appears on paper- we deal with people, both those that we serve as well as those delivering the service.  People have needs and expectations that often fall outside of what can be anticipated.  All that in mind, it is SCSI’s commitment to innovation and best practices that have made this transition a natural next step in the movement toward fee-for-service Community Support and evidence-based practices. 

A word about the staff- we have asked them to change their daily work in a variety of ways.  This includes their documentation content, length of sessions, location of appointments, and number of visits per month.  We’ve added additional assessment tools, tracking forms, and training sessions.  These changes have been only secondary to asking them to enhance and modify HOW they deliver services to the people we serve.   Staff have handled these changes with grace and ongoing commitment to assure that whatever changes are made, are executed with the best interests of the people they serve, at the forefront.   Kudos to them- they are the ones that create and promote positive change every day.  The feedback from the persons served has been extremely positive- they continue to feel that they receive services that are helpful and effective, delivered by staff that truly care about their well-being.  As SCSI continues to change and grow, it’s that overall commitment to the persons served that will carry us where we need to go. 

Jessica

Be well!

Where Are We Going?

Here at Sound Community Services we are always evaluating the work we do and looking for ways to improve the services we offer. The Annual Consumer Satisfaction Survey is an example of a tool we use to do just that.  You can review  our most recent survey at https://sites.google.com/a/soundcommunityservices.org/care-review/Home/satisfaction-survey-1  The Annual Consumer Satisfaction Survey focuses on how those we serve perceive our services, programs and staff.  While consumer input is very valuable it is not the only tool we can use to evaluate the quality of our work.   And today I want to discuss with you an initiative that you will start hearing more about in the next few weeks and months.

Sound Community Services is one of several behavioral health agencies in Connecticut that is participating in  a Connecticut Community Providers Association (http://www.ccpa-inc.org) (CCPA) sponsored statewide Benchmarking Initiative.  CCPA is sponsoring this important initiative in collaboration with Behavioral Pathway Systems  (http://www.bpsys.org) (BPS). Through this initiative, we will receive benchmarking reports that will measure our performance in many areas of operation against that of other behavioral health agencies in Connecticut and around the country.

What is Benchmarking-   Benchmarking was a term first used by cobblers to measure people's feet for shoes. The cobbler would place someone's foot on a "bench" and mark it out to make the pattern for the shoes with the intent to provide the best possible product for the customer.  "Benchmarking" assured that the  shoe that was made fit the foot of the customer.  Today benchmarking refers to a series of “measurements” about various aspects of a business ( in our case our agency and the other agencies in the project) and the comparison of those measurements to  what are thought  to be the best practices in the field.  Benchmarking is a powerful performance management tool that can have significant value in behavioral health/human services settings as we strive to assure we provide the best possible services to our clients.   


This CCPA project is a best practice benchmarking project that will allow us to compare our agency to the other CCPA agencies  involved in the project and other similar agencies nationally.  We will learn where we do well by comparison and where there is  room for improvement.  We will then develop plans on how to make improvements or adapt specific best practices. As a result we should be able to improve the services we offer our clients.

Much work has already been done on this project .  Our work began last June when I, Emily Reynolds and Cindy Kirchhoff  participated on a statewide planning committee that worked to identify benchmarking metrics and operational definitions in several operational areas.  Once the metrics and definitions were agreed upon by the participating agencies, work began on the survey tool that would be used to collect the data.   That survey tool was completed in October.   Data collection will begin sometime in late November or December.   

The survey that many of you will be asked to complete will involve almost all aspects of the agency and most staff will complete only  the parts of the survey that relate to their jobs.  Data on the many of the following metrics have been included in the survey:

Financial Benchmarks

Current Ratio of Payer Mix

General/Administrative Expenses as a percent of Total Expenses

Days of Cash on Hand

Days in Accounts Receivable

Net Margin Percent

Cost per Person Served per Year

Cost per Unit of Service and per Person Served (By Service Area)

Bad Debt Percent

Accounts Receivable over 90 Days

Operational Benchmarks

No-Show/Cancellation, Rate (Initial, Ongoing, Medication Appointment)

Productivity (By Service Area)

Access (Days from Request to Initial Assessment)

Access (Days from Request to Psychiatric Medication Management Appointment)

Access (Days from Request to Psychiatric Evaluation)

Subsequent Access (Days from Intake to First Service Appointment)

Utilization (Residential or Inpatient Length of Stay/Outpatient Visits per Person)

Occupancy Percent

Clinical Benchmarks

Client Satisfaction

Psychiatric Hospitalization Rate

Discharge Status (By Service Area)

Manual Restraint Rate (By Service Area)

Medical Hospitalization Rate

Emergency Room Visit Rate

Suicide Rate

Involvement with Criminal Justice System

Employment Rate

Homelessness Rate

Organizational Climate Benchmarks

25 Item Organizational Climate Survey

Staffing Retention/Turnover by Role

Staffing Retention/Turnover by Tenure

Average Tenure of Staff

 

Be well!

Do You Know the "Truth?"

I am joined to day by guest blogger Tracey Hauser, LCSW, Director of Quality Care.

Many years  ago as an undergraduate majoring in Chemistry  at the University of Rhode Island I was enrolled in a course titled The History of Science. In this course I was introduced  to an idea that I found to be absolutely astonishing.  In a nutshell the idea was that what we consider to be “truth” changes as our understanding of the environment or circumstances change.  Thomas S. Kuhn (http://en.wikipedia.org/wiki/Thomas_Kuhn) in his very influential book The Structure of Scientific Revolutions (1962) tells us that  “truth” is not a constant!  Kuhn coined the term “paradigm shift” to describe this idea of “truth" changing and shifting across time.  In Kuhn’s lexicon “ paradigm shift” refers to a radical change in the basic assumptions within the ruling theory of a particular scientific field- a scientific revolution if you will.  

While Kuhn’s work referred specifically to the so-called hard sciences- chemistry, physics etc, his ideas are interesting from  the perspective of what we do as human services professionals.  Moreover, this idea of paradigm shift helps us understand why the treatment models that  we use do change and shift- why the “truth" in our field does change and why we must be aware of these shifts. 

Sound Community Services is committed to providing the very highest quality of services to our clients.   You might ask how do we know if the services we provide are good or not, are valuable to those we serve or not or even if we should consider continuing to do what we do.  In order to answer those questions we collect and analyze much data but we also are committed to the accreditation process.  Accreditation is a process in which an outside agency examines the competency, authority, or credibility of our practice and services.  Accreditation compares what we do to the current accepted paradigms in the field.

 Over the next several months, you will  notice that  we are beginning to spend more of our time and resources in getting ready for our CARF accreditation visit.  Our Director of Quality Care Tracey Hauser, LCSW has ably led our agency in its last two accreditation visits and will do so again for the upcoming 2012 visit.  The high quality of her work has been recognized by CARF and she has been invited to join the ranks of CARF surveyors.  I have asked her to reflect on accreditation and what it means to the agency and her recent experiences in training to become a CARF surveyor.

Gail Lawson, PhD

 Last week I traveled to Tucson, Arizona, courtesy of CARF International – the Commission on the Accreditation of Rehabilitation Facilities.  The reason?  I was scheduled to attend a three day mock CARF Survey with the goal of becoming a CARF surveyor.  For those of you who worked for SCSI in May 2009 – the date of our last 3-day CARF accreditation survey – you may remember the numerous preparations for that visit.  You may have met the survey team or participated in the exit conference before they left.  For those of you newer to the agency – you hopefully remember hearing about CARF during your orientation process. 

CARF International accredits behavioral health programs across the country, in Canada and abroad.  CARF has identified standards for practice in the behavioral health care field that address both the business aspects of agency operation, as well as the services provided at the program level.  These standards are extensively reviewed and annually revised, not only by behavioral healthcare professionals, but by persons served, family members and other stakeholders.  Accrediting bodies, like CARF, promote the best practices in the field, as well as act as a barometer for where the field is moving.   CARF utilizes professional peer surveyors to conduct each survey.  While it is the organization’s responsibility to demonstrate its conformance to each of the CARF standards at the time of the survey visit, CARF surveyors are responsible for offering suggestions on ways the organization can improve services and organizational functioning.  This consultative approach is a cornerstone of the CARF survey process.  CARF surveyors are not on the lookout for mistakes, but rather seeking to identify conformance with the intent of the CARF standards.  “CARF accreditation signals a service provider’s commitment to continually improving services, encouraging feedback and serving the community.”  http://www.carf.org/home/

What we present to CARF during each survey visit is our best work at that time - the ‘truth’ as it were.  Accreditation through CARF provides us with a snapshot of our current services and program operation, as well as helpful consultation from professionals in the field on ways to meet, or improve how we meet, those standards with which we struggle.  These standards historically have included ways to improve service accessibility; ensuring connections between assessments, progress notes and goals; and inclusion of natural supports and family in program planning.  For the last 15 years, CARF has found this agency worthy of accreditation at the highest level – three year accreditation.  As I write this, our next survey awaits us on the horizon, 584 days away, in 2012.  Many of you may have heard me say that CARF is not a 4-letter word.  Instead, it is an opportunity for demonstrating our recovery-focused culture, our person-centered planning, and our commitment to quality services.  

  

Tracey Hauser, LCSW 



Be Well!