Rona Harris u09a1 Leadership Development

Rona Harris
u09a1 Leadership Development:
Strategic Planning for Collaborative Service Delivery
HMSV5340 Leading in For-Profit, Nonprofit, and Government Organizations
Mary Rockey
September 9, 2018
Abstract
The purpose of this paper is to provide my understanding in developing a brief strategic plan for building a collaborative service delivery model for the Targeted Case Management organization. Effective leadership within an organization is essential to building a team of competent workers to address issues and concerns within the organization.
 
Introduction
As the Targeted Case Management Supervisor my responsibility is to ensure that the Case Management staff are working with clients to develop person centered based care plans addressing their barriers to securing and maintaining mental health stability. This position is also responsible for providing supervision to staff and daily operations as well as Data Quality in HMIS, also carrying a small caseload. Targeted Case Management provides support to the community tenure at the highest possible levels of personal autonomy for persons with disabilities resulting from mental illness, alcoholism, or drug addiction, by providing and ensuring whatever services are needed by the client for as long as they are needed.  Targeted Case Management works with other agencies and organizations in both the public and private sectors to prevent the incidence of alcohol, drug abuse, and mental health problems.  Also, working to meet the needs of all Delaware citizens with problems with alcoholism, substance abuse and mental illness by providing and promoting services that are culturally, racially and age appropriate.

The Strategic Prevention Framework (SPF) of Targeted Case Management is built on a community-based risk and protective factor. It’s approach is preventing a series of guiding principles that can be implemented at the Federal, State and community levels. Although SPF funds are directed through the States and federally recognized organizations, Division of Substance Abuse and Mental Health (DSAMH) envisions the SPF prevention activities will be implemented through partnerships between the States and their respective communities.

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The Strategic Prevention Framework requires recipients to systematically accomplish the following steps in order to provide culturally competent and sustainable prevention programs, policies, and practices:
Assess prevention needs based on epidemiological data Assessment
Build prevention capacity Capacity
Develop a Strategic Plan Planning
Implement effective community prevention programs, policies, and practices Implementation
Evaluate efforts and outcomes Evaluation (Delaware.gov).
Needs Assessment Methodology
The Needs Assessment for the Targeted Case Management Program is intended to provide states and other payers with information on the pervasiveness and use of the mental health and substance abuse services provided, utilizing a chronic logical instruction to create forecasts of utilization under program expansions; factoring in appropriate mix of aids, amenities, and providers to meet the needs of clients that have severe and persistent mental illnesses that are dealing with substance abuse issues that wouldn’t ordinarily seek out services. By developing these tools within the strategic plan, it allows the organization to continue moving towards the intended direction of the services provided (Watson & Hoefer, (2014). The Strategic plan was developed by the Division of Substance Abuse and Mental Health Services Administration (SAMHSA).

The plan provides guidance on key questions that address issues with problems within the community, and other payers may need to answer regarding mental health treatment and substance abuse needs for service. It also summarizes how several states have move toward planning for populations with the greatest need. Its estimates the frequency of mental health disorders and use of services among populations who are currently have no health insurance and may become eligible for insurance. According to Watson & Hoefer, (2014) the strategic plan will allow Targeted Case Management to assess their vision, mission, and all their efforts to be able to accomplish its goals and objectives in conjunction with the Department of Health and Social Services (DHSS) being able to describes how the states mental health and substance abuse authorities can use data to plan for the best quality of service of care throughout the state and its communities. The State of Delaware has been asked to improve the quality of services for better care, making services affordable and helping people in the community to seek services. services.
Better care making mental health care more person-, family-, and community-centered, dependable, reachable, and safe.

Making communities more aware of resources provided by improving services that offer proven interventions to address mental, social, cultural, and environmental factors of addressing substance abuse and mental health care .

Affordable Care which will increase the value of mental health for individual and families.

The Plan highlights ways in which planning efforts can influence the Department of Health and Social Services which can include information on conditions and use of mental health and substance abuse services by developing subpopulations affected by new program and insurance expansions.There is a significant need to avoid unintended problems with access and costs for populations that would benefit from the services needed (Delaware.gov).

Building Capacity
Building organizational capacity is vital for nonprofit organizations to be maintainable and purposeful. Nonprofit human service leaders build and maintain capacity in a challenging climate, which influences how they operate. In an environment of high accountability and performance-based contracting, there are inherent obstacles to the sustainability and effectiveness of these organizations, particularly the relationship between mission and public funding and the relationships between the other two social services providing entities: governmental agencies and for-profit companies.

The connection amongst the government and nonprofit organizations is complicated. The government plays numerous roles in the service delivery arena. It funds and contracts with nonprofit agencies that provide parallel services as a public provider. The governments nonprofit talks as a “hollow state” in which the organization of third-party compensation splits government from service delivery. This phenomenon places nonprofit human service agencies in a role in which they need to implement stability that requires the demands of the government with clients they serve. Organizational capacity is theorized as a range of resources, actions, and activities necessary for the organization to withstand, growth, to be operative in attaining its drive and mission. This characterization distinguishes that organizations or agencies move through phases of growth at the same time, retains an emphasis on achieving mission and purpose.
Cultural Awareness and Competency
Cultural competency is very important in the field of human services specifically where there is a high degree of professional contact with a variety of different cultures present. Leaders must display cultural awareness and cultural competency to achieve the goals of an organization. Those who plan on working in the Human Services field needs to continuously presume cultural competence. The most effective way of developing cultural competency is by examining cultural biases, learned prejudices, active listening, effective communication and spending time with others who are working on their own cultural competency (Sue, Sue & ProQuest Ebooks., 2016;2015;). Spending time with others interested in cultural competency can range from attending workshops and trainings to taking classes on multiculturalism, diversity or cultural competency in a formal academic setting.

The key components for a high degree of Cultural Competency are:
Being aware, having a good attitude, being knowlegable of your own individual biases and reactions to people who are of a different culture or background from your own allows the professional the ability to work towards other aspects of Cultural Competency.

Attitude. The significance of attitude in cultural competence is to delineate the difference between just being aware of cultural differences and actively analyzing your own internal belief systems and developing awareness.
Knowledge. Research into human behavior has shown that our values and beliefs about equality may not line up with our actual behaviors and further we often are ignorant as to the degree of difference between our beliefs and our actions. It has been shown that people who may test well in regards to having low prejudices may in fact act with great prejudice when actually interacting with other cultures. Understanding this disconnect is why knowledge is considered a key aspect of developing one’s own cultural competence.
Skills. This component is about actually taking practices of cultural competency and repeating them until they become integrate into one’s daily behaviors. The most important aspect of the skills component is having an excellent grasp on effective and respectful communication whether within an organization or between individuals. An often overlooked aspect of communication is body language and the sometimes extreme variation in the meaning of gestures between one culture and another.

Once you begin to integrate all four components into your day to day behaviors your degree of cultural competence will increase dramatically. By being aware of your internal learned biases, having an attitude that reflects a desire to deeply understand your own behavior, showing a high degree of knowledge of the subject and implementing the skills of cultural competency, you will soon move from the realm of theory and learning to that of active practice. As the world becomes more global the need for a high degree of cultural competence will only grow and few fields will this be a more important trait than in that of Human Services. Developing your own cultural competency will help you to become the most effective human services worker possible and will greatly increase your chances of gaining and maintaining employment in the field.

Timeline for Planning, Implementation, and Evaluation
The distinguished (A-level) scoring requirements are: Develops a timeline for the planning, implementation, and evaluation stages of a human services initiative, using a visual timeline graphic. Justifies the elements of the timeline.

Use at least one source from the course syllabus reading list or another academic reference to support the content in this section. Avoid copying directly from your source—summarize the content in your own words.

The Delaware Division of Substance Abuse and Mental Health (DSAMH) offers multiple programs for a wide range of individuals in the community and in residential setting. The overall mission statement for  The Delaware Division of Substance Abuse and Mental Health (DSAMH) is “To improve the quality of life for adults having mental illness, alcoholism, drug addiction, or gambling addiction by promoting their health and well-being, fostering their self-sufficiency and protecting those who are at risk.”    This mission statement applies to all program falling under The Delaware Division of Substance Abuse and Mental Health (DSAMH) umbrella.

One of the organizations under The Delaware Division of Substance Abuse and Mental Health (DSAMH) is Community Mental Health” Targeted Case Management Program. Targeted Case Management Program is dedicated to beneficiaries with a history of Severe and Persistent Mental Illness (SPMI) and is residing or has recently resided at Delaware Psychiatric Center.  While the target referral source is Delaware Psychiatric Center (DPC), TCM may accept referrals from other referral sources (PROMISE, Community Behavioral Health Outpatient Programs (CBHOTS), self-referrals, family members, private psychiatric Hospitals, as needed, etc. ) when capacity is available and needs cannot be met by traditional referrals in the existing service system.  
TCM is designed to provide extended (“wrap around”) services to DSAMH clients with the goal of deterring re-hospitalization and maximizing personal independence for participating. TCM originated out of Department of Justice Settlement Agreement that cams to some conclusions in 2016. The goal was to provide services to those with severe and persistent mental illness who had difficulty exiting the Delaware psychiatric system.

The TCM program provides a wide range of serves.:
Engaging the client in treatment with an outpatient mental health or substance abuse provider.   
• Provision of 85% of contacts in the community.

• Assistance with applying and follow up for benefit linkage (SSD, Medicaid, Food Stamps, etc.).

• Assistance with determining housing needs and eligibility, and engage in proactive task to establish secure housing for clients.

• Assistance in locating and obtaining appropriate employment and/or employment resources. based on client goals
• Assessment and plan for development of basic life skills (ADL skills, budgeting, etc.).

• Assistance determining eligibility and applying for appropriate transportation services.

• Provide service to individuals awaiting higher level of care including medication monitoring.

• Assistance with developing preparedness to utilize Self Help support groups (i.e.: AA, NA, Anxiety support group).

• Community contact focused on client needs including but not limited to ADL training, socialization, and transportation training.

• Assistance in referrals for geriatric individuals.

• Assistance with securing, attending, interpreting, and adhering to comprehensive medical care through community PCPs.

• Identification of core obstacles preventing completion of Care plan within 90 day period.

• In addition to providing these services, staff is experienced and able to assist clients in managing and addressing effects of symptoms of Axis I and II diagnosis on their ability to function in the community.       (cite)
 
CHALLENGES: The challenges for the CMH Targeted Case Management Program   
Maintaining intensive services to a population that has patterns of treatment non adherence and lack of follow up due to the nature of their proposed illnesses.

The recurrent changes in a public sector program give the political views at any given time. (focus, where the funding goes –based on beliefs of the parties in power)
Assisting with service to a clients that are needed while not imposing against their rights of choice
 
FUNDING:    TCM programs does not charge clients for services. Therefore, the program is fully funded by state and federal monies. The primary funding source is dictated by the DSAMH fiscal budget each year. Since the start  of the program in 2010 there has bene no major funding cuts towards the program due to its success in its target goals.  The state’s DSAMH budget partially subsidized , in general, by federal monies and grants.      https://treasurer.delaware.gov/financial-information/ 
GOVERANCE: The program administrations governance has accountability step through four “in house” levels of administration whom then answer the office of the governor of the state of delaware. The governor’s office is generally accountable to the executive branch of the government. This provided a multi –layer or reporting and accountability to insure the ethical, productive, and fiscally responsible practices of the base program.  
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While there are variations in the approach to strategic planning, the basic steps are, typically, as follows:
STEPS IN THE STRATEGIC PLANNING PROCESS
1.   Determination of nonprofit values, vision, and mission
2.   Setting goals and objectives to accomplish the mission
3.   Conducting a SWOT Analysis or other analytical assessment
4.   Developing strategies to meet goals and objectives
5.   Evaluating performance in meeting goals
6.   Learning from evaluation and making necessary corrections (Watson 63)
Watson, Larry D., Richard Hoefer. Developing Nonprofit and Human Service Leaders: Essential Knowledge and Skills. SAGE Publications, Inc, 20131021. VitalBook file.

Evaluating Success of Initiative
The distinguished (A-level) scoring requirements are: Identifies tools and practices that will be used to assess success in a human services initiative. Indicates what success will look like.

Use at least one source from the course syllabus reading list or another academic reference to support the content in this section. Avoid copying directly from your source—summarize the content in your own words.

——The ability to measure success of a continuous improvement initiative is critical to the overall success of the project. From a change management perspective, projects are more likely to be successful when executive sponsors are visible and active. For executive sponsors to take on this active role they need to understand the value the initiative is bringing to the organization. If the value is great, then precious resources will be allocated to the project at the expense of other competing initiatives. Quantitative and qualitative measures of the initiative’s value can be combined to determine a measurement of success.

The ability to measure success of a continuous improvement initiative represents the “check” in the Plan-Do-Check-Act cycle introduced by W. Edwards Deming and is foundational to the scientific method. The Check entails observing and assessing results against objectives established in the Plan phase. If the results do not meet expectations then adjustments are made and the cycle repeats.

Measuring success is also important from a change management perspective as a means to increase organizational awareness, create a desire for change, and reinforce the value of the initiative to the organization. Awareness, desire and reinforcement, together with knowledge and ability, are key elements of a successful change management plan.1 These elements are critical for eliminating employee resistance, thereby addressing the number one obstacle to success for major change projects.

With an understanding of why it is important to measure success, let’s explore several methods for how to measure success. When committing to a new initiative, or simply analyzing the results of an existing one, the discussion invariably turns to how to measure the success of the project. Leaders of lean implementations are always prepared for the inevitable question, “How do you know that you are successful?” Most often it is the finance person asking, but the appeal is universal. Consider the following three ways for measuring success.

 
Assessing Sustainability of Initiative
The distinguished (A-level) scoring requirements are: Assesses the sustainability of a human services strategic plan based on governance structures and policy changes that may impact continued implementation. Provides suggestions for enhancing sustainability.

Use at least one source from the course syllabus reading list or another academic reference to support the content in this section. Avoid copying directly from your source—summarize the content in your own words.

——The U.S. Department of Health and Human Services has developed the Strategic Action Plan on Homelessness to outline a set of goals and strategies that will guide the Department’s activities related to homelessness over the next several years.  This strategic action plan serves as the next iteration of the strategic action plan released in 2003, Ending Chronic Homelessness: Strategies for Action, which outlined the Department’s strategy for contributing to the Administration goal of ending chronic homelessness.  The intent of this new plan is to refine the goals and strategies of the 2003 Plan to reflect the changing set of challenges and priorities four years after the development of the first plan. 
Goal 1:   Prevent episodes of homelessness within the HHS clientele, including individuals and families
Goal 2:    Help eligible, homeless individuals and families receive health and social services
Goal 3:    Empower our state and community partners to improve their response to individuals and families experiencing homelessness
Goal 4:    Develop an approach to track Departmental progress in preventing, reducing, and ending homelessness for HHS clientele
Summary/Conclusions
Summarize the planning process in 2?3 paragraphs.
———Although every strategic planning process is different for every business, the Visual Strategic Planning process is modeled off of this cycle, where the steps are followed in this order:
1 Propose mission
2 Propose goals
3 Examine internal issues
4 Examine external issues
5 Summarize findings in a SWOT analysis
6 Formulate strategy
Strategic planning is an iterative activity; you might begin the strategic planning process with one mission and end with another. It really depends upon what your findings are during the process.

——Strategic planning allows an organization to evaluate the vision, mission, and all that the organization does to accomplish its goals and objectives. Without a clear and up-to-date vision and mission for the organization, there is the danger that there will be a great deal of activity but very little accomplished. If we don’t a have good idea about our ultimate destination, it doesn’t make a lot of difference what direction we take to get there. Alice learned this lesson from the wise cat in Alice’s Adventures in Wonderland. (Watson 63)
Watson, Larry D., Richard Hoefer. Developing Nonprofit and Human Service Leaders: Essential Knowledge and Skills. SAGE Publications, Inc, 20131021. VitalBook file.

References
Delaware.gov. (2018). State of Delaware Strategic Prevention Framework State Incentive Grant. Delaware’s SPF SIG Information Portal. Retrieved from https://dhss.delaware.gov/dhss/dsamh/spfsig.htmlMcCann, K., & Kowlaski, C. L. (2015). An analysis of human and community service organization directors’ self-efficacy levels associated with their financial management, advocacy, and marketing skills. The Journal of Nonprofit Education and Leadership, 5(2), 89–100.

Morgan, S. D., ; Stewart, A. C. (2017). Continuous improvement of team assignments: Using a Web?Based tool and the Plan?Do?Check?Act cycle in design and redesign. Decision Sciences Journal of Innovative Education, 15(3), 303-324. doi:10.1111/dsji.12132
Neese, B. (2016). A Guide to Culturally Competent Nursing Care. Retrieved from
https://online.alvernia.edu/culturally-competent-nursing-care/UNITED STATES OF AMERICA vs
STATE OF DELAWARE retrieved from https://www.justice.gov/sites/default/files/crt/legacy/2011/07/06/DE_settlement_7-6-11.pdfSue, D. W., Sue, D., ; ProQuest Ebooks. (2016;2015;). Counseling the culturally diverse: Theory and practice (7th ed.). Hoboken, New Jersey: John Wiley ; Sons, Inc.

Sue, D. W., Rasheed, M. N., Rasheed, J. M., ; ProQuest Ebooks. (2016;2015;). Multicultural social work practice: A competency-based approach to diversity and social justice (Second ed.). Hoboken, New Jersey: Jossey-Bass, A Wiley Brand.

Watson, L. D., ; Hoefer, R. A. (2014). Developing nonprofit and human service leaders: Essential knowledge and skills. Thousand Oaks, CA: Sage Publications.

Williams-Gray, B. (2016). Building capacity in nonprofit human service agencies through organizational assessment during the accreditation process. Journal of Nonprofit Education and Leadership, 6(2) doi:10.18666/JNEL-2016-V6-I2-6499