CEO Letter Q3 09

Key Performance Indicators

I am always interested in which Key Performance Indicators (“KPIs”) our customer agencies use to measure their progress.  Measures of quality, child safety, care outcomes, financial performance, staff development are common and critical.  I believe there is another area of KPIs that is critical, and not commonly measured.

Let me lay the foundation. I see private child and family service agencies facing an increasing pace of change from all levels of government.   Governments have already put welfare and Medicaid reform on the front burner as they try and respond to the economic pressure.  Along with the pace of change, in times of significant economic pressure, governments will also push through increasingly radical types of change. Examples include privatization of entire systems of care, and shifts from block payment systems like per diem rates towards fee for service models. In addition, agencies need to be able to react to opportunities that may emerge in different geographic of service areas and shift resources from struggling programs into potentially successful ones. For these reasons, and others, we know that while we can’t predict the exact changes that will happen, we can absolutely predict that there will be significant and frequent changes that require some significant process changes at the private agency level.

This brings me to the group of KPIs that I believe agencies should measure in order to thrive into the future:  Capacity for Change Management. To thrive, I believe agencies are going to have to be nimble – to be able to put through significant changes in administrative and service processes quickly and cost effectively.  Agencies that have this capacity are going to be a significant competitive advantage. It has a foundation of HR and management skills such as morale, training, compensation, culture, and communication.  But in addition, it requires some hard skills, such as technological competence.  I could make the case that technological competence should be a KPI on its own, although that sounds somewhat self-serving. Technology, including KaleidaCare Solutions, provides a platform for managing workflow, documentation, and reporting, thus enabling process changes to be rapidly and consistently rolled out across an entire organization.   Technology competence is therefore a critical factor in the Capacity for Change Management.   

By way of example, the Chief Administrative Officer at Meritan, Jeff Weesner, was talking about how KaleidaCare enabled him to launch new programs in new states very quickly and effectively – because all his staff were trained on KaleidaCare, all he needed to do was get a laptop in the hands of the staff in question.  Whatever forms and reports that would be required could quickly be created and made available.

I’m going to work on some suggested elements that could be measured in a Capacity for Change Management KPI.  I’d love to hear from any of you that have ideas on what could and should be included. Please email me your thoughts: adeakin@kaleidacare.com

Thank you for all that you do to serve children and families.  We are proud to play a small role in supporting your work on the front lines.

Your partner in service,
  Alistair

User Group Updates

National User Group

The KaleidaCare National User Group was held April 22-24, 2009 in Austin, Texas.  It was a good mix of outside practice information, user discussions, and KaleidaCare demonstrations. 

Dr. Wayne Carson and Wendy Spiro from All Church Home outlined how they approached their KaleidaCare Solutions Implementation and how their implementation is an ongoing process.  Dr. Carson, who completed his thesis on change management, applied the theory to the practice in implementing a major organizational change.  Shane Frazier, MIS Director at Omni Visions, discussed how their organization utilizes KaleidaCare Solutions to manage their organization.  Using reports from KaleidaCare Solutions, Omni provides feedbacks to each of their offices on their key indicators of growth and quality.

Barb Odenweller, Director of Training at SAFY, demonstrated how she provides new employees and ongoing training on KaleidaCare Solutions to offices in eight states.  In addition to providing one-on-one trainings, Barb is providing group trainings using a web conferencing system and a shared drive for specific training resources.  Rochelle Conway, Regional System Administrator at Phoenix Homes, outlined how they train foster parents to be a KaleidaCare Solutions User.  Rochelle discussed how they set the expectation that foster parents will utilize KaleidaCare Solutions to assist them in being part of the treatment team.  Phoenix Homes provides group training and an individual PowerPoint Refresher for their foster parents.

Allison Supancic and Ellen Moutos-Lee from the Regional Foundation Library at the University of Texas provided excellent resources for agencies that want to pursue grant funding as a funding stream.  Their presentation included a live demonstration of how to search for grants on the foundation’s web site (www.foudationcenter.org), tips for seeking grants -- such as researching what they have previously funded and which foundations have formal or informal relationships with one another, and some state specific resources for those in the audience.  Blake Grove, eCRM Specialist with Convio, provided a presentation on how to use the web as a fundraising tool.  Blake reviewed using the agency’s website, social networking tools, and email campaigns to increase awareness and grow the donor base.

Chip Bolyard provided an overview of existing and upcoming reports by discussing how the system can answer various practice and management questions.  Luanne Barr and Kelly (Gober) Stepura provided a hands-on training on how to download KaleidaCare Solution Reports and manipulate the data in Excel by using filters, sorting, and pivot tables.  Our development team also provided an overview of upcoming functionality.  We also took the opportunity to demonstrate some of the user controls we are reviewing as we plan the next generation product.  While we haven’t landed on any specifics yet, users had the opportunity to see some of the options we are exploring.

We will be releasing the dates of our 2010 National User Group later this year.  We hope you will be able to join us for another interesting and informative three days.

Online User Group

Our Online User Group took a holiday in July, but we will be back on Tuesday, August 11th at 12:00 PM ET / 11:00 AM CT / 10:00 AM MT / 9:00 AM PT!  Please mark your calendars for this new date.  Based on participant input we have moved the Online User Group to the second Tuesday of the month.  The Online User Group is open to all System Administrators and any other interested parties.   If you haven’t participated in an online event, but are interested please contact Chip Bolyard at cbolyard@kaleidacare.com.

KaleidaCare’s Newest Customers

Walden Family Services (San Diego, California) is an FFTA membership agency that provides Foster Care, Adoption and Independent Futures Program to San Diego, Los Angeles, Riverside, San Bernardino and Orange Counties for the last 33 years.  Walden Family Services is excited to manage their multiple offices with KaleidaCare and to reduce the administrative burden of running separate sites.

Baptist Children’s Home of North Carolina (Thomasville, North Carolina) is a COA accredited agency that serves 5 family services areas in North Carolina.  They serve children and families through programs like Residential Services, Emergency Care and After Care. 

Masonic Home for Children (Oxford, North Carolina) serves clients through Residential and Independent Living Programming.  Masonic Home for Children wanted to use KaleidaCare several years ago, but chose a different software because it was financially supported by a University Endowment.  Now that the Endowment has ended, they are excited to begin using KaleidaCare for all of their Case Management needs.

York Place: Episcopal Church Home for Children (York, South Carolina), a ministry of the Episcopal Church, has served children and families for over 150 years.  York Place provides Residential treatment to 36 female and male residents and a High Management Group home to 12 residents.  York Place is accredited by the Council of Accreditation (COA).

CITY House (Plano, Texas) will use KaleidaCare to manage its Emergency Shelter, Transitional Living Program and Family Counseling Center.  CITY House’s new project, My Friend’s House, will provide emergency shelter to children ages newborn to nine once construction is completed.  CITY house provides the only homeless teen shelter in Collin County, and will be the only place for children younger than ten in the Collin County placement system after My Friend’s House opens.

Nazareth Children’s Home (Rockwell, North Carolina) is situated on a beautiful rural 296 acres and has been operating for over 100 years.  Nazareth, a COA accredited agency, serves clients through Foster Care, Transitional Homes, Residential, Day Treatment and a Preparation for Adult Living (P.A.L.) service. 

CEDARS Youth Services (Lincoln, Nebraska) is one of the largest nonprofit child caring organizations in Nebraska.  CEDARS served 3,560 children and youth last year through services like Foster Care, Residential, Emergency Shelter, Juvenile Justice Services, Counseling, In Home services, and Transitional Care.  In 1995 CEDARS was awarded the first ever the Better Business Bureau Integrity Award in the nonprofit category. 

Recent Enhancements

KaleidaCare continues to improve the system functionality.  During the last quarter we made the following enhancements:

New Information Sections

We have recently released 20 new Information Sections for use on Agency Documents, Face Sheets, and Information Report:

• Active Client Payers (in priority order)
• Active Authorizations
• Alias
• Allergies
• Author Name (for all types of agency documents)
• Client Identification
• Creation Date (For all Types of Agency Documents)
• Current Community Based Programs
• Current Diagnosis - Compressed
• Current Staff Assignments
• Current Treatment Team Members
• Date of Admission
• Last Psychiatric Visit
• Pertinent Information
• Place of Birth
• Placement Information
• Placement Information with Caregivers
• Referral Source (CBS) (for client/individuals and families)
• Referral Source (SC)
• Religion

Health Care Log

Several enhancements related to the Health Care Log have been implemented to assist agencies in tracking specific appointments.  A field for Time of Appointment has been added and as well as a new Compressed Report that displays the Date, Type, Next Due Date, Time of Appointment, and Clinical Professional.  The Clinical Professional and Time of Appointment also now pull into the Tickler Report.

KareSearch

KareSearch, a new key word search tool, is currently being beta tested by several Texas agencies.  This tool searches the database for key words determined by the agency.  The search includes Logs, Agency Documents, and Client Tracking.  The search can be narrowed for a specific level of care or wide open for all clients.  The report displays the Client Name, Tool, Tool Date/Time, and Author.

We are working on a number of other report enhancements that are planned to be released in August.  Please contact your Account Manager with any questions about these recent enhancements.

Georgia User Group

Eight people from seven agencies participated in the most recent Georgia User Group on June 11th.   These meetings are held quarterly and are a great way for the Georgia agencies to make connections and share information with each other. 

This focus was on how to get CQI/PQI data out of KaleidaCare, and several agencies presented items they use in the system as examples.  Chatele’ Chester from Gwinnett Children’s Shelter reported that their direct care workers enter Progress Logs each shift.  They then use the Progress Logs Totals for a particular client to easily compile a tally of their behaviors.  They also like the ability to look at the Totals format for an entire unit in order to analyze issues in that milieu.  This lead to a discussion of how different agencies have found a way to allow direct care staff to enter notes in KaleidaCare while also providing supervision of the clients.  Gwinnett purchased several laptops so their staff did not have to sit in the office while entering notes.  Hillside has their day-time staff jot notes on a sheet by hand and their overnight awake staff are able to enter them in KaleidaCare that night.  Some agencies have also found that building in a short shift overlap can accommodate this need.  Other agencies who have not been using the system for daily/shift notes were interested in taking these ideas back to their agencies. 

Jill Myers from Methodist Home demonstrated an Agency Document that they built recently in order to measure treatment services they provide in the Residential program for which they cannot be reimbursed.  They built in checkboxes and dropdowns so they could pull data from the Agency Document Aggregate Report to analyze this.  Gwinnett is also using the Agency Document Aggregate Report to analyze the data from their Work Order document (such as number of different types of issues, number of days until the issue was repaired, etc.).  This was a big hit and they agreed to share it, so Trish will be sending out screen shots so that other Georgia agencies can recreate this in their system.  If any other agency wants this information, please let Trish know so she can include you as well. 

Other CQI items that were demonstrated included the Client Status Report, Event Reasons Report, and how to track the percentage of Annual Physicals and 6 Month Dentals completed on time. 

Trish also demonstrated some Recent and Upcoming Enhancements with the group.  The end of the meeting focused on the Revenue Maximization Module and Electronic Billing functionality.  All of these agencies had just met the previous week to prepare for the upcoming July 1st Medicaid service code changes.  Trish showed some Service Billing enhancements, too.

Thank you to MAAC for providing some refreshments and hosting the meeting in the United Way building.  Mark your calendars now for the next meeting on Thursday, September 10th at 2:00 p.m.  Hillside and Lutheran Services of Georgia have offered to host once they check the availability of their conference rooms.  A final location with directions will be sent out in advance to remind everyone.  The final date for the 2009 meetings will be December 10th.

Heather Rowles, the Executive Director of MAAC and Trish Murphy are the co-chairs of the Georgia User Group.  For more information about these meetings, please contact Heather at (404) 880-9323 or hrowles@maac4kids.org or Trish at (404) 580-1142 or tmurphy@kaleidacare.com.

Dealing with Deficiencies

De*fi"cien*cy\, n.; pl. Deficiencies. [See Deficient.] The state of being deficient; inadequacy; want; failure; imperfection; shortcoming; defect.*

No one likes to be deficient.  It’s a negative word and for those who work with children it may mean the difference between being licensed and having your license removed. 

The Texas Department of Family and Protective Services recently published their Top 10 List. It includes the top ten residential care deficiencies from January 1, 2008 to May 31, 2009 in Child-Placing Agencies, General Residential Operations, RTCs, and Foster Homes.  The lists are worth reviewing to be aware of where other agencies like yours are falling short (see sources below).  But more importantly, the list will allow you to think ahead and avoid being caught deficient.

One deficiency that cropped up in several of the domains was for Background Checks.  In Texas the requirements vary, but include background checks for each person over age 14 who will be regularly or frequently present while children are in care, background checks every 2 years for staff in residential facilities, and background checks when you apply to be a foster or adoptive parent.  The 4th ranking deficiency for CPAs was for required TB screenings.  And of course incident reporting requirements and adequate tracking of required training were on the lists. 

One key to successfully avoiding deficiencies lies in maintaining accurate and detailed records.  Many times, it’s not necessarily that an agency didn’t do something that was required, but instead that it wasn’t documented properly.  There are many methods of documenting the work that is done and the required elements of providing care for children. KaleidaCare Solutions provides an easily accessible, secure environment to document the work that is done on behalf of children in your agency.  Let’s look at how just a few of the deficiencies that made it to the TDFPS Top Ten list could have been avoided with proper documentation.

Background Checks:  The Facility Review and Inspection log allows you to document when a Background Check is completed, the Individual it was completed on, and the date it is next due.  The next due date sends a “tickler” to the appropriate staff 30 days prior to coming due so that appropriate steps can be taken. 

Some Texas agencies that use KaleidaCare have created a Facility Review/Inspection type called “Child Turning 14”.  By entering a log using this type and entering the Next Due Date as the child’s 14th birthday, they are reminded when a child in the home is approaching 14 so that the required background check can be done.  This simple step allows them to create this reminder when a Foster Home is first set up and lets them be confident that they will be reminded when it’s time for  it to be done, even if that is years down the road.

TB Screenings:  The Facility Review/Inspection Log again is used to track when TB screenings are done and the results of the screening.  When required follow ups are needed, the next due date ensures that they are done in a timely manner.

Incident Reporting:  The standard Incident Log in KaleidaCare has many of the required elements built in.  One tip that several Texas agencies use to meet the requirement that the agency address appear on all incident reports is to add their address to their logo that is loaded on the system.  Since the logo automatically prints on every Incident Report, the address requirement is met automatically.

Required Training:  KaleidaCare University offers a simple way to track training hours that a Foster Parent or Residential Staff person obtains and even allows them the opportunity to take online trainings that are relevant to the work they do.  The reporting system allows supervisors and case managers to check on their training status.  KCU even allows the agency to set up online registration for the classroom courses that they offer. 

Take a few moments to review the TDFPS Top Ten Lists and think how your agency can prevent being deficient through proper and accurate documentation.  Talk to your KaleidaCare Account Manager to determine how you can better utilize the standard logs and tools to help you stay in compliance.

Sources:

Texas DFPS Website’s Top Ten Lists: http://www.dfps.state.tx.us/Child_Care/Residential_Child_Care_Licensing/2009-06-15_top10_deficiencies.asp

"deficiency." Webster's Revised Unabridged Dictionary. MICRA, Inc. 30 Jun. 2009. <Dictionary.com>.