The Commission for Accreditation of Rehabilitation Facilities (CARF) awarded Henrico County’s eight MH/DS services another three-year national accreditation — through November, 2016.
In January, 2014 a team of surveyors conducted a three-day site visit to assess programs seeking re-accreditation.
Summary Section from 2014 CARF Survey Report
Henrico Area Mental Health & Developmental Services (HAMHDS) has strengths in many areas.
- HAMHDS has excellent leadership provided by a talented and visionary executive director who reports through the county administrative structure. HAMHDS has a board appointed to it by supervisors in the three counties of the service area. The members of the board are highly motivated and knowledgeable about the HAMHDS programs.
- The executive director uses the high level of skills possessed by the organizations senior leadership group. These individuals have varying levels of tenure on the job with several having been with HAMHDS for 20 to 30 years. This provides continuity of operation and at the same time the infusion of new perspectives.
- An excellent strategic planning process is utilized by the organization to chart its course forward in these uncertain times. This plan is carefully used and modified and is supplemented by sub plans from the various operating and program areas of HAMHDS. Information from a wide variety of sources and from a wide array of high level involvements is used to manage the accomplishment of the targets of the strategic planning process.
- The organization, its leaders, and its staff members are highly thought of by third party stakeholders. One stakeholder stated that, “They’ve institutionalized the concepts of cultural competency. They’re always willing to try new things.” Another was very impressed with the quality of the leadership team and its abilities. Another stakeholder saw HAMHDS as a leader among community service boards. It was said that representatives of the organization are usually at the head of important task forces and committees as a sign of the respect with which they are held. “They are a model of a good local government agency,” said another. “They do the smart thing and the right thing well, irrespective of whether funds have been provided to them.”
- Maintenance of the health and safety of the environment is a high priority for HAMHDS. Facilities’ needs and requests come from all programs, from the risk management committee through emails to the facilities coordinator, or through the work order system. Critical health and safety issues are prioritized and promptly addressed. Projects, including accessibility improvements, are added to the facilities project list. In July each year, the list is reviewed for content and cost by the leadership group. Once the fiscal year’s projects list’s funding request is approved by the county, the facilities department begins to complete the projects. Accessibility, health, and safety have the highest priority. The status of accessibility projects is reported on the accessibility plan.
- Financial management is outstanding. There is a transparent fiscal management process in which staff members can view the financials for their own and for the entire organization.
- The organization is involved in a wide array of advocacy and other efforts in its communities.
- The consumers are very involved in peer service at HAMHDS. For example, the consumers are involved in the instruction process and feedback efforts that the organization undertakes in its extensive crisis intervention training (CIT). Relationships are so strong between HAMHDS and the local police that the police department funds officers to serve at the organization and for the CIT of police officers. Through this process, more than 200 police officers on the force have received CIT.
- The organization is administrative agent for the Virginia Housing Development Authority and handles the entire Section 8 program in Henrico County. As a result, there are currently 250 individuals with a Section 8 voucher. HAMHDS is also administrator of the Homeless Veterans program to help these veterans find suitable housing in the county.
- HAMHDS’ vocational programs offer the consumers a wide array of employment opportunities including janitorial, healthcare, manufacturing, packaging, and shipping positions.
- The marketing specialist has established strong business networks in the community that have resulted in new employment opportunities for the consumers. The marketing specialist seeks job opportunities that match the skills and abilities of the consumers in the vocational programs.
- The consumers interviewed throughout the vocational programs proudly describe the jobs they hold and the duties required of the various positions and consistently reported how much they enjoy the opportunity to work and receive a paycheck.
- The organization uses the profits from the contracts to upgrade equipment, perform required maintenance, and purchase new equipment that will enable it to further expand its contract opportunities.
- One of the current outcomes goals is to provide community activities with groups of no more than three consumers in integrated settings. This offers the consumer the opportunity to expand his or her natural support system.
- The organization offers the consumers a number of ways to pursue employment. The Consumer Work program enables qualified consumers to obtain employment within the organization for a time-limited period. The consumers are assisted to transition to positions within the community at the end of the allowable period.
- The consumers reported great pride in working, demonstrated knowledge of their assigned tasks, and expressed gratitude to the vocational staff members who are obviously deeply committed to providing them with meaningful employment opportunities designed to meet their individual needs and abilities.
- A number of the consumers shared that they had purchased vehicles, opened bank accounts, established 401K plans, obtained private insurance, and in general benefitted substantially from working as a result of the HAMHDS programs.
- Health Diagnostic Laboratory, Inc. (HDL, Inc.) employs a number of consumers who package testing materials for distribution throughout the area. HDL, Inc. has hired a supervisor to work with the crew who reports how well the team members work together to perform their tasks. These individuals have the ability to earn substantial quarterly bonuses and share in all corporate activities, including the corporate exercise program. The employees were given the opportunity to go to the NIKE, Inc., website and design their own tennis shoes.
- Omnicare’s regional service area director in the Richmond area reported that the on-site crew is an integral part of his operation. A national medication packaging corporation with operations in 46 states, Omnicare provides packaged medications and healthcare products to nursing homes and assisted living programs in the area. One of the organization’s referrals to Omnicare is employed as a pharmacy technician.
- The organization works with employers who utilize the work crews to ensure that these groups are fully integrated into the work setting.
- The staff members of all of the vocational programs work collaboratively to assist the consumers in achieving their vocational objectives. It is very evident that their ultimate goal is to assist the consumers to find the vocational opportunity that the consumer determines is best for him or her.
- HAMHDS has developed an intensive community treatment (ICT) program, a new and innovative model complementing the organization’s strong program of assertive community treatment (PACT) program. This enhances treatment options for persons receiving community based psychiatric services. The ICT program has the capacity for becoming a new evidence based practice model that can be replicated nationwide as a complement to the well-established PACT model.
- HAMHDS has significantly strengthened its PACT and case management service models by adding, in addition to team members who are nurses, nurse practitioner prescribers, licensed practical nurses, and pharmacy technician positions.
- Innovation and information technology continue to be a cornerstone of the organization. Business, clinical, prevention, and outreach practices include the use of laptop computers for case managers; E-Scrbe for medical staff prescribers; and the use of social media, internet resources, and PDAs
- HAMHDS has continued strategic development of its website and developed program websites that further enhance its outreach capacity especially to youth, families, and other community stakeholders served though the prevention programs.
- The staff members support the mission and values of the organization to achieve outcomes meeting the needs of the consumers and impacting the greater Henrico area.
- The organization is commended for its continuing commitment to effective advocacy efforts across all programs to meet the unique needs of the persons served families, and communities served.
- HAMHDS is commended for its strengths in coalition building, proactive planning, and relational style, developing close working relationships with government agencies including social services, vocational rehabilitation, correctional services, and local businesses to enhance services.
- HAMHDS continues a legacy of providing action-oriented and engaging prevention programming driven by a commitment to excellence; improving outcomes for children, youth, families, and community. The prevention program strategically developed and implemented by a dynamic staff has developed its own best-practices model guided by consistent outcomes-based data and feedback, which eclipses the various practice models embedded in its various prevention programs.
- The organization continues a fourteen-year history of guiding administrative functions and behavioral health services. The facilities continue to be well maintained and attractive, and community-based facilities in neighborhoods and schools are carefully chosen and maintained in a manner respecting the dignity and meeting the needs of children, youth, families, and adults served.
- Pharmacy services for case management, PACT, and ICT programs are coordinated by licensed pharmacy technicians who have implemented both innovative tracking software and a patient assistance program (PAP) with various pharmaceutical companies, advocating for persons unable to afford the cost of medication. Pharmacy services were intentionally developed in response to the needs of the persons served and support medical staff, and, with only a core year of funding, have established a sustainable PAP model for continuing services.
- The organization has enhanced the health and wellness of of persons served by adding nurses to the case management, PASCT, and ICT staffs to coordinate community delivery of medications to consumers at home.
- HAMHDS has a medical team of psychiatrists and nurse practitioners led by an engaged medical director who actively participates in strategic planning, administration, clinical supervision, and direct care and coordinates a string, ongoing peer-review process for prescribers.
- Personnel policies support the long-term retention of clinical and supervisory staff at multiple levels across programs and throughout administration.
- Although funding has been reduced, HAMHDS continues a strong and effective peer counseling component. Peer counselors play an active role in programs, leading a consumer recovery council and organizing an annual recovery dinner in addition to advocating for and linking consumers with community resources.
- The organization’s vocational services completed the specialized requirements necessary to become an organic certified site in order to obtain a packaging contract from a local food-service manufacturer. The organization had to demonstrate conformance related to pest control, cleanliness, quality, and package tracking. This contact opportunity provides employment for a number of the vocational consumers.
- Clinical Files are thorough with well-written documentation. Individual service plans demonstrate person-centered goals and objectives and are broken down into measurable steps for skill building and a sense of achievement. Progress notes reflect encouragement and positive regards for change.
- The quarterly quality records review system is specific to each program and gathers significant and abundant data to assist in clinical performance improvement.
- The consumers appear to recognize the care and concern of the staff members, who are compassionate and sensitive to their individual needs.
- The commitment, professionalism, and (in most cases) longevity of the staff members are indicators of consistency of service delivery.
- The direct service staff members are knowledgeable about the consumers and address their interventions to fit their unique needs and personal situations. These qualities assist personnel in focusing on producing positive outcomes for the consumers.
- HAMHDS provides training and supervision to ensure that evidence-based treatment modalities are implemented appropriately and effectively throughout its programs.
- Supported living and community housing sites are well maintained and furnished in a a manner that engenders a feeling of self-worth and empowerment. The residents expressed gratitude and a feeling of safety.
- Colorful and inspirational artwork and pictures, many of which have been created by the consumers, are evident at several sites throughout the organization. Through the creativity of paint, pen and ink, and woodworking, the organization allows the persons served to reinvent their lives from within, build confidence while creating a future, and set free the part of the spirit not defined by the illness.
HAMHDS should seek improvement in the areas identified by the recommendations in the report. Consultation given does not indicate nonconformance to standards but is offered as a suggestion for further quality improvement.
On balance, HAMHDS is in substantial conformance to the CARF standards. The leadership is present and very approachable by the consumers, staff members, and other stakeholders. Services and programs function at an exceptionally high level, and administrative support processes are excellent. The organization is committed to meeting the CARF standards. The programs are highly thought of by third-party stakeholders. The consumers have high praise for the staff members that serve them, commenting often on how these staff members have changed their lives. The history of the organization’s follow-up of previous improvement opportunities and the commitment of the leaders to maintain conformance to the CARF standards give reasonable confidence that present conditions will be maintained or improved over the foreseeable future.
Henrico Area Mental Health & Developmental Services has earned a Three-Year Accreditation. Those involved in achieving this recognition, including the consumers, leaders and other staff members, board members, and other stakeholders who have shared the work in earning this recognition, are congratulated. The organization is encouraged to utilize the tenure of this accreditation to promptly address the very few opportunities for improvement noted in this report and to continue to maintain operations in conformance to CARF standards.
The mission of CARF is to promote the quality, value, and optimal outcomes of services through a consultative accreditation process that centers on enhancing the lives of the persons served.
Please feel free to contact Yvonne Russell at (804) 727-8514 for additional MH/DS’s CARF information or questions.