Our year in review.
Fiscal Year 2013
Are we doing what we say we’ll do?
The short answer? Yes, and we say that because we check and recheck. All the time. In fact, we opened our agency to more than 800 hours of surveying by 6 separate accrediting bodies demonstrating our commitment to both organizational transparency and a willingness to welcome thorough examinations of our practices at any given time. But just inviting scrutiny doesn’t begin to cover it. We also ask more than 600 of the families we serve how we’re doing and whether we’re living up to their expectations, and hold ourselves
A REPORT CARD WE’RE PROUD TO STICK ON THE FRIDGE.
UNWAVERING COMMITMENT TO PROFESSIONAL DEVELOPMENT
We’re not your average Wraparound Care provider. Literally. For four years in a row now,
we’ve scored higher than the national mean score of organizations using the University of Washington’s Wraparound Fidelity Index Scale. This isn’t a committee or a taskforce. This is a test. A test that we ace...every time.
In an age when we can access real time information on the experience and proficiency of doctors, car mechanics, dentists, and teachers, shouldn’t people be able to get that kind of information about their human services provider? Yes, they should. The stakes are too high for families not to be skeptical, and for them we carry around our annual report card.
From left, COO Jeff Folsom, Dr. Amy Hunter, Dr. Rob Corso, Early Childhood Services Director Melinda Edwards, CEO Larry Noonan, and Dr. Pat Friman at the 2013 Consortium.
All of our work, regardless of the service, community, or level of staff, is conducted by Montana’s best-trained, most informed specialists. And the trainings that we’re conducting aren’t your typical workplace safety videos, and no name is too big to be put on our list. Dr. Pat Friman, Director of Boys Town Center for Behavioral Health
Dr. Sung Woo Khang of the Kennedy Krieger Institute Mary Grealish, M.Ed. of Community Partners, Inc. in Pittsburgh
rs using the
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OUR PERFORMANCE AND OUTCOMES-BASED CULTURE OF INQUIRY
Outcomes are a priority at every level of service. In the span of one year, we voluntarily underwent independent reviews by three of the country’s leading accrediting bodies; CARF International; the National Children’s Alliance; and the National Association for the Education of Young Children. None of these accreditations are required, and all of them are rigorous. We like the spotlight, we
like speaking with people about what we do, and we speak with conviction.
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These are the people who write the textbooks, and we search tirelessly to find them and bring them here. You can’t put a price on
excellence, but it’s not cheap, and we spend $X/year to train our staff.
But it’s not only our employees we’re teaching; psychiatrists from the world’s most prestigious universities and From left, Dr. Martin Drell, Dr. Brian Matz, Dr. Ellen Leibenluft, Correll and Medical Director Dr. Len Lantz at practices come to Dr. Christoph the 2013 Big Sky Psychiatry Conference in January. Montana for our Big Sky Psychiatry Conference where the Pacific Northwest’s psychiatrists can spend faceto-face time with the leaders in their field in an intimate, meaningful way that would be nearly impossible in other venues. The event grows exponentially every year, and the conference is quickly becoming a destination event for the field.
A SER CALL
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Do people like what we do?
Our work needs to be measured, and we measure all of it. We love to tout the results of surveys and studies that vindicate our approach, results like 98.5% of community stakeholders agreeing that AWARE provides quality services to the community. We care more, though, about what our clients think of our ability to be respectful in their home, be culturally aware, and, above all, facilitate an experience in which the family is in control. Our most recent satisfaction survey showed that an overwhelming 91% of clients and families think that’s the case.
Cold Mountain Pottery, located in Billings, is the newest enterprise in our statewide business network. The longstanding privately owned company produces custom earthenware mugs that can be found in national park and museum giftshops around the country.This is the second year in the continuing development of the network, and is the second year that we’ve adopted fully functioning businesses for the sole purpose of giving real jobs with living wages to people with disabilities.
A SERVICE CALLED ADVOCACY Too many times, the right thing for a family has been compromised for the expedient thing. We’re committed to doing the right thing, and that doesn’t always mean providing a traditional service. We’ve long respected the advocacy work of The Arc, a network of more than 140,000 members and more than 700 affiliated chapters nationwide, and the largest grassroots movement to protect the rights of people with developmental disabilities. How have we shown our respect?
We became the Montana Chapter of The Arc, our commitment to the 10,000 people in Montana with developmental disabilities.
WE TRUST IN THE ABILITY TO SUCCEED Our Supported Living programs have doubled over the course of the last year. Why? Because community-based services means more than an office in town, it means constant motion toward increasing independence at work, at play, and at home. We embrace systems of daily life that aren’t named, rather, they organically trust in the ability of a person with disabilities to succeed at their employment and allow for the consequential self-confidence to feed that success in the community. AWARE’s Farm in Great Falls is an example of a program that embraces as many aspects of independent living as is possible, and we, along with the residents of the home at the farm, have spent the year laying a foundation of Montana-made success in agriculture and marketing. An operating farm production requires myriad positions, innovations, supports, and teamwork, and an effective partnership with a community requires the same
Is it possible to intertwine good, quality services and programs and a storybook slice of Montana life? Yep.
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Are the things we do worth doing?
Is it worth it to help someone get their first job? Is it worth it to help a kid succeed at school for the first time? Is it worth it to keep kids at home and nearest to that which is important to them? Is it worth having an exit meeting with a family after years of exhausting work? Of course it is. We wouldn’t do any of this if the families and communities we serve didn’t deserve every bit of it, and we have a staff that wishes who could do more. We’re keeping kids at home, in school, and out of trouble, and only 89.6% of the kids we’re serving require an intervention that occurs outside of their home community or school. We’re clearly doing something right, especially in light of the 60.6% rate of all other providers combined.
BUCKING TRENDS IN COWBOY COUNTRY Even in such a large state, we still take it personally when we hear that people continue to lack access to quality mental health care in Montana. With a staff of more than 1400 people, we all know someone who needs access to psychiatry to be a little easier.
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After years of development, the Center for Excellence, located in Anaconda, has finally opened, officially bringing the first phase of a multi-year plan to a close, a plan that involves:
66 full time jobs with benefits $2.8 million in annual local purchasing $4 million in annual salaries and benefits $6.6 million in annual direct economic impact $75 million estimated 10-year economic impact $6 million in short-term local construction impact The center as it exists now and into the future is about supporting the high utility services that we offer these kids, and the intensive nature of their treatment demands it. The Center for Excellence represents a return to the community for the kids who have had the roughest go of it, and have often endured multiple placements at institutions around the country. This trend of bouncing around placements is common for this population of kids.
Whether it’s our services for United States veterans, American Indians. or our correctional (adult and youth) psychiatric interventions with the only childtrained forensic psychiatrist in the state, we couldn’t be more comfortable bringing traditional and nontraditional together in a way that could only suit Montana.
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CENTER FOR EXCELLENCE OPENS IN ANACONDA
Yes, we offer one of the most dynamic and flexible telepsychiatry networks in the Northwest U.S., and it has grown into a vehicle for psychiatry, referral and assessment, curbside consultation, and professional development. The technology has served as our tool—not our identity—for Montana’s most rural families. Whether a mother is looking to connect with her child being served out of the home or a family is participating in group therapy between six locations, AWARE has brought human and technological capital together in a way that brings the best of a community to those who need it.
In fact, their familiarity with impermanance leads to more run-ins with the law than students in all other disability categories. But in our school-based services, we have 8 programs for which there were no referrals to law enforcement, unheard of for kids with this background of constant institutional surrogacy.
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REVOLUTIONARY IDEAS. WITHOUT THE REVOLUTION. We hold service and communitywide annual elections for non-magagement-level staff to contribute to our Corporate Congress AWARE’s place for ideas, debate, and the foundation of the coming year’s strategic plan. By the end of
OUR UNDERSTANDING OF THE MISUNDERSTOOD As the first and only accredited autism services provider for adults and children in the state, Montana’s history of caring for people with autism began with AWARE.
the session, on December 7, the Board of Directors was presented with 25 clear set of specific mandates based on the voices of staff, community partners and stakeholders, and, most importantly, the people we serve. The notion
We opened the first and only residential program in 2008, and since that time, we’ve become the go-to provider of services for youth who have presented the very greatest of challenges. When we were approached about providing academic services for youth with autism whose disabilities made it nearly impossible for them to get the education they deserved in a traditional setting, we collaborated with that district to develop, open, and operate the state’s
of doing what we say we’ll do begins by holding ourselves accountable and ensuring that our efforts originate in a grassroots way that embraces lofty aspirations.
BIG SERVICES, BIG EXPECTATIONS
Why is it important to offer early interventions to infants, toddlers, and families when they’re showing signs of Severe Emotional Disturbances or developmental delays? Because we have experience with some of those who didn’t receive those interventions early enough.
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Harvard University’s Center on the Developing Child has conducted significant research on the subject, and have determined that
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“high quality intervention programs for vulnerable infants and toddlers can reduce the incidence of future problems in their learning, behavior and health status.”
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We address this because we know it’s right. But what about tangible benefits to individuals, families, and communities?
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In the nursery, in the classroom, or in the home, the sense of urgency isn’t lost on us.
We’re the first and only accredited provider of services for children with autism in Montana. Outcomes? How about the
school’s inaugural graduating class of four? How about the 28 kids who are no longer in an institution and living in brand new, family-style homes?
“Programs are operated by a group of caring, competent, professional staff membes who take obvious pride in the delivery of quality supports and who demonstrate satisfaction in the effectiveness of the programs and the benefits of recovery as reflected in the progress of persons-served.”
-Summary comment, 2013 CARF accreditation
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Targeted Case Management 673 served
Adult Mental Health Case Management 377 served
School-based Services 335 served
Children’s DD Services Autism Work & Day 45 served Homes Services Adult DD 23 served Youth 79 served Homes Homes 65 served 161 served Early Adult DD Supported Head Start Living Services 69 served 28 served
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AWARE will, consistent with its vision, develop the highest quality, individualized, community-based supports and services, which includes providing access to the right services, to the right people, at the right time while fostering and advocating the inclusion, acknowledgement, and respect for those with disabilities to be a meaningful part of their community.
AWARE envisions a world in which no child or adult with developmental disabilities or mental health diagnoses will ever need to be in an institution, and will have the opportunity to make choices and benefit from services assisting them in becoming as successful and living as full a life as they are able.
Our Principles of Unconditional Care. Families are our most important resource.
Our connection with communities is vital.
We are agents of change.
I’m OK, you’re OK.
We take on—and stick with—the hardest challenges.
We strive to the highest quality of care.
Lighten up and laugh.
It takes a team.
Everything is normal until proven otherwise.
Building on our strengths is the key to our success.
Good preparation = good stewardship.
The balance scorecard uses strategy maps for each service we offer and for the organization as a whole. Think of it as a one-page depiction of a company’s strategy consisting of objectives across the financial, stakeholder, process, and people perspectives. It feeds the scorecard’s primary purpose: answering the question: “how do we know we are making progress toward reaching our strategic goals?”
Improve client outcomes
Build strategic relationships across communities
Informal service partners provide services
Provide outstanding service
Reinvest cash prudently
Shape federal and state regulatory environment
Maximize revenue with quality services Collect receivables
Manage controllable expenses Manage organization-wide risks
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We Provide Innovative Services
Like a for-profit venture, we have a responsibility to manage resources in a way that brings the best value to the people who are buying the services we offer.
For-profit companies around the world have a responsibility to their shareholders. The shareholders expect that the organization they’ve invested in is doing everything it can to balance its diversification, risks, and human capital. We liked that, so we sought some help. Much like with our trainings, we decided to go big. We wanted to move beyond motivational posters, conferences, and webinars, so we began working with Paladino and Associates, a Pittsburgh-based consulting firm that has worked with Fortune 500 We Manage a Sustainable Business We are Residential, Community Care & companies around the world. Working on Treatment, and the AWARE Business Network what? A balanced scorecard.
Identify opportunities for growth (try stuff)
Pilot new opportunities (do stuff)
Market and provide PR for businesses & services
Provide the right services to the right people, at the right time
Comply with all regulations
We Value our People, Climate, & Culture
Case ement erved
Progress. Governed by values.
Identify, recruit, and retain talent
Build organizational depth
Pursue service excellence through professional development and training
Enhance and reward professionalism
Meet health and wellness, safety, and environmental goals
Cultivate a performancebased culture
™Paladino Associates/AWARE, Inc.
As AWARE grows more diverse in both its person-centered services and ventures around the country we think it’s more important than ever to be working toward a clear and common goal, and to satisfy our commitment to our shareholders. Montanans.
Jack H Chair, A
A note from our Board of Directors. Dear Reader, It’s with a great pride that we submit this report. As you can imagine, trying to pick and choose the things that get highlighted in something like this is an exercise in thrift. Everyone we’ve talked to in the process of putting this together has been eager to talk about the things they’ve done over the course of the year. When CARF auditors were with us this summer, they spread out in every different direction, auditing files and charts, touring facilities and interviewing staff at every level. Independent of one another, each CARF representative made note of the fact that, regardless of the community they were in, and regardless of the population being served by any given staff member, employees from entry level all the way up to our leadership thoughtfully answered interview questions in a way that incorporated our Principles of Unconditional Care. You may notice that we’re asking the same questions of ourselves year after year, and you’ll see them here, too: ‘are we doing what we say we’ll do?’, ‘do people like what we do?’ and ‘are the things we do worth doing?’ By asking ourselves these questions at every juncture in our work, we’re forced to examine our ability to work toward our mission and view the challenges and successes of the communities and families we work with through an unconditional lens. We’ve been doing this for 38 years. For the first 13, we were an Anaconda-grown, grassroots organization helping people we knew. For the last 25, we’ve been led by CEO Larry Noonan, who came in with the confidence that AWARE could keep the intimacy that makes a service relevant to a family or community, while promoting a culture of confidence and risk for the benefit of others. That culture leads to innovation and exemption from the status quo. Despite being the fourth largest state in the country we’re pretty small, and our communitybased work relies heavily on people talking, debating, asking questions, and demanding more for their family. As a board, we value these things, and invite your involvement in the discussion, too. Blast away.
Jack Haffey Chair, AWARE Board of Directors