Summary of Feedback from Annual Staff Visits (FY19)

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Suzanne Koesel | Indiana | Feb. 08, 2019

Last fall, Shirley Arney, Robb Backmeyer and Dawn Kutruff accompanied me to visit with staff at twenty Centerstone sites across Indiana. We talked about the most recent Employee Engagement Survey results, and most importantly what folks are excited about and what keeps them engaged at work, and what things make their job harder or create barriers to their success and engagement. We had great turnouts at most locations and overall the tone was positive, perhaps more so than in previous years. As promised, here is a summary of what we heard and some initial responses to your ideas. 

What Works

  • People generally feeling positive about their management, feeling recognized and supported.
  • Locations/teams with the highest engagement scores felt that their managers supported them, developed them, and valued their input.
  • Appreciation and acknowledgment of support staff’s contribution to organizational success.
  • Compensation and incentive program
    • Appreciate bringing threshold for incentive down to 100% of Hours of Care (HOC).
    • Pay is competitive with the incentive pay considered.
  • Locations where teams and management (clinical, support, medical) are aligned and folks functioned as one team, supporting each other, were more engaged and happy with the organization.
  • Clinical trainings and accompanying supervision (EMDR, Substance Use Disorders, and Anxiety) have been excellent and have had a real impact on the outcome of care.
  • Benefits are good or at least fair relative to market.
  • Lots of enthusiasm and gratitude for new clinic space in North Vernon and Nashville.


What Gets in the Way, and Ideas for Improvement

Issue: We need a better way to handle training time and PTO in relationship to the monthly Hours of Care target; not hitting the target makes people feel bad, even when supervisors acknowledge the legitimate reasons why and they don’t get incentive, effectively lowering pay for the month.

Response: After working for some time with our Analytics Team to make changes to our productivity system to automatically adjust targets to account for PTO taken, and encountering challenges and delays, we are considering another option to address the issue with incentive pay: a monthly payout that looks at the rolling 12-month average instead of percentage for the given month. This way staff can take their PTO without missing their variable pay if they are otherwise in good standing. More to come on this idea.

Issue: Wish we could recognize travel time in expectation, particularly in more rural/large counties.

Response: We agree that in larger and rural counties, travel related to meeting with clients eats into available face-to-face time. The reality of how we are paid for services does not take this into account, so it becomes another deflating factor as we try to balance all the financial variables. Reducing targets for those in more remote locations would mean we would have to increase them for others in order to balance things out. Some staff, we know, have specific strategies for how they go about scheduling services in more remote locations (e.g. teams have divided caseloads by zip code.) We encourage you to work with your Team Leader, Manger, or Director to share ideas that are working. We are also open to ideas about how we might organizationally get a better balance with HOC targets, personalizing according to the type and place of work, but when it comes down to it, we still have to come to a 1200 hours/year average for each FTE in order to be financial viable. 

Issue: We don’t have bereavement time specifically, it currently comes out of PTO which doesn’t seem fair.

Response: We understand that when staff lose a loved one, time off from work is important to allow space for grieving. When Centerstone moved to a PTO system many years ago, we took vacation, sick, personal, and bereavement time and rolled it into a single bank of hours for employees to use as they need. We do not intend to go back to a system that distinguishes paid time off in different categories, as the PTO system seems to offer staff the most flexibility overall.

Issue: We wish training was more accessible, provided locally, or available by video. It impacts HOC.

Response: We agree that travel for training is a burden and we are looking at ways to make more of it available by e-learning and video, or for standardized training like CPR, allowing staff to meet requirements taking classes locally from a certified trainer. 

Issue: Avatar - no big complaints (yay!) except connectivity in a few locations.

Response: We are following up to see if anything can be improved in the few locations where connectivity is poor. As a web-based product, Avatar speed and function is dependent of that connection. Please continue to routinely report problems with connectivity to the IT Helpdesk.

Issue: Support staff incentive plans requested by both clinical staff and support staff, tied to organizational/location success.

Response: We agree! It is a bit more challenging to distinguish meaningful and measurable metrics as each office professional’s role is different, depending on the needs and distribution of work at the office. We will work with support staff leaders to come up with some ideas for how to structure a plan for variable or incentive pay.

Issue: Many teams feel understaffed and therefore overworked; larger caseloads make it harder to hit HOC.

  • Coworkers leaving for higher pay.
  • Coworkers leaving for jobs without productivity requirements.
  • Need more adult services therapists, particularly in Bloomington, Richmond, New Castle, and Winchester.

Response: Yes, it has long been observed that larger caseloads have negative impact on productivity and quality of care. We have just started working with some more aggressive recruiting tools, and are considering how we might incorporate stay bonuses for hard-to-recruit locations. Our strategies include creating an affiliated FQHC and/or expanding CCBHC certification beyond the 2-year grant in Bloomington, offering a more permanent funding shift in more of our locations. Both of these strategies, if successful, would provide significant increases in payment rates for our most expensive services, allowing us to offer more competitive compensation. We have expanded our internship program in many locations and the good news is that there are new financial resources allowing us to offer stipends to some of our interns. We know that interns who decide to move into a position after they graduate are often some of our best staff. Finally, we are working on a more expansive telehealth strategy to include more therapists in addition to our doctors and nurse practitioners. This will both help us shift resources to where they are needed, but also add additional staff without the barrier of geography.

Issue: Staff wish they could access Centerstone Services at an affordable rate, which the current benefit plan doesn’t allow.

Response: We hear you, and agree that we need to ensure that Centerstone services are accessible to our own staff if needed. Our EAP service, which provides five free sessions for employees, is sometimes not enough. We have established a financial assistance program in Indiana for staff who cannot afford the out-of-pocket expense of care from Centerstone. For more information or to request assistance, please contact Dawn Kutruff, our HR Director. 

Issue: Facility-specific issues

  • Bedford request for better work stations and more secure front desk area.
  • Bloomington and Mooresville noted that the facilities are in need of upkeep and repair, looking trashy.
  • Jeffersonville needs adequate office space and needs office professional support, particularly for access, intakes, and opening charts for new clients.
  • Richmond adult services needs new space to address safety, accessibility, and expanding services over past several years.
  • Greenwood is outgrowing their space, has significant challenges with the other staff/agencies in the building, and not enough parking for staff or clients available.

Response: We are addressing each of this issues, though some will take longer to address because they require a significant new investment. Please know that we heard you, and we are working on developing a plan to address these needs.


Suzanne Koesel
Regional CEO, Indiana