The purpose of the Central Counties Center for MHMR Services (Center) Operating Plan (Plan) is to define an operational plan that communicates the mission, vision, values, goals, and objectives throughout the organization; it furthers the Center’s development by providing a framework to accomplish those goals and objectives. The Plan describes the Center’s programs and services while providing a systematic, organization-wide approach to designing, measuring, assessing, and improving consumer treatment, outcomes, and support services. The Plan is designed to be responsive to community and consumer needs and improve consumer outcomes

The Plan represents a collaborative effort, all parts of the organization contributed to its development. The Center goal and objectives located in Attachment I were developed by the Executive Leadership Team (ELT) from reviewing the following: Fiscal Year 2005 Performance Contract; input from the Planning and Network Advisory Committees (PNACs), consumers and community representatives, staff through All Staff /Leadership forums, and the Quality Improvement Council and it’s sub-committees. The Plan is comprehensive and integrates all the planning requirements contained in the Texas Department of State Health Services (DSHS) and the Texas Department of Aging and Disability Services (DADS) FY 2005 and FY 2006 Performance Contracts. It includes the required elements from the Local Service Area Plan (LSAP), Quality Management Plan, and the Utilization Management Plan. The Jail and Detention Diversion Action Plan and the Provider of Last Resort Plan were submitted earlier in the year as required by the FY 2005 Performance Contact. The Provider of Last Resort Plan requirement of facilitating public input into decisions related to the solicitation of an available and appropriate provider base {Health and Safety Code Section 533.035 (c)} is addressed in the LSAP section. The planning matrix located in Attachment II is a guide to locating the different required elements throughout this document.

The Plan is the framework for performance improvement initiatives. Services and departments identify the Center’s goals and key functions that most affect the outcomes of treatment and personal outcomes. Leadership, management, and quality improvement bodies analyze and focus initiatives in order to improve processes and/or correct identified problems

To be a strong, stable, and highly valued Mental Health and Mental Retardation Center known for uncompromising commitment to consumers and vigorously supported by the communities we serve.

Improving the lives of the people we serve.

The ELT developed a set of guiding principles in January 2002 to provide a basis for decision-making and prioritization of the Center’s activities and use of resources. The use of the guiding principles by Center staff in their daily activities and decision-making should strengthen the Center’s performance as a consumer-focused service delivery organization bringing best value return on the public funds invested in our mission. The guiding principles are as follows:

The primary goal for Fiscal Years 2005 - 2007 as identified through planning process and as adopted by the Executive Leadership Team is as follows:

A Board of Trustees, comprised of nine members, is responsible for the effective administration of the Center and makes policy that is consistent with the department’s rules and standards. The Board of Trustees has the authority and responsibility within the local service area for planning, policy development, fiscal oversight and ensuring the provision of mental health and mental retardation services. The Center is considered a unit of local government. The Center’s Board of Trustees has representatives from each county of the local service area. Trustees are appointed by their County Commissioner’s Court and approved by the remaining County Commissioner Courts’ from the local service area for a two-year term. The Center’s legal counsel attends all Board of Trustees meetings to provide legal advice. The Board of Trustees hires and oversees the Executive Director.

The Executive Director is the Chief Executive Officer and is appointed by the Board of Trustees. The Executive Director is responsible and accountable to the Board of Trustees. The Executive Director is responsible for the Center infrastructure, functions, resources, services, planning, implementation, monitoring, evaluation, and administrative supervision of all staff and all operations. The Executive Director directly supervises the Deputy Executive Director, , Chief Financial Officer, Director of Information Services, and the Director of Human Resources. The Deputy Executive Director supervises the Director of Mental Health Services and the Director of Mental Retardation Services/Quality Management.

The organizational structure is described on the chart on the following page.

There are six bodies that plan, manage, operate, and evaluate the entire spectrum of Center activities. These bodies are composed of staff from all areas of the Center to ensure that a cohesive focus of effort from both clinical and administrative departments is achieved in all undertakings. These bodies are the Executive Leadership Team, Mental Health Management Team, Mental Retardation Management Team, Early Childteam Intervention Planning Team, Quality Improvement Council (QIC)/Leadership Forum. The bodies coordinate with other areas of the Center in quality improvement efforts and problem solving.

Regardless of the specific delegation of duties to each body, each body is individually capable of planning and decision-making in a collaborative and interdisciplinary manner. The membership, mission, and goals of each body, excluding the QIC that is discussed in the Quality Improvement System section of the plan, is as follows:

Executive Director Director, Mental Health

Deputy Executive Director Director, Medical

Director, Mental Retardation/ Director, Information Services

Quality Management Director, Human Resources

Chief Financial Officer * Other key leadership staff as necessary

The mission of the Executive Leadership Team (ELT) is to model knowledge-based, visionary leadership that effectively develops, aligns, and utilizes resources to accomplish our service mission while maintaining a healthy organization in a changing environment.

To ensure that the Center leadership is operating from the same base of knowledge and from an agreed-upon prioritization of efforts.

To promote clear communication.

To serve as an effective decision-making and deliberative institution.

To foster an integrated approach to leadership.

To promote cohesive and consistent leadership values and behaviors that facilitates the mission of the Center.

To ensure a proactive approach to leadership.

To ensure effective prioritization and management of resources.

To recommend policy to the Board of Trustees through the Executive Director for the Center, consistent with those set forth by the TDMHMR.

To manage all quality improvement activities of the Center.

To monitor the Plan for identification of problems/opportunities.

To remove barriers to achieving objectives in the Plan.

To develop quality improvement initiatives

 

 

 

 

Mental Health Director ACT Team Program Administrator

Children’s Mental Health Services Program Temple Adult Mental Health Program

Administrator Administrator

TIMA/Community Support Services Lampasas Adult Mental Health Program

Program Administrator Administrator

Killeen Adult Mental Health Program Hamilton/Coryell Adult Mental Health

Administrator Program Administrator

Milam Adult Mental Health Program Administrative Support Coordinator

Administrator

The mission of the Mental Health Management Team is to work together to provide the coordinating leadership that will facilitate effective delivery of mental health services to adults and children in the Center’s five-county catchment area.

To utilize a data-driven and participative management approach to the solving of problems.

To keep clients and family members as the primary focus as challenges are met and decisions are made.

To retain a strong commitment to being responsible stewards of public funds and of the public trust.

To adopt and model interactional and problem-solving styles that are professional and respectful to all customers of the Center, internal and external.

To communicate with staff in an accurate and timely fashion.

To be guided at all times by the overarching philosophy of "what is the right thing to do?"

 

Mental Retardation Director Intake, Assessment, and Referral Program Specialist

Administrative Support Coordinator Service Coordination Program Team Leader

Residential/Supported Home Living/ Nursing Services Program Administrator

HCS Program Administrator Supported Employment Services Coordinator

Behavioral Support Services Comprehensive Training Services Program

Coordinator Administrator – Western Area

Comprehensive Training Services Program

Administrator – Eastern Area

The mission of the Mental Retardation Management Team is to dedicate themselves to enabling each individual with mental retardation to participate in the normal life of the community to the fullest extent of his/her potential and personal desires. To this end, we will provide a high quality system of services and support to persons with mental retardation and their families.

Goals

To utilize the participative management approach to problem solving.

To actively problem solve – peer to peer – at the level within the Division most affected by the problem.

To provide accurate and timely communication to all staff.

To utilize a systems-thinking philosophy in addressing issues.

To seek a win-win solution when addressing concerns.

To obtain all relevant information about an issue before decisions are reached

To make reaching decisions with the client a primary focus.

To problem solve with the edit "What is the right thing to do?"

To achieve a seamless interdependence among all MR systems.

 

ECI Program Administrator Temple ECI Regional Coordinator

Copperas Cove ECI Regional Coordinator Harker Heights ECI Regional Coordinator

Self-directed team member representatives

The mission of the ECI Planning Team is to provide opportunities for all ECI employees to have input into program organization and functioning, resulting in a program that is responsive to family and program needs and a program that works for all involved.

To provide early identification of children with developmental delays and subsequently link them with appropriate service providers.

To develop individualized service plans for each child and family, based on strengths and needs as determined through team assessment.

To provide an array of intervention services for families to meet the individual needs of their infants and toddlers with developmental delays.

To address children’s needs in the context of the family unit, provide instructional and support services for family members.

To assure the provision of comprehensive services to children with developmental delays through interagency coordination of services.

To promote program effectiveness and accountability through staff and family program evaluation.

To provide opportunities for professional development of the staff.

Among professionals and the general public, facilitate awareness and education regarding child development and available intervention services.

The mission of the Leadership Forum is to work together to be enlightened leaders that support staff in providing effective services to our consumers.

The Center is an integral part of the communities it serves. Communication between the Center, consumers, families, and the community is encouraged and facilitated so that the Center is responsive to the community’s needs, delivers services in the most effective and efficient manner, and ensures the protection of the legal and human rights of the individuals served.

The figures on the following two pages describe the Center’s local planning structure, membership, functions, and processes for input into the Center’s plan.

The community, consumers and family members not participating on advisory committees have several different means to provide planning input, assess services and supports and submit recommendations for consideration. Opportunities for providing input and determining community needs/priorities are as follows: interviews with Center/State staff, Adult/Child Mental Health Survey, complaint process with Consumer Advocate staff, consumer satisfaction survey cards at all service sties, advocacy meetings, consumer/family community forums, citizen comments at the Board of Trustees meetings and public forums.

Drives quality improvement deeper into the organization.

Promotes departmental and individual accountability.

Collaborative in nature.

Supports effective organization-wide communication.

Linked to organizational planning (mission, vision, values, and goals).

Measures and assesses performance data.

Anchored in improving clinical care and organizational performance.

Based on the principles of continuous quality improvement.

 

The Center’s Quality Improvement System (QIS) provides the framework within which quality improvement activities are conducted. The QIS is constructed to provide knowledge and information to people nearest to the source of activity that will facilitate an understanding of what our performance priorities are, what individual roles and expectations are, and how we aggregate data to determine the Center’s overall performance. The QIS requires that processes be designed to reflect the Center’s mission, vision, and goals, the needs of consumers, families, staff and community, current knowledge-based information, and information regarding the Center’s performance, measured both internally and externally. These processes are systematically measured to identify areas for possible improvement and to determine if change can improve those processes. Additionally, professional and administrative staff assess and improve the quality of consumer care and clinical performance. Changes to consumer care and clinical performance are reported to the QIC so it may fulfill its responsibilities to assure that important internal processes and activities throughout the Center (those that affect consumer outcomes most significantly) are continuously and systematically assessed and improved. The overall purpose of the QIS is to establish a systematic process for collecting and analyzing data in order for the Executive Director and other administrative Center leaders to determine:

1. The level of performance and the stability of existing process which support the identified goals of the Center’s operations,

2. Priorities for improving existing processes or outcomes,

3. The design and implementation of actions needed to improve performance or outcomes,

4. The effectiveness of actions taken purportedly to improve performance or outcome,

5. When new processes are needed, and

6. A framework for collaborative quality improvement systems with active interface with staff, consumers, families, the community, DADS/DSHS related components and other affected or interested parties.

 

The basic components and structure of the QIS is built on the formulation of the Center’s mission, vision, values, and specific goals and objectives related to organizational performance. The Center’s QIS consists of key components. These include:

The Plan is a comprehensive plan that integrates all the planning requirements within the Texas Department of DADS/DSHS Performance Contract. The Plan includes the required elements from the Local Plan, Quality Management Plan, and the Utilization Management Plan. The Plan is designed to include both a management plan component as well as a quality improvement component. The organizational leaders are committed to incorporating quality planning into their overall planning process. This approach enhances the integration of management and quality goals and decreases the likelihood that quality improvement is viewed as an isolated "stand alone" activity. This integrated approach conveys the idea that improving performance must be a systematic, organization-wide activity if the strategic and organizational plans are to be realized.

The Plan provides the framework for all service/department quality improvement initiatives. Goals and objectives are identified and developed within individual service/departments to improve processes and/or correct identified problems within the particular areas. Service/Department staff are expected to monitor initiatives and provide status reports at service/department meetings. Directors are expected to provide status reports to the Executive Leadership Team and to the Leadership Forum/Quality Improvement Council as necessary.

This group is made up of all the Center’s Directors/Supervisors with the primary purpose of sharing information among executive management and leadership regarding hot topics, management directives, implementation of policies and procedures, and progress on achievement of Center goals and objectives. Leadership staff are responsible to provide the information discussed at the meeting to service/department staff. Supervisory and leadership training is also provided during these meetings. The Leadership Forum serves as the Quality Improvement Council (QIC)

The Center conducts assessment activities throughout the year in order to measure progress and identify areas for improvement. Some of these assessments include the organizational quality survey and the program quality survey. Results of these assessments are analyzed and reviewed by the PNAC/QIC/ELT/Board of Trustees and the appropriate management team for the development of improvement initiatives and integration into planning.

The QIC is the integrating vehicle for quality initiatives. The QIC comprises the Leadership Forum. All Center-wide quality improvement activities are managed and coordinated by the ELT and the QIC. The ELT and the QIC will monitor the Plan to identify problems and /or opportunities, to remove barriers to achieving the objectives, and develop improvement initiatives. Additionally, QIC sub-committees report to the QIC on membership issues, developments, accomplishments, barriers, actions and recommendations for quality improvement. Consumer/family members serve on the Human Rights sub-committee.

This QIS function allows staff to implement quality improvement initiatives utilizing performance data or other data sources to target improvement initiatives and validate improvement plan effectiveness. This is where quality improvement work really gets done and is based on the Continuous Quality Improvement (CQI) principle that staff performing the work processes are best situated to make quality improvements. Without the empowerment of staff to make improvements, real improvement and cultural change cannot occur. The membership of a work team will vary depending upon the quality improvement initiative. The reporting mechanism of a work team could be to a QIC sub-committee or directly to the ELT or other bodies depending on the quality improvement initiative. One process a QIS body can use follows:

Utilizing the seven-step problem solving process (quality improvement wheel).

Reviewing and monitoring performance data and data from other sources.

Studying performance improvement opportunities utilizing performance data and/or data from other sources and applying CQI tools (e.g., Pareto diagram, cause/effect diagram, flow charting, affinity diagram, etc.) to determine root causes of quality improvement opportunities.

Selecting and testing improvement interventions.

Observing, analyzing, and communicating results of intervention(s).

Implementing an intervention or re-designing then implementing it.

Monitoring intervention(s) for effectiveness.

Maintaining communication with the QIC, including receiving necessary approvals at different stages of activity depending upon the charge.

 

The QIS structure on the following pages illustrates the QIS structure, different bodies, communication flow, and functions.