Blue Ridge Area Foundation, Inc

BLUE RIDGE AREA FOUNDATION, INC.

Strategic Plan

2015-2018

119 Tunnel Road, Suite E

Asheville, NC 28805

Developed: 07/26/2015

Updated: 09/28/2015

Table of Contents

Mission…………………………………………………………………………Page 3

Guiding Principles…………………………………………………………Page 3

Vision……………………………………………………………………………Page 3

History…………………………………………………………………………. Page 3

Purpose of Plan…………………………………………………………….Page 4

Input for Plan……………………………………………………………….Page 7

SWOT Summary…………………………………………………………… Page 7

Goals…………………………………………………………………………… Page 9

BLUE RIDGE AREA FOUNDATION, INC.

Strategic Plan

2015-2018

MISSION

Blue Ridge Area Foundation, Inc. provides individualized, comprehensive and high quality residential and vocational services to adults with developmental disabilities.

GUIDING PRINCIPLES

We value each person’s individuality and believe that each person deserves to be treated with dignity and respect.
We value each person’s ability and believe that each person should have the opportunity to maximize his or her potential through active treatment and individualized training.
We value providing the best quality care and believe that ensuring each individual’s healthand safety is fundamental to their quality of life.
We value our employees and believe our delivery of high quality, individualized care is dependent on our well-trained and dedicated staff.
We value teamwork and believe that staff, families, and board members working together can ensure that individuals reach their potential.

VISION

We envision people with developmental disabilities having a life enriched by where they live, work and participate in community life. Blue Ridge Area Foundation is dedicated to people’s well-being, quality of life and development of their potential.

HISTORY

Blue Ridge Area Foundation was created to respond to a need for community based group home living opportunities for people with developmental disabilities in Buncome and Madison counties. Blue Ridge Area Foundation incorporated as Blue Ridge Homes and received its 501(c)(3) status in 1984 and admitted its first residents to the Pisgah home on the Swannanoa campus in the summer of 1988. In the fall of 1988, admissions began at the Mars Hill campus. In 1989, the homes on the Swannanoa and Mars Hill campuses were both fully occupied and have since served as home for 32 residents each. In 1997, a home was constructed in the New Stock area to serve 6 additional residents.

Vocational services have been provided for clients who live in the group homes operated by Blue Ridge since its inception. Blue Ridge has developed relationships with other organizations and state and federal programs which has allowed Blue Ridge to expand vocational services to the community. Currently, Blue Ridge Area Foundation operates 3 vocational centers in Buncombe, Madison and Mitchell counties. Blue Ridge also provides Supported Employment services in Buncombe, Madison and Mitchell counties.

PURPOSE OF PLAN

At a minimum, this Strategic Plan will consider the following:

Expectations of the persons served
Expectations of other stakeholders
The competitive environment
Financial opportunities
Financial Threats
The agency’s capabilities
Service area needs and demographics
The agency’s relationship with external stakeholders
The regulatory environment
The legislative environment

This Strategic Plan will also address the agency’s strengths, weaknesses, opportunities and threats.

1.Expectations of Persons Served

The persons served by Blue Ridge Area Foundation, Inc. include the 70 individuals with developmental disabilities who reside in 9 ICF/IID group homes as well as up to 75 additional individuals served in 3 vocational settings and various community employment locations. The persons served expect the following from this agency:

To live in a home-like environment with adaptations available to meet their individual needs and preferences.
To receive the active treatment approaches necessary to reach maximum potential on all identified habilitative objectives.
To employ staff who are sufficiently trained to:
Provide active treatment in order to meet each individual’s needs,
Conduct themselves in a manner which supports a therapeutic relationship at all times,
Protect each individual’s rights by demonstrating advocacy at all times, and
Treat all person’s served in a manner that promotes and portrays dignity and respect at all times in every interaction.
To be provided opportunities to access and fully participate in community life.
To be provided access to the necessary professional staff necessary to meet all service needs.
To remain compliant with all regulatory and legal requirements to maintain all required licensure and certification of ICF/IID, state funded and Innovations Waiver services

2. Expectations of Other Stakeholders

Other stakeholders include regulatory agencies, vendors, payers and the community.

Regulatory agencies include DHHS, responsible MCO’s/LME’s, OSHA, CARF and local Health and Safety inspectors. Each of these stakeholders have specific expectations and requirements for which BRAF is responsible for remaining in compliance with.

BRAF’s vendor list is extensive. However, all expect that BRAF will meet their financial obligations and remain in good standing.

Payers include WNC Group Homes for Autistic Persons, MCO’s and private pay individuals. All payers expect to receive the services as specified in each individual contract.

The community expects that BRAF and its clients will participate responsibly and professionally in all areas of community life.

3. The Competitive Environment

The state of North Carolina continues to address budget deficits related to Medicaid spending. Due to this process, it is imperative that service providers are competitive and innovative in the manner in which they provide services and manage the business operations of the organization. In the Managed Care environment of today, providers are expected to operate with both excellence and efficiency. Blue Ridge Area Foundation, Inc. collaborates with stakeholders in the community regarding residential and vocational needs of the persons served and best practices in the field, in general. The agency also assesses the climate on a regular basis for needed revisions or additions of services.

4. Financial Opportunities

Blue Ridge Area Foundation, Inc. and WNC Group Homes for Autistic Persons are in the process of forming an Affiliation in order to strengthen the financial position of both agencies. This collaborative effort also allows both agencies to continue to seek potential opportunities for expansion or establishment of efficiencies.

In addition, the ability to negotiate rates within the managed care environment requires active analysis of costs per service and return on investment as well as innovation in service provision.

5. Financial Threats

There are a number of financial threats including:

No or limited future rate increases for Medicaid services.
Potential decreases in Medicaid funding.
Inconsistent or erratic Medicaid funding affecting cash flow.
Non-renewal of loans from banks.
Loans with higher interest rates or with terms that are unfavorable to the agency.
Increased length of time required to fill open beds in the ICF/IID homes.
More challenging and, therefore, more costly client base.
Potential changes in Wage and Hour regulations which affect the ability to pay client workers a special minimum wage.
Stricter regulations and limitations to adults with developmental disabilities being allowed the choice of a segregated vocational or Day Program.

6. The Agency’s Capabilities

Blue Ridge Area Foundation, Inc. is serving an increasing number of residents within its ICF/IID group homes with co-occurring intellectual and mental health disabilities. The agency is also diverse in its ability to serve a variety of challenging individuals with challenging behaviors.

BRAF provides an array of services.

BRAF has dramatically increased its capacity for community services such as Supported Employment.

BRAF maintains relationships with local and state wide providers and provider agencies to ascertain current trends and best practices within the field.

The agency provides a strong staff training program to prepare persons with little or no experience in the field to work proficiently with individuals with intellectual and developmental disabilities.

BRAF employs a strong clinical team with skills in a diverse array of specialty areas.

7. Service Area Need and Demographics

BRAF fulfills a need for agencies capable of dealing with challenging client behaviors. Many people currently served would be homeless without the services of Blue Ridge Area Foundation.

8. Agency’s Relationship with External Stakeholders

BRAF has exceptional relationships with the regulatory agencies which monitor our provision of services. Staff work hard to develop strong working relationships and to utilize regulatory agencies as resources for information regarding best practices in service implementation.

The agency also has supportive relationships with facility service vendors such as vehicle maintenance, HVAC services, electricians, plumbers, etc. These relationships allow the agency to receive prompt services during both routine and emergency situations.

9. The Regulatory Environment

Blue Ridge Area Foundation is currently regulated and/or monitored by the following entities:

Division of Health Services Regulation
Managed Care Organizations (Smoky, Partners, Sandhills and Cardinal)
OSHA
Fire Marshall
DHHS Life Safety
Health and Sanitation
Social Security Administrations
North Carolina Medicaid
Department of Social Services
CARF

The agency also complies with all regulations required of any business operating within North Carolina.

No new regulatory bodies are currently anticipated. However, rules and service definitions are constantly changing.

10. Legislative Environment

Given the numerous issues dealt with by the state legislature during each session, it is important for NC Senators and Representatives to receive information about the field of mental health from the persons providing and receiving services. Participating in The North Carolina Association of Community Based ICF/IID Providers and the North Carolina Association for Rehabilitation Facilities allows the agency to impact changes within the legislative system.

North Carolina is currently undergoing a tenuous Medicaid reform process which encompasses all areas of service provision. New legislative mandates are inevitable in the near future and likely for years to come.

INPUT FOR PLAN

Input for the development of this Strategic Plan was obtained from the following sources:

Client/ Guardian Satisfaction Surveys
Staff Satisfaction Surveys
Agency Stakeholder Satisfaction Surveys
Agency Strategic Planning sessions
Informal discussions with staff and clients/ guardians

STRENGTHS

Blue Ridge Area Foundation:

Has a long history of providing quality care to challenging people.
Provides services to a minimum of 140 persons with intellectual and developmental disabilities annually.
Has consistently high satisfaction from guardians and persons served, especially in the Vocational area.
Employs a strong clinical team of professionals.
Prepares staff to work proficiently with individuals served.
Offers a rich benefits package to employees.
Maintains a high level of staff to client ratio.
Has many long term staff of 20 or more years.
Has a good relationship with local MCO staff.

WEAKNESSES

Blue Ridge Area Foundation:

Competes with numerous service providers in the areas for both staff and residents.
Has older homes which are in need of extensive and expensive repairs/ remodeling.
Competes with the community at large for staff in an improving economic climate.
Faces increased operating expenses created by unanticipated licensure and certification requirements.
Provides many services which are not viewed as best practice by many people/ entities.
Serves persons with challenging behavioral issues causing increased risk for staff injury.
Serves a large number of older and increasingly fragile individuals.
Cannot expand the number of ICF/IID residents served.
Has been unable to provide overall staff raises for the past 8 years.

OPPORTUNITIES

Blue Ridge Area Foundation has the opportunity to:

Increase community awareness of the agency and services provided.
Educate the community about individuals with disabilities.
Improve financial solvency by increasing the variety of funding streams.
Create an endowment.
Create a donor base.
Apply for grants.
Partner with other provider agencies to become more innovative and competitive in service provision.

THREATS

The primary threat for Blue Ridge Area foundation is its ability to remain financially sound. Many areas have the potential to negatively impact the viability of the agency at any given time. These include:

Extended periods of time with open ICF/IID beds.
Significant behavioral issues of the persons served.
Increasing operating costs without corresponding increased income.
High staff turnover.
Poor economic donor environment.

GOALS for 2015 – 2018

1. Organizational Development

a. Identify potential opportunities to strengthen the viability of BRAF in the managed care

environment.

b. Improve technology capacity to provide efficiencies for organizational work processes,

protection of client information and upcoming state and federal requirements.

c. Identify new services in an effort to offer a continuum of care for residential and

vocational client needs.

2. Capital Development and Asset Management

a. Identify strategies for the development of a foundation by working with local financial

institutions.

b. Increase number of potential donors by developing community relationships outside the

MH/DD/SAS provider arena.

c. Improve facility structures, grounds and vehicle fleet quality to minimize expenses

related to repairs and maintenance.

d. Refinance Riverside Drive property to include redesign of facility.

3. Program Development and Service Diversification

a. Explore strategies for supporting co-occurring disabilities more effectively.

b. Explore alternative service array opportunities.

c. Explore opportunities to decrease open bed days by planned discharges.

4. Staff Development

a. Provide opportunities for staff to participate in continuing education.

b. Develop comprehensive staff recruitment plan.

c. Develop succession plan for key employees.