[NYAPRS Enews] MHW: Bad Economy Requires Creativity To Retain MH Staff

[Matt Canuteson]

Challenging Economic Times Require Creative Strategies To Retain MH
Staff

Mental Health Weekly April 27, 2009

 

Attracting and retaining a strong and quality mental health workforce is
a challenge at any time, but particularly so during tough economic
times. Two organizations however have seized on opportunities to
maintain and even recruit staff by holding staff accountable and
aligning their performance with organizational goals, and implementing a
performance-based incentive compensation program. 

 

Behavioral health organizations can help retain staff by holding them
more accountable, said Michael Flora, chief executive of the Ben Gordon
Center in DeKalb, Ill. In recruiting employees, organizations should
look for the best employees to fit into a new performance culture. "Part
of the cultural shift we seeing across the country is a greater emphasis
on performance," he told MHW.

 

"Employee retention and [maintaining] a performance-based culture become
key drivers in the organization's success," said Flora. "People want
clear expectations before they start the job," he said. It's also
important for managers to coach and mentor this workforce to optimal
performance, Flora noted. 

 

"By adopting a performance culture, organizations support increased
service capacity to optimize opportunities to exceed expectations and to
take advantage of new funding opportunities, such as parity will bring,"
he said.

 

Flora spoke about staff turnover and accountability at the National
Council of Community Behavioral Healthcare's annual conference in San
Antonio, Texas earlier this month.

 

Avid Learners

The level of performance improvement needed today requires lots of
learning, said Flora. "We must be avid learners in order for an
organization to change," he said. Flora pointed to Peter Senge, senior
lecturer at the Massachusetts Institute of Technology, and author of The
Fifth Discipline: The art and practice of the learning organization, who
defines a learning organization as one in which individuals at all
levels of the company continually increase their capacity to produce
results that meet both corporate and personal goals.

 

Using data to drive decisions, using best business practices and
continually re-engineering to meet the needs of customers are all a part
of creating a learning environment, said Flora.

 

Aligning the performance of staff to how the organization generates its
funding is critical always, but especially now in this era of continuing
funding challenges in most states, said Flora. It is essential that team
members' performance be linked to the agency's goals and the strategic
business plan. In the new funding environment, accountability and
performance are the benchmarks for both that move us from not just
merely surviving, but thriving. "Team members' performance must measure
the same indicators that the organization is required to deliver, which
is immediate access, quality care, and direct service interventions with
those we serve," he said.

 

Flora added, "When you link agency performance with team performance
it's a win-win for the organization."

 

Flora cited a Fortune magazine article that indicated that failure to
effectively manage low performers is the number one reason why leaders
fail and lose their job. According to the article, 87 percent of
employees say working with a low performer has decreased their
productivity, hampered their development and made them want to change
jobs.

 

Valuing Employees

Aligning compensation with performance helped to improve staff
retention, said Flora. The Ben Gordon Center has been able to align
performance with an increase for staff members, despite its own
financial challenges, he said. Staff members have received up to a 5
percent raise every year based on their performance, he said.

 

Showing appreciation for valued employees is very important in today's
workplace environment, he noted. Even during financial constraints
employers can show staff how much their work is appreciated with a
simple and inexpensive thank you note, he said.

 

It is also important to take a look at service capacity, Flora noted. If
someone leaves the organization, for example, could you take that
compensation and spread it out to others as incentive pay who may be
exceeding company goals rather than hire a new person, he said. "Align
compensation with performance," added Flora.

 

Many states are shifting from a grant-based environment to a feefor-
service one, noted Flora. "Organizations can and do thrive in a feefor-
service environment," he said. For low-performing staff members it is
important to develop an action plan, he noted. 

 

Define areas for improvement and set target dates for success, said
Flora. Periodic follow-up meetings should be conducted with employees to
determine the results of the action plan. "The rainmakers in your
organization will thrive" he noted.

 

Low performers who do not meet the organization's performance
expectation may have to be "coached out," said Flora. The position might
not be a good fit for them. You might say 'This doesn't seem to be
working; what else can we do?'"

 

Middle performers may have to be reassured that employers value them and
that the goal is to retain them, he noted. Thank them for what they do
well, reaffirm their good qualities and express appreciation, said
Flora. High performers should be rewarded, he noted.

 

Compensation Retains N.H. Staff, Helps Clients

Citing financial challenges facing their own staff and the need to
retain them, the Center for Life Management implemented a performance-
based incentive compensation system that rewards staff for productivity
that exceeds their monthly requirements.

 

The Derry, N.H.-based Center, one of 10 comprehensive Community Mental
Health Centers across the state, represents 11 towns. The Center
provides behavioral and mental health services, psychiatric treatment,
acute care, emergency intervention, and family support services 24
hours, seven days a week. The center serves about 5,000 children, adults
and seniors per year.

 

The compensation program has helped to recruit and retain staff and
improve access to care, said VicTopo, president and chief executive of
the Center. The compensation program, which has been in place for about
three years, is aimed at addressing retention while recognizing limited
resources of employees due to the economic downturn, he said.

 

"As employees fulfill their responsibilities with their clients and
[complete] the required documentation, they're also benefitting
themselves," Topo told MHW. "They provide additional services and they
take additional work above and beyond what they're required to do."

 

The industry is not noted for compensating mental health staff with high
salaries, he said. Many employees enjoy clinical work and working with
their clients, he said.

Rather than be faced with an employee seeking opportunities elsewhere,
the compensation program helps retain them.

 

"We're providing more services to the community and helping [employees]
financially with additional income," said Topo. "It works out well for
us and has resulted in a low turnover rate over the last three years."
The compensation program is also used to recruit staff, he said.

 

While Topo cannot provide precise numbers on the turnover rate, he did
indicate that this year the overall turnover rate was 14 to 15percent
compared to roughly 20 percent prior to the implementation of the
incentive program, he said.

 

Currently this new system applies only to direct care staff such as
outreach workers, clinicians, counselors and therapists. In the upcoming
fiscal year, the company plans to make the program available to
non-direct care staff, said Topo. Staff who participate in the program
and work the extra hours are required to complete specific documentation
to be eligible for the incentive pay.

 

The pay is distributed to employees separately from their regular
compensation. "The money is disbursed on a monthly basis," he said.
Staff members participating in the program provide the additional
services and are paid expeditiously.

 

The program has resulted in unintended consequences, noted Topo.  He
said when staff is unavailable to treat new clients the existing staff
helps to fill that void when they participate in the compensation
program  More clients are able to be seen and treated, rather than
remain on a waiting list, he "We're able to get more patients into the
organization more quickly, he said.

 

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