When Susan Lewis Kaylor became president and CEO of the St. Vincent Family Center early in 2017, she’d followed the Ohio Medicaid behavioral health redesign on a policy level.
“But what I realized is following policy and putting it into practice at a direct care level is a very different exercise,” she says.
After a six-month delay, the redesign went into effect Jan. 1, 2018, which meant the pediatric nonprofit agency that provides behavioral health care services has had to change how it delivered and billed for its care. It even altered how it recruited and trained people because of changes in licensure.
St. Vincent serves 5,000 families through its 40,000 square-foot facility on the near east side of Columbus. Before Kaylor came on board, the organization expanded its campus to serve more children at its day treatment program, St. Vincent Prep Academy.
Consultants also assist preschool teachers and families so more of those children can stay in community schools. In the first quarter of 2018, a full-time consultant was added, which took 10 preschools off its wait list.
So, change isn’t unknown to an organization that already deals with the high staff turnover rates that come with its industry — it’s typically 50 percent or higher. But the redesign meant Kaylor had to hit the ground running.
An opportunity to do more
The Medicaid redesign was the biggest change in 20 years for community mental health providers. Kaylor says the organization wanted to use it as an opportunity to make its programs better. So, in her first 30 days, she sat down with the senior team to pound out St. Vincent’s guiding principles.
“We crafted our guiding principles, and at the very top of that was just to provide outstanding, clinical care for the youth and families we serve,” she says. “Sometimes that gets lost in these kinds of big policy and system changes, so we kept going back to that.”
St. Vincent’s senior team also identified seven employees who could kick the tires. They spent time — often before or after work or during lunch — talking through what needed to be done differently and how the organization could improve, before any changes were rolled out to those delivering care.
“I believe you can’t make significant organizational change until you take it down to the boots on the ground — who’s delivering the care,” Kaylor says. “Then we tried to mix it up to have people from different expertise and different programs, so that we weren’t doing siloed thinking and that we were really looking across the agency and what’s best for the youth that we serve.”
Kaylor also knows change has to be based on good data. For instance, St. Vincent started working on its next strategic business plan within the first six months she was there.
“I started with a survey of 200 stakeholders that interact with St. Vincent Family Center. I think you have to do your own market research that’s data-based and I think you have to get stakeholder feedback,” she says.
Once you have a data-informed plan, you must engage every aspect of the organization, and then keep communicating the reasons for change with them, Kaylor says.
“Keep bringing it back to, ‘Is this working?’ Not every idea is a good idea, and just be open and transparent enough to correct and make things better when you’re getting feedback from your team members that it’s just not working,” she says.
An eye to the future
One initiative that came out of the new three-year strategic plan was the unmet community need for foster care. Kaylor says St. Vincent only has a small foster care program, just 24 children, but the organization wants to double that.
“Really, it has nothing to do with Medicaid redesign. It has everything to do with being in the eye of this opioid epidemic, and our board coming together and saying, ‘We have a moral obligation to do more there. There are not enough places for these children to go whose parents are in the throes of addiction,’’’ she says.
Because St. Vincent can train and license foster families, it wants to start with a campaign to find interested families.
Another initiative Kaylor is looking forward to is a partnership with Columbus State Community College.
When St. Vincent expanded its campus, all the work was inside its walls. Columbus State’s landscape architecture program will do a design and plan, so St. Vincent can organize an army of corporate volunteers to revitalize the exterior this summer.
“When you get inside our building, it is so beautiful, but if you walked around the perimeter, no one would know the fabulous things going on around here because we just lost steam,” Kaylor says. “We need to do the same thing on the outside to be an oasis in this community. I’m really excited about it.”