efficiency
m e e t s
e m p a t h y
portage path behavioral health • annual report 2003
perspective
During the year of 2003, Portage Path faced unpredictable resources,
increased expenses and altered methods of operations in its efforts to stay
ahead of the changing tumultuous economic environment and the rocky landscape of behavioral healthcare. We faced these challenges in addition to coping with the ramifications of a still uncertain nation with the echoes of 9/11
still reverberating two years later.
Just when we thought we could let out a collective sigh and relax, the terror
alerts changed color again, forcing us to reexamine just how safe we really
were. Would there be another attack? Would it occur during a major national
event? But life had to continue and we couldn’t let our fears control us.
Even during heightened alert, we had to maintain our families, our jobs, our
chores, school and even our leisure activities, despite a level of fear buzzing
in the back of our minds. We had to focus on budgets, programming and the
latest in clinical care. We at Portage Path had to keep our focus on our clients.
One thing remained constant while everything else was wavering; our commitment to top-of-the-line care for our clients and members of the community. The dedication of the staff at Portage Path helped us to make difficult decisions and work even harder to ensure that the services we offer were nothing
short of state-of-the-art, just like our motto says.
Our ability to provide exceptional care, even in times of uncertainty, speaks
volumes to the efficiency and adaptability of our staff who continues to do
more with less each year.
I hope to report next year that our path was not as difficult. Then again, to
quote the great African-American statesman Frederick Douglass, “without a
struggle, there can be no progress.”
Here’s to the future and any of the struggles it brings...
may even greater progress be the result.
- Jerome T. Kraker, President
accomplishments
Administrative
With so many clients dealing with varying degrees of need, we knew we needed to revamp our patients’
access to appointments to ensure proper treatment. Patients who are not clinically judged to be in
immediate need of an Intake appointment are mailed the Intake paperwork for completion. Upon return
of the paperwork, the patient is contacted and the Intake appointment is scheduled. This has had the
effect of advancing intake appointment slots for those most in need of seeing a therapist immediately,
and has had the added benefit of reducing the overall “no show” rate in the Intake department.
Client rights and responsibilities have always been an integral part of PPBH’s delivery of care and in
2003, we re-examined them. These patient responsibilities revolve around patients keeping appointments or giving adequate time if they need to cancel, because absenteeism and late cancellations impair
our ability to use the time for the needs of other patients. Also, we expect patients to pay the remaining
fee after we apply the sliding-fee scale. During Intake, patient rights and responsibilities are discussed
with the client so we all know our role in continuing state-of-the-art care.
In a perfect world, we could provide care completely for free. Actually, in a perfect world, clients wouldn’t
need our services at all. Sadly though, our services are needed and client fees allow us to continue to
offer better and more clinical programming. We made continued progress in the recovery of fees associated with our services, which ensures our quality of service remains consistent. We developed a central
payment location at check-in, allowing clients to pay at the time of their appointments and we have made
strides in better identification of what funding source should be billed for each client. These efforts resulted in reducing our error rate in anticipating rejected billing to under 5%.
In 2003, PPBH employees at all levels received a three day training session to formally implement the
Health Insurance Portability Accountability Act (HIPAA). Mandatory from the federal level, the extensive
act further ensures doctor/patient confidentiality, but more importantly, the act allows patients to take
“ownership” of their records and treatment. All of PPBH’s clients have the right to view and contest their
records and their complete privacy is ensured.PPBH employees were trained in proper HIPAA protocol.
When the state wanted to implement a changed billing format to MultiAgency Community Services Information System (MACSIS) by July 2003,
Portage Path was the FIRST AGENCY in Summit County to pass both Tier One
and Tier Two testing to use the new system. The Information Systems team,
including Steve Sharrock and Laura Shilling, completed the massive overhaul
just inside of six months, allowing PPBH to submit service claims using the
new system.
Every year the Mental Health Association of Summit County awards excellence in four areas: leadership, programming, media and youth. Once in a
while, they give out a special award - the Heart of Gold - to someone who
has gone above and beyond in selfless pursuit of helping others. In 2003, this
very special award was given to Maintenance Supervisor Don Walters. On
his way in to work one day, Don saw a woman ready to jump from the All
Maintenance Supervisor Don Walters
America Bridge. Don stopped his car, leapt out, pulled the woman away from accepts the Heart of Gold Award from
MHA Executive Director Rudy Libertini.
the edge, and talked with her until paramedics arrived.
Clinical
The name of the game was efficiency in 2003 and we focused hard to increase responsiveness to growing patient flow and to provide more immediate and targeted care to the clients that came through our
doors. In 2002, we embarked on a major project to meet growing numbers of patients and streamline
their treatment to specific needs; in 2003, the final steps were taken on the two-year project .By targeting
services to specific patient needs, more clients are able to receive the services they need in a more timely manner, as opposed to waiting for a general appointment.
When the state of Ohio allowed its advanced practice nurses
(APNs) to apply for the ability to prescribe medication, PPBH
stayed current by beginning an APN program. The program was
developed as a response to team nurses spending a great deal of
time problem-solving medication issues. The result: hire more
APNs with the ability to prescribe meds and free up the psychiatric
counseling sessions for dealing with emotional issues. The hiring
of APNs allowed for the development and construction of the new
Medication Clinic, located at the Akron Outpatient building.
Patients needing a refill on medications can walk in and get the
meds they need from an Advanced Practice Nurse, rather than
scheduling another appointment with their psychiatrist. This allows
that psychiatrist to help more clients at a time without having to
focus strictly on refill issues. In addition, it allows PPBH to better
monitor its clients between appointments more effectively.
Candace Pallante, former Psychiatric Emergency Services (PES)
Operations Coordinator took over as director of the facility in the
fall. A late start didn’t prevent her from beginning several new projects. For example, an Oversight Committee was designed to
review internal processes and keep them current and operating at top efficiency. The medication guidelines were also reviewed in the areas of monitoring and how they are administered. PES also revised its
admissions process. Now, patients in emergency crisis get a rapid “mini-assessment” and can be immediately directed toward the service that they need. This large project was intended to increase patient satisfaction and ensure that patients did not leave before being treated.
Psychiatrist Dr. Ronald Immerman helped
make October’s National Depression
Screening Day a success.
PES employees continued to hold Advanced Crisis Intervention Training for the Akron Police
Department, paying special attention to the officers employed as security at the PES facility, including
providing Therapeutic Assault Prevention (TAPS) training to officers. In addition, PES employees crosstrained with the Akron probation department to network resources and better understand each other’s
role in coping with mental health issues.
A residential licensure survey was conducted by the Ohio Department of Mental Health at the PES
Crisis Stabilization Unit (CSU), resulting in the CSU achieving residential status. What this means is that
CSU is now classified as a residential unit and lives up to state standards. Planned to begin in 2004,
PES staff worked to develop individual and group counseling sessions on the unit, to help stabilize
patients and offer them a much needed service.
PES also continued to host its educational programs. Nursing students from both the University of Akron
and Kent State University did their clinicals at PES, and Emergency Medical Technicians did a great deal
of their behavioral health training there. In addition, doctors form the Barberton Family Practice work one
shift a week at PES to help hone their mental health treatment abilities..
One of the major initiatives for the clinical staff at all locations in 2003 was the Utilization of Outpatient
Services Workgroup, designed to improve clinical efficiency. The purpose of the group, which will continue into 2004, is to examine ongoing patient issues such as no-show rates, appointment availability, treat-
ment expectations / limitations, caseloads, and paperwork issues. As a result of the workgroup, PPBH
implicated a new Walk-In Program at all three clinics. The new program opens up four hours a week for
patients to come in without an appointment to receive the help they may need when they’re between
appointments or if they are unable to schedule a regular appointment.
In addition, the workgroups responded rapidly to updates in the Ohio Department of Mental Health
Standards that allow staff to complete less paperwork, which means they have more time to focus on the
most important issue, patient care.
Support Hotline Crisis Intervention and Prevention
For over 35 years, Portage Path’s Support Hotline has been the place where people in Summit County
turn when they have no one else to talk to. The hotline, operating 24 hours a day, deals with a range of
crisis calls, including relationship conflicts, abuse, financial stressors, substance abuse and grief. Roughly
10 - 15 percent of calls deal with suicide. While not every call is life-threatening, they are all life-disrupting, making the hotline a valuable County resource. In 2003, 3,436 calls were placed to the hotline.
Volunteers provided 3,112 hours of supportive and active listening to callers, leading to over 3,000
referrals to community agencies. These referrals are not only beneficial to the callers, but
they also increase the efficiency of the hotline in that it reduces the number of repeat
callers by helping them find the service organization to best help them with their problems.
While the average number of calls decreased slightly in one year’s time, the number of male
callers increased. This is significant because men are less likely than women to seek help, indicating that
men are feeling more comfortable using hotline services than ever before.
Finally, Support applied for certification from the American Association of Suicidology, to be awarded in
the spring of 2004. The AAS certification will signify that the hotline has been evaluated and has met or
exceeded specific standards in administration, training, service delivery, services in life-threatening crisis,
ethical issues and community integration and program evaluation. Most importantly, it will signify that
Support has become part of the national suicide prevention movement that links the resources of accredited hotlines across the country.
Community Relations
Portage Path’s Marketing Department continued to increase community awareness on a variety of
behavioral health issues by sending out monthly press releases, media updates and public services
announcements. Regular radio play of service announcements and continued press coverage supported
Portage Path’s efforts to educate the public and encourage them to seek help when it’s needed.
Over 1,200 people benefitted from the knowledge that Portage Path has to offer through participation in
our Speaker’s Bureau. PPBH staff addressed many different civic, community, and corporate groups,
including Support Hotline coordinator Barb Medlock speaking to the Akron Police Dispatchers on dealing
with suicidal calls and psychologist Tracy Dawyduk addressing the Cuyahoga Falls Chamber of
Commerce on dealing with agitated customers and employees.
In addition, we continued to assist the local medical and social service community by distributing
Community Pathways and Clinical Pathways, newsletters that help community members and healthcare
professionals better identify behavioral issues and understand the treatment process, and creating specialized handouts to help people better understand a myriad of issues like depression, bipolar disorder,
and alzheimer’s disease. If you would like one of our handouts, call our Marketing Department at
330-253-3100.
demographics
statement of financial position
based on 7,299 clients served in 2003
2002 numbers based on 7,535 clients
Age
2003
2002
0 - 18
19 - 25
26 - 35
36 - 45
46 - 60
61 - 74
75+
0.40%
14.4%
24.3%
26.8%
28.5%
3.90%
0.60%
1.14%
14.98%
24.49%
27.18%
27.21%
4.21%
0.80%
Race
2003
2002
Caucasian
African American
Hispanic
American Indian
Asian
Unknown
72.19%
23.58%
0.36%
0.19%
0.18%
2.69%
74.09%
23.69%
0.23%
0.29%
0.21%
1.49%
Education
2003
2002
27.69%
44.18%
3.45%
15.3%
1.89%
3.56%
1.27%
1.75%
26.86%
42.96%
3.12%
15.89%
2.51%
3.88%
1.58%
3.21%
Grades 0 - 11
H.S. Grad.
Trade/Tech.
Some College
2yr. Degree
4 yr. Degree
Grad. Courses
Unknown
Referral Source
Self
Health Care Plan
Social Service
Outpatient M/H
Medical Facilities
Private Physicians
Court Corrections
Other
2003
18.8%
0.62%
1.18%
25.96%
14.19%
6.51%
6.56%
15.45%
2002
16.06%
1.07%
13.18%
23.86%
16.14%
5.80%
8.81%
15.08%
Year Ending December 31, 2003
Public Support and Revenue
2003
2002
Summit County ADM Board
Medicaid/Medicare
Grant Revenue
Pharmacy In-Kind Allowance
Special Events
8,083,275
1,698,048
0
268,155
4,972
7,990,643
1,589,507
5,375
148,199
7,019
Total Public Support
10,054,450
9,740,743
Fees for Service
Psychiatric Staffing
Miscellaneous Revenue
Contributed Services
Interest Income
Realized (loss) gain on investments
Unrealized gain (loss) of investments
Donations
369,105
8,188
15,905
39,156
9,314
1,580
12,508
625
463,303
14,596
9,003
38,636
28,516
(8,343)
638
2,815
Total Operating Revenue
456,381
549,164
Total Public Support and Revenue
10,510,831
10,289,907
2003
Expenses
Program Services
Management and General
Loss on Fixed Assets
2002
9,341,159
1,028,910
0
Total Expenses
10,370,069
Change in Assets Increase/(decrease)
9,281,050
961,654
61,756
10,304,460
140,762
(14,553)
Net Assets of the Beginning of the Year
1,056,974
1,071,527
Net Assets of the End of the Year
1,197,736
1,056,974
Going OnLine
www.portagepath.org
In 2003, PPBH’s website allowed users to screen for
symptoms of depression, manic-depressive disorder,
generalized anxiety disorder and eating disorders.
all free and in the privacy of their own homes.
While screenings can’t actually diagnose disorders,
they do detect the presence of symptoms.
At the end of the screening, users
had the ability to take the first steps
to register for an appointment at PPBH.
Disorder
# Screened
% Positive
Depression
89
85.40
Generalized
Anxiety
52
88.46
Manic Depressive
36
27.78
Eating
26
42.31
patient improvement and
satisfaction
The Quality Improvement Team continues to monitor inpatient clients at the Crisis Stabilization Unit during both
Admissions and Discharge for symptoms and levels of functioning, while clients at the outpatient clinics are measured
every 90 days during their treatment. For both kinds of clients, the same instruments of measure are used, a
computer analyzes the data, and overall, scores indicate that symptoms DECREASE SIGNIFICANTLY.
The Joint Commission on Accreditation of Health Care Organization (JCAHO) is the nation’s oldest and
largest health care accrediting body. It is the same group which certifies that healthcare companies are
providing quality, safe care, using hundreds of standards to measure performance. They gave us an outstanding rating of 95 out of 100! To make sure we live up to that score, PPBH measures patient satisfaction in threee areas and the results CONSISTENTLY show that patients are HIGHLY SATISFIED with services they receive at
Portage Path Behavioral Health facilities.
Satisfaction is measured in three categories.
Access and Service:
How easy it was to get a referral
The comfort, cleanliness and appearance of the facility
Personal Bond:
The understanding given to me and my problems
The warmth of my therapist
Goals and Progress:
How clear I am about the goals of my treatment.
My understanding of the things that take place during my treatment
PAT I E N T S AT I S FA C T I O N S C O R E S
(OUT
OF A PERFECT
5)
Outpatient Clinics
Access & Services:
Personal Bond:
Progress & Goals:
4.22
4.19
4.31
1) to measure patient outcomes and treatment;
2) to benefit patient treatment planning;
3) to access and improve programs and processes;
4) to provide marketing-related information;
5) to supply information to the county funding body
(The ADM Board of Summit County)
and others involved n the passage of county tax levies.
PES- Crisis Stabilization Unit
Access & Services:
4.05
Personal Bond:
4.05
Progress & Goals:
3.98
Portage Path is one of very few mental health centers who currently have the
ability to collect such in-depth data - data which continues to be used to
improve services to our clients.
PES- Emergency Evaluations Unit
Access & Services:
Personal Bond:
Progress & Goals:
3.77
3.96
There are five reasons we have placed such an importance on collecting information on patient improvement and patient satisfaction:
4.02
While some of these satisfaction numbers may appear low, it is important to
keep in mind that all of these people are in some sort of emotional distress,
which directly impacts the scores.
Board of Trustees
Ross Black, II, M.D.
Mill Pond Family Physicians, Inc.
Donald A. Bosshart, Ed.D.
National Center for Evaluation of Residency Programs
Roy Call
Summa Health System
Portage Path Behavioral Health
Service Awards - 2003
20 years
Linda Lich,
15 years
Shirley Hoyle-Bird, Secretary/Receptionist
Lisa Fair, Team Leader CIRS
Charles Goold, Psychiatric Social Worker
Myunk Kwak, Psychiatrist
Antonio Montinola, MD, Director, Psychiatric Emergency Services
Denise Nash, Administrative Assistant
Susan Yount, Clinical Information Rep.
Pamela Zeh, Accounting Assistant
10 years
Ravinder Brar, MD, Psychiatrist
Jill Lowery, Psychiatric Counselor
Nancy Ulrich, Psychiatric Social Worker
5 years
Laura Favaro, Emergency Clinician
Ned McClintick, Accounting Manager
Dawn McKinney, Behavioral Medication Program Nurse
Scott Schmitt, MD, Psychiatrist
Hem Sharma, MD, Psychiatrist
Melissa Stokes, Administrative Assistant
Isiah Daniels, III
The University of Akron
Rebecca Gilliam
Just Solutions
Richard L. Hansford
The University of Akron (retired)
Dale M. Lewison, Ph.D.
The University of Akron
Robert Pfaff
Metro Regional Transit Authority
Charlene A. Schmidt
Ernst & Young
John Solomon
Vorys, Sater, Seymour and Pease LLP
Psychiatric Nurse
Kenneth Verbic
First Energy (retired)
John Woods
County of Summit ADM Board (retired)
Judith Young
Aultman Health Foundation (retired)
Memberships
Akron Regional Development Board
Better Business Bureau
CMHC Systems
Cuyahoga Falls Chamber of Commerce
Joint Commission on Accreditation of Healthcare Orgn.’s
Ohio Council of Behavioral Healthcare Organizations
Ohio Department of Mental Health
Psychiatric Outpatient Centers of America
Public Relations Society of America
South Summit Chamber of Commerce
State of Ohio Department of Mental Health Facilities
State of Ohio Bureau of Workers’ Compensation
Stow/Monroe Falls Chamber of Commerce
Affiliations
Access, Inc.
Akron Child Guidance Center
Akron General Medical Center
Barberton Citizens Hospital
City of Akron Public Health Department
Community Health Centers
Community Support Services
County of Summit Children Services
Cuyahoga Falls General Hospital
Kent State University
NEOUCOM
Summa Health System
Summit County ADM Board
The University of Akron
Executive Staff
Jerome T. Kraker
Anna Himelrigh
Timothy L. Morgan
Sara Stein, M.D.
Phillip Heislman
Tracy Davis Yaeger, Ph.D.
James A. Crouse
Antonio Montinola, M.D.
Candace Pallante, L.S.W.
Shelly Obert, L.I.S.W.
Bonnie Bricker
Gregory Ford
Steve Sharrock
Cindy Kaminsky
President
Special Assistant to the President
Senior Vice President
Senior Vice President/Medical Director
Vice President - Operations
Vice President - Clinical Operations
Vice President - Marketing
Director - P.E.S.
Director of Operations - P.E.S.
Director of Quality Assurance
Director of C.I.R.S.
Director of Human Resources
Director of Information Systems
Director of Billing Reimbursement
Team Coordinators
Joyce Beck, P.C.C., R.N.C.
Linda Johns Bradley, L.S.W.
Kathy Cockfield, M.S.N.
Judith Corcelli, M.S.N.
Cynthia Seibel Lormor, Ph.D.
James D. Mullen, Ph.D.
Avery Zook, Ph.D.
Intensive Treatment Services
Admissions Team
North Summit Clinic
Akron Clinic Team A
Akron Clinic Team C
Akron Clinic Team B
Barberton Clinic
portage path
behavioral health
340 SOUTH BROADWAY STREET • AKRON, OH 44308
Non-Profit
U.S. Postage
PAID
Akron, Ohio
Permit #178
WWW.PORTAGEPATH.ORG
OUR MISSION
is to provide outpatient,
inpatient, emergency, and
specialized behavioral health
services to individuals
and other purchasers in the
Northeast Ohio region.
Our services are shaped
by the needs of our
various clientele, and are
accessible, affordable,
and of the highest quality.
AKRON OUTPATIENT CLINIC
BARBERTON OUTPATIENT CLINIC
340 S. BROADWAY ST.
AKRON, OHIO 44308
330-253-3100
105 FIFTH ST. SE, SUITE 6
BARBERTON, OHIO 44203
330-745-0081
NORTH SUMMIT OUTPATIENT CLINIC
PSYCHIATRIC EMERGENCY SERVICES
792 GRAHAM RD., SUITE C
CUYAHOGA FALLS, OHIO 44221
330-928-2324
10 PENFIELD AVE.
AKRON, OHIO 44310
330-762-6110