Community Support Services Techology Utilization

Community Support Services, Inc. is a provider of behavioral healthcare in Summit County, Ohio.  In the 2008 calendar year, 240 staff provided over 300,000 services to over 6,000 consumers.  As a community-based agency providing services to individuals with a combination of severe mental illness, substance abuse disorders, homelessness, and unemployment, many of the services are provided where the consumer resides instead of the requiring individuals served to come to agency facilities.  Technology enables the agency staff to gain access to consumer information and community resources, capture service delivery information, and schedule future services while in the community.  Through this service delivery model, staff is better able to support consumer recovery opportunities as well as collaborate with other providers in the community.

Central to technology utilization has been the development and implementation of a consumer information database.  Developed in-house using Visual Studio programming tools and MS SQL Server databases, the consumer electronic record is available via a web-browser accessible on any computer in the agency.  Data in the client database can be uploaded into Pocket PCs and laptops so that staff has the information necessary to provide services.  Information captured on the Pocket PCs and laptops can be downloaded back to the consumer information database to update existing information.

Consumers receiving services from the agency also benefit from the use of technology.  Community Support Services is the representative payee for over 700 individuals.  In this role, the agency is responsible for ensuring that a consumer’s basic housing, utility, food, and clothing expenses are met. The Payeeship program utilizes General Dynamics - Great Plains software to manage the payeeship accounts.  Staff and consumers leverage a web-based interactive application that teaches consumers how to budget so that necessary expenses are paid and discretionary income is available.  Anytime an individual electronic budget is changed, payeeship department staff are notified and provided with reports so that consumer accounts are updated in a timely manner. This application replaced an error-prone paper-based process that required significant staff time to complete before it was forwarded to the payeeship department for additional processing. 

Collaboration between CSS and US Bank resulted in each individual in the payeeship program receiving a debit card.  Through ACH processes each individual has immediate access to budgeted monies.  Consumers no longer experience problems with cashing checks in the community.  Implementation of this program resulted in a 50% decrease in the number of checks written to consumers and a 95% decrease in lost or stolen checks.  Consumers can quickly receive reports of funds disbursement through a direct link between the consumer information database and the payeeship accounting system.

Consumers seeking employment use computer labs in the agency to obtain job bank information, develop resumes, practice interviewing skills, and communicate with prospective employers.  Consumers can also use the computer labs to enhance their own computer skills and knowledge.

Individuals with severe mental illness die on average 20 years earlier than the general population in the United States, often due to an inability to access physical health care and complex medical issues.  With operations beginning in November 2008, CSS opened a primary care clinic to provide consumers with access to physical health care within the mental health facility.  This clinic involves collaboration between the Margaret Clark Morgan Foundation, the Northeast Ohio Universities College of Medicine and Pharmacy, the University of Akron, Kleins Pharmacy, Summa Health Systems, and numerous state agencies.  Additionally, the primary payer for medical services, Buckeye Health Plan, is collaborating with CSS to determine how to best provide preventative care to a group of individuals who typically utilize expensive hospital emergency rooms for health care services.  Through technology, we are able to coordinate mental health care with physical health care via a shared electronic medical record system.  Data exchange between the collaborators is designed to ensure that the consumer is receiving the most appropriate care in the most appropriate setting.  With the implementation of this clinic, some consumers are obtaining their first medical care in 10 years and more.

As all data systems run on MS SQL Server, data from multiple systems and sources can be combined to provide detailed management reports. Reporting from all information systems is accomplished via Crystal Reports and MS Access. Many reports are available on demand through a web interface while other reports are emailed directly to staff to assist them in caseload management. 

With service delivery captured electronically, billing information is extracted from the service documentation and processed into the billing systems without a manual re-entry process.  Service coding validation rules and error reporting ensure that service coding is accurate when it enters the billing systems.  Development and implementation of these processes resulted in a decrease in data entry error from 15 incidents per 1000 entries to less than 1 incident per 5000 entries.  Staff time previously used for data entry and service coding review has been reallocated to billing and payment research. 

Community Support Services recognizes the importance of technology as a means to accomplishing the mission of the organization, especially in an era of increasingly limited resources.  Where many processes required movement of paper from one location to another and manual re-entry of data, capturing and processing information electronically has resulted in better management of staff time and services, easier access to information, and quicker identification of consumers most in need of services.