We recently sat down with Maggie Labarta, Founder and Consultant at Impact Non-profit Consulting. Maggie is a veteran of the human services industry and has extensive experience both on the front lines as a clinical psychologist and on the management side as a program director and CEO of various human services organizations. In this Five Question Friday session, we take a look at how far the human services industry has come over the years, what organizations are currently struggling with the most, and where organizations are heading in the future.
1. You have a very impressive background, including a PhD in Clinical and Community Psychology, and you were previously the CEO of Meridian Behavioral Healthcare for 20 years. Now, you’re offering strategic planning and consulting services through Impact Non-profit Consulting, a company you founded. Can you tell us about the services you offer and your goals for the company?
Thanks – when I was planning for retirement, I thought about the things that I was passionate about as a CEO and that in talking with other non-profits were often a struggle. Typically, organizations – especially smaller non-profits – are created to perform a certain set of actions or respond to certain specific circumstances. Boards are often formed to oversee those activities. While that gets things off the ground, without a strategic plan, things can easily go off the rails. So, among the things I do the most is help with planning processes: mission and vision clarification, defining values, and then using those to test future initiatives and evaluate current programming. I use a basic framework that helps clarify and develop a formal plan – one that hopefully won’t sit on a shelf until the next plan is “due.” Sometimes that involves starting from scratch and having others help re-vamp and update a plan that has been sitting.
The other area that I consult on is analytics. I believe we have to measure what we decide is important – the decision process comes first. Many non-profits are not measurement oriented; they haven’t created a dashboard of key indicators or a set of data that everyone trusts and relies on, especially data that is in real time and can help address problems as they emerge, not months later once they have damaged operations or the bottom line. So, I help organizations define their key indicators, and create metrics within their existing resources.
2. When consulting with human services organizations, have you noticed a common theme in what they tend to struggle with? Or what do you wish more human services organizations knew?
By far the most common is information management. Most human services organizations run on razor-thin margins. It does not take much to generate losses. And yet, many don’t know what it costs to deliver the different services they offer. Or how much service a single staff person should deliver to cover their direct and indirect costs. Or how to make things more efficient by changing some of those variables.
As funding has become more value-based and outcomes as well as efficiency become critical to negotiating contracts that result in a positive bottom line for the organization, this kind of information is critical. In health care it was defined by the “Triple Aim”: Better outcomes, better patient engagement, lower cost of care. All of that requires metrics. And now the IHI (Institute for Health Improvement) has added a fourth aim related to staff engagement, which also leads to needing consistent metrics.
3. The human services industry has come a long way over the years, as you’ve seen and experienced first-hand. Looking back, what do you see as the greatest accomplishment or the biggest “win” for the industry over the past 20 years or so?
I think the growing recognition that much of the effectiveness of health care lies in addressing social determinants has huge implications for all sorts of human service entities. Many are able to partner with health systems to drive the goals set in the now Quadruple Aim. Likewise, criminal justice reform can only be effective if services related to housing, substance use disorders, mental illnesses, and racial equity/diversity initiatives are effective. We have seen excellent outcomes when social determinants are addressed, and human services organizations can take advantage of these efforts to grow their services and collective impact.
4. You’ve mentioned previously that lower than average reimbursement rates often leave human services organizations operating on razor-thin margins. What strategies have you employed to balance on that tight rope? Are there any key metrics or specific indicators you think organizations need to keep a keen eye on?
I do think there are things that can be done – all while also advocating for fair reimbursement rates that provide a living wage for the service providers and cover all the additional costs organizations must bear. In health care, for example, reimbursement rates for behavioral health run 20% behind those for general health care. Strategies need to be on several fronts, some more easily said than done.
First, I’d say know your business – what is a fair service volume to require? What does every kind of service cost? Which services yield the best outcomes and lowest cost to deliver? For example, group therapy has been shown to be as good or better in most instances than individual; it is also significantly lower cost.
Second, look to broaden offerings – all while not straying too far from the organization’s traditional wheelhouse if “investment” capital for new initiatives is short.
Third, look to diversify payer mix. This can be challenging, especially since human services’ funding is largely driven by government dollars or philanthropic gifts.
5. Looking ahead, is there something in particular you see as the single greatest challenge for human services organizations going forward?
I think there are two: the growing role of technology, which the COVID pandemic has accelerated, and the increasing pressure on organizations to demonstrate value – that is, to show what you have achieved, for whom, and at what cost. Human services organizations are challenged to be able to invest in technology. But, when they do, it enables a re-thinking about:
- Facility needs, as workers use telecommuting and tech-enabled service delivery platforms
- Staffing needs, if therapists become more like coaches and treatment can be more self-directed through computer-assisted platforms for therapy and wellness maintenance
Demonstrating value is a challenge because the impact of human services can usually only be measured indirectly. Often, we rely on proxy measures such as community tenure, lack of hospitalizations, or criminal justice recidivism. The impacts of prevention services are often not felt until years after the intervention. So, we need to develop measures that more closely approximate the thing we are trying to address and then measure routinely.
Applying these Insights at Your Organization
We’d like to thank Maggie for her insights during this Five Question Friday. If your human services organization is looking for assistance starting up or creating a strategic plan for the future, we encourage you to get in touch with Maggie Labarta at email@example.com and tap into her expertise through Impact Non-profit Consulting.
DATIS provides a unified HR and Payroll software solution that’s purpose-built for human services organizations. Our software can help address many of the metrics and technology enablement challenges that Maggie discussed throughout this session. If you’d like to learn more about how our HR and Payroll software can help your organization better achieve its mission, contact us today to see our solution in action.