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Curriculum Center Browse Bibliography Build EPacket Pricing Structure Distribution Process Management Control in Nonprofit Organizations
 
South Central Mental Health Association
Author(s):
Charns, Martin P.
Young, David W.
Functional Area(s):
   Management Control Systems
   Organizational Behavior
Setting(s):
   Healthcare Management
Difficulty Level: Intermediate
Pages: 9
Teaching Note: Available. 
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First Page and the Assignment Questions:
We’ve met most of the administration’s objectives for the MIS [management information system] and have made some progress in addressing the clinicians’ dissatisfaction, but it has been slow and time-consuming. However, it’s very clear to all of us that the long-range success of the MIS depends on its ability to meet the needs of clinical personnel, as well as those of central administration. I’m not quite sure why the clinicians are so dissatisfied, but too many are.

Charles Fowler, Director of Planning and Evaluation of the South Central Mental Health Association (SCMHA), was responsible for the development and implementation of the association’s management information system. Since the inception of the MIS several years earlier, he had worked with personnel at all levels of the organization in attempting to adapt it to their needs. The system had proven itself to be a useful tool for billing and government reporting purposes, but problems existed in its application to clinical work and program planning. He continued:

Some staff complain that the MIS is being used to demand unreasonable levels of productivity. Others protest that too little emphasis is placed on non-billable activities affecting the quality of patient care. Still others object to the use of the MIS on philosophical grounds, and question the reliability and usefulness of the information it produces. While I’m aware of these complaints and want to remedy the problems related to clinical management and use of the MIS, I’m not sure exactly how to proceed.

BACKGROUND

SCMHA was a mental health service delivery network serving the South Central Area of Los Angeles. It had evolved from the South Central Child Guidance Clinic, which began operations in East Los Angeles in 1996. It operated four outpatient counseling centers and other mental health agencies serving the East Los Angeles, Monrovia, El Monte, and Watts areas. Each served populations of 13,000 to 60,000 people with clinical staffs ranging from 16 to 28 full-time equivalents (FTEs) and administrative and support staffs ranging from 3 to 5 FTEs.

The populations of two of these areas were predominantly African American and of low socioeconomic level and had recently absorbed a large influx of transients. The population served by the third clinic was characterized by a high degree of unemployment, poverty, and social distress. Fifteen to 20 percent of its residents were Hispanic, and the center offered special programs to them. A large number of young transients and deinstitutionalized chronic mental patients inhabited the fourth clinic’s service area.

Besides the four counseling centers, there were three day-treatment programs, an emergency services program, and several residential programs. Although the Los Angeles Department of Mental Health (LADMH) funded most of its clinical positions under a partnership agreement, SCMHA hired its own administrative and support staff. All staff were employed on a salaried basis, and no direct billing was done by clinical personnel at the centers. The Director of Clinical Services, Dr. Deanna Chopra, supervised all clinical activities. The SCMHA central administrative office had final authority in all financial, operational, and personnel matters. In practice, however, most of this responsibility was delegated to administrative coordinators at the operating units. An organizational chart is contained in Exhibit 1.

As a part of its contractual arrangements, SCMHA was obligated to report on its activities to LADMH personnel who oversaw the delivery of mental health services in the Greater Los . . .

Assignment

  1. What are the problems that Mr. Fowler faces?
  2. What steps should he take, and in what sequence should he take them to address these problems?