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Uniting to support integrated care

July 1, 2008
by Alan Mabry, PhD
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Three Cincinnati agencies merge to achieve this goal

Centerpoint Health, a comprehensive behavioral healthcare agency in Cincinnati, Ohio, was incorporated in January after months of preparation. The agency was formed through the consolidation of three Greater Cincinnati mental health agencies: Center for Children and Families (CCF), Core Behavioral Health Centers, and NORCEN Behavioral Health Systems.

Each agency had been a specialty service organization: Core provided adult case management and adult outpatient services; CCF focused on child outpatient care with limited child case management services; and NORCEN provided adult outpatient programming. This model had been forcing consumers and families, who often had limited resources, to navigate systemic barriers while still not receiving integrated treatment planning. The merger was an opportunity to improve consumer access, integrate care, and reduce administrative costs. Centerpoint Health marks a return to comprehensive, neighborhood-based centers serving clients where they live and work.

Early Affiliation

The founding agencies were formed in the 1970s as part of the federal community mental health center initiative. In the early 1990s, Hamilton County's mental health system was reorganized to have specialized service providers, which moved service delivery away from the comprehensive model.

The road to consolidation truly began in the late 1990s, when CCF, Core, and NORCEN started to combine backroom operations through affiliation agreements with Talbert House, a community-wide nonprofit social services network in Greater Cincinnati. Talbert House, opened in 1965 as a halfway house, provides programs in community corrections, mental health, substance abuse, and welfare-to-work. Under the “affiliation model” each agency had a separate 501(c)3 status, budget, and board of trustees.

This model created a network of services for the region and reduced administrative costs, with Talbert House offering finance, human resources, information technology, and development services to the three agencies. Merging the backroom operations increased economies of scale for all four agencies. For example, the group purchased a computerized clinical records system with integrated billing services that none of the organizations would have been able to afford independently.

Merger Support

According to the Scripps Howard Center for Civic Engagement and Nonprofit Development at Northern Kentucky University, Greater Cincinnati nonprofits have been growing rapidly, with one in five being established since 2000. As a result, The United Way of Greater Cincinnati and Hamilton County Board of Commissioners encouraged nonprofits to merge to maximize dwindling community resources. The Hamilton County Mental Health and Recovery Services Board, the agencies' main funding source, also had a financial incentive to encourage mergers, as consolidation would provide significant indirect savings by eliminating multiple contracting and oversight costs.

Each agency's board debated the pros and cons of consolidation, focusing on issues such as better access to funding, loss of community identity, and corporate structure. To facilitate a decision, the agencies created an ad hoc committee comprised of three board members from each agency. After careful review, the committee recommended consolidation of the affiliate agencies. The three agency boards independently debated the merits of consolidation and voted separately in September 2007 to approve the merger, effective January 1, 2008. The Talbert House board then ratified the decision, strengthening the affiliation structure with this new consolidated agency while allowing for future partnerships.

To oversee the restructuring and to identify ways to improve productivity, a consultant specializing in work-flow management was hired in June 2007. Also, an internal redesign team comprised of staff from various job classifications was established, and several suggestions from the team were implemented, including establishing a lead financial support position, refining documentation practices at each office, and creating a central intake department to assign and schedule all new referrals into the organization.

It became clear that five of Talbert House's mental health programs would be better aligned with Centerpoint, since the new agency would be specializing in integrated mental health programs. The programs merged into Centerpoint included a 24-hour crisis hotline, prevention services, substance abuse/mental illness case management, victims' services, and early childhood intervention.

Centerpoint Health founding agencies*

*Data for FY 2007

Year founded

1971

1973

1973

Location

North Central Hamilton County, Ohio

East Hamilton County, Ohio

Western Hamilton County, Ohio

Number of employees

40

70

104

Number of clients/year

584

2,400

2,900

Number of programs

5

6

6

Gross revenue

$2 million

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