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Firm Specialization

With offices in Atlanta, Georgia; Chicago, Illinois; and San Antonio, Texas, and St. Louis, Missouri; CR brings a fresh consulting methodology to critical local issues such as healthcare delivery systems and issues related to poverty. HIV/AIDS, Mental Health, Substance Abuse, and Maternal/Child health are topics that resonate with our client base. Our extensive knowledge in community health and social services planning, administration, healthcare finance and reimbursement, grant-writing, and not-for-profit operations, our clients are positioned to better serve those who matter most: their clients. CR delivers problem-solving skills while outlining clearly defined courses of action.

Quality Management Proficiencies

CR has a wealth of experience gathering data and presenting it to all audiences that comprise the various stakeholders. Our commitment to our clients is clear: we strive to collect quality data so that our clients can make informed decisions to impact positive health outcomes for impoverished people in their communities. Our intent is to develop long-standing partnerships with the clients we serve. It is our goal to position our clients for the most advantageous funding outcomes possible.

CR is familiar with Federal funding sources (e.g. CDC, HRSA, SAMHSA) and possesses insights and expertise into funding objectives and the mandates to ensure successful implementation and management of such a program at the grantee/provider level.

Specific Quality Management proficiencies include:

  • Developing and refining Standards of Care
  • Quantitative measurement of compliance (standards of care and program monitoring)
  • Ability to determine chart-audited vs. CAREWare/AIRS QM data discerning what are practice vs. documentation issues
  • Benchmarking to national practice
  • Use of QI Storyboards to inform the efforts of providers, consumers and grantee work groups to improve system delivery issues
Health Access Proficiencies

In the turbulent healthcare environment, CR capitalizes on our expertise in research and quality management and transfers it into preserving access to care throughout the communities our clients represent. This is achieved through a solutions-oriented approach focused on strengthening integrated health systems throughout multiple layers.

The guiding principles surrounding Health Access include:

  • Helping clients improve the wellbeing of communities in crisis, through provision of health and public health services, capacity building, and resource enhancement to ensure the delivery of high-quality care, preventative and treatment programs
  • Supporting fiscal and compliance efforts, through expertise in a wide array of funding vessels (federal, state, and private)
  • Leading program management efforts from development through implementation, using a ‘hands on’ approach while ensuring successful outcomes
  • Consistently monitoring and researching new developments on health policy, impacting funding, and service delivery

Specific input for Health Access clients includes:

  • Grant writing
  • Strategic Plan development and facilitation
  • Asset development and refinement
  • Facilitation of integration discussions
PCAN Comprehensive Assessment &
Strategic Planning Orange County, Florida
click to download
Grant Writing, Management, Evaluation

In the competitive healthcare landscape, it is vital for organizations to understand funding opportunities and be responsive to the requirements of funders.

There is a large array of Federal government grants. Federal government grants can be awarded to individual states and city governments as well, each with their own set of requirements and expectations. CR has first hand knowledge and expertise sorting through viable opportunities and helping organizations identify solid opportunities. The team is able to navigate the process from beginning to end:

  • Establishing the funding source: including eligibility and funding match requirements, competitive nature of the opportunity, timelines, proposal review criteria
  • Constructing the proposal: The CR grant writing team becomes an extension of the respective organization in order to capture the full scope of the mission, culture, needs and service delivery model. This is a vital element in developing the highest quality and competitive application to ensure funding is obtained
  • Program implementation: Once the funding has been granted, CR taps into its extensive program implementation and design abilities to assist the organization’s leadership, ensuring that activities outlined through the grant are successfully implemented in a timely manner
  • Evaluation and reporting: Program milestones are established through the quality assurance component of the program and/or funding source. CR’s quality assurance experts ensure that all requirements and expectations are successfully achieved and reported on to the funders and stakeholders, including consumers and board of directors

In addition to grants management services, CR understands the need, the time restrictions and limitations of funders. The team works closely with its clients to explore opportunities to maximize resources and build sustainable program models.

CR on grant writing, management and evaluation

  • CR has successfully assisted health access networks throughout the nation with review of effective programs and services in light of state and national healthcare reform
  • CR obtained a Planning Grant from Kresge Foundation, with the Health Policy Division of the Cleveland Clinic, to develop community input for Social Determinants of Health for the City of East Cleveland. CR facilitated this 9-month planning grant after assisting the client in obtaining one of 12 awards (out of 180 applicants). The results of that 9-month planning grant enabled their client, the Cleveland Clinic Foundation, to achieve the top rated score of the final seven implementation grants awarded for a three-year period
  • CR researched Social Determinants of Health in the City of East Cleveland then replicated a Social Health System Model to other cities in Cleveland
  • CR developed three (3) continuation grants for Outpatient Ambulatory Medical Care, Mental Health and Oral Health for a large organization dedicated to serving the medical needs of homeless and residents of publicly subsidized housing in Cleveland
  • CR developed a national research and development grant (Special Projects of National Significance or ‘SPNS’) receiving a score of 95 out of 100 to successfully procure $400,000 a year over 4 years
  • CR supported a large Northeast Prevention Consortium to develop a peer adolescent outreach. This client obtained $500,000 per year for a five-year period
  • CR assisted a free clinic develop a grant for financial relief from malpractice for physicians, dentists and dental hygienists, providing free care
SPNS Award Article - Ohio
click to download
SAMHSA Grant Press Release
click to download
Ryan White HIV/AIDS Services

The Ryan White Act is a Federally funded HIV/AIDS Program designed to provide HIV-related services in the United States for those who do not have sufficient health care coverage or financial resources coping with the HIV disease. The program is intended to fill gaps in care not met by other payers. For nearly ten years, CR has worked in12 cities and 6 county grantees of Ryan White Part A funding, with 4 states that receive Ryan White Part B funding and with 5 direct recipients of funds for medical care under Ryan White Part C. CR supports the Quality Management function and provides Planning Council support. CR has conducted dozens of needs assessment for In Care and Out of Care population. Products of these assessments are client and provider quantitative surveys; qualitative focus groups and presentations that provide grantees with an in-depth view of the services landscape in their respective communities. In addition, CR conducts numerous studies of the newly diagnosed and prepares cost studies by special population to further refine the needs of those disproportionately impacted by the disease.

CR on HIV/AIDS Services

  • Conducted full Needs Assessment of In Care and Out of Care populations
  • Comprehensive Strategic Plan and Needs Assessment
  • Organized & conducted modified RARE (Rapid Assessment Research and Evaluation) study
  • Evaluation of the impact, effectiveness and cost: benefit of a multi-agency intervention funded by the Sylvester Consortium
  • Convened work groups to develop Social Standards of Care including Standards for Housing Separately developed Medical Standards of Care
  • Develop, Assess, Refine & Implement Standards of Care
  • Chart audit of all services with revision to Standards of Care
  • Extensive Planning Council support with conduct of Priorities & Allocations process
  • Creation and refinement of Standards of Care using provider ‘pods’
  • Assess specific service categories including Outpatient/ Ambulatory Medical Care and Oral Health in terms of costs, quality & utilization
  • Quality assurance audit of AIDS Housing providers in Connecticut
  • Extensive Planning Council support with conduct of Priorities & Allocations process
  • Developed integrated epidemiologic profile combining surveillance data with behavioral risk for the State of  Georgia, consisting of 9 regions & 19 districts
Community Planning

While healthcare organizations are in the forefront of community needs and experience first hand the gaps in service delivery, it is imperative to quantify the magnitude of health disparities in a given community. CR works closely with providers, government official, community based organizations, and consumers and/or residents. CR has a proven track record conducting effective needs assessments and feasibility studies with the highest level of data integrity, and providing information to healthcare executives and funders. Effective community planning is an essential element in determining resource allocation for safety net provider networks.

CR on Community Planning

  • Developed the health access initiative for the uninsured and underinsured for small businesses in the City of Los Angeles
  • Conducted a comprehensive rural health and social services needs and resource assessment and health and social services plan for the state of Delaware
  • Developed a Business Plan for a comprehensive and internationally recognized child abuse and neglect program to interface with national, state, and community agencies
  • Conducted a community health needs assessment for a county in northeast Ohio, with comparison of survey results from 1% of adult residents to findings of Healthy People 2010 to the state of Ohio and the United States
  • Facilitated three separate health access and community planning efforts in Cuyahoga County, Ohio:
    1. Access to a Medical Home Initiative – worked with the Office of Health Policy to determine the extent of resident (Cuyahoga County) inappropriate use of local emergency departments for non-urgent chronic medical conditions
    2. Cuyahoga Health Access Partnership – developed an 18 member stakeholder organization dedicated to administratively resolving the issue of health access by adults at or below 200% of the Federal Poverty Level as one result of AMHI
    3. Social Health System Model – facilitated a 9-month planning grant awarded to the Cleveland Clinic Foundation’s Office of Health Policy & Research to develop a system of care using peer navigators in conjunction with social, clinical and behavioral health navigators to allow disenfranchised populations fully access a comprehensive system of care
2005 Community Health Assessment-Lake County, Ohio
click to download
OIMRI Date Needs Assessment report & OIMRI Chart Book-Ohio
click to download
Hospital Strategic Planning

In a business environment where dynamic change is routine, it is imperative to have a strategic plan guiding the institution, and to consistently refine goals to ensure they are in line with this multifaceted and complex industry. Changes in reimbursement rates combined with the burden of providing care to individuals who are uninsured or underinsured contribute to deteriorating hospital financial performance. For over 20 years, our team has effectively led hospital administrators through short and long-term strategic processes that have improved service delivery as well as strengthened financial viability.

CR on Hospital Strategic Planning

  • Vision Process: led senior and middle management group of a mid-size community hospital through workshops and individual interviews to determine their vision with input from community leaders and medical staff
  • Bed demand: determined sizing for pediatric inpatient beds based on market demand
  • Conducted a comprehensive strategic, business and facility plan for a regional children’s hospital including determination of market share (historical and projected for 5 years), financials (overall and by clinical service, payer with 5–year projection), with capital expenditure and development ramifications
  • Pennsylvania Hospital, the nation’s first hospital, worked with Tracy Kulik when considering and then completing their merger with The University of Pennsylvania Health System (UPHS)
  • Developed a Clinical Service Group Structure to rebuild volume and fiscal health with Tracking & Impact Tools to gauge success and implement corrective measures.
  • Determined financial viability and market potential of pediatric specialties resulting in business plan for construction of a new children’s health center.
  • Conducted full strategic plan of a significant Children’s Hospital with review of their clinical, research and education missions.
  • Determined Profitability by specialty analysis, statewide market share forecast & integrated vs. separate  pediatric functions for a large integrated Children’s Hospital.
Executive Summary_CH MCCG
5 Yr Plan-Children's Hospital Central Georgia
click to download
Behavioral Health

CR has significant experience guiding major metropolitan areas (Kansas City, MO & KS, Cleveland, OH); states (Alabama) and disparately impacted groups (the Navajo nation in Fort Defiance Indian Health Branch) through strategic behavioral health needs assessments and operational review of their behavioral health operations.

  • CR assisted two urban entities, a federally qualified health center and a regional behavioral health organization, through a facilitated six-month discussion of their integration options
  • CR conducted a comprehensive review of the operations of the in and outpatient behavioral health services at Fort Defiance Indian Health Branch, the capital of the Navajo nation, as they examined their service offerings and the extent of integration of traditional Navajo healing with Western behavioral health care
  • CR is currently assisting both the State of Alabama, Department of Mental Health and a consortium of providers and funders in Spartanburg, South Carolina with strategic review of their behavioral health continuum from a 360-degree review of consumers, providers and funders
MARC Children's Behavioral Health
Needs Assessments-Kansas City
click to download
Managed Care

Managed care refers to the risk-based reimbursement and delivery models that state, federal and governmental payers currently operate under. CR has extensive experience determining risk exposure and working with health care providers to manage their delivery and service portfolio given their financial reimbursement. In addition, increased demand for accountability including development of accountable care organizations has emerged as payers blend financing with achievement of quality results.

CR on managed care

  • Developed reimbursement, service definitions and enabling legislation for six of the eight initial Medicare+ CHOICE pilot programs (Medicare risk)
  • Drafted enabling legislation for State Children’s Health Insurance Programs (SCHIP) for the states of Arkansas, Georgia and Kentucky
  • Developed strategy for major Academic Medical Center in the Northeast for Medicaid reimbursement on risk basis
  • Conducted Business Review of the Managed Care portfolio of specific Academic Medical departments
  • Crafted the operational response of a major Academic Medical Center’s Faculty Practice Plan to a Medicare+Choice, demonstration site and a Medicaid Options (voluntary risk) product
  • Negotiated allocation of the capitation payment between the Medical Center and Foundation and within the Faculty Practice Plan Foundation
  • Received Certificate of Authority (HMO License) within record 9 months in the State of Georgia (vs. average 15 months)
  • Conducted twelve focus groups in creation of the HMO
    • Corporate Leaders
    • Large Employers (300+)
    • Medium Employers (51-299)
    • Small Employers (under 50)
Executive Summary_CH MCCG
5 YR Plan Children's Hospital Central Georgia
click to download