2024?!?!?!?

Dear Imagine friends and family,

We had a wonderful and challenging December to cap our wonderful, challenging 2023. Looking forward, we are hoping for a wonderful and challenging 2024 with some different wonders and fresher challenges.

Everyone who reads and believes the sincerity of this newsletter (and thank you and bless you) will know that after their heroism and great effort during the pandemic, Imagine set out to make 2023 the year of the caregiver. We are here for the people we serve and the direct caregivers focus on our clients. We wanted the leadership to focus in 2023 on the care we give to them, validating their work and our appreciation of it through better compensation, more attention to their professional development, faster and more effective attention to their concerns and a more supportive agency environment.

We will continue to work, especially around building better communication between teams, more training opportunity and responding more quickly and effectively to concerns and ideas that arise, but we had a pretty successful year. In 2023, our base wage for awake shifts rose 12%, leaving them, by September nearly 25% above where they had been 18 months earlier. We also built in premiums for more experienced direct care staff, those accepting less desirable shifts and some of those serving clients with especially intensive needs. About 10% of our caregivers are now paid similarly to certified technicians in the healthcare industry.

We also renormalized old standards which had deteriorated in recent years, including those that supported staff development, healthy team dynamics and better communication among stakeholders. As examples, our training budget has grown and is being used more fully than in the recent past and regular, monthly house meetings including training and person-centered thinking have returned to most teams. We believe that nurturing our caregivers is the best way Imagine can create the conditions for our clients' success against their individual challenges.

In the process of improving conditions for caregivers, we quickly found that facilitation was breaking down. An example of that breakdown is that annual evaluations, a long-standing standard, were one of our failures. Nobody can do caregivers evaluations but the Facilitators who observe the caregivers directly and we failed pretty thoroughly last year in this regard. For evaluations to go reliably and equitably forward, it is necessary for our Facilitators to have time to thoughtfully work with caregivers on how they can improve their work for those we serve.

So we have, throughout 2023 been working to better support our Facilitators as well. Facilitators have much higher turnover than our caregivers in recent years, although previously they were some of our more stable employees. As we set out to implement our improvements to caregiver lives, we kept bumping into exhaustion and burnout among even newer and younger Facilitators.

One result was in our Year of The Caregiver, we put a lot of work and thought into systematically improving facilitation at Imagine. In 2024, our next focus, as a means of better supporting our clients, is a Year of Facilitation.

We also want to welcome two new members of our leadership team: Lia Vargas is our newest Facilitator and Maggie Amezcua is our new Administrative Assistant. Please welcome them, as they are great people and we're glad to share our mission with them.

Just below this column is a fuller explanation of where we see ourselves now, what we did in 2023 in an effort to improve, how we analyze the opportunity to improve and the efforts we plan for 2024. Here is a trigger alert for especially parents of our clients: Caseloads are growing, not shrinking in the near term. I hope you will give us a fair reading and I welcome your input, including outrage.

Further down, this month's newsletter includes the following:.

Patty Lopez, welcomes you into the new year and wishes you well.

In The Service Sector this month, Lead Facilitator Stephanie introduces you to her role.

It's important to and for the Person-Centered Evolution column to talk this month off.

In Community Connections, big news. We think we have found a leader for the group for 2024.

Our usual stuff in the columns around advocacy, self-determination and Transparency.

This month we have spotlights on Wendy and Nate, who is going to be his own employer of his staff through self-determination in 2024.

As ever, I am at your service. If you have any questions, feedback or concerns, please don't hesitate to get in touch. You can write me here. I look forward to hearing from you.

Gratefully yours,

Doug

The Year of The Facilitator

Sincere Holiday Greetings to you all;

As many of you recall, 2022 ended for Imagine without a Director of Services and, after a hard good faith effort to hire a replacement, I formally assumed supervision of the Facilitators with a lot of support from Patty, Imagine's Assistant Director. We quickly recognized that stress and organizational challenges were making work hard for Facilitators and submitting the goals and mission of the organization as well as the security and support of our clients to risk and damage.

Our response started with "Facilitator Support Plans," which were essentially a do-over of the Facilitators' evaluations with an emphasis on strengths, challenges and how Imagine's Executive and Administrative teams could better provide both accountability and support. A lot of our efforts to improve the proactive person-centeredness of our services, the work environment for our caregivers and communication with caregivers all suffered because Facilitators were overwhelmed. Our ability to make things better was challenged when we lost three Facilitators in the first half of 2023, who of whom had only spent a year in the role. Six is how many we have.

In June we surveyed our Facilitators about the hardest parts of the job and based on the collective input, we tried to systematically address both the pain points and to provide accountability, particularly on those areas of the job where failure had substantial impact on the development and/or deterioration of strong, effective, caring circles of support. We used some funds budgeted for the Director of Services to respond.

We created a temporary Lead Facilitator position with the purpose of doing for the Facilitators as a group some of those activities that cause stress individually. The Lead Facilitator manages the Client Care Responders (CCRs) who provide coverage when caregivers are sparse or ill; provides training and help to Facilitators and Lead Staff especially around individual service needs and planning; and audits house meetings and the use of Person-Centered Thinking tools. Stephanie is our Lead Facilitator.

We also temporarily enhanced our Book-keeping position to make it an Operations Manager position. In addition to the book-keeping, the Operations Manager also audits Facilitators records to make sure quarterlies and annuals are produced, kept and available; the Operations manager also insures that client financial records are kept well, accurately and up-to-date. Heather is our Operations Manager.

Additionally, Patty and Jen took on new roles. Patty now supervises our hourly administrative staff which frees me up to better support Facilitators and Jen has taken the responsibility of helping caregivers and facilitators get through payroll entries. Finally, using finds allocated for a Director of Services, we added an additional CCR to help Facilitators with coverage.

Our recruiter's position was enhanced to better provide for training needs and a new part-time recruiter was brought in to make sure that hiring continues in a way that prevents big gaps in coverage, which are an often-cited and pretty obvious source of Facilitator burnout.

It is very important to remember that all of our current and recent facilitators inherited caseloads where the practices that build stability and security and create the foundation for person-centered care were in many cases very far behind. Some of this is due to the impact of COVID on previous Facilitators. We can't and don't simply expect Facilitators to catch up and build great teams without substantial support. All of the 2023 changes will need time to make it easier to be a better Facilitator. But we take it as an important indicator that since changing the system in 2023, two more Facilitators have resigned after a year or less. Happily, both of these are staying with Imagine in other roles.

In describing where we are going, I want to share what now feels like the central insight: Excellence in care, robust teams, good communication, efficiency and the prevention of personal and staffing crisis are all the product of good, regular and routine upkeep of relationships, documentation, responsiveness and planning. The primary obstacle to each of these are the overwhelming needs that can be created by big things and small. (As an example of big, a client's health event. As an example of small, try a change in staffing.) Our current thinking is built around this idea: that keeping the quality of our care high and the condition of our facilitators spry requires us to address acute problems as a team so that the facilitators experiencing them can continue to build their teams through a close and consistent presence.

Here is a secondary math equation: The difference the number of clients makes is smaller than the impact of creeping chaos. As an illustration, a Facilitator with 6 clients who needs half their time to spend on maintenance efforts and can spend the rest being meaningfully present with each team, has three and a third hours per team available. One with 4 clients has five hours. Speaking from where I am sitting, the problem of not enough time for Facilitators to spend with each client seems less detrimental than the fact that current Facilitators addressing coverage issues and crises generally spend all their time on one or two teams and have trouble maintaining their involvement with other teams or even working proactively with the clients getting all their time.

So looking forward, we are working to develop a better, sustainable system for making sure our Facilitators can support teams that enrich client lives in a person-centered way without burning out or failing. A first look at our ideas will be presented to the board at the February meeting for inclusion in the development of next fiscal year's budget.

In the meanwhile, we are piloting our favorite current idea. We want there to be one Supporting Facilitator set aside with a small (or no) caseload of their own, but who understands the clients and the position well enough to join facilitators dwelling in a chaotic abyss. The goal is to make sure that each Facilitator is able to see all of their clients and participate meaningfully in their care and teams, to respond to everyone and to improve person-centered services even when a key staff has departed or a client needs new or different care.

In the current fiscal year, we don't have funds for new Facilitator positions, but we can make an experiment cost neutral by increasing the caseloads of every other SLS Facilitator by one and leaving another Facilitator with responsibilities for fewer clients but more for colleagues, clients and stakeholders. If this makes a difference, Imagine's finances permit and the board approves, we can return caseloads to their present size and keep the Supporting Facilitator role in the new fiscal year.

OK, let me have it.

-Submitted by Doug