Circles of Care August 2007

1. Circles of Care August 2007 Feasibility Assessment: Using Resources Wisely Joan O’Connell, PhD Circles of Care Evaluation Technical Assistance Center American Indian and Alaska Native Programs University of Colorado at Denver and Health Sciences Center

2. Feasibility Assessment Specific Components I. Model Description II. Needs Assessment III. Human Resources/Other Inputs Analysis IV. Management Analysis V. Financial Analysis VI. Economic Analysis

3. I. Model Description Target Population Definition of SEBD Number of youth and location How they are identified? Model for a System of Care Programs Elements/Services New program elements Modification of an existing program(s) Add elements Expand existing services

4. Using Resources Wisely • Financial Analysis: Is the program practical and fiscally sound? Is the program sustainable? • Economic Analysis: Does this program providing value when compared to other programs? • Why Conduct Both Types of Analyses?

5. Using Resources Wisely • Obtain support for the proposed program. • Promote discussions of financial sustainability • Resources are limited and resources could be used for other valuable programs.

6. V. Financial Analysis - Questions 1. How are program resources utilized? 2. Are there sufficient resources to meet the needs of the target population? 3. How does the average program cost per child served compare to costs of other health programs?

7. V. Financial Analysis - Questions 4. How do program costs change overtime? 5. Is the program fiscally sound? Do program revenues cover program costs? 6. How do program revenues change overtime? Is the program sustainable?

8. Building Space Outdoor Space Office Supplies Program Supplies Computers, Software Utilities Travel Training Human Resources People with human service knowledge and skills People with cultural knowledge and skills People with compassion & people skills Financial Analysis – Resource Needs

9. Financial Analysis – Resource Allocation

10. Financial Analysis – Human Resources

11. Financial Analysis Staff per Youth Served

12. Financial AnalysisEstimated Costs per Child Served

13. Financial AnalysisEstimated Costs per Visit

14. Financial AnalysisProgram Phases Planning Planning or pre-implementation phase Year 1: May include a start-up or pilot phase Ongoing: Years 2-4 Year 1 Ongoing

15. Financial Analysis Planning The planning or pre-implementation phase includes: Recruit and train staff Data collection Develop relationships other organizations (in-kind support) Establish revenue sources Year 1 Ongoing

16. Financial Analysis - SpendingPre-implementation Phase Planning Year 1 Ongoing List services and items provided by sponsors, etc. to quantify the amount of matching funds.

17. Financial Analysis Planning The planning or pre-implementation phase questions: Are there sufficient resources for the proposed work? Are the cost estimates (or value of donations/in-kind support) correct? Year 1 Ongoing

18. Financial Analysis Planning Other questions: Are sufficient resources allocated to staff recruitment and training? Are sufficient resources allocated to youth identification and assessment? Year 1 Ongoing

19. Financial Analysis - Revenue Pre-implementation Phase Planning Year 1 Ongoing List services and items provided by sponsors, etc. to quantify the amount of matching funds.

20. Financial Analysis – Year 1Spending Planning • Services are provided. • Provision of services may be limited: • A pilot or start-up phase may serve fewer patients or provide limited services • Staff planning and training time may be greater during the first year Year 1 Ongoing

21. Financial AnalysisOngoing Phase: Year 1 Program Costs = Revenues Salaries Grants Supplies Reimbursement Utilities Matching funds Travel Service fees Training Is the Program Fiscally Sound?

22. Financial Analysis – Year 1Revenue Planning There may be several sources. Some revenue sources may depend upon the volume of services. With a pilot project and the provision of fewer services, revenues may differ from program operation during later years. Example: Medicaid funds home visits and travel costs but only if service is provided. Year 1 Ongoing

23. Financial AnalysisOngoing Phase: Years 2-4 Planning • Service provision increases. • Additional staff are hired to provide services • Expenditures increase with the increase in services • Service revenues increase • How do expenses and revenue change overtime? Year 1 Ongoing

24. Financial AnalysisOngoing Phase: Years 2-4 Costs:?Office space (rent, mortgage)  Salaries and training  Utilities, supplies, travel  Program operations Revenues: Grants  Sponsor donations, in-kind support  Revenue from service fees Planning Year 1 Ongoing

25. Financial AnalysisOngoing Operational Phase: Years 2-4 • The best time to answer questions: • How does the average cost per service compare to service fees and reimbursement? • How does the average cost per child served compare to alternative programs such as residential treatment programs? Planning Year 1 Ongoing

26. Financial AnalysisGrantee Work Session Goal: To identify human resource needs for the program component(s) addressed in the feasibility assessment - service provision only Group: Grantee community Time: 30 minutes Report Back: approximately 5 minutes each on Wednesday morning