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Deficit spending among nonprofits in the San Francisco Bay area rose from 29% in 2000 to 51% in 2003, according to results of a study by the Stanford Project on the Evolution of Nonprofits (SPEN), sponsored by the Center for Social Innovation. Study results were based on interviews of a representative sample of 200 nonprofit leaders from the autumn of 2003 to the spring of 2005.

More likely than other nonprofits to report an operating deficit were hospitals and nonprofits providing human services. For example, in 2000, 39% of hospitals, and 26% of human-service nonprofits reported operating deficits, while only 13% of religious nonprofit organizations and 11% of environmental organizations did (p.20).

Among nonprofit leaders, 89% reported a decline in funding even while many confronted an increased need for the services their organizations provide. The 2001 economic downturn was cited by many nonprofit leaders as a critical turning point in their financial stability. To adapt to declining revenues, many organizations responded with strategic initiatives to diversify revenue sources, and modify their procurement and deployment of resources. These strategies, however, require cash and time to implement, and their benefits are neither immediate nor certain. Only 15% of the nonprofit organizations had an endowment.

The extent to which the study findings can be generalized to nonprofits in northeast Ohio is uncertain, and we are not aware of any similar study of nonprofit organizations in the greater Cleveland area. The nonprofit organizations studied in the San Francisco Bay area were similar to those in the overall U.S.A. in terms of size, median assets, and age. What the study highlights are the risks that nonprofit organizations have faced in the first half of this decade, and the disproportionate burdens faced by hospitals and organizations providing health and human services.

References

Gammal, D.L., Simard, C., Hwang, H., & Powell, W.W. (2005, August). Managing through challenges: A profile of San Francisco Bay area nonprofits. Stanford, CA: Stanford Graduate School of Business, Center for Social Innovation. Download the report, a 69-page, 521kb PDF.

Responding to uncertainty: Nonprofits and the economic downturn. Center for Social Innovation Newsletter, Volume 2, Spring 2007, p. 7. Stanford, CA: Stanford Graduate School of Business.

Hospitals in Ohio and Michigan earned more places than hospitals of any other states in Solucient's 100 Top Hospitals National Benchmarks for Success program for 2006. Solucient, an information products company, says it maintains "the nation's largest healthcare database." Fourteeen hospitals in Ohio, and 16 in Michigan were among "hospitals that achieve the highest scores in the nation on a set of measures that, together, represent superior organization-wide performance."

There were 2,834 U.S. hospitals in the final study group. Although speciality hospitals, including psychiatric and substance-use treatment hospitals, were excluded from this group, many of the top hospitals have inpatient mental health and substance-use treatment units. Among the nation's top 15 "major teaching hospitals" for 2006 was University Hospitals Case Medical Center in Cleveland, Ohio. (Among the most-consistent winners in this category during the six years of the National Benchmarks program was the Cleveland Clinic Foundation.) Among the nation's top 25 "teaching hospitals" for 2006 were Fairview Hospital and Hillcrest Hospital, both part of the Cleveland Clinic Health System. Of the nation's top 20 "medium community hospitals" was Southwest General Health Center in Middleburg Heights, Ohio, part of the University Hospitals Health System. Because of its role in providing 24/7 mobile crisis intervention services for adults and children in Cuyahoga County, Ohio, MHS maintains affiliation agreements with these and other area hospitals in order to better coordinate services with their emergency and psychiatric departments.

Measures of clinical excellence that were used in the evaluation of hospitals included the risk-adjusted mortality index, risk-adjusted complications index, risk-adjusted safety index, and core measures of heart attack, heart failure, and pneumonia. Measures of efficiency and financial health included the severity-adjusted average length of stay, expenses per adjusted discharge, operating profit margin, and cash-to-total-debt ratio. The measure of responsiveness to the community was the growth in patient volume.

MHS congratulates the hospitals in northeast Ohio that demonstrated "superior, organization-wide performance" by earning a place among the Solucient 100 Top Hospitals. Despite the region's many economic and social challenges, the superior performance of these hospitals is an expression of their principled leadership and commitment to clinical innovation and service excellence.

"My cousin's daughter took her life a year ago today" wrote Regina Brett of The Plain Dealer, in her column of Friday, 16 March 2007. "Keely was only 16 when the darkness consumed her. She had struggled with bipolar disorder for four years.... She laughed and smiled and goofed off like every other teenager at Shaker Heights High School. Most people never saw the pain she was in. I didn't."

Ms Brett later writes that "...Keely's dad said the great outpouring of support right after her death was followed by an overwhelming isolation. Some people avoid you, others ask how you are doing and actually want to know, he said. A few feel the suicide was avoidable and all but blame you for not preventing it."

I've never had so many people call me in tears," wrote Ms Brett two days later in her column of Sunday, 18 March. "It seems that everyone has a family member who suffers from depression, bipolar disorder or schizophrenia." She quotes at length from the many and varied responses she received. Near the end of her column, she states: "If you are suicidal, call the 24-crisis hot line at 216-623-6888 or 1-800-273-8255." This is the number to the MHS Mobile Crisis Team and its 24/7 Suicide Prevention Hotline.

MHS has played a leading role in the Cuyahoga County Community Mental Health Board's Suicide Awareness Prevention Campaign. The number of suicidal callers to the MHS Mobile Crisis Team increased since the public information campaign begain in February 2005. Click here to review preliminary data.

References

Brett, Regina. (2007, March 16). Invisible disease is misunderstood. Cleveland, OH: The Plain Dealer, p. B-1.  Click here to retrieve the article without charge, for a limited time after publication.

Brett, Regina. (2007, March 18). Sharing the tragedies of mental illness. Cleveland, OH: The Plain Dealer, p. B-1.  Click here to retrieve the article without charge, for a limited time after publication.

A devotion to product quality and customer service are values that fueled Burt Saltzman's success as Cleveland's first large-store grocer. A feature article on the first page of the business section of The Plain Dealer describes how Mr. Saltzman leads a thriving, independent, family-owned grocery business in an economic environment thought by many to be hostile to such small businesses.

He brings these same values to his duties as a member of the MHS Board of Trustees. His leadership has been instrumental in the agency's growth, and in its achievement of important initiatives. Click here to read The Plain Dealer feature article.

"The body of a man with schizophrenia who was released from jail during a January cold snap was found covered with snow in a lumber yard days later."

James R. Smith, Jr., 63, was homeless, and had a schizophrenic disorder.   He was a client of Columbus Area, Inc., a community mental health center of the Alcohol, Drug, and Mental Health Board of Franklin County, Ohio.  According to the story, he had been released from the Franklin County jail "after sunset on Jan. 18, after pleading guilty to a cocaine possession charge. ... No one was there to pick him up."

Everybody thought they were acting to protect him.   Jail authorities, seeing that he was frail and thin, arranged for his plea and release to get him out of jail after only 48 hours.   His case manager "thought she had arranged for the jail to hold him until the next morning," and "was working to arrange transportation and housing at a group home."  But officials from the Franklin County jail "said they can't hold an inmate after a judge orders release."

What has Cuyahoga County done to prevent a similar occurrence?   MHS Executive Director Steven M. Friedman, Ph.D., and Director of Homeless Services Eric Morse, LISW explain that the Cuyahoga County Community Mental Health Board has had a Forensic Liaison program in place for two years.   This program identifies clients of the Cuyahoga County community mental health system when they are booked into the Cuyahoga County jail, and alerts social workers from the mental health centers of this booking.   Most important, in Cuyahoga County, the client's social worker can request a hold on the client's release from jail, and, critically, the written hold request is placed directly on the client's booking slip in the jail, so that it can be easily visible to any staff member of the jail who is planning to release the person.

Jean Moran-Hadden is the MHS Forensic Liaison to the Cuyahoga County jail.   She works from a small office in the jail.  She says "I learn about MHS clients who are in jail from Elizabeth Koenig, the Cuyahoga County jail social worker. But I also learn about others -- people who are mentally ill and homeless, but may not be getting service from a mental health center -- from bond investigators, corrections and probation officers, and family members. Once I learn about the clients in jail, I see them, and my main focus is advocacy. I want to see that they get treatment while they're in jail. I want to see that they get treatment and housing when they get out of jail."

"If the person is stable and could return to the community while awaiting trial," says Ms Moran-Hadden, "I'll refer the client to Dan Peterca of the Community Supported Release program, and I'll participate in the client's pre-trial hearing. If the client is to be released, I notify the case manager. Case managers must meet clients in jail to begin services. If the client stays in jail, I meet with him or her at least weekly. I do a lot of system monitoring, and I do a lot of advocacy. I'm present during the trial. I can request a meeting with the Judge. I make recommendations for sentencing. It's all about seeing that clients are taken care of."

Mental health problems were reported or evident in 64% of local jail inmates, according to a Special Report of the Bureau of Justice Statistics of the U.S. Department of Justice, published in September 2006. Nearly half were found to have both a mental health problem and a substance-use disorder (abuse or addiction). Seventeen percent of local jail inmates in the survey reported delusional beliefs, and 14% reported hallucinations.

Other community mental health centers who have Forensic Liaisons who work in the Cuyahoga County jail are Bridgeway, Inc.,   Center for Families and Children,  Murtis H. Taylor Multi-Service Center,  North East Ohio Health Services, and  Recovery Resources.

References

Mentally ill man died in cold after jail release. (2007, March 6). Cleveland, OH: The Plain Dealer, p. B4. Retrieve the article from Cleveland.com. (Articles are available without charge for a limited time.)

James, D.J., & Glaze, L.E. O'Malley, Michael. (2006, September). Mental Health Problems of Prison and Jail nmates. Report NCJ-213600. Washington, D.C.: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics. See this study.

On a single day in the United States of America, there are 754,147 homeless men, women, and children, according to data published by the U.S. Department of Housing and Urban Development (HUD). The newly published count, taken in January 2005, is believed to be to most accurate ever done, because it was based on data from a nationwide homeless information system used by all HUD-funded homeless assistance programs. The HUD Annual Homeless Report to Congress (AHAR) of February 2007 was based on data from 80 communities across the nation. To see HUD data from the Cleveland and Cuyahoga County Continuum of Care, click here.

Nearly one-fourth of all homeless persons in shelters are children. Twenty-five percent (25%) are disabled, including those with severe mental disabilities and chronic substance-use disorders. Twenty-three percent (23%) are chronically homeless. Forty seven percent are single men, and 45% are African-American.

The nation's inventory of emergency shelter beds decreased 35% from 333,500 in 1996 to 217,900 in 2005. However, transitional housing beds increased 38% during this period, from 160,200 to 220,400; permanent housing beds increased 83%, from 114,000 to 208,700. The HUD report attributed the change in this distribution of shelter and housing beds, in part, to the priority HUD has placed on permanent housing opportunities for homeless persons.

This and future counts, the report concludes, are expected to provide more accurate data to help communities "to strategically allocate homeless assistance funds, improve program operations, and inform future national policy aimed at reducing homelessness in the years to come."

Click here to examine recent local counts of homeless persons.

MHS was awarded $2.54 million in homeless assistance grants in the fiscal year (FY) 2006 nationwide competition for Supportive Housing Program funds from the U.S. Department of Housing & Urban Development (HUD). HUD announced that it will fund more than 5,300 homeless assistance projects nationwide with grant awards totaling $1.37 billion, 3% more than last year’s funding of $1.33 billion.

All six renewal applications that MHS submitted to HUD in May 2006 were funded. In addition, HUD funded a new MHS program that will add 44 one-bedroom permanent housing units for homeless adults who have schizophrenic or other severe mental disorders. This program is expected to begin in November 2007.

Throughout Ohio, FY-2006 HUD grants for homeless assistance and emergency shelter programs totaled $64 million, 1.5% less than the FY-2005 total of nearly $65 million. Total HUD funds awarded to these programs in Ohio was $68.5 million in FY-2004, $60 million in FY-2003, and $55.6 million in FY-2002.

In Cuyahoga County, HUD grants to 37 homeless assistance programs totaled $21.1 million. HUD also awarded 1.2 million to Cuyahoga County for its emergency homeless shelters. The homeless assistance grants were made to 17 nonprofit organizations that are part of the Cleveland and Cuyahoga County Continuum of Care. The Cleveland and Cuyahoga County Office of Homeless Services (OHS) leads the County's Continuum of Care homeless assistance and emergency shelter projects. HUD grants to Cuyahoga County Continuum of Care projects totaled $20.5 million in FY-2005, $18.7 million in FY-2004, $15 million in FY-2003, and $14.4 million in FY-2002.

Ruth Gillett, (at right), Program Manager of the Cleveland and Cuyahoga County Office of Homeless Services told a reporter for The Plain Dealer: "This is a great amount of money and a great benefit to the community. But Cleveland and every other community needs more, nees to figure out how to help more people earn a better wage or figure out how to increase the basic housing subsidy mechanism, because without housing, people can't go on. They can't get a job, they don't have a stable place to send their kids to school, they can't take care of their own health. It's really fundamental."

The Office of Homeless Services leads the community's efforts to provide coordinated, efficient, and effective services to protect the safety and health of homeless persons, and to help them achieve housing, income, and independence. The Office worked with non-profit organizations and units of local government to submit the County's comprehensive proposal to HUD in June 2005. All programs in the proposal were awarded the HUD funds that were requested.

Copyright © Mental Health Services for Homeless Persons, Inc. (MHS) 1744 Payne Avenue; Cleveland, Ohio 44114 U.S.A. 216-623-6555 - TTY/TDD: 216-623-6540 The URL of this page is http://www.mhs-inc.org/News2007p1.asp It was most recently updated on 31 May 2007. We welcome your comments. Please write to Joel[at]mhs-inc.org Explore!   Enter search terms in the text-box below, and click the Search button to find information within the MHS website, or throughout the web.