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Kelly A. Hague
Wilmington University
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Agency Report: Fellowship Health Resources
variety of clinical and supportive services to individuals recovering from mental illness,
substance use disorders, and co-occurring disorders. FHRs person-centered clinical model
promotes independence and skill-building to its clients. This organization is motivated by the
beliefs that everyone can recover and grow and that all people have the same basic needs
(Fellowship Health Resources [FHR], 2017). FHR operates several different programs in all
three counties of Delaware: three group homes, four outpatient programs, and four community
based programs.
Mission
The mission of FHR, according to their website, is to assist people of all ages to improve
their behavioral health, well-being, and quality of life (FHR, 2017). FHRs mission is fulfilled
in part by following the PRISM Model. The PRISMMODEL for the Effective Treatment of
Serious and Persistent Mental Illness is a clinical approach that focuses on client strengths. This
approach encompasses the following elements: motivational focus, steadfast support, actions and
goal oriented, build on successes, and failure as an opportunity (FHR, 2017). Every facet of
FHRs clinical approach is geared toward meeting a person where they are or working with
Demographic Information
The programs that FHR offers represent a broad demographic throughout Delaware. The
current census for all Delaware programs is 2,338 participants. It should be noted that this
number could be affected by pending discharges. The ages of participants range from 6 years to
senior citizens. The residential programs which include the three group homes in Sussex County
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house 23 individuals. The community programs include the Childrens IOP (Intensive Outpatient
Program) and ACT (Assertive Community Treatment) Teams. There are 129 participants in
community based programs. Outpatient programs (called CBHOT) provide psychiatric and
counseling services for children and adults. The census in these programs is 1,897 participants.
Participants can also be divided by county. Sussex County serves the most participants,
1,882. Kent County programs serves 375 participants and New Castle County serves 64
participants. The programs that have been around longer have a higher census. Sussex County
programs were established in 1981, Kent programs in 2014, and New Castle programs are the
Organizational Structure
organizational structure. At the top of the hierarchy is Michelle Serrano, the Regional Director.
She oversees all of the Delaware programs. On the next level are the director and supervisors of
all the residential, outpatient, and community based programs. In addition, the Assistant
Directors of the three group homes work under the Director of Residential Services. Aside from
these administrative positions, there are support staff such as nursing staff, clinicians, residential
assistants, peer workers, etc. A visual of this organizational structure is evident in the FHR
Governance
FHR has a board of directors with 13 members from different states and different
educational backgrounds and fields. For example there is a business person, doctor, lawyer, and
peer on the board. The members meet quarterly to approve all financial budgets, the quarterly
balanced scorecard, policies, etc. Policies and procedures are based on different states funding
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regulations and CARF accreditations. Each department head has their own to develop using
committees (nursing, clinical, etc.). All policies and procedures are reviewed by and approved by
Funding Sources
Several funding sources support FHR programs. The largest funding sources are the state
run Managed Care Organizations or MCOs: Blue Cross Blue Shield Health Options and United
Healthcare. There are also state funds allocated for certain programs from the Department of
Substance Abuse and Mental Health (DSAMH) and the Department of Prevention in Behavioral
Health (DPBH). Finally, programs also receive payments from third party insurance providers
It is important for FHR to maintain relationships with other agencies to provide a more
comprehensive continuity of care. The Promise Program through DSAMH works to ensure that
FHR participants are receiving all the services they need. FHR works closely with psychiatric
hospitals (Delaware Psychiatric Center and Dover Behavioral Healthcare, among others) as well
as crisis services such as Recovery Innovations when clients require a higher level of care than
FHR has to offer. Also, referrals for substance use treatment come from the Treatment Access
Center (TASC) and probation and parole. ACT Teams use Horizon House as clients payee.
Finally, group home clients are referred by the EEU, a department of the state.
As with any field, this organization has its strengths, trends, and challenges. I interviewed
Regional Director Michelle Serrano to get her take on this topic. One of the main strengths of the
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agency is that it is very person-centered, toward staff and participants. The staff is very family
oriented and the participants are treated as individuals with individual needs.
One of the trends is the increasing requirements of the state through regulations without
any increase in funding. This makes it difficult to keep quality staff to keep these requirements
adequately fulfilled. A common trend in participants that FHR serves is that clients are becoming
more and more medically compromised. This makes an impact on the programs, requiring an
increase in Certified Nursing Assistants and nursing staff throughout programs, especially group
homes. Also, drug addiction is on the rise. Because of this, administrators are focusing on
The FHR agency is also met with a set of challenges concerning participants and staff.
There is limited housing for clients. This makes it difficult to place clients when they are ready.
On the business end, it is difficult to keep enough quality staff to fit the budget, which relies
growth. The FHR programs in Delaware, especially in northern Delaware, are growing rapidly
and the current infrastructure is inadequate to support that growth. Finally, in Delaware, there is a
Interns Role
My role as an intern is, first and foremost, to learn about the administrators role in FHR
programs. This includes observing managerial styles and tactics in the office setting, taking part
in various administrative meetings, and completing various administrative tasks for my site
supervisor and other people in leadership positions. Im also responsible for organizing a
FHR. (2017). FHR: Fostering hope and recovery. Retrieved from https://www.fhr.net/
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Appendix A: FHR Organizational Structure
REGIONAL OFFICE
GEORGETOWN DELAWARE
Michelle Serrano
Regional Director