Running head: STRATEGIC PLAN: Father Joe’s Villages, Village Health Center 1

Eight-Step Strategic Plan: Father Joe’s Villages, Village Health Center

Kerry Stack

University of San Diego

HCIN 558: Strategic Planning and Management

Dr. Burkard

August 21, 2020

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Step One – Set the Stage

There is a homeless crisis in California. According to the United States Department of

Housing and Urban Services (HUD), as of January 2019, in California alone, over 150,000

people were experiencing homelessness. Homelessness exacerbates health problems and the

ability to access appropriate care. Chronically homeless individuals generally have long

histories of homelessness, struggle with disabilities, and disabling health conditions (HUD,

2012). They experience high rates of chronic physical illness, substance abuse, and serious

mental illness. The mortality rate for chronically homeless persons is four to nine times higher

than that of the general population, according to the United States Interagency Council on

Homelessness (HUD, 2012).

Father Joe’s Villages (FJV) has been helping the homeless in San Diego since 1950. First

as St. Mary of the Wayside, and then it was re-dedicated under the protection of the patron saint

of the poor and become St. Vincent de Paul Village. In the 1980s, Father Joe Carroll took over

and realized that more was needed than just a hot meal. He envisioned a comprehensive plan,

where a variety of programs could be housed under one roof. He called it “one-stop shopping”

(Father Joe’s Villages, 2020) and it has come to be identified as the continuum of care model.

Programs include Food Service Program, Housing Program, Health Services, just to name a few.

Now, affectionately called Father Joe’s Villages, after Fr. Joe, more than 5,600 homeless have

achieved permanent housing and more than 2,000 homeless our housed nightly (Father Joe’s

Villages, 2020).

“Neighbors Helping Neighbors” is the objective of FJV. This is accomplished through

their CREED – Compassion, Respect, Empathy, Empowerment, Dignity – which defines the

mission, vision, and philosophy at FJV (Father Joe’s Villages, 2020).

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The Village Health Center is one of the many programs at FJV. It is a federally qualified

health center (FQHC) for the homeless. The FJV leadership team, health center leadership team,

Board of Directors, health center staff, and residential staff have been brought together to

develop a strategic management plan for FJV, Village Health Center.

Jeffrey Norris, MD, Chief Medical Officer will be responsible for all medical aspects,

policies and procedures, contact with the health insurance plans, approve the space and direct

what is needed medically. Deacon Jim Vargas, President and CEO, will be making the final

decision. Bill Bolstad, Chief Operating Officer, will secure the space needed. Ruth Bruland,

Chief Programs Officer, oversees all the programs within FJV. Robert Dorsey, Chief Financial

Officer, will examine the financial aspect of the project. Other health center leadership and staff

will bring their experiences and knowledge of what type of improvements need to be made.

The timeline for this project is one year. Meetings will be held quarterly to evaluate the

implementation of the plan. Assumptions of this strategic plan are that funds are available for

needed upgrades and bringing on more staff, that leadership recognizes the need to re-evaluate

the multiple projects the clinic is trying to take on and recognize the potential for staff burnout.

Step Two – Doing your Homework

Father Joe’s Villages (FJV), Village Health Center serves FJV residents and community

members, presenting for medical, dental, psychiatric, and behavioral health care. In a review of

the organization’s stakeholders map, the organization’s ecosystem (Ginter, Duncan, & Swayne,

2018), organizations that affect and are affected by FJV, Village Health Center, contains a variety

of organizations, strategic partnerships, and resources, internally and externally, that improve the

delivery of care to all patients. A SWOT (strengths, weaknesses, opportunities, and threats)

analysis provides an overview of the external and internal situation (Ginter, Duncan, & Swayne,
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2018). FJV, Village Health Center SWOT analysis is shown in Figure 1. Their strengths,

weakness, opportunities, and threats are listed. Strengths include a strong team of employees and

multiple programs, but at the same time, there is a high turnover of staff, multiple projects being

taken on, and a lack of technology as the weaknesses.

FJV, Village Health Center has a strong team of employees. They are flexible, creative,

and are there to meet the needs of their patients. During the current pandemic, FJV, Village

Health Center staff has expanded their services to the San Diego Convention Center (SDCC) to

provide care and testing for those staying there. This has meant a shift to staffing in the clinic.

FJV, Village Health Center staff rose to the challenge with positive attitudes and ideas of how to

make everything work smoothly. They have also brought on new staff to increase their ability to

see a larger number of patients.

The Village Health Center offers many services to its patients. These services include

medical, dental, psychiatric, and behavioral health. Within the medical, there is also a

medication-assisted treatment (MAT) for patients with drug addiction. Addiction treatment

education counselors (ATEC) are part of the behavioral health and help with addiction. A street

health team goes out into the city to do outreach and bring health care to the people on the

streets. Another service provided is the pharmacy. FJV, Village Health Center has partnered

with Medical Center Pharmacy and opened a pharmacy onsite. The pharmacy is MediCal

licensed and participates in the 340b program for discounted prescriptions for MediCal patients.

This partnership enables patients to obtain needed medications.

Weaknesses of FJV, Village Health Center include high staff turnover rate, taking on

multiple projects, and technology. There is a high turnover rate of staff at the Village Health

Center. Working with the homeless and at-risk population is not for everyone. A high turnover
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rate means more time is taken for continually training new staff. Management has taken on

multiple new expansion projects in the last year – therapeutic childcare (TCC), recuperative care

program (RCP), and COVID-19 response, to name a few. With these multiple projects, they may

be spreading themselves too thin and quality of care to others might slip. Due to being a federally

qualified health center and a non-profit, FJV, Village Health Center does not have the latest and

greatest in technology. With the addition of seeing patients at SDCC, FJV, Village Health Center

found that they needed more laptops and multiple laptops needed updating.

Recognizing these weaknesses, some improvements that can be made relate to staffing.

Bringing on more full-time employees, promoting employee career growth, and cross-train staff

to increase skills. With so many expansion projects, some will need to be put on hold to focus on

the current pandemic situation. The TCC and RCP are two projects that will need to wait while

the Village Health Center focuses on the COVID-19 response.

Growth opportunities are related to funding and continuing with expansion projects.

Arcadia population health software implementation will help track patients’ gaps in care and

open risk scores. Tracking these will increase insurance payments as insurances move to a value-

based care reimbursement model. Additional grant opportunities will increase funding of the

Village Health Center and could provide opportunities to improve technology.

Once this current pandemic ends, FJV, Village Health Center can focus back on its

expansion projects. An RCP is needed in San Diego. Homeless patients need a place where they

can fully recover after being discharged from the hospital. The RCP will bring partnerships with

local hospitals and insurance companies.

Will all the growth opportunities, there are threats to the organization. FJV, Village Health

Center contracts with the University of California, San Diego medical school and has residents
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work at the clinic. Through this contract, the Village Health Center offers many providers for

patients to see. It is an expensive program and takes a lot to manage it. Funding for an FQHC is

never certain and can change anytime. One last threat would be staff burnout.

Moving forward, FJV Village Health Center needs to work on staff retention, continue

building partnerships in the community to expand and improve services, and update technology

to become a cutting-edge provider. FJV, Village Health Center has grown and expanded a lot in

the last few years and will continue that growth with the right team, partnerships, and resources.

Figure 1 Internal External

Positives Strengths Opportunities

 Strong Team (flexible &  Arcadia population health
creative) software implementation
 Multiple programs – medical,  Recuperative Care
dental, psychiatric, behavioral  Fully stocked & operational
health pharmacy
 Pharmacy on site  Additional grant opportunities
 Outreach
 Insurance enrollment
improvements
Negatives Weaknesses Threats
 Staff turnover (need biller and  UCSD Contract & Costs
dental assistant)  Funding – uncertainty regarding
 Trying to take on multiple long-term federal FQHC funding
projects  Staff burnout
 Technology

Step Three – Describe Your Culture

Father Joe’s Villages (FJV), Village Health Center’s mission is “Every day, we provide

the highest quality healthcare to our homeless and at-risk neighbors and support our community

in ending homelessness one life at a time.” They serve FJV residents and community members,

presenting for medical, dental, psychiatric, and behavioral health care. FJV, Village Health
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Center’s mission, CREED, and objective are consistent with their institutional business plan,

purpose, and values.

“Our mission is to prevent and end homelessness, one life at a time”, is the mission

statement of FJV and describes their purpose. FJV, through its many programs, is working

towards ending homelessness. The Village Health Center adds to this mission by stating their

role of providing the highest quality healthcare to their homeless neighbors. Healthcare is an

important part of FJV’s mission because health conditions suffered by chronically homeless

people impede their ability to obtain and retain housing. Stable housing in combination with

health care and services is essential to improving health and ending chronic homelessness (HUD,

2012).

The values and foundation of the work at FJV, Village Health Center are laid out in their

CREED. Compassion is shown through concern for others and a desire to assist. Respect, an act

of giving particular attention or special regard, is shown to every patient that receives care at the

Village Health Center. Empathy, understanding, an awareness of and sensitivity to the feelings

of others is how employees interact with clients. Empowerment, helping others to help

themselves, is a core value of FJV. Many programs help clients learn new skills and how to take

care of themselves. Last of the core values is dignity, counting all people worthy of our esteem.

FJV believes that every person, housed or not, is deserving of respect and dignity and has the

ability to lead a productive and fulfilling life (Father Joe’s Villages, 2020) and that is shown

through their mission statement and values.

Through their mission and CREED, FJV is San Diego’s leading homeless service

provider - having helped more than 5,600 achieve permanent housing in the last 5 years and

housing more than 2,000 people nightly. The Village Health Center served over 3,000 patients
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and saved the City of San Diego over $4.7 million due to decreased use of emergency services.

FJV, Village Health Center will continue to help our neighbor’s in need by following their

mission statement and CREED.

Step Four – Identify Your Strategic Area

Strategic areas are major concerns that are top priorities for an organization (Ebner &

Smith, 2015). Identifying strategic areas is an important step and is the base from which action

steps are developed. FJV, Village Health Center has three strategic areas that need to be

addressed to be successful and thrive in their market.

Technology

The first area of concern is technology. FJV, Village Health Center is lacking accessible

technology, like laptops, tablets, and internet. There are not enough laptops and tablets for staff

to use at the clinic and at outreach projects. Not only are there not a sufficient amount, but many

times at least one or two are in need of repairs and the decreases the number available to use

even more. How can funding be obtained for the improvement in technology needed? Slow

internet speeds and inability to connect to the internet, slow the entire process of the clinic. If the

internet accessibility is not up to date, many workflows in the clinic are hindered. Improved

technology will increase efficiency and improve quality of care to the patients (Jones, 2018).

Multiple Projects

Second, taking on multiple projects is a strength and weakness. Multiple projects can

benefit the organization and get their name out there but doing too much can decrease quality of

care in other areas. Just the same, it is not good to only focus energy on one project. A balance

is needed between the number of projects and continuing to provide the quality of care patients

expect. The organization offers a lot through their multiple projects and they reach patients that
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might not be able to obtain medical care without them, but priorities will need to be made on

which projects are the most critical.

Staff Turnover and Burnout

This leads to the last strategic area – high staff turnover and burnout. Multiple projects

stretch the staff thin and other staff are then pulled in multiple directions working on multiple

projects. How can staff be used effectively in multiple areas that do not lead to burnout? Signs

of burnout include forgetfulness, pessimism, irritability, and poor performance, to name a few.

Staff pulled to work in an area that they are not familiar with may result in mistakes and errors.

Staff burnout will lead to a decrease in the quality of care provided by the organization.

Addressing these strategic areas of technology, multiple projects, and staff turnover and

burnout, will help FJV, Village Health Center determine the direction the organization needs to

go and what the next action steps will be.

Step Five and Six – Strategies and Action Steps

As identified above, the three key strategic areas of concern must be addressed for FJV,

Village Health Center to continue to provide the highest quality of care to their neighbors in

need.

Strategic Area #1: Technology

Strategy: To increase the number of workable computers, laptops, tablets, and mobile phones,

and to acquire a more reliable internet.

Action Step #1: Action Step #2: Action Step #3:

The assistant clinic manager The clinic director will The clinic director will

will identify all laptops, investigate purchasing new investigate a new internet

tablets, and mobile phones laptops, tablets, and mobile provider with greater

that need repair and have phones for clinical use within bandwidth and more
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them repaired within the next the next six months. reliability and switch services

three months. within the next six months.

Strategic Area #2: Taking on Multiple Projects

Strategy: Re-evaluate the number of projects being undertaken and choose the projects that

are the most critical to focus one.

Action Step #1: Action Step #2: Action Step #3:

The chief medical officer will Assistant clinic director will The clinic manager with

evaluate the need for a assess services needed at the evaluate the need for a

recuperative care by San Diego Convention Center therapeutic childcare

discussing with local and for Street Health and program, if the program has

hospitals and insurance evaluate for effectiveness, been successful, what is

companies. Then decide if amount of time needed needed to improve the

FJV, Village Health Center outside of clinic, and use of program, or if the program

should continue with efforts staff in within the next needs to be discontinued

to open a recuperative care, if month. within the next nine months.

more staff is needed, and

develop a timeline for

opening within the next six

months.

Strategic Area #3: High Staff Turnover and Burnout

Strategy: To increase the number of staff, promote career growth, improve team morale, and

streamline training. To meet and discuss goals quarterly to provide timely feedback, improve

staff’s skills and retention.

Action Step #1: Action Step #2: Action Step #3:
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Clinic manager will assess Assistant clinic manager will Clinic manager will promote

the need for increase in staff, meet with staff individually career growth by informing

fulltime, part-time, or to discuss goals, provide staff of possibilities for

temporary, and recruit for feedback, and discuss what is training and growth within

needed staff within the next needed to meet staffs’ needs the organization in the next

six months. to improve morale within the nine months.

next three months.

Step Seven – Vision Statement

Father Joe’s Village's vision is to prevent and end homelessness in San Diego. They

envision a community where all people have the opportunity to achieve their highest level of

self-sufficiency; where everyone has food, housing, healthcare, education, and the means to

maintain them. The Village Health Center’s vision - to provide the highest quality of healthcare

to neighbors in need and support the FJV in their commitment to end homelessness, one life at a

time - supports the overall vision of FJV.

The vision is supported in the CREED – compassion, respect, empathy, empowerment,

and dignity. The CREED is the cornerstone of their work and their way of doing business. FJV,

Village Health Center, through their many programs, empowers patients to achieve better health

and self-sufficiency.

FJV, Village Health Center’s Medication Assisted Treatment (MAT) Program, assists

patients in ending and recovering from substance abuse. Evidence clearly shows a connection

between homelessness and substance abuse. They are a known risk factor for homelessness and

data shows that substance abuse and overdose disproportionately affect the homeless (National
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Alliance to End Homelessness, 2016). MAT empowers the patients to take control of their life

back and is a step towards self-sufficiency and ending their homelessness.

Recuperative care, a new program FJV, Village Health Center is adding to their services,

will combine healthcare and housing to empower patients to take care of themselves and obtain

housing. Patients, who are too sick to be discharged from the hospital back to the streets, will

have the option to continue recovering in FJV, Village Health Center’s recuperative care program

(RCP). While recovering, housing needs will be assessed, and the goal will be to discharge

patients from the RCP into housing and not back to the streets.

FJV’s vision to prevent and end homelessness is shown through their CREED and in their

many programs aimed at assisting clients into housing. The Village Health Center supports this

vision and adds to it through their many programs that empower patients to take control of their

health and become self-sufficient.

Step Eight – Action Plan

1. Strategic Goal #1 – Update and Replace Aging Technology

1.1 Strategy Objective #1: Acquire higher speed and more reliable internet

Timeline: Within the next 3 months

Team Members Responsible: Clinic Director

1.1.1 Action Item 1: Research internet providers for increase bandwidth and more

reliability

1.1.2 Action Item 2: Compare prices of internet companies

1.1.3 Action Item 3: Select new internet company and start new service

1.2 Strategy Objective #2: Identify all laptops, tablets, and mobile phones in need of

repair
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Timeline: Within the next 3 months

Team Members Responsible: Assistant clinic manager and staff

1.2.1 Action Item 1: All laptops with continuous problems will be identified and

sent to IT for repair.

1.2.2 Action Item 2: All tablets in non-working order will be identified and taken

out of use

1.2.3 Action Item 3: Mobile phones older than two years will be identified and

taken out of use

1.3 Strategy Objective #3: Purchase new laptops, tablets, and mobile phones for clinic

use

Timeline: Within the next 3 months

Team Members Responsible: Clinic Director

1.3.1 Action Item 1: Identify how many new laptops are needed with the increase

in services provided outside the clinic

1.3.2 Action Item 2: Identify the need for tablets and mobile phones for clinic use

and determine how many are needed

1.3.3 Action Item 3: Compare prices of laptops, tablets, and mobile phones. Select

and purchase new laptops, tablets, and mobile phones

2. Strategic Goal #2 – Re-evaluate the number of projects undertaken by clinic staff and

choose the most critical projects to focus on

2.1 Strategy Objective #1: Assess services needed at the San Diego Convention Center

(SDCC) for Street Health and COVID-19 response

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Timeline: Within the next 3-6 months

Team Members Responsible: Clinic Director and Clinic Manager

2.1.1 Action Item 1: Assess COVID-19 response and need for further testing in

regards to status of global pandemic and San Diego County’s current situation

2.1.2 Action Item 2: Assess need for Street Health at SDCC

2.1.3 Action Item 3: Assess amount of time needed outside of the clinic and the

number of staff needed to ensure there is coverage in the clinic

2.2 Strategy Objective #2: Evaluate the need for recuperative care in the City of San

Diego

Timeline: Within the next 3-6 months

Team Members Responsible: Clinic Director and Clinic Manager

2.2.1 Action Item 1: Discuss with local hospitals and insurance companies the

need for recuperative care and have them sign contracts for beds at FJV to be

used for recuperative care

2.2.2 Action Item 2: Assess amount of staff and hours needed to staff recuperative

care

2.2.3 Action Item 3: Develop timeline and decide on open date

2.3 Strategy Objective #3: Assess the need to provide medical and dental services and

Therapeutic Childcare

Timeline: Within the next 3-6 months

Team Members Responsible: Clinic Director, Clinic Manager, and Assistant Clinic

Manager
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2.3.1 Action Item 1: Discuss with Director of Therapeutic Childcare the need for

medical and dental care during childcare hours

2.3.2 Action Item 2: Evaluate success of program prior to COVID-19 and how to

move forward

2.3.3 Action Item 3: Identify and assign staff to champion services in Therapeutic

Childcare

3. Strategic Goal #3 – Prevent high staff turnover and burnout

3.1 Strategy Objective #1: Improve team morale

Timeline: Within the next 6-9 months

Team Members Responsible: Clinic Manager and Assistant Manager

3.1.1 Action Item 1: Assess level of morale of team

3.1.2 Action Item 2: Plan team building time and activities

3.1.3 Action Item 3: Meet with staff and discuss goals and provide feedback

3.2 Strategy Objective #2: Promote Career Growth

Timeline: Within the next 6-9 months

Team Members Responsible: Clinic Manager and Assistant Manager

3.2.1 Action Item 1: Inform staff of possibilities for training and growth within the

organization

3.2.2 Action Item 2: Give staff time to attend training and/or higher education

3.2.3 Action Item 3: Evaluate possibility of tuition reimbursement incentive for

staff to return to school and further their education

3.3 Strategy Objective #3: Increase staff

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Timeline: Within the next 6-9 months

Team Members Responsible: Clinic Manager and Assistant Manager

3.3.1 Action Item 1: Assess need for increase of staff and how many and where

3.3.2 Action Item 2: Decide if fulltime, part-time, or temporary staff is needed and

what the clinic has funds for

3.3.3 Action Item 3: Recruit for new staff through advertisements, job boards,

word of mouth, etc. Interview and higher staff.

Conclusion

Father Joe’s Villages, Village Health Center has been serving the homeless and those at

risk for homelessness in the San Diego Area since the 1980s. They are a non-profit organization

that relies on government funding for being an FQHC, donations, and insurance reimbursement.

The Village Health Center needs to develop and evaluate a strategic plan that will take them into

the future.

Homelessness is not going away, and with the current global pandemic, the numbers of

homeless are likely to increase due to the loss of employment and income for many. FJV, Village

Health Center needs to strategize and make certain they are ready for the possibility of increasing

numbers of homeless to serve.

This strategic plan for FJV, Village Health Center will help them address the need for

improved technology, increase staff and prevent burnout, and determine the most critical projects

the clinic should undertake within the next year. These strategies will set them up for the future

and help them continue to be a needed resource in San Diego for the homeless population.
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References

Ebener, D. R., & Smith, F. L. (2015). Strategic Planning: An Interactive Process for Leaders.

Amsterdam, Netherlands: Amsterdam University Press.

Father Joe’s Villages. (2020). 2020 Employee Handbook. San Diego, CA: Author.

‌HUD USER. (2012, Summer). Linking Housing and Health Care Works for Chronically

Homeless Persons.

https://www.huduser.gov/portal/periodicals/em/summer12/highlight3.html#title

Jones, M. (2018, December 26). HealthCare: How Technology Impacts the Healthcare Industry.

Retrieved from https://healthcareinamerica.us/healthcare-how-technology-impacts-the-

healthcare-industry-b2ba6271c4b4

National Alliance to End Homelessness. (2016, April 5). Opioid Abuse and Homelessness.

Retrieved from https://endhomelessness.org/resource/opioid-abuse-and-homelessness/