How to become a best company to work for: Horizon Health Services

Submitted by: 09/12/2012 by Maureen Fitzgerald


Horizon Health Services in Buffalo, New York, offers a range of mental health and substance abuse treatment services. Founded in 1975, Horizon has a staff of 325 and treats almost 10,000 patients each year.

Like many behavioral health care organizations, Horizon Health Services has struggled with recruiting, rewarding, and retaining staff. In 2007, the turnover rate for clinical positions was 46 percent. Yet, by 2011, that rate had declined to an annual average of just 18 percent, and Horizon had reduced the average number of open revenue-producing positions from 12 to two.

And in 2012, Horizon Health Services was recognized by Best Companies to Work For New York—for the fourth year in a row.

Paige and colleague Lisa Arnet, Vice President of Corporate Relations, described this transformation in “How to become a destination employer—Building a culture of success,” their how-to workshop at the 2012 SAAS National Conference and NIATx Summit held in New Orleans in June.

The answer to recruiting and retaining great staff lies in creating a strategy to build a strong, effective culture, the attendees learned.

Like all NIATx process improvement projects, having executive buy-in was a key component to this workforce initiative. “It all starts at the top,” said Paige and Lisa.

Making the human resources department part of the executive team was also important. “We found that the organizations most successful at recruiting and retaining a workforce are those where human resources is at the executive level.”

Understanding and involving the customerin this case, the Horizon employees—was critical. The change team had a chance to listen to these “customers” in a series of mini town hall meetings. They learned that staff were feeling burned out by excessive paperwork and poor communication. Staff also acknowledged feeling disconnected from senior management.

Paige and Lisa also encouraged attendees to “ask staff what they want and then listen.” The top requests from Horizon staff were salary increases and help with their health insurance costs.

With this information, the change team set about changing the organization’s culture. Their strategy included: 

  • Productivity contests that led to quarterly individual bonuses of up to $2000. “We use an open-book approach, which I think separates us from other organizations,” says Paige. All Horizon employees know how the services they provide translate into profit or loss for the organization. “Each employee knows how well they’re doing as an individual, how his or her team is doing, and how the organization is doing.”
  • “WOW” benefits that include profit sharing checks, no rate increase for health insurance, and a home buying program that provides a match of up to $7,000. Low-cost “WOW” benefits range from at work massages to a paid-time-off buyback in December, to discounts on products or services from local retailers.
  • An improved orientation and “onboarding” process. New staff receive a thorough overview of the company and meet all senior staff. Prizes and fun are also part of the introduction to Horizon. Says Paige, “One recent hire told us that ours was the best orientation she’d ever experienced.” 
  • Structured development and advancement opportunities. Horizon offers a mentoring program as well as formal training that allow employees to advance within the company. “We have a lot of success helping people grow into new jobs within the company,” says Paige. Other trainings that deal with topics such as Customer Service, Mental Health & Chemical Dependency 101, Confidentiality, and Corporate Compliance must pass the FUN test: be humorous, interactive, and have cash prizes.
  • Recognition programs and teambuilding activities. An annual “Oscar” event during work time to recognize staff has been a big hit. Team building activities range from a traditional family picnic to the “Outrageous Olympics,” where teams from each clinic represent a country, competing in such un-Olympic events Sock Speed Skating, Butt Volleyball and Glow in the Dark Shuffle Board. Many of these ideas came directly from the staff. “I’ve found over and over again that employees come up with some of the best ideas,” adds Lisa.
  • An internal marketing communications program. Keeping staff informed has helped them feel more connected to senior management. “All employees receive a letter from the CEO three times a year, delivered to their homes,” adds Paige. “This personal letter and other internal communication activities have helped bridge the communication gap.”

These strategies have been well worth the effort, concluded Paige and Lisa. “Our climate has improved so much that we have a waiting list for new grads seeking employment with us.” Recently, 80 qualified candidates applied within a four-hour period for two open clinical positions.

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