Above and Beyond Home Care Budget Plan Shanitra Williams
Webster University- LRAFB

Abstract
There are many home care agencies and organizations with the demands of providing services to much of our communities. One must wonder consider what is the cost to funding particular organization to meet this demand? The cost is just as extensive as the reasons why resources are made available to the agencies. There are many governmental grants, and funding that may provide assistance to these agencies. The need to present an appropriate budget is just as important as providing the services. The organization need to have a plan in how their services and resources will be distributed throughout the term of the each year. Above and Beyond Home Care is one many agencies that have the passion to make a difference in individuals who have the will to live independently. But without the proper budget it would have been impossible for this happen. This research will have detail research information about their procedures, annual budgets, participants, results and data analysis.

Above and Beyond Home Care is one of many health care agencies that provides services and resources to individuals. I chose this agency not only because of its name but because what is stands for. As I research the background of the agency, I notice that they have the patient to endure just about anything. In the research I volunteered my time and made an effort to seek to understand their need to influence the lives of other. I discovered that even though they came in with passion to create independent living for many with a disability, they still needed a plan, a budget plan. As I interviewed these individuals, I discovered their budget process, their annual reports, how the budget was presented, the responsibilities of the business owners, the population that they serve and who are their key stakeholders and why all of these are important. I discovered that just like many other health care agencies, Above and Beyond Home Care goes the extra mile to make these services available. I had a chance to research hard copies of their budgets and a chance to look their direct interview transcripts. My expectations about the agency is to get understanding about their budget process. The budget system is a tool that all business owners use and it plays a valuable role when comes to borrowing, getting and balancing the funds that are needed.

Overview
Above and Beyond Home Care is a care given community, founded, owned, and operated by Arkansans for Arkansans. This particular site was opened and license by two motivated and inspiring individuals in. The agency is licensed by the Arkansas State Board of Health and offers individualized in-home care and services. The agency has the philosophy and principles of the Eden Alternative, honoring choices and preferences of those they serve to create life worth living. Their dedication to changing lives are priceless.
The population that the agencies serves is gradually on the rise. The local communities and surrounding areas are taking advantage of their services. They currently serve individuals that have private pay, Medicaid, Veterans Benefits, and Long Term Care Insurance. The agency knows that the cost of care is important, so they work with the patient or the family member towards their source of reimbursement.
The owners of Above and Beyond Home Care have more than 40 years’ experience in providing healthcare services. Their Registered Nurse co- owner is a Certified Eden Educator and Mentor and provides all staff with on-going, enhancing training in the principles of the Eden Alternative. All care and services are planned, directed, and supervised by the RN, who is available to clients, families, and staff for consolation.
Their direct staff includes Certified Personal Care Aides, Nursing Assistants, and Home Health Aides. Case Managers are Licensed Practical Nurses, RNs, or other Healthcare Professionals with Bachelor’s Degrees who identify, access, and coordinates needed services to meet the specific needs of each client.
The agency budget is prepared by both administrator and the owner, and after careful analyzation it is then presented to State Board of Health. Once everyone agree with the funding of the budget it is then put into effect. There are always changes in the policies and implementation and available resources, so the budget gets reviewed quarterly of every year. The healthcare system is a market that will always be around and there will be people in the need of its services and resources. Above and Beyond Home Care realizes the need and is making it a goal to provide these services for the people.

Design

When designing the budget for Above and Beyond Home Care both the administrator and operation manager announces their concerns. “We both work together as partners to come with agreements, concerning the budget,” says the Operation Manager. The budget is a cash basis and a combination of many factors. Their knowledge of available resources is critical at this point. The importance of their research is the heart of the agreement when it comes to the budget process. The agency wants a balance, but it simultaneously wants to maintain their services that it sponsors, and the agency does not want to increase their cost.
Their budget sometimes has to be redefine because of some its deficits. Once deficits are acknowledge the difficult task of restoring budget remains. While there are many programs and entitlements that benefit the clients and the agency, its challenge to know where and how to cut expenses while maintaining acceptability to the clients. The agency aims to make a difference for all who participate in their services.
Once the operation manager research the available resources, grants and funding, the information is then collected to create a budget. The operation manager than preforms the interview process and format each document that represent the budget process. The budget process is sometime predictable and controllable because of the degree of local competition. The funding is determine on the program structure. The cost of some of the agency programs are more easily estimated and more controllable during the budget preparation. Both partners work out how much the services are likely to cost during the budget year, and allocate some of that amount to toward their services. To deal with some uncertainty, both partners may have to estimate expenditures high, save money in other funding accounts, or build up fund balances from year to year. This shows who gets what, who wins, and who loses, and this is not just a function its and essential to funding; it also depends on program structure and on the changes in the environment or society (Public Budgeting pg.140).
Materials
Since grants and other funding have to be maintained and recorded the agency have to follow policy mandates. Budgets are prepared in September and October of the year before using information from Budget vs Actual from the year before. The agency offers incentives to engage in certain activities and that relates to the budget. After the operation manager research and revise the budget, he then presents to the administrator. The administrator makes necessary adjustments and approves the budget for the year. “We use Excel spreadsheet and we have to update it each month based on actual results,” states the Operation Manager.
The budget is than presented to the State Board of Health for approval. The agency knows that they have to carry out particular policies in order to be funded the necessary monies. While many state grant funding programs are discretionary and can be estimated to advance and reduce if needed by other stakeholders, the agency have to have more open-ended or automatic features in their formulas. This helps the agency make budgetary decisions in making changes for taxations and allocations the following year.
To simplify communication between State Board of Health and the agency, the budget procedure often dictates open hearing before any allocations. Extensive reporting is required to assure that the agency spent the money appropriately. The State Board of Health has many constraints that characterize the budget process. So the agency has to follow guidelines to expenditures or revenues at the start of preparing the budget. The process can be lengthy but with careful discussion, and analysis, the owners finally are able to come with a budget. The budget is than present before the State Board of Health and other decision makers
Procedures
The agency budget process may allow a variety of changes during the year to accommodate their revenue or emergencies. The consistency of decision making offer ways in adapting to conflict when or if it threatens the budget in any way. The agency has been resourceful to the economy but if services were down that year, the budget could have a higher spending level and permit deficits. The agency budget procedure has to regulate competition among other agencies and organizations that may hinder their business.
To make sure that all the services and resources that the agency provides the procedures has to be determine between the owners and the stakeholders. For example, when applying for grants the agency sends out questionnaires, including indicators of their financial affluence and descriptions of their client’s base. The budget procedure regulates some levels by determines which of the agency programs services compete with some of the other services. This competition determines how much money is spent, and then assign them to a particular pool of funds.
The budget is than active for a one year before reviewing is needed. When making financial decision both administrator and operation manager has veto power when executing the budget. The importance of the resource determines what gets veto, and both are qualified to make that decision. “We have been friends for almost twenty years and this is our foundation for success”, states, Operation Manager. This is why I believe, that to be successful it not just about the business but about the people of business. The results says it all!
Results

Discussion

After researching and discussing with the agency, I have found that budgeting is more than a decision. When creating a budget, one must consider borrowing, resources, implementing, stakeholders, and reporting information. The fashion of the budget and what is required to even start the budget process is just as important. The agency wants to influence the response of each budgetary need and base their decision on that specific needs. This makes easier to come up with recommendations and follow through for administering.
As I interviewed Paul, the Operation Manager of Above and Beyond Home Care, he made it very clear that they were there for the people. They design and alter the budget to produce the results they hope for. Their participating efforts to change the lives made it clear how they presented parts of the budget. They were very aware of policies, and regulations that comes with the budget process. The agency has built its trust with their clients, and their budget demonstrates not only that priorities were followed, but their services were well manage and effective.
I like the fact that the agency does not do any advertising, but increase their services by word of mouth. This way they can spend the extra money on providing incentives to their employees. I believe that this also helps them in preparing their budget each year. Even though they may have open-ended responsibilities, I think their annual budget reports represent accountability and responsibility. As the agency mission states, I believe they are “Raising the bar in home care.”

References
Above and Beyond Home Care - Raising the Bar in Home Care. (n.d.). Retrieved December 10, 2015, from http://www.aboveandbeyondhomecare.org/

The Eden Alternative® - Improving the Lives of the Elders. (n.d.). Retrieved December 10, 2015, from http://www.edenalt.org/