A CEO’s Legacy

Under Phil Pangrazio’s leadership, Ability360 developed into one of the nation’s largest Centers for Independent Living and established itself as a premiere model for other centers throughout the country.

Phil has been helping build Ability 360 for 21 years now, prior to working at Ability 360 he started off in health care and got his Master’s Degree in Health Services Administration and Policy from Arizona State University. He worked for 10 years at Maricopa Integrated Health System and Maricopa Medical Center, where he held multiple positions in financial Management and Administration. Then Phil landed his Job with Ability 360.

Phil guided Ability360 to an annual budget of more than $48 million and the expansion of its programs and services to include Home Care Services, SSA Work Incentives Planning and Assistance, Ticket-to-Work Employment, Youth Transition Services, and the Living Well with a Disability program, among others.

Phil also directed the planning, construction and financing of the Ability360 Center in Phoenix, home to Ability360 and 9 other non-profit organizations that serve people with disabilities in Arizona.  The $12.3-million Ability360 Sports & Fitness Center was opened in 2011, the first of its kind in the southwest.

Creating Ability360

The whole goal was to bring together the different non-profits, that they always collaborated with, but not to the degree they could have if they were closer in proximity, this concept came up and gave them the idea for the Disability services campus, they started thinking about it and they thought ‘hey this could be really cool’ they put in the sports fitness center which was kind of the cherry on the cake, pretty unique, really never had been done In the country, first to do this disability campus thing and also a sports facility for the disabled, sports and fitness is important to these individuals, and without this they might not have a place to host their games, like wheel chair basketball, etc., and a place to call home.

Phil first got involved in the early 1990s. He was first on board for 9 years before becoming CEO, he was involved in the governance aspect of things which he believes helped him when he stepped into the CEO role. There was a desire to do this (build a campus for the disabled) for a while, most of the individuals who were on the board when Phil started are no longer there, and when he started he looked up to these board members as his mentors and Hero’s, they wanted ability 360 to be self-stainable, efficient and didn’t want to be dependent on government grants. They wanted a more diversified revenue stream. Phil started the community based program that partners with us, which is a revenue stream for the organization which allows them to have resources to invest in other things.

The Future for Agencies

The Future is going to be interesting for the organization, and disability rights as a whole. Disability Rights are evolving and changing, but it is hard to say what it will look like in the future, The work that was done in the 70s and 80s was so prominent, however there will still be plenty for the younger generation to work on and advance, and advance disability rights depending on what is going on at the time, but it will definitely be interesting to see what is in the cards for people with disabilities in the future, hopefully more people with disabilities  will be working and not having to live off the government , because that isn’t the best place to be in.


The biggest thing is to treat your employees with fairness, listen to them, and realizing you can’t function without your people. Treat them well – that goes along way.

Using Scheduling for Residential Billing

Providers use Staff and Client Scheduling to track billing for group homes.

This method for tracking client attendance in residential programs assumes clients are in attendance most of the time. It follows the exception rule: if 80% or more of the time, what happens is what is scheduled, an effective solution will update the schedules to reflect what actually occurred.

The only edits required are to track absence and reasons.

Day-to-Day Operational Steps

  • Maintain daily schedules for individuals by Group Home. This is easy and requires little maintain as attendance changes very little, or not at all.
  • Edits are only needed for an “on exception” basis if the individual was absent for some reason, such as hospitalization, with family or guardians, etc.
  • All that is required is to update the hours, change the billing code, and document the reason.
  • Admin can audit reports and generate billing directly from schedules.
  • At the end of the billing period, administration rolls the schedules forward for the next Billing Period.

Advantages Over Using Spreadsheets

  • Unlimited history is automatically retained for audits and queries.
  • A record of who changed which schedules, and when, is captured automatically.
  • Client schedules can be shared across the agency.
  • A record of schedule vs. actual is retained and available for cross-checking.

Advantages Over Using EHR

  • Using schedules is simple and requires little training.
  • The license fees are much lower than for an EHR.

Why the Worker Shortage Continues

The Wall Street Journal reported on Friday, May 7th that there are many reasons holding back potential employees from the labor market. Over 4-8 million fewer people are currently in the labor force than before the pandemic, depending upon how they are counted.

  • Fear of Covid-19, sickness (the USA still averages over 45,000 positive cases a day). If 45,000 people quarantine for 14 days, that removes approximately 500,000 from the available workforce even if they don’t get really sick
  • Lack of childcare and open schools
  • Previous employer has offered to rehire soon
  • Few job openings in their area
  • Extended jobless benefits

“I think this is just as much about a shortage in labor supply as it is about a shortage of labor demand,” Jason Furman, an economist at Harvard University commenting on the weaker than expected April jobs report, told CNBC. “If you look at April, it appears that there were about 1.1 unemployed workers for every job opening. So there are a lot of jobs out there, there is just still not a lot of labor supply.”

Census data taken in recent weeks suggests the closures of day-care centers and schools have forced millions of Americans to stay home and care for children or oversee online learning.

According to a Census Household Pulse survey taken in late March, 6.3 million people reported that they were not working because they needed to care for a child not in a school or day care. Another 2.1 million were caring for an older person.

An additional 4.1 million Americans said they were not working because of concerns about getting or spreading Covid-19.

The labor shortage should ease in 2021, but the process may take months as:

  • Vaccination rates continue to rise
  • Schools fully re-open
  • $300 per week federal unemployment bonus above and beyond what states provide, expires in September

For a more in-depth look into hiring, download the eBook: Tips for Boosting Applications and Hiring in 2021 or the myApplicants fact sheet.

To discuss hiring, onboarding and training, email agencysuccessteam@mitcsoftware.com.

Why Providers Struggle with EHR and Documentation

A big question for the future of technology in health and human services – how to make EHRs better serve the professionals delivering care? That was the focus of a discussion with Peter Flick, Chief Executive Officer of Remarkable Health, at a recent OPEN MINDS Technology & Analytics Institute.

The history of EHRs has created a challenge. Flick explained, “The best thinking in software in the 90s was, ‘let’s take our paper-based process and put it online.’ EHRs were designed to help a provider organization better manage information across the board and demonstrate meaningful use for compliance. They were not designed from the ground up to help make clinical professionals more efficient and effective. That’s kind of a backwards way to do things. The EHR is really powerful and can do the work of 10 to 40 staff once the data is in the system but getting the data into the EHR is a challenge and the bane of clinical professionals’ existence.”

Most clinical professionals are unable to do concurrent documentation, and the inevitable delays cause inaccuracies. Flick elaborated, “The average time from session to actual note signing is 3.3 days, which is a lot of time. The clinical professionals finally get the note in and then there’s a review process and a quality assurance process. Some provider organizations told us that they have certain programs that are that are only at 50% utilization, because they’re spending the other 50% of their time on documentation!”

Client Profiles was designed in 2020 to better manage the affordability, poor work flows, and low adoption and usage rates many providers struggle with using traditional EHR. Download the most recent Client Profiles Alerts fact sheet to learn more.