Performance Improvement Plan
For The Fiscal Year Ending June 30, 2018
	
The mission of TRADE Industries is to provide assessment, vocational, counseling, residential, and advocacy services to those persons with mental and physical disabilities from Hamilton County and adjacent counties.  The goal of these services is to facilitate those persons served in reaching their maximum potential as individuals and citizens of the community. TRADE has continued to fulfill this mission for over 50 years.  It has been successful in expanding both the depth and quality of its services and now the shift is to maintain this. TRADE enjoys the longest number of continuous maximum levels of accreditation by CARF of any organization in 26 county region that is southern Illinois. It also enjoys the longest affiliation with CARF of any organization in southern Illinois.  

TRADE, over the years, has responded to community needs in the past and to modify services to fulfill the current need.  Many of these services have been added and/or phased out as consumer needs have dictated.  Although other services are provided, TRADE Industries chooses to have Community Integration (Adult Habilitation - DT) and Community Housing (CILA) accredited due to their Medicaid-based funding.  CARF accreditation minimizes the level of review required by the State.  There is no mandate for CARF accreditation otherwise.

As the State of Illinois continues to address its financial challenges, TRADE is significantly impacted.  Past issues dealing with the State budget, and the funding tied to it, has created challenges for TRADE.  This, coupled with upcoming changes proposed to the Waiver in Illinois, may pose a major change in service delivery in the upcoming year.  Nevertheless, TRADE is addressing possible future challenges by building its asset base.  Increased attention is being paid to the bottom line.   Little is accomplished if TRADE succeeds in providing quality services but risks its existence based upon financial need.  But, as a point of balance, little is accomplished if TRADE succeeds financially and fails to provide sufficient services.  Our challenge continues to be one of finding balance.

TRADE's commitment over the past few years, as part of our overall strategic plan, is an emphasis toward residential services. Unfortunately, over the past two years, we had residents pass away and others opt for alternative service providers forcing us to close a second home.  This, coupled with referrals that TRADE is unable to serve without putting our current residents at risk necessitated the sale of Tradewinds. We have completed the remodeling of Whittington House and look too transfer residents from Waggoner House to the remodeled home and potentially sell Waggoner.

The Adult Habilitation program (DT) has also been impacted by the before mentioned client losses.  Changes in funding source by Meadowbrook and Stuart Estates has most definitely impact the DT budget due to a limit of 1100 hours of funding for each fiscal year.  Their downsizing to individual homes has put an even tighter pinch on available workforce for DT and CILA.  Our consumers continue to show a high level of satisfaction with our services. Overall, TRADE's employee workforce this past year has been a concern, but still is better when compared to state and national averages.  Our biggest staff concern is finding a sufficient number to ensure that quality services are offered.  Employment, although somewhat weaker than in the past is still provided.

What measures have been taken to assure the reliability, validity, completeness, and accuracy of the information in this report?

Every reasonable effort has been made to make this report a functional tool.  TRADE chooses indicators, measures, and other data elements that measure what is intended to be measured and will consistently allow for comparisons of both past and future data.  Data collected is cross-checked between at least two staff.   Once collected, the data is traced backward to make sure it accurately reflects what is intended to be measure.  This information is again cross-checked through other records if possible.  As the data is compiled quarterly, it is shared with key staff to verify its accuracy and completeness. If problems are found, the information is researched further and corrected as needed.  

What types of data are collected by the organization?

This report is one element in TRADE's efforts to continue to meet the needs of our stakeholders including those we serve. Other elements continue to be balancing those served with other stakeholders, maintaining financial solvency, compliance with insurance and risk management requirements including risk analysis, ongoing performance improvement, development and implementation of corporate responsibilities, compliance with all legal and regulatory requirements, and a commitment to cultural diversity of both staff and those served.  Many activities are involved in accomplishing the goals of TRADE Industries   These include satisfaction surveys of our stakeholders, self-inspections, third party inspections, risk management plan, accessibility planning, technology planning, strategic planning including resource allocation, human resources including staff training, cultural diversity planning, service delivery planning, and financial information.  

TRADE Industries strives to be a customer-focused organization which seeks to use the expectations of persons served and other stakeholders in developing the services we offer.  The needs of the persons served are our upmost priority.  Every effort is made to determine why he/she is seeking services, the goals they wish to achieve, activities in which they want to engage, and their roles and participation in their communities of choice.  TRADE includes numerous other stakeholders: family members, guardians, referral agencies, funders, residential providers, and the community at large.

Data for this report is collected on an ongoing basis through surveys, the ICAP, meetings, interviews, injury reports, incident reports, financial reports, accessibility reports, risk analysis, human resource information, technology reports, information obtained through funders and consultants, and various monitoring checklists including service delivery. This data is compiled quarterly within the various programs and is finally merged together at the end of the fiscal year as an annual report. 

This report, as with previous reports,  is used by the TRADE Industries Board of Directors, management, and staff to assess program accomplishments and to identify areas of improvement. Elements of this report are brought to the Board’s attention at each meeting and the entire report is reviewed on an annual basis. Elements of this report are also addressed at the Management Meetings of TRADE Industries and quarterly results will be monitored to ensure that goals are purposeful and potentially obtainable. Input is sought from various stakeholders including those served, families, funding sources, and staff.  This information is used to make the necessary modifications in program delivery and service. These modifications include, but are not limited to policies, procedures, treatment methods, staff assignment and makeup, time management, marketing, and long-term planning.

What characteristics of the persons served are collected?

The following data characterizes those served by TRADE Industries in the most recent fiscal year.  Some clients may have been served by more than one program at the same time.

Adult Habilitation Services  (Developmental Training)
	
# of new clients: 1	
# of discharged clients: 3
# pending discharge:	0
# average of clients attending during year:	28

Male clients: 			15
Female clients:                        13

Age distribution:  	18 to 29 years =   2
			30 to 39 years =   4
			40 to 49 years =   8
			50 to 59 years =   6
			60 & over       =   9
Diagnosis
			ID =  25
			Autism = 2
                                    Dual diagnosis with MI = 18
			Other = 1
			Some have multiple diagnosis
Adaptive Behavior
			Safely crosses street independently =  7
			Writes Notes =                     	             10
			Self Medicates=                                    1
			Plans and prepares meals =                  1
			Independent Toileting =                     15

Problem Behaviors  (number of individuals with problem behaviors)
	  2017	 2018	
Harmful to self	      6	    3    	
Harmful to others	      8	   10	
Harmful to property	      6	    5 	

Seizures 
	 2017	2018	
Monthly or more	     2	   3	
Less than monthly	     6	   2	

Residential Setting (CILA)

		# of new clients:                         1
		# of discharged clients:              2
	Number of clients:	              13
	Male clients: 			   9 
	Female clients:		   4

	Age distribution:  	18 to 29 years =     2
				30 to 39 years=      2
				40 to 49 years=      5
				50 to 59 years =     4			
                       		            60 & over       =     2

		Living Arrangement:		Independent =                    	  1
						Lives in group setting  =  	14

	Diagnosis (some have multiple diagnosis).
			ID=               2
			Autism =      2
			ID/MI =        11
			Other =         0

	Adaptive Behavior
			Drives Car =  			    0
			Crosses Street Safely  =              7
			Writes Notes =                            9	
			Self Medicates = 	                1
			Plans and prepares meals  =  	    1
			Independent Toileting  =           14

Problem Behaviors  (number of individuals)
	 2017	 2018	
Harmful to self	    5	    4	
Harmful to others	   10	    7 	
Harmful to property	    8	    7	

Seizures 	Number of Individual having seizures more than  Monthly = 2
		Number of individuals having seizures less than monthly = 0
			
What data is collected about persons served.....?

At beginning of services:

Specific information is provided under program demographics.  In general, new clients are seeking CILA housing.
Three new clients in Developmental Training

Follow-up On Persons Who Have Been Discharged.

	In the past year, 2 people have been discharged from all of TRADE’s programs. 

      Both of the clients discharged were male.

      	Diagnosis were intellectual disability.

	One individual moved to Saline County, and the other was transferred to Choate Mental 	Hospital.

	Both were from a CILA home
	
	Follow up on those discharged revealed:

	1 remains in State Mental Hospital
	1 remains in another CILA

Why Do People Seek Services From TRADE?

The reasons why people seek services from TRADE remain stable. The most common reasons they seek services from TRADE are:

a. 	A need for further training in a given area. Often this is some form of self-care.
b. 	A need for residential assistance.
c. 	“Something to do”

This order, while previously tending to shift from year to year, remained  the same the last three years.

What Goals Do People Wish to Achieve While They Receive Services?

a. 	Obtain a higher level of functioning and independence.  
b. 	Engage in more activities and outings.
c.	Obtain a higher level of employment.

As previously mentioned, these are the top three goals although the order may change from year to year.

 Persons Awaiting Services

No one waited for services more than one week after approval from the state.  In most cases services were initiated prior to approval.  

Persons Not Accepted For Services

Twenty-two individuals applied for services this fiscal year, one of which was accepted for Developmental Training.  Five were denied due to high level of behaviors or intensive staff support needed, three were still in the legal system, four for sexual/self injurious behavior, nine for no female openings, and one for no male opening.

PROGRAMS RESULTS

Adult Habilitation (Developmental Training)

1.	Have the wages of those served been maintained from the past year?

There was a very small increase in wages from last year (.007%).  Shifts in the new rest area contract did have a major impact on job opportunities for DT clients.  Modifications planned for the Recycling Center rest rooms were delayed, which also limited the number and the time at this program.  More recycling jobs were performed by additional clients at the main program building.  The goal for the upcoming year is to maintain the current level of income per client.  A new goal will be established as well to achieve 65% of DT clients obtaining a paid job.

2.	Are the clients being integrated into community settings?

The goal is to have approximately 1.25 community outing per week per client or 6 per month.   The monthly average for community outings per client was 4.  Staff shortages limited the availability of community outings.  This continues to still be an emphasis for the upcoming year so we will try to achieve this year's result of 4.

3.   Are the treatment goals being met?

 This year's goal was to meet 75% of treatment goals. This year 70% of the treatment goals were met.  The goals were then revised and new goals were put in place. We will maintain the goal of 75% for the upcoming year. 

4.   What does it cost to provide services? 

The goal was to maintain an average cost per person equal to or lower than last year ($1,257.87/month).  The average cost per person served was $1,271.44 per month.  While we didn't meet the goal, we will maintain the same goal for next year. Profitability and efficiency of costs are high concerns.

5.   Is the program operating at a profit?

The program ran at a loss of $47,000 for the year.  First of all, the program loss two individuals this year.  Staffing levels have been adjusted for this.  Secondly, the program has been assigned responsibility for the operation of recycling, it is running in the red.  This is seen as a reasonable trade off because of the work opportunities created.  Emphasis on cost cutting and increasing recycling income will be an emphasis over the next fiscal year.

6.	 Once intake material has been obtained, what is the length of time to initiate 	services?  

0 days. TRADE initiates services prior to formal approval from the state.  Same goal.
 
7.  How many applicants have been turned down due to inability to access services?

0

8.    Are the clients satisfied with their services?

The program met its satisfaction goal of 90% by it consumers reporting a 90.0% satisfaction level.    This goal will be continued for next year.

9.  Are the funders satisfied with the services provides?

Those responding expressed 100% satisfaction with services against a goal of 80%.  This goal will be maintained.

10.  How satisfied are the parents and residential facilities with the services provided?
 
Parents/guardians expressed 100% satisfaction with the services provided.  This was against a goal of 80%.

This year the residential facilities expressed a satisfaction score of 100%.  The goal was 80%.  

Both goals will be continued in the upcoming year.

11.  Was staff turnover minimized?

In past years turnover had been a problem with consistency of services.  A goal was set to reduce turnover to one staff per year.  Our turnover decreased to five for the year.  This is still a major goal for the Adult Habilitation program and the goal to minimize turnover must be set to two per year.

12.  What areas need to be improved upon?

Community based involvement at all levels needs to continue to be increased.  The variety of paid work needs to increase.  Increasing efficiency in the recycling program will be stressed.  That being said, it is difficult to imagine when we would be satisfied with any level concerning the above in that there is always room for improvement.

13.  What corrective action will be taken? 

Gains continue to be made.  Changes to the State's waiver and new rest area contract regulations may weaken work opportunities in the future.  Recommended waiver changes require more community-based involvement.  Contacts with profitable recycling programs will be made to gather information for proper procedures and avenues for selling finished material.  Programs will begin addressing these proposed changes to improve options for those served.

Residential

1.	How many clients are living at their recommended level of independence?

Intermittent CILA  100%
CILA  Homes         100%

The figures from last year were the same. 

2.	Are the clients being integrated into community settings?
 
The goal is to have approximately ten (10) community outings per month per client.   The monthly average for community outings per client was 14.47.  This has been a greater emphasis and will continue to be with the positive feedback we are getting from clients.  The goal will be maintained at an average of 10 per month next year.  More emphasis will be made on integration through the week for the consumer having weekend family visits.

	2017	2018	
Reynolds	 17.66 per month per person	 16.25 per month per person	
Waggoner	 13.83 per month per person	 15.33 per month per person	
Harre	 10.25 per month per person	 11.83 per month per person	
  
3.   What success have the clients had in meeting their treatment goals?  Goal 80%

Treatment goals were met at an extremely high level and compared to last year.  New methodologies from the State will make the tracking  of goals more difficult to track in the coming year.  We will maintain the goal of 80% again until a better understanding is achieved.

	2017	2018	
Intermittent CILA	100%	   100 %	
Reynolds	100%	    90%	
Waggoner	94%	    92%	
Harre	88%	    90%	

4.  What success did we have at minimizing medication errors? Goal less than 20 per year.
There were 55 medication errors over the year.  The goal will be maintained for the upcoming year and compared to this year as well.
5.  Was full occupancy for funded beds achieved?

We had two individuals transfer to other residential programs.  During the same time span, we have no placements.  One home has been shut down to remodel home and improve efficiency  of costs.  These repairs have been made and we anticipate moving residents into this home early next fiscal year.  The home in Dahlgren was sold late in the fiscal year.  Plans are to sale another home in town once the move is complete.
	
6. What is the average cost of providing services in this program per person per month?

	2017	2018	
Intermittent CILA	$1,031.00	$826.00	
Reynolds	$4,902.00	$5,139.00	
Waggoner	$4,645.00	$4,358.00	
Harre	$4,495.00	$4,990.00	

7.   Was referrals denied (other than high medical and behavioral)?

All referrals denied were due to high behavioral and/or medical concerns.  Same goal for next year.

8.    Were services provided within 30 days of acceptance?

There was only one referral for year and he was served within the 30 day period.  Maintain same level for next year. 

9.   What is the level of satisfaction the clients have with the services they are receiving?  Goal = 85%

This year	   90.0%  	  Last year  88.6%

10. What is the level of funder satisfaction with the services provided? Goal = 80%

This Year      100%             Last year 100% 		Keep Goal.
 
11.  Was staff turnover minimized?

As with Habilitation Services,  past years turnover had been a problem with consistency of services.  A goal was set to reduce turnover to five staff per year.  Ten staff left employment this year.  Of these, half were over six months of employment.  Emphasis is being put on defining job and the training required during the interview to hopefully minimize the number of staff leaving during the training period.  This is still a major goal for the Residential program and the goal to minimize turnover to five staff per year must be attained.

12.  What areas need to be improved upon?

TRADE Residential services receive high ratings from parents, clients, and the DHS survey.  Still there is room for improvement. Residential staff turnover remains higher than desired.   Staff training has been improved through the use of computer based training.  Sign-on bonuses have been offered near the end of the review period which did show some success.  Follow-up will need to be done on longevity of those hired with bonuses for future use.  While residential consumers are engaged in frequent outings, those outings need to be more creative and focus more on the wishes of the consumers.  Though, marked improvements have been made in this area.

13.   What corrective action will be taken?

Efforts will be made to accept referrals that will not be a danger to our current residents and staff.  Currently, two individuals have 1:1 staffing levels.  Management is investigating the terminology to be used to more effectively and efficiently serve these individuals.  Continue to expand the quality and quantity of community outings.

How will this information be used?

The above information has been and will be shared with TRADE’s governing body.  This information will also be shared with the community at large both in printed distribution and on TRADE's webpage. From there it will be used to modify TRADE’s Strategic Plan immediately.  The information will be used by the various program leaders as a guideline for their time allocation.  Summary information will be provided on our webpage as well.

How is this information used in organizational decision making?

The summary of business information and performance is shared with the management team and indeed all staff. Management and the Board of Directors has used this information to clarify and guide its decision making in the following areas:

Financial

•	Below are the actual income and expenditures for 2017 vs. 2018 of overall agency financials:
	   Income	s		   Expense			Profit/Loss	
2017	$1,842,392			$1,803,519			  $38,873
2018	$1,535,514			$1,609,413			($73,899)*			*$94,000 were losses on sale of buildings
•	Verification from the audit report of "no instances of noncompliance or other matters that are required to be reported".
•	All monthly financial statements are reviewed by the Board of Directors.
•	All financial policies and internal control procedures were reviewed and updated as needed in preparation of the CARF review and cleared the financial audit.

Accessibility

•	Lighting kits replaces older lights that flickered or went off and on.
•	Due to attitudinal barriers identified, four presentations were made in the community about TRADE and its services.
•	Heavier community integration in both DT and CILA.
•	New electronic formats of consumer files and CARF files have received high praise.

Resource Allocation

•	Extremely large amounts of overtime has been paid to the CILA program due to staff shortages.  This was another underlying purpose for shutting down a home.  
•	Sign-on bonuses provided as an incentive to develop adequate staffing levels in both programs.

Surveys, Trends and Awards

•	Received a Three-year accreditation from CARF for Community Integration and Community Housing.
•	Conducted annual satisfaction surveys from all stakeholders.
•	Re-certification from DHS for Adult Habilitation (DT).
•	Re-certification from Bureau of Quality Management (BQM) for both programs

Risk Management 

•	Annual review of all insurance policies to insure proper coverage is maintained.
•	Major efforts to investigate ways to get more quality staff.
•	Remodeled main entrance after risk of violent person discussed.  Furthermore, new policies on using main entrance only.
•	One insurance review in FY 2018 with minimal loss exposure identified.  All identified were immediately repaired.

Human Resource Activities

•	At the end of 2018 fiscal year, we employed the following
-  4 full-time Administrative employees
-  1 full-time Registered Nurse
-  2 part-time RN
-  3 Job Coaches
-  2 full-time Adult Habilitation staff
-  5 part-time Adult Habilitation staff
-  18 full-time Community Habilitation staff
-  3 part-time Community Habilitation staff
** Many of the staff "cross-over" to multiple programs
•	All newly-hired employees are trained using the on-line training curriculum provided by Relias Learning.  Annual re-training is mandatory as well.
•	All newly-hired direct-service employees (DSP) receive 120 hours of computer and job shadow training prior to be given complete responsibility of the persons served.  New employees that area already certified as DSP or will not be working as DSP still receive 40 hours of training. 
•	Turnover continues to be one of the biggest hurdles facing programs.  A few of the staff who have left employment, have come back.  TRADE will continue to investigate additional incentives to minimize turnover.

Technology

•	Theraps Services LLC are utilized for daily documentation, tracking of goals, and electronic MARS.
•	Relias Learning has been utilized now for five years to provide on-line training and education for orientation and annual recertification.  Alternative training opportunities are available as well to staff interested.
•	Five Kindles are provided in the Adult Habilitation program to assist with increasing knowledge and provide a basis for improving other targeted skills identified in the participant's plan.
•	A training room with five computers is available to staff to meet initial and ongoing training needs.  Training days are provided nearly every month to assist staff in meeting annual training requirements.
•	Internet access is available in all homes of TRADE Industries for staff and resident use.

Health and Safety

•	Agency policy and procedures were reviewed and updated as needed as part of CARF review process.
•	Internal health and safety inspections are performed at all locations on a quarterly basis by the Health and Safety Director.  Follow-up is made in the event the potential for risks and/or safety are an issue.
•	Various external inspections are performed by insurance agencies, fire marshal, sprinkler systems, and fire alarm monitoring.
•	All employees are trained and certified in First Aid, CPR/AED, and Crisis Prevention Intervention  (CPI).
•	All homes and facilities have at least one AED device.
•	Safety Data sheets are kept up-to-date and maintained at all sites.
•	Fire drills are conducted at each location, on each shift on a monthly basis.  All other safety drills are conducted at least quarterly, on each shift (Tornado, Earthquake, Bomb Threat, Utility Failure, Medical Emergency, Violent Situation).  Staff are retrained annually in regards to the organization's emergency procedures and as to which require full evacuations.
•	Transportation safety policies are maintained in all vehicles owned and operated by the organization.  Drivers are requires to maintain a regular driver's license, proof of insurance, and go through the annual safe driving course, as well as how to operated the lifts and securing riders.
•	TRADE had 71critical/accident reports in FY 2018.  Fourteen were by employees (of which were loss time) and fifty-seven were client-related.  Most of the employee reports were caused by a consumer that was  transferred to a State Operated Facility on November.  Minimal trends were identified during analysis of client incidents/accidents.  
•	There were 55 medication errors.  None of these errors were required to be reported.  Two required retraining of staff due to revocation of medication pass privilege.
•	In FY 18, there were 11 cases turned into Office of Inspector General.  None of these were substantiated and one was completely unfounded.  There are still 10 open cases for this period.
•	No vehicular accidents reported in FY18.
•	No communicable diseases reported in FY 18.

Strategic Plan

The Director of Operations took the lead on developing the Strategic Plan this year.  She met with individual departments and talked to staff and clients, and then held a roundtable discussion with board members during one of their regular meetings.  Objectives with priorities were established and a plan was developed.  The following were points of major emphasis:
•	Develop fundraising opportunities to benefit various need levels through establishing a  "Wish List".  The list would be posted on our webpage and shared in our quarterly newsletters.   
•	Handicap accessible restrooms at the Recycling Center.
•	Increase the variety of work options.
•	Look into senior program due to the increasing age population.
•	Determine need for homes and develop a plan to sell or rent.
•	Repair the block building (garage) to help it to be used effectively.
•	Guttering needs to be re-attached to main building.
•	Drainage and resurfacing to parking lot needs to be considered.

Field Trends

The education and re-education of employees via the Relias Learning online training, various surveyors, and workshops provide an on-going opportunity for our employees to receive information and training on the current trends and progressions to provide our clients with the best possible opportunities while under our organization's care.

Service Delivery

Funding losses due to loss clients will have to be absorbed in some way, but at no time will the staffing ratios be jeopardized.  The new waiver being written by the State, includes new terminology for various levels of 1:1 funding.  These clients will still be monitored, but the "arm's length" rule will not apply.  This will ease payroll issues and hopefully negate some of the staff that might have been let go.

How are trends determined?

TRADE has various employee committees, board committees, a consumer committee, and committees involving a mix of various stakeholders.  These committees, as well as those individuals with responsibility over the various program and service areas, review the data concerning their areas of interest.  This data is then shared with other concerned staff in the form of reports, memos, and meetings.  

Trends are looked at for both within the given service area, as well as cross checked with other programs and service areas to identify organizational patterns. From time to time information is shared with representatives of other organizations at area wide meeting to see if patterns or trends of a larger scope exist. The President/CEO is actively involved with SIARF to gain input regarding regional trends.

What Are The Trends?

As has been mentioned numerous times already, the submission of a new State waiver is going to have dramatic effects on TRADE.  "Workshops Without Walls" is the push from this waiver.  Funding amounts, which are already insufficient, will be tightened even more if efforts to get individuals served out into the community are not demonstrated.  Also, subminimum wage certificates may be done away with forcing TRADE to pay anyone who works at least minimum wage.  Lower functioning individuals most likely will lose their opportunity at income if this is finalized.

TRADE will continue to attempt to mitigate this trend through reducing operational costs and building assets.   Realistically, we must be able to create the necessary reserves to function for 12 months without income based upon the present political trends in Illinois.  While TRADE is progressing in this direction, our progression is not to the degree needed.

While unemployment remains relatively high,  the quality of an applicant is often less than we would like. A side effect of this is that key staff have had to assume a greater work load.  TRADE continues to expand its use of technology to take pressures off the staff.  In recent surveys it is clear that TRADE salaries and benefits are competitive with similar organizations.

TRADE continues to look to stabilize its residential program, but does not want to jeopardize its current residents just to fill homes.  Tradewinds, due to the length  of time to respond to emergencies (both by Trade staff and emergency personnel) has been sold.  It is anticipated that residents from Waggoner will move into the remodeled Whittington House and Waggoner will be attempted to be sold.  

TRADE continues to experience high consumer satisfaction scores.  Information gathered through a variety of methods appear to agree.  

We have seen an increase in the number of its consumers exhibiting harmful behaviors over the last two years.  As state operated facilities are emptied, we can expect to see a continued increase.  Training has been enhanced to address these issues.

TRADE switched medication providers due to quality of services provided.  This has significantly lowered the number of medication errors from the previous year, but errors are still being made.  Ultimately, TRADE must have a goal of zero (0) medication errors.

While Adult Habilitation met their goals in community integration, the program will be urged to continue to improve its level of community interaction even with funding cuts.  This challenge will include providing opportunities that require little or no cost.

With most of the behavioral challenges rectified in the Residential program, greater levels of community inclusion will be stressed in the coming year.

In general, TRADE continues to remain fiscally solid as it improves the quality of services it provides.

Conclusion

TRADE Industries successfully continues to fulfill the letter and spirit of its mission.  TRADE continues to operate in the black overall, and it continues to make efforts to expand its consumer base.

TRADE must step away from the growth philosophy that it has followed over the past 5 - 10 years and look to stabilize services.  Current programs will be looked at to maximize efficiencies and minimize costs.  Management had submitted plans for a new building, but due to anticipated costs have been forced to rethink our needs.  A revised plan to remodel our current building will be developed to address present and future needs.

The organization, through the leadership of the Board of Directors, continues to work toward and develop plans and strategies for the continued growth of the programs and services offered to all clients.  It is essential that the employees providing the direct services to the clients continue to receive the highest training and acknowledgement of their contributions to the success of the organization.  Sign-on bonuses, as well as other incentives are going to be introduced to hopefully increase the number of quality applicants.  

Finally, the Board of Directors has developed a Fundraising Committee which plans to develop some type of fundraiser/activity on a quarterly basis.  A bingo fundraiser has been set to help raise funds for the recycling program.