Counseling Center

BUSINESS PLAN     JUNIPER COUNSELING CENTER (JCC)

1600 West Main Street
Ann Arbor, Michigan 48106

The Juniper Counseling Center (JCC) is a mental and health counseling/education center focusing on teen mothers, troubled children/youth, and senior citizens with mental/health issues. The business plan was developed for the purpose of a start-up business loan in the amount of $20,935.

• executive summary
• company summary
• services
• market analysis summary
• strategy & implementation summary
• management summary
• financial plan
• appendix

EXECUTIVE SUMMARY

The Juniper Counseling Center (JCC) is a mental and health counseling/education center focusing on teen mothers, troubled children/youth, and senior citizens with mental/health issues. JCC is located at 1600 West Main Street in Ann Arbor, Michigan. The business plan was developed for the purpose of a start-up business loan in the amount of $20,935. The total amount needed to open JCC is $26,935. The owner's investment is $6,000.

Our projected sales for 2002 is over $290,000 and our first year projected net profits are well over $40,000.

Juniper's keys to success include: marketing, service quality, growth potential, implementing an effective cash flow plan, achieving efficiency, running our counseling center professionally, and maintaining a serious business discipline in everything we do.

Mental and health counseling and educational training services, as shown in our plan, have an excellent profitability level and growth rate. Our competitive edge along with new counseling techniques put JCC in the forefront of counseling and educational services. We are living in an age where new techniques for mental and health counseling are in great demand. Our center will differ from the traditional counseling services because of our added personal touch.

Objectives

Our objectives are to:

• Provide counseling to individuals, couples, and families.
• Provide various therapeutic group sessions (i.e., bereavement, divorce, teen parenting, senior citizens' health issues, troubled children/youth).
• Provide health prevention and maintenance groups.
• Provide various disease-focused therapeutic groups.

Mission

JCC's mission is to empower disadvantaged and disenfranchised individuals, families, and youths to take control of their destiny and function productively by providing them with the necessary skills to realize their dreams, through counseling, education, social skills training, motivation, and participating in the treatment of abnormal behaviors to become successful.

Keys to Success

Juniper's keys to success include: marketing, service quality, growth potential, implementing an effective cash flow plan, achieving efficiency, running our counseling center professionally, and maintaining a serious business discipline in everything we do.

JCC's cash flow plan is to:

• Maintain enough money on hand each month to pay the cash obligations the following month.
• Identify and eliminate deficiencies or surpluses in cash.
• Alter business financial plans to provide more cash if deficiencies are found.
• Invest any revealed excess cash in an accessible, interest-bearing, low-risk account such as a savings account or short-term CD or T-bill.
• Clearly understand the mental health education market and competition while continually adjusting accordingly.
• Keep enough cash, as needed cushion for security, on hand to cover expenses.
• Reduce accountant expenses by producing our own summary statistics and projections via accounting software Therapist Helper.

COMPANY SUMMARY

Our vision is to move Washtenaw County's disenfranchised population to a condition of empowerment and self-determination, by enabling them to employ innovative strategies to produce desirable actions that lead to healthy results. JCC is dedicated to the community it serves. Through seminars, therapeutic groups, individual, couples, and family counseling, the center strives to raise public awareness to the needs of at-risk residents within our community. Services are designed to strengthen and increase self-esteem, self-respect, and respect for others in society, promote health, and to address issues relating to improving the quality of their lives.

Company Ownership

The founder and owner is Rolanda K. Walker, R.N., MSW, Ph.D. It is a privately owned corporation.

Company Location and Facilities

JCC will be located at 1600 West Main Street, Ann Arbor, Michigan.

Business Operations

The process of the JCC business operations is as follows:

• Counseling hours will be 9:00 A.M. until 5:00 P.M., Monday through Friday with flexible weekend and evening hours.
• Clients will come for services via physicians and school referrals, court orders, and by word-of-mouth. Per request, some clients with special needs will receive home visits.
• A client's first visit will be called in to the client's insurance company for approval of services.
• The client must have prior permission from the insurance company before they can receive services.
• On the day of the initial in-take, the client is assessed and a treatment plan is sent to the insurance company.
• The insurance will return payment for services in about 14 days.

Start-up Summary

Our total start-up costs are $26,935, which is mostly for furniture, equipment, working capital, and expenses associated with opening our first office. Direct owner investment will be $6,000. JCC will seek a commercial loan for the remaining $20,935 needed to start up the business. The assumptions are shown in the following table.

SERVICES

Services offered include education, training, and counseling to empower and implement a change in a person's behavior and thinking.

JCC will also provide the following services to individuals, families, couples, and youth:

• Violence/Conflict Resolutions
• Positive growth
• Bereavement
• Families in Crisis
• Grandparents Parenting
• Teen Parenting
• Relationship Problems
• Out-of-Control children and teen youths
• Health Services Utilization
• Alcohol/Substance Abuse
• Employment Difficulties
• Home Visits Available

MARKET ANALYSIS SUMMARY

JCC will be focusing on providing education and counseling services to teen mothers, out-of-control children/youth, individuals with mental health disorders, and senior citizens with mental and health issues.

• According to the National Campaign to Prevent Teen Pregnancy 1996 Michigan Report, a total of 29,840 15 to 19-year-olds gave birth.
• About 20 percent of U.S. children and adolescents (15 million), ages 9 to 17, have diagnosable psychiatric disorders (MECA, 1996, the Surgeon General, 1999)
• Chronic disease, memory impairment, and depressive symptoms affect large numbers of older people, and the risk of such problems often increases with age. In 1995, almost 60 percent of people age 70 and older report having arthritis, up slightly from the proportion reporting arthritis in 1984. The prevalence of arthritis and other chronic diseases, such as hypertension, heart disease, cancer, diabetes, and stroke are also reported, and vary by race and ethnicity. Increases in memory impairment and depressive symptoms occur with advancing age: one third or more of men and women age 85 and older have moderate or severe memory impairment and 23 percent of this group experience severe depressive symptoms.

Target Market Segment Strategy

The U.S Census Bureau County Population report of 1998 states that there are approximately 436,084 people living in Washtenaw County. Any of these individuals is a possible client for JCC.

JCC knows we cannot survive just waiting for the customer to come to us. Instead, we must get better at focusing on the specific market segments whose needs match our offering. Focusing on targeted segments is the key to our future. Therefore, we will focus our marketing message and our service offerings. We will develop our message, communicate it to our referral partners, and make good on it.

Teen Mothers

Nearly one million teen girls get pregnant each year. More than four out of 10 young women get pregnant at least once before they turn 20. Each year the federal government alone spends about $40 billion to help families that began with a teenage birth.

In Michigan, 11,350 15 to 17-year-olds gave birth, and 18,490 18 to 19-year-olds gave birth. Michigan ranks 24 (Rank of 1=largest decrease) for teen pregnancy rate with 87 pregnancies per 1,000 girls. Teen pregnancies were down in all age groups ranging from girls aged 14 and younger to girls aged 15 to 19-year-olds. Twenty-two percent of births in Michigan are to teens who have already had a birth.

Hispanic/Latina girls were the highest in birth rates among different racial/ethnic groups with African Americans being the second highest and White (non-Hispanic) being the third highest. From 1991-1998 African American girls has had the highest decrease in births with a 35% decrease. White (non-Hispanic) came in second with a 22% decrease and Hispanic/Latina with a 3% decrease in births. Asian/Pacific Islanders had an increase of 7% in teen births. JCC will continue this fight against teen pregnancy through our educational and counseling programs for teens.

Troubled Children/Youth

On January 17, 2001 David Satcher, M.D., Surgeon General of the United States of America unveiled a compelling report on youth violence to the frontline caregivers of our nation. The report was commissioned after the now infamous 1999 Columbine event that focused America's attention on children's behavior and their sometimes inability to cope with stress. In the report, Dr. Satcher invites families, school personnel, and public health communities to take a proactive role in the prevention of youth violence. "This is no time to let down our guard on youth violence," said Dr. Satcher.

Dr. Satcher's public health perspective identifies behavioral, environmental, and biological factors associated with youth violence. The report goes on to encourage our nation to take steps in educating individuals, communities, and primary care physicians to protect themselves from these risks. Dr. Satcher's public health approach offers a practical, goal-oriented, and community-based strategy for promoting and maintaining health. "The most urgent need now is a national resolve to confront the problem of youth violence systematically using researchbased approaches and to correct damaging myths and stereotypes that interfere with the risk at hand," said Satcher.

According to the American Academy of Child and Adolescent Psychiatry (AACAP) the needs and voice of child and adolescent psychiatry have been buried under the sweeping forces of federal mandates and national medical organizations' consensus on the oversupply of specialists. They have failed to recognize the continuing critical shortage of child and adolescent psychiatrists. There is a danger of becoming marginalized when the profession cannot provide needed services and contribute to society. The serious undersupply of practitioners has resulted in children receiving inadequate care from mental health professionals who lack the necessary training.

Report of the Surgeon General's Conference on Children's Mental Health: A National Action Agenda released the following information on January 3, 2001. From this information a report was developed and is the culmination of nearly a year of significant activities that were launched with the March 22, 2000, White House Meeting on Children's Mental Health. The report emphasizes the magnitude of the problem facing us in the United States. One in 10 children and adolescents suffers from a mental illness severe enough to cause some level of impairment. The report also emphasizes that it is estimated that fewer than 1 in 5 of these children receive needed treatment in any given year.

As stated in the foreword to the report, "The burden of suffering experienced by children with mental health needs and their families has created a health crisis in this country. Growing numbers of children are suffering needlessly because their emotional, behavioral, and developmental needs are not being met…… It is time that we as a Nation took seriously the taskof preventing mental health problems and treating mental illnesses in youth."

Prevalence and Magnitude of Child and Adolescent Psychiatric Problems

• The Center for Mental Health Services (1998) estimated that 9 to 13 percent of U.S. children and adolescents, ages 9 to 17, meet the definition of "serious emotional disturbance" and 5 to 9 percent of U.S. children and adolescents, "extreme functional impairment."
• Only about 20 percent of emotionally disturbed children and adolescents receive some kind of mental health services (the Surgeon General, 1999), and only a small fraction of them receive evaluation and treatment by child and adolescent psychiatrists.
• The demand for the services of child and adolescent psychiatry is projected to increase by 100 percent by 2020. (U.S. Bureau of Health Professions, DHHS, 2000).
• The population of children and adolescents under age 18 is projected to grow by more than 40 percent in the next 50 years from the current 70 million to more than 100 million by 2050 (U.S. Bureau of the Census, 1999).

Senior Citizens Health Status

Older Americans are living longer and living better than ever before. But many of those age 65 and older face disability, chronic health conditions, or economic stress according to a new federal indicators report that describes the status of the nation's older population.

Population:

The number and proportion of older people in the U.S. population has grown and generally will continue to grow at a very rapid pace. Aging in the twenty-first century will be characterized by a steep rise in the population age 85 and older and increased racial and ethnic diversity.

• The number of older people in the U.S. has increased tenfold since 1900. Today, an estimated 35 million people, 13 percent of the population, are age 65 and older. By 2030, 20 percent of Americans, about 70 million, will have passed their sixty-fifth birthday. The population age 85 and above is currently the fastest-growing segment of the older population; its growth is particularly important for anticipating health care and assistance needs, because these individuals tend to be in poorer health and require more services than people below age 85.
• The racial and ethnic makeup of the U.S. is changing, and the older population is no exception. In 2000, an estimated 84 percent of the population age 65 and older is non-Hispanic white, 8 percent non-Hispanic black, 6 percent Hispanic, 2 percent non-Hispanic Asian and Pacific Islander, and less than 1 percent non-Hispanic American Indian and Alaska Native. By 2050, those proportions are projected to be substantially different: 64 percent of the older population is expected to be non-Hispanic white, 16 percent Hispanic, 12 percent non-Hispanic black, and 7 percent non-Hispanic Asian and Pacific Islander, with the non-Hispanic American Indian and Alaska Native populations remaining at less than 1 percent.
• Today's older Americans are better educated than their counterparts 50 years ago, a factor that can positively influence socioeconomic status and health. In 1998, a high school diploma was held by some 67 percent of older Americans, compared with just 18 percent in 1950. About 15 percent of older Americans had earned at least a bachelor's degree in 1998, increasing from 4 percent in 1950.

Health Status:

Older Americans are living longer and feeling better. An overwhelming majority rate their health as good or excellent. Men and women report comparable levels of well-being. Disability rates are declining as well. But large numbers of older people find their health threatened by memory impairments, depression, chronic conditions, and disability, especially at very advanced ages, which can substantially diminish quality of life.

• Americans born at the beginning of the twenty-first century are expected to live almost 30 years longer than those born at the turn of the twentieth century. In 1997, a newborn baby girl could expect to live 79 years and a boy 74 years, compared to 51 years for a girl and 48 years for a boy born in 1900. Life expectancy varies by race, however. The average life expectancy for a white baby born in 1997 was 6 years higher than for a black baby born in the same year.
• Despite the prevalence of illness or chronic conditions, the proportion of Medicare beneficiaries age 65 and older with a chronic disability was 21 percent in 1994, down from 24 percent in 1982. During this time period, the older population grew significantly, and the number of older people estimated to have functional limitations increased by 600,000. This was considerably fewer, however, than the 1.5 million increase projected had disability rates not declined.

Industry Analysis and Trends

Overall teen pregnancies have decreased but they are still too high. The overall U.S. teenage pregnancy rate declined 17 percent between 1990 and 1996 (the most recent year available), from 117 pregnancies per 1,000 women aged 15-19 to 97 per 1,000. The national teen birth rate declined 3 percent between 1998 and 1999, reaching a rate of 49.6 births per 1,000 women ages 15-19—the lowest rate ever recorded. Since 1991, the teen birth rate has declined 20 percent. Nearly one million teen girls get pregnant each year. More than four out of 10 young women get pregnant at least once before they turn 20. Each year the federal government alone spends about $40 billion to help families that began with a teenage birth. Yet, much work is needed to be done in order to keep teen pregnancy down, such as more educational and counseling programs.

About 20 percent of U.S. children and adolescents (15 million), ages 9 to 17, have diagnosable psychiatric disorders (MECA, 1996, the Surgeon General, 1999). "There is a dearth of child psychiatrists…… Furthermore, many barriers remain that prevent children, teenagers, and theirparents from seeking help from the small number of specially trained professionals…… Thisplaces a burden on pediatricians, family physicians, and other gatekeepers to identify children for referral and treatment decisions." (Mental Health: A Report of the Surgeon General, 1999). The population of children and adolescents under age 18 is projected to grow by more than 40 percent in the next 50 years from the current 70 million to more than 100 million by 2050 (U.S. Bureau of the Census, 1999).

The number of older people in the U.S. has increased tenfold since 1900. Today, an estimated 35 million people, 13 percent of the population, are age 65 and older. By 2030, 20 percent of Americans, about 70 million, will have passed their sixty-fifth birthday. The population age 85 and above is currently the fastest growing segment of the older population; its growth is particularly important for anticipating health care and assistance needs, because these individuals tend to be in poorer health and require more services than people below age 85.

The global population is aging at a rate unprecedented in history. In the U.S., the population age 65 and older is expected to double by 2030. The Forum developed the report "Older Americans 2000: Key Indicators of Well-Being" to regularly track trends as society and individuals look for ways to address the aging boom. Today's report, which brings together information from more than a dozen national data sources for the first time, will serve as a baseline for future updates.

Americans age 65 and older are an important and growing segment of our population. While many federal agencies provide data on this diverse population, it is sometimes difficult to understand how this group is faring. For the first time, the federal statistical system has come together to provide a unified picture of the overall health and well-being of older Americans.

—Katherine K. Wallman, Chief Statistician, U.S. Office of Management and Budget

Competition

As a Registered Nurse and Health Psychologist, Rolanda K. Walker is equipped with advanced training and information about the interaction of psychological and medical conditions (or psychomedical disorders). This includes information about psychological difficulties that can be caused by medical conditions, as well as psychological factors which can complicate or delay recovery from medical conditions. This is the kind of expertise that will stimulate further thought about the assessment and treatment of patients with psychomedical disorders. This is the expertise that will give Juniper Counseling Center a cutting edge over their competition.

STRATEGY & IMPLEMENTATION SUMMARY

JCC will focus on servicing Washtenaw County and the surrounding areas. The three population segments will be individuals, families, and couples. The target customer is usually a person or persons with some type of behavioral dysfunction.

Competitive Edge

We start with a critical competitive edge: there is no competitor we know of that can claim anywhere near as much specific expertise on the problems and opportunities of psychological treatment as JCC. Our positioning on this point is very hard to match, so we must maintain our focus in our strategy, marketing and business development, and fulfillment. We should be aware that the tendency to dilute this expertise with more generalized counseling work could weaken the importance of our competitive edge.

Also, our potential competitor does not make home visits. Our staff is prepared to take our services to our clients. Older citizens many times are unable to leave their home for reasons such as lack of transportation, limited mobility, fear of driving, and issues of personal safety, to name a few. We will provide a holistic approach to total wellness by including intensive medical education pertaining to all medical diagnosis and treatments.

Price of Service

Prices will vary according to a person's insurance coverage and their ability to pay. Generally the cost of service averages about $75.00 per one-hour session. There will be one group session with 10 clients at $30 per client for the length of 52 weeks.

Sales Strategy

Sales in our business is client service. It is repeat business. One doesn't sell a session, one develops a treatment plan that works for the client.

We expect to see at least 15 clients per day. Dr. Walker will consult with 5 clients at an average of $75 per session, and each of her therapists will consult with 5 clients at an average of $75 per session. There will be at least one ongoing group session per week, averaging 10 clients at $30 per client, running for 52 weeks.

We expect to make enough money to expand the programs that Dr. Walker will implement in order to reach all disenfranchised individuals in the surrounding area.

Sales Forecast

We expect sales to increase as our staff and referral base increase. The following table gives a run-down on forecasted sales.

MANAGEMENT SUMMARY

JCC's staff has an accumulated 75 years plus in the Health Care industry related to experience. All are well versed in the evolution of the Health Care industry and share a vision for the successful positioning of Juniper Counseling Center within the Health Care Industry.

Our professional staff come to you with many years of experience, compassion, sensitivity to cultural values which affect the treatment outcome, and a strong desire to make life the best that it can be for all of its citizens.

Our management team consists of founder Rolanda K. Walker (RN, MSW, ACSW, Ph.D.), who has worked in the Health Care arena for over 20 years as a Registered Nurse/Health Educator and Social Worker for the last 5 years. Dr. Walker is a graduate from Wayne State University as a Health Educator and is also graduate from University of Detroit Mercy's MSW program. She is currently finishing up her Ph.D in Health Psychology from the University of Michigan-Ann Arbor.

Our professional support team will consist of of three registered nurses who will provide health education through medical seminars, groups, and individual counseling.

Personnel Plan

The following table summarizes our personnel expenditures for the first three years. We believe this plan is a compromise between fairness and expedience and meets the commitment of our mission statement. A professional staff of three RNs, 3-4 Therapists, Office Manager, Billing Clerk, Payroll Manager, Accountant, and Cleaning Crew will be assembled. These individuals will provide health education through seminars, groups, and individual counseling.

All the therapists will be paid 50-50. This means that for all counseling services provided, the therapist will be paid one-half of the amount the insurance company pays. For example, if a insurance company pays $75.00 per session, the therapist will be paid $37.50 per session.

FINANCIAL PLAN

The financial plan is for rapid, but controlled growth. Initial capitalization is pegged at 150K with cash streaming in from referrals over a period of six months. We plan to increase our clientele and cashflow through networking.

Break-even Analysis

The following table summarizes our break-even analysis. With approximate fixed cost of $2000 per month at the outset (a bare minimum), we need to bill $4000 to cover our costs. We really don't expect to reach break-even until a few months into the business operation.

Projected Profit and Loss

Our projected profit and loss is shown in the following table, with a net sales of more than $40,000 the first year to more than $60,000 through the third, and profits almost negligible for the start-up phase of this business.

Detailed monthly projections are included in the appendices.

Projected Cash Flow

Cash flow projections are the most critical indicator of our business's success. Attainment of the targeted population participation will ensure the accumulation of required cash to execute the running of the organization. The annual cash flow figures are included here and the more important detailed monthly numbers are included in the appendices.

Projected Balance Sheet

The balance sheet in the following chart shows managed but sufficient growth of net worth and a sufficiently healthy financial position. The monthly estimates are included in the appendices.

Assets

APPENDIX

Sales Forecast

Personnel Plan

General Assumptions

Profit and Loss (Income Statement)

Projected Cash Flow

Projected Balance Sheet