Surviving Fee-for-Service and Productivity Standards

Administrators at community mental health centers have increasingly adopted productivity standards and fee-for-service models for evaluating the performance of their clinical staff. Under these administrative models, the financial risks associated with missed appointments and premature termination—common phenomena at community agencies—have been transferred from the agency as a collective to individual clinicians. These polices may not only lower morale and have financial implications for counselors, but also be at odds with agencies' service missions and result in cost transfers to other social service systems in the community. The purpose of this article is to describe the twin phenomena of fee-for-service and productivity standards, discuss the potential negative consequences of these models for multiple stakeholders, and offer strategies for counselors in persevering in these work environments.