Case Studies

Citizen Advocates: “Finally, we didn’t need a policy for everything.”

Clarity about organizational culture doesn’t happen overnight. It’s an organization-wide process of reflection and conversation. Without clarity, change can’t happen.

James Button, CEO of Citizen Advocates, understands this from a growth perspective. For him, creating a workable definition of “culture” was the first necessary step in crafting a more resilient present and future for his employees.

Founded in 1975, Citizen Advocates meets a widening care gap in New York state’s healthcare landscape. The organization employs more than 750 health professionals to treat and support those living with developmental disabilities as well as mental health and substance abuse issues.

It is no easy task to identify a shared culture among health professionals and caregivers who have trained in different modalities, hold different beliefs, and come from a variety of backgrounds. Button acknowledged the challenge from the onset:

“We knew we had ‘culture,’ but we didn’t have a common language for it. We knew we had large groups of people with different offerings and perspectives. We needed a common language to be able to articulate in really easy terms what we believe and how we approach, together, what we provide to our communities.”

Crafting cultural beliefs eliminates “policy cravings”

Culture should represent the daily activity of an organization’s values. Button recognized a disconnect occurring at Citizen Advocates:

“When people didn’t know what the values were, they would ask for a policy or procedure,” he said. “With the introduction of cultural beliefs, we didn’t need a policy for everything. Articulating our cultural beliefs allowed us to function as one team, thriving together.”

Instead of fueling a surface-level craving for policy, Button and his teams answered the organization’s deeper need for cultural beliefs to refer to together in challenging moments of change and growth. Here’s what they crafted and put into action for their workforce and stakeholders:

  • Communicate courageously: I communicate and listen honestly, respectfully, and thoughtfully to foster trust.
  • Build bridges: I explore and collaborate outside my department to ensure whole-person care.
  • One team: I value everyone, each of us plays an equally important role in our success.
  • Own it: I commit to making lives better regardless of the task.
  • Thrive together: I contribute to our success by focusing on quality care and supporting financial responsibility.

Culture transformation at Citizen Advocates

To date, 97% of Citizen Advocates workforce has completed workshops focused on manifesting the organization’s “one-team” culture. Button has witnessed a sea change: fewer requests for additional policies or procedures. And the change has not just been internal; Citizen Advocates is attracting new employees due to its intentional internal shift. “When new employees are in orientation, they say their decision to join our team was because they have heard about our culture work,” said Button.

Of course the work isn’t easy or without struggle. “We’re still pouring concrete,” said Button. “The awareness is there. Our culture facilitators needed training first, and now we’re seeing a measurable difference: our people are leaning into culture to help them build and reinforce their teams.”

Citizen Advocates is integrating culture work into the entire employee life cycle, with focus on benchmarks like performance appraisals and reviews. Recognition is key, and these benchmarks have been revised to focus on how employees are activating the organization’s cultural beliefs. Anonymous, quarterly employee surveys and patient surveys will now provide a gauge for culture adherence in measurement.

The culture journey has realigned two goals at Citizen Advocates: providing quality, whole-person care for patients and financial stability and profitability for the organization. Button has received positive feedback from all stakeholders: community, workforce, and Board.

“Walking our talk”

Citizen Advocates’ mission to make lives better sets a high bar, one that James Button takes into his small community. Our culture is integral to the success of the mission, and Button is more than aware that he’s part of it:

“I’m more cognizant of walking my talk. I want to be a person who is able to demonstrate my cultural beliefs whether I’m in a meeting or at the grocery store. People are always looking for reasons to say you’re full of it: let’s see if the leaders at Citizen Advocates really walk the talk. So I ask the team to be very conscious of how they carry themselves in the community.”

Cultural beliefs unite Citizen Advocates and galvanize the organization, at every level, to recognize each other as individuals dedicated to whole-person care in the community. 

“Work is not family,” Button emphasizes. “Work is a community of like-minded individuals.” The distinction is a strong bridge for Citizen Advocates to build on.

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