A Message from the Chairman of the Board

Mark Whitworth

Our Mission:To enrich communities and enhance the ability

of individuals and families to improve their lives.

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The Board of Directors at Northeast Kingdom Human Services is made up of unpaid volunteers from our community. The Board’s goal is to ensure that NKHS provides the best possible service to our friends and neighbors and help them face mental health challenges, recover from addiction, and live fulfilling lives in spite of emotional or developmental disabilities. We understand that in order to provide the best possible services, we need to create a workplace that is collegial and professional, offer rewarding careers, and provide competitive pay packages.

The budget that we have approved for the new fiscal year emphasizes these workplace priorities.Our new budget includes a substantial increase in professional development funding. This will enable us to begin a professionalcoaching initiative for NKHS leadership and offer more generous assistance to staff members who wish to advance theircareers by earning new certifications or pursuing relevant educational goals. We will also engage outside professionals who willhelp us improve our workplace by conducting an assessment, developing a program of continuous improvement, and providingus with tools to measure our progress.

The budget will also enable NKHS to establish a new compensation structure that will be rational, fair, and more competitive.The new structure will:

• Reward the experience that comes from years of service• Encourage career advancement through educational achievement and the pursuit of professional credentials

The Board wishes to thank all of the dedicated professionals who carry out NKHS’s mission. We wish to thank CEO TomaszJankowski and his team for all of the hard work that they have done to create a budget that reflects these important priorities.We also wish to express our gratitude to Tina Norton who retired from the Board this past year and offer our thanks to AmyMorley who has taken over as Board Treasurer.

A Message from the President and CEO

Tomasz Jankowski, DPT, MHA, MBA

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It has been a privilege serving Northeast Kingdom Human Services as its President andCEO for over a year. After having succeeded Carol Boucher, as leader of the organization,I have opened multiple channels of communication, such as "Ask Tomasz," Quartetly EmployeeForums, monthly Round Tables, and visiting our group homes, to ensure I learn and understandthe issues affecting all Staff and our organization. This has been an ongoing process and I lookforward to continuing the dialog.

With that said, it was a dynamic, and at times, challenging year. In January of this year, our organization has began providing mental health services under the new payment reform system leading to a significant shift and adjustment in the way deliver our services. Internally, several leadership changes have led to redesigning our organizational structure in an effort to streamline operations, improve communication, and facilitate horizontal integration across clinical and administrative boundaries. These efforts have led NKHS to realizing significant savings and achieving successful financial performance that allowed us to recognize and compensate all our staff for their hard work. Furthermore, it had also paved the way to developing a competitive salary structure and aggressive recruitment and retention tools. The strong financial performance has also allowed NKHS to look into the future by investing in growth through technology and communication tools, such as the new human resources and payroll system, general ledger, and telephone system. NKHS is also well on its way to evaluating and selecting its new electronic medical records system.

None of our plans or achievements would have been possible without the unparalleled commitment, and the hard work of our talented cadre of staff, who, countless times, have stepped up to ensure we meet the challenges and expectations of the communities we serve. NKHS is a closely knit community, in and of itself, and this past year, we have said thank you to several retiring individuals who have spent decades ensuring we live up to our mission to enrich communities and enhance the ability of individuals and families to improve their lives.

As I look forward, I see a bright future for NKHS. While it may not be easy, I strongly believe, it shall be rewarding. Working together, and under the leadership of our Board of Directors, we shall achieve and deliver Operational Excellence, Amazing Patient Experience, Creating the Future, Employee Engagement, and Community Benefit.

Sincerely,

Tomasz Jankowski, DPT, MHA, MBAPresident and Chief Executive Officer

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Our Services

At A Glance

At NKHS, we are making a difference. In fiscal year 2019, NKHS employed 430 people and served 3,264 clients. Whether it is in our Developmental Disabilities programs, our Community Rehabilitation Treatment programs, our Addicitions, Children's or Adult Services, we are involved in every aspect of our communities and providing the necessary supports to truly enhance the lives of all individuals.

By providing more supports to more people in Vermont compared to national averages, we estimate that the VCPNetwork community based programs and services have saved taxpayers over $50 million through the reduced

emergency department utilization and hospital bed stays.

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Client Access ServicesBringing People Together

At Northeast Kingdom Human Services, our Client Access Teams are the first faces you see when entering our buildings, and the first voices you hear when calling our offices. Nothing is more important than feeling welcomed upon a first visit, or a 100th visit - whether coming in the front door, or calling in to speak with one of our receptionists. We pride ourselves on our Access Teams’ professional, supportive, friendly, empathetic, and resourceful ways. We strive to make a difference in whether or not a first visit or phone call will lead to a second. The Team is passionate about our mission; I have often heard them remark on how very rewarding it is to know how a simple kindness and a helping hand on the front end can make such a difference in someone’s life. Knowing that this team could very well mean the difference between someone pursuing services at NKHS or opting out, is in itself an incentive to provide a customer service model which is second to none! Whether it be coming in to do registration paperwork, scheduling an appointment with one of our clinicians, looking to speak with a case manager, or coming into the office for an interview in pursuit of employment with NKHS……the Client Access Team is here and ready to Welcome You!

- Denise Lepine-Whitehead, CMAA, CEHRS Senior Director- Agency Support Staff Services

The staff pictured here are the smiles you will see when you walk in our doors! The Derby staff are pictured on the left and in the middle: April Mead, Carleen Starr, Angela White, Sue Miltner, Tracy Fortin, Christine Pateneaude, Dani Hoyt, Carol Breen, Coral Sargent and Erin Gaudreau (not pictured). In St. JOhnsbury: Wendy O'Brien, , Jess Trepanier, Gidget Boutah-Lyon, Lynn Ruggles, Kim Payne, Sandra Austin and Patsy Whitcomb.

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Intellectual and Developmental Services

Shining On

I learned about how to: Take care of myself. I learned how to manage my money better, I have learned to take contructive criticism. I can be on time for work. I have learned to keep my opinions to myself, and not to take stressful situations to work with me. I have learned to care about how others may feel and to be completely honest with myself and others. This program has done so much for me and if you all work at it this program will do so much for you, too.Job Connect wont always be easy and you will have to work really hard at everything you all will do, be doing, or already have done. But, if I can do it then you can and you will get a job and be successful. I have started working on my job on October 17, 2018 and I had to work really hard at it.If you stay focused and committed even when things are extremely emotional and hard, this program will do all of

you a world of good. Job Connect wont always be easy and sometimes you may not like the people you work with. Just like life it isn't generally easy. But, I can do it then I know, you can too. Thank you for listening and remember if you really apply yourself I mean really, really try hard, you can be successful.

Sincerely,

Tiara K. Mandala

Tiara K. Mendala pictured here with our Employemnt Coordinator, Norma Gregory

Dear People who are going through the Job Connect Program:My Name is Tiara K. Mendala. I learned about the Job Connect Program through my Case Manager, Carol Simmons. At 15 years old I was a very unruly individual, and I really didn't care about anyone but myself and my own feelings. I wasn't responsible, organized to anyone or even respectful to others. I didn't even care about my appearance at the time.

Our goal in IDDS is that our staff and individuals we support will have the empowerment that comes from knowing they are believed in and can believe in themselves.

-Sharon Ryan, IDDS Director

Adult Divison of Services

Making a Di�erence

“At the root of this dilemma is the way we view mental health in this country. Whether an illness affects your heart, your leg or your brain, it's still an illness and there should be no distinction.”

- Michelle Obama

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�is piece of art was painted by a young woman named Ruth of Cra�sbury, VT for our annual "What is Mental Health" coloring contest.

At NKHS, our Adult Outpatient Program supported 1,131 clients in FY19. When we serve 1,131 people, we are helping not only the individual, but their entire family support system. At NKHS, we work together to break down stigma and help consumers learn that it is okay to not be okay, and to ask for help.At the NKHS Open Houses in June, we had messages on Poster boards posted all over the grounds. Some of the messages were simple, such as, “Togetherness," "Community," and "Welcome." Then there were others with quotes or facts. One of them was a sign that stated, "a person dies by suicide every three days in Vermont." Two different people reached out to staff members about that sign, mentioning that by reading it, it made them feel less ashamed for having deep feelings of unworthiness themselves, and suddenly they understood that they were not alone, that many people struggle, and that maybe struggling is not the most shameful thing in the world. Because every single person struggles on some level at some point in their life. And the more we, those who care for people and their minds, can make it less of a scary and shameful thing to admit, the more people we can help and the happier more people can become. Suicide is a permanent solution to a temporary problem. There is hope, every single person matters.

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Children, Youth and Family Services

Support and Strength

In 2019, Children Youth and Family Services brought in $5,462,187 billable hours of revenue. CYFS served 853 clients in FY 2019. Mental Health and Emotional stability begin at home and we are working hard to support our

families to be well balanced.

In June 2019, NKHS hosted two open houses, one in Derby on June 22 and one in St. Johnsbury on June 29. Staff were there to welcome families and individuals to tour our buildings and enjoy hot dogs and ice cream. Over 100 families came and many staff brought their children as well. Embracing the communities here is the heart of why every single staff person shows up to work each day.We had over 100 entries in the Coloring contest, and every single one was beautiful. NKHS offered wagon rides at our Open Houses, from The Kingdom’s Horse Drawn Rides. One of our Developmental Disabilities clients arrived to the event and so desperately wanted a horse-drawn wagon ride. She was in her wheelchair and it was unclear how to get her properly restrained in the wagon in her chair. Luckily, we had the ambulance there to show the kids, with a special restraint seat on board. The EMT, the Fireman who was there with the Derby Firetruck, and the Horseman, all lifted the client into the restraint seat and then lifted her onto the wagon. Her smile lit up the sky. After her ride as she was being wheeled past the front of the horses, with their big, heavy, gorgeous faces. One of them reached around and gently nuzzled her. One could almost feel her heart leaping. It was such a beautiful moment. It is those moments that keep us going, that remind us why we are here doing this work. We are here to help people, to lift people up, to give them hope and healing. To offer them a bit of light, and plan to keep it, when the world feels heavy and dark.

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Substance Use and Addiction Services

Hope is the lifeline for change

In FY 2019, NKHS served 712 clients for substance use disorder. NKHS offers individual and group therapy for clients who are looking to make a change in lifestyle. At Northeast Kingdom Human Services, we look at the whole person during treatment. We evaluate the causes of why an individual might be choosing to use. We offer healing of the underlying pain as part of our treatment approach.

At NKHS, we look at the whole person, and often substance use is co-occurring with other mental illnesses. NKHS offers treatments such as Dialectical behavioral Therapy, and group therapy, as well as individual therapy.

New in 2019 NKHS began the Seven Challenges Adolescent Treatment Program. NKHS offered one group session in 2019. Our goal is to embed this program into four local high schools by 2023. This program is

an evidence based, trauma-informed program that encourages youth to understand coping mechanisms and make choices that support self-care rather than to mask their pain or trauma with drugs or alchohol.

In FY2019, NKHS brought in a total of $867,184 for billable hours in SA treatment. We are working hard for our friends, familes and neighbors.

Zero Suicide Initiatives

Question, Persuade, Refer

Did you know? We are in the midstof a suicide crisis in Vermont. One person dies by suicide every three days in the state, and nationally one person dies every 40 seconds.

Zero Suicide implementation requires transformative change that cannot be borne solely by the practitioners providing clinical care. Zero Suicide requires a system-wide approach to improve outcomes and Essential Elements of Suicide Care. After researching successful approaches to suicide reduction, the Action Alliance’s Clinical Care and Intervention Task Force identified seven essential elements of suicide care for health and behavioral health care systems to adopt:

LEAD system-wide culture change committed to reducing suicides TRAIN a competent, confident, and caring workforce IDENTIFY patients with suicide risk via comprehensive screenings

ENGAGE all individuals at-risk of suicide using a suicide care management plan TREAT suicidal thoughts and behaviors using evidence-based treatments TRANSITION individuals through care with warm hand-offs and supportive contacts IMPROVE policies and procedures through continuous quality improvement

Zero Suicide is a call to relentlessly pursue a reduction in suicide and improve the care for those who seek help. By June 30, 2019 NKHS staff have trained 450 colleagues and community members in the span of 22 trainings in

the QPR (Question, Persuade, Refer) Suicide Prevention Gatekeeper online training.

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NKHS funds the QPR prevention through fundraisers, keeping the cost low to our communities.Almost $4,000 was raised to support QPR training initiatives.

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This friend of mine, was not a close friend anymore. He was a person five or six years younger than me who I used to babysit when I was an overly responsible and very anxious seventh grader. He was a boisterous little guy that loved brownies and hot fudge, and I loved how excited he would be when I would let him have seconds. He didn’t know I was also delighted because I was a kid loving the freedom of letting us BOTH have seconds. Time passed, and we grew up. I didn’t see him until my late thirties when he frequented my booth at the farmers’ market, and we would find ourselves in the midst of deeply emotional conversations. Our deep conversations at the market were not uncommon because, as a farmer raising animals for meat, it was easy to leap to conversations such as the fleeting beauty of life. I was newly divorced and raw. He was newly convicted of another DUI and raw. He was trying to survive, work, and play music with no driver’s license, and after a bit, no job. We would speak on those Saturday mornings of the harsh judgments of onlookers who don’t stop to understand the full story. We would speak of our perceived remedies for shame: the importance of human connection, forgiveness, and hope. I remember the day he came to describe the crane that lifted his baby grand piano out of his apartment- the apartment he was getting evicted from because he was too loud with his late night piano playing and too late with his rent. My heart broke for him as he described watching his piano being lifted to storage. Neither of us knew this would be the last place he ever saw it. The more we can all remember this, and check in with our friends on more personal levels, the safer, happier, more connected and hopeful we will all remain.What is it that makes people give up? With Suicide on the rise at a 33% increase since 1999, and 45,000 people dying by suicide in 2016, alone, it is a difficult question to answer. In general, overarching issues involving shame, hopelessness, and isolation seem to be prevalent. The research tells us is that one in five adults are having or have had suicidal thoughts, which means that if you look to your left or to your right in any moderately populated area, you are likely seeing at least one person who is suffering and in need of hope. Suicide is often said to be a permanent solution to a temporary problem. But the temporary problem brings suffering that is suffocating to the extent that it doesn’t feel that there is any other way out. But there is always another way, and it is up to every single one of us who is alive today, to learn how to ask our friends how they are doing, to love them through their suffering, and to always provide hope. Asking a friend who is struggling, “Have you thought about killing yourself?” is an okay question to ask. It shows you care. It shows that they are not permanently flawed for having the thought. It shows that it’s okay to talk about. Talking about things, the hardest of things, is what brings us closer, provides tethers of connection and understanding, literal lifelines of hope, empathy and understanding. We as a nation need to keep extending the lifelines and holding tight for all our friends.At the end of the day, it is judgment that is the destructive force for most of us. Judgment leaves no room for understanding. When we feel judged, we immediately feel less worthy and misunderstood, and it sets our emotional footing on untrustworthy grounds.“It’s hard to find a piano sometimes…” Could mean just that. It could also mean, “I am alone, without the healthy outlet I have to process my darkness…” Let us all go about our lives remembering to love, to offer support without judgment, to be brave and ask our friends hard questions. We will then create longer and stronger lifelines, from one person’s hope to another, to another, to another. The hard work that is happening at mental health agencies across the state is good, hard work, that deserves our funding and attention. The more education and outreach there is, the more support there will be to help all individuals see that every single person has beauty. We are all worthy, and it is up to each of us to remind each other to love and hope, every day. -Lila Bennett, Director of Marketing

Zero Suicide Initiatives

�e Opposite of Suicide is Connection

"It's hard to find a piano sometimes..." It was the last post that my friend put on his Facebook page. The last effort of reaching out beyond the loneliness, shame, and despair that was silently consuming him until July 3, 2019 when it took his life. It's not an uncommon story anymore. The silent sadness of our friends suffering alone, their only connection through the mirage of social media.

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Community Rehabilitation andTreatment Services (CRT)

Respecting Independence

Today, David has a regualar job, an apartment, and he is also cultivating his talents as a magician. At our Open House events in June, David performed his magic tricks for the crowds. Children and adults were in awe not only at his incredible skills as a magician, but at his composure and confidence in his presentation of the show. This is the heart of what CRT, and NKHS as a whole, is all about.

The CRT program served 243 Clients in FY19, bringing in a total of $4,732,829 to the NEK.

A message about Heather, a CRT client:

Heather Lawson has always been an artist, but never thought she would be the type to have an opening at a gallery, and then at that opening sell five paintings in one night. Her style is acrylic, with dashing colors, and vibrant images that are striking and very pleasing to the eye. Art is expression of human emotion. Heather’s art keeps her happy, healthy and is a wholesome outlet for the stress in her life. We all need to have healthy and wholesome outlets for stress, and Heather is a shining example of someone taking a passion and using it for good. Northeast Kingdom Human Services is a team of professionals who are working hard to foster the strengths of our clients, and exemplify the mission, and help others like Heather become living, breathing examples of enjoying a happy and independent life.

CEO Tomasz Jankowski pictured with Heather at her art show at the 99 Gallery in Newport.

David, our CRT magician, sharing a magic trick at an NKHS open house event.

A message about David, a CRT client:

David entered the CRT program four years ago. At the time he was not emplyed and did not have stable housing.

Orleans

Caledonia

Essex

Emergency Services

React, Respond, Respect

At NKHS, we offer services around the clock, 365 days per year. We have emergency services teams and specialty teams who are on call and ready to assist in individual or community wide crises. These screeners evaluate people in crisis in the office, at local hospitals and in clients’ homes. When Screeners evaluate a person in crisis, offering the least restrictive environmental aspects while keeping the individual and community safe are a priority. The client’s own natural supports are incorporated into a safety plan. When the person and/or family members require additional support, NKHS Cadre Team can assist directly in the home. Some of the NKHS Cadre team are able to provide peer-support through their own lived, shared experiences. Peer Support and WRAP (Wellness Action Recovery Plans) are integral to our care plans and supporting the whole individual in an empowering, respectful way.

Our Direct Service Providers, our support supervisors, directors and therapists travel throughout our three-county region (Orleans, Essex and Caledonia) providing services. We span 2027 square miles. Our staff are out in the community supporting clients at work, school and home. We help our clients be happy, respected and contributing members of our communities.

Our teams helpavoid costly Emergency Room

visits. An average Emeregency Room visit costs

over $2,000.Emergency responders are

able to provide enough support to help clients in crisis and avoid costly visits to the

Emergency rooms.

NKHS Medical Director Dr. Richard Edelstein and Emergency Services Director Tonya Davis

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"What mental health needs is more sunlight, more candor, and more unashamed conversation."

- Glenn Close

FINANCIAL OUTCOMES

Fiscal Year 2019

2019 Our services save taxpayer dollars. The average annual cost per-person nationally for institutionalized care is$501,370.00 whereas the annual cost per individual in Vermont on support services and living in the community is $56,672.00.

Soure ExpensesChildren Services 5,209,384 Adult Outpatient Services 1,763,477 Community Rehabilitiation & Treatment 3,931,684 Emergency Services 623,546 Developmental Services 25,162,763 Substance Abuse Prevention & Treatment 929,657 TOTAL EXPENSES 37,620,512

EXPENSES BY PROGRAMFiscal Year Ending June 30 , 2019

(Unaudited)

REVENUE BY SOURCEFiscal Year Ending June 30, 2019

(Unaudited)

Children Services 5,462,187 Adult Outpatient Services 1,379,021 Community Rehabilitiation & Treatment 4,732,829 Emergency Services 921,147 Developmental Services 25,009,366 Substance Abuse Prevention & Treatment 867,184 Admininistration 168,957 TOTAL REVENUES 38,540,691

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Wellness

We Care about our Sta�

The NKHS Wellness Committee meets monthly, working closely with Blue Cross Blue Shield of Vermont to meet our vision statement “To recognize a culture at NKHS that promotes total well-being and balance in work and life” by organizing special events, awareness, education, and challenges to promote a healthy lifestyle for our employees and their families.

The Wellness Committee implemented a “Healthy Hump Day” usually held on the �rst Wednesday of the month. Teams of co-workers sign up to provide healthy snacks for the agency that day.

This committee has applied for and earned the Vermont Governor’s Council on Physical Fitness and Sports Excellence in Worksite Wellness Award for NKHS the past 12 years! This year NKHS received the GOLD award. Representatives from the NKHS Wellness Committee attended the Worksite Wellness Conference to learn about health and wellness ideas.

Top photo: Gov. Phill Scott, Nancy Benoit,Kendall Middleton, Claire Roberts, Carole Breen.

Bottom photo: At NKHS, we do Tabata, a group movementactivity for fifteen minutes twice a day. It's fun and healthy!

www.NKHS.org

No one has ever become poor by giving.

A BIG “Thanks” to all of Our Donors, for supporting NHKS programs through appropriations, donations and/or grants. Thank you to the Towns of: Albany, Barnet, Bloom�eld, Brighton, Brownington, Burke, Canaan, Charleston, Concord, Coventry, Craftsbury, Danville, Derby, East Haven, Glover, Granby, Greensboro, Groton, Guildhall, Hardwick, Holland, Irasburg, Jay, Kirby, Lemington, Lowell, Lunenburg, Lyndon, Maidstone, Morgan, Newark, Newport Center, Norton, Peacham, Ryegate, She�eld, St. Johnsbury, Stannard, Sutton, Troy, Victory, Walden, Waterford, West�eld, Westmore, Wheelock and Newport City. Thank you Vermont Community Foundation, Northeast Kingdom Fund, Community National Bank, Northern Counties Health Care, Supporters through Vermont Gives Day, The Pizza Man, St. J Village Pizza, The Moose River Lodge, The Pick and Shovel, RecFit, Shaws, XIP Training Center

Thank You to Our Individual Donors:Effie Brown, Rep. Martha and Stephen Feltus, Nancy Warner, Mark Whitworth, Timothy Doran and Anonymous Donors.

2 OFFICE HEADQUARTER LOCATIONS:

181 Crawford Road Newport, VT 05855(800) 696-4979

2225 Portland Street St. Johnsbury, VT 05819(800) 649-0118