[1] Strategic Plan 2018-2020

Great Lakes Recovery Centers

Strategic Plan 2018-2020

Plan Updated: September 13, 2017

Mission: “Empowering recovery through hope and change.”

Vision:

“Helping to create healthy communities one person at a time.”

[2] Strategic Plan 2018-2020

Accomplishments: Our Empowerment and Recovery (EAR) Team met to review our previous plan and in doing so identified our list of accomplishments over the last 2 years. Some of these accomplishments include the following:

• Access Center Developed and streamlined screening and scheduling for all outpatient programs

• Expanded Social Detox to Adult Residential services in Marquette

• Developed and operated Sue B’s House, a recovery residence for women, which served 15 women the first year

• Closed Fiscal Year 2016 with our highest profit margin in over a decade

• LUNA: Look Uncover Nurture Act Neuro-Developmental Trauma Assessment Center was developed and served 15 children in the initial year

• PREA audit accomplished for Adult Residential Services in Marquette

• Staff went through a major platform change when NorthCare switched from CareNet to ELMER

• DSM-V adaptation for clinical services

• Clinic locations in Iron River and Hancock established

• Telehealth infrastructure was secured through grant funding and provided a video-platform for clinical supervision, team meetings, and case review

• Developed our Emergency Shelter Beds at ASC in partnership with Marquette County Juvenile Court

• Developed 3 distinct Communities that Care Coalitions (CTC) to serve as a prevention platform for mobilizing education and advocacy in Iron Mountain, Manistique, and St. Ignace

• Implemented our CIC – (Continuous Quality Improvement) internal committee to help with quality improvement over clinical services

• Expanded our dashboard for quality reporting

• Negotiated and secured NorthCare regional rate increases to help solidifying payment for services which assisted with improvement in Cash flow

• Re-implemented Women & Families programming

• Expanded prevention programming

• Michigan Department of Corrections contracted with GLRC for Offender Success operations for all 15 counties for prisoner re-entry programming and management

• ASC received grant funding for the establishment of a trail system and healing circle

• GLRC received grant funding for the implementation of Mental Health First Aid trainings throughout the Upper Peninsula

[3] Strategic Plan 2018-2020

• Relocated our outpatient office in St. Ignace to co-locate with new service development for Beacon Living Services

• Relocated our Iron Mountain office after a 30-year period

• Developed an Administrative Services Organization (Recovery Centers of Michigan) as a strategic partnership with several Northern Michigan providers including the Phoenix House, 10-16 Treatment Centers, Addition Treatment Services, and Harbor Hall

In Addition, Our Empowerment Team had identified the following items for continued growth:

• Additional trauma-informed therapy, curriculum vision

• Curriculum development and alignment among Residential and Outpatient Systems

• Further development of our person-centered treatment process

• Developing increased fidelity with (MCBAP) through documented supervision

• Ongoing Clinician development

• Ability to leverage new funding to assist with homeless

• Continue to seek out new funding initiatives

• Continue with Residential Forum focusing on reducing programmatic silos

• Refinement of Women & Families program services

• Consistency in services offered at outpatient clinics through the Outpatient Forum process

• Continuation of services tied into prevention, outpatient, etc.

• Additional services for behavioral health, MAT, Telehealth

• Opiate addiction product – defining what it means to GLRC

• Cultivate an agency-wide medical director; dedicated medical infrastructure for clients in residential

• Efforts at Recovery Centers of Michigan ASO

• Full utilization of billing – EHR to client accounting alignment

• Electronic file/paperwork consistency

• LPC development

• Continue to build cash reserves

• Further development of recovery residence for women

• Establish recovery residence for men and children

• Sell six (6) acres in Ishpeming – cash reserve

• Outcome collection established

• Outcome collection/drive practices

• Utilizing peer support, involved with follow-up

• Peer support/peer recovery continued development

• Exploration of digital signing pads

• Piloting fully electronic files

• Great Lakes Recovery Centers evaluating the feasibility of a training and development coordinator

[4] Strategic Plan 2018-2020

Our Strategic Goals for 2018-2020 Include: Internal Financial Goals:

1. Reduce accounts receivable beyond 90 days to 10% or under

2. Streamline billing through our EHR 3. Planned replacements for infrastructure

including technology upgrades 4. Planned replacements for vehicles 5. Property sale – AMCAB 6. External billing system review

Operational Goals:

1. Offender Success: 5-year program implementation

2. Trauma-based service expansion to outlying clinics beginning with Hancock and Ironwood

3. Recovery residence development in targeted communities including Marquette, Sault Ste Marie and Escanaba

4. Telehealth service implementation beginning in Manistique

5. Specialty behavioral health clinic development to include autism spectrum services, testing and limited psychological services

6. Medication-Assisted Treatment [MAT] clinic expansion in Sault Ste Marie and Hancock

7. Organizational changes and alignment with service systems to reduce silos and improve clinical consistency

8. Peer coaching services expanded in targeted locations

9. Acudetox services expanded in targeted locations

External Facility Master Plan:

1. Market analysis for potential sale of Tobin building with relocation to Teal Lake Medical Facility

Market Positioning:

1. Continue exploration of partnership with Upper Great Lakes for integrated care

2. Teaching Family Homes analysis for consulting or management services

3. Positioning with UPHP for regional streamlining and Medicaid services

4. Recovery Centers of MI project goals – alignment with health plans for marketing of residential care

5. St. Ignace Shores partnership with Hope Network

Workforce Development:

1. Continue partnership development with NMU and Lake State University for addiction counselor training and education

Clinical:

1. Establishment of agency-wide Medical Director

2. Refinement of co-occurring capabilities in residential facilities

3. Continued growth for our Clinical Model (Multiple Pathways for Recovery)

4. Residential: Development of intake coordinators to improve efficiency and scheduling

5. Clinician billing streamlining through EMR 6. Nursing services expanded to New Hope

residential programs 7. Residential and outpatient addiction

programs development of specific opiate response and services

Additional Plan Areas Great Lakes Recovery Centers engaged in a realignment of our management system and service delivery model in 2017 that culminated in the development of 5 pillars of services. We realigned our management team structure to provide for an overall Director over each pillar of service. Our previous model had focused on a regional distribution of management. This new realignment is aimed at eliminating programmatic silos while encouraging the streamlining of our service models regardless of geography.

[5] Strategic Plan 2018-2020

As a part of our overall review of our service system, we have orchestrated a fiscal analysis of each pillar of service that includes the following:

PILLARS OF SERVICE *Based on total agency income and expenses

Outpatient Adult Residential Children’s Services Prevention Offender Success

% of Revenue 36.1% 37.8% 17.4% 2.9% 6%

Cost 32.7% 38.4% 16.1% 3.5% 6%

Margin 58.6% 33.6% 4.7% <-.007%> --

32.0%

20.0%18.4%

10.3%

8.0%

11.3%

Outpatient Revenue

Medicaid Insurance

MDOC Crisis Services

Self-Pay Other

61.4%14.6%

4.1%

3.4%

2.3% 14.2%

Outpatient Expenses

Payroll Admin Costs

Rent Emp Benefits

Subcontractors Other

[6] Strategic Plan 2018-2020

72.9%

7.3%

6.6%

4.7%3.6% 4.9%

Adult Residential Revenue

Medicaid FBOP MDOC

Insurance Self-Pay Other

54.2%

13.2%

4.0%

3.9%

3.7%

21.0%

Adult Residential Expenses

Payroll Admin Costs

Program Costs Bldg & Maint

Utilities Other

79.7%

5.9%

5.0%

3.9% 2.9% 2.6%

Children's Services Revenue

Medicaid Tribal Fund Court Fund

Easterseals Self-Pay Other

56.8%

14.3%

5.1%

4.6%

3.1%

16.1%

Children's Services Expenses

Payroll Admin Costs

Program Costs Bldg & Maint

Utilities Other

100%

Offender Success Revenue

Expense-based

45.7%

30.0%

14.3%

3.3% 3.0% 3.7%

Offender Success Expenses

Client Housing Payroll

Admin Costs Client Soc Support

Client Emp Readiness Other

[7] Strategic Plan 2018-2020

Executive Summary – Many Pathways to Recovery The past two years we continued our strategic initiatives and advancements. At the heart of our continued development has been a clinical platform shift to understanding the treatment for behavioral health issues and disorders as a recovery “Pathway” to personal transformation. Our treatment paradigm is one that focuses on offering multiple pathways to recovery that is individualized and co-created with the client, which in turn strengthens the outcome of the treatment experience. Our clinical team has been working on operationalizing the concept of Multiple Pathways to Recovery and the diversification of treatment options and treatment planning that goes along with this model. The goal for our clinical services is to create a treatment experience that is recovery oriented (long term sustained recovery) regardless of the presenting condition or conditions. This can be found throughout our various platforms of services (Offender Success, Prevention, Residential, Children’s Services, and Outpatient). In addition to our model development surrounding multiple pathways to recovery, GLRC has engaged in several items of innovation during the past two years that have strengthened our services and our agency. Several examples of our innovation items include:

• Telehealth systems created in agency programs have allowed us to perform clinical supervision and clinical team meetings.

• GLRC was a leader in the creation of Recovery Centers of Michigan. RCM is an administrative services organization created to bring together 5 addiction treatment providers representing ¾ of the State’s geography in efforts to aid in contracting with health plans, insurance carriers, and the sharing of resources.

• GLRC developed our first Medication-Assisted Treatment clinic site in Ishpeming.

• GLRC increased our peer mentoring/coaching services.

• GLRC received a grant for the development and promotion of mental health first aid services throughout the Upper Peninsula.

• GLRC received a 5-year contract award from the Michigan Department of Corrections to expand Offender Success services throughout the Upper Peninsula.

• GLRC applied for and received federal incentive funding for the increased utilization of an electronic health record system.

• GLRC, in partnership with Easterseals of Michigan, developed the northern-most clinic site in the State of Michigan for neuro-developmental trauma assessment services (LUNA).

• GLRC, in partnership with the Michigan Department of Health & Human Services, developed the first service location for a trauma coordinator/services program in Gogebic County.

100%

Prevention Revenue

Expense-based

63.5%15.5%

6.1%

4.4%

4.3% 6.2%

Prevention Expenses

Payroll Admin Costs

Program Costs Rent

Staff Travel Other

[8] Strategic Plan 2018-2020

• GLRC developed our first recovery residence program for women at 241 Wright Street. The recovery residence was named after long-time program director Sue Burcar.

Our strategic framework for the 2018-2020 Plan is vested in balancing our internal and external initiatives in efforts to keep alignment with funding sources and to make sure our platform of services is positioned for future changes in the industry. This strategic positioning is comprised of two central challenges or themes:

1. Engagement into Integrated Care for Regional Strength through partnership with Upper Great Lakes Family Health Center (FQHC)

2. Re-trenching of Specialty Service Provision: strengthening the agency through state-wide affiliation via strategic partnership with other specialty service agencies. This can be accomplished through our own developed ASO Model-Recovery Centers of Michigan, or through such entities like Hope Network or Pine Rest Christian Mental Health Services.

We continue to work parallel paths with respect to our two core options as it is unclear where the future of state and federal financing will go with respect to Medicaid funding (our largest and most vital area of funding). Our ultimate decision on remaining a specialty service provider of behavioral health versus melding into an integrated health system will be based on a) What is the best care option for our clients; and 2) the funding platform that best represents quality care for our clients. How these two vital criteria come together will be the impetus for continued growth, sustainability, and the future direction of the agency. GLRC is committed to keeping current with federal, state, and local initiatives and advancements in the field. We will continue to be a leader in the development of quality behavioral health programing and services within our region. The GLRC Board of Directors, management team, and staff are committed to the further exploration and development of the items contained in the strategic plan. Progress on our strategic plan is made throughout board and staff meeting throughout the course of the year, as well as an annual plan review. Respectfully,

Greg Toutant, CEO