A Chance to Change Foundation Annual Performance Report for July 2013-June 2014

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1 A Chance to Change Foundation Annual Performance Report for July 2013-June 2014 A Chance to Change Foundation (ACTC) has reviewed the agency s performance, in order to assess the quality of programming and identify any needed improvements to the services provided to clients, program participants, and the community. This Annual Performance Report encompasses financial and program activities for July 1, 2013 through June 30, 2014, with additional information through the end of the calendar year and beyond. MISSION Offering a chance to change lives affected by addictions and behavioral disorders. OVERVIEW ACTC views chemical dependency, problem gambling, and other addictions as treatable illnesses. Prevention, education, early intervention and outpatient counseling programs are provided to help those suffering from these disorders. The entire family is affected by someone s addiction, and all are encouraged to participate in recovery. The unique aspects of ACTC are: the provision of a continuum of care which includes prevention, education, early intervention, and treatment; emphasis on treatment, for family members of those suffering from addictions; providing trauma focused counseling and trained trauma counselors; providing private practice quality at an agency; providing a wide variety of specialists including counselors for children, adolescents, adults, and families; offering free education, prevention, and early intervention programs, especially for youth; the primary substance abuse service agency in the area to provide EAP and insurance funded services; openness to collaboration with other agency partners fundraising efforts of board, donors and foundations and corporate grants, accounting for 40% of total revenue; SUMMARY OF PROGRAMS SUBSTANCE ABUSE SERVICES Outpatient Treatment Individual, group, & family counseling is provided for substance abuse and addiction. A Chance to Recover As a United Way partner, A Chance to Change provides substance abuse and related family counseling for adolescents, adults and families with low incomes. Family Intervention Services A Chance to Change provides the opportunity for families to intervene with loved ones to stop addictive behaviors and explore ways to get help. 1

2 ADDICTIONS & BEHAVIORAL DISORDERS Problem Gambling Treatment A Chance to Change has a certified counseling program for problem gamblers and their families. Specially trained counselors provide individual, group, and family counseling. We have an agreement with the Oklahoma Department of Mental Health and Substance Abuse Services to provide our problem gambling program at low cost for those who need it. Trauma Focused Counseling A Chance to Change counselors have extensive training in working with trauma victims including those with a history of violence, abuse, other traumatic events, as well as co-occurring addiction issues. Child and Adolescent Services We provide specialized services to children and adolescents, including working with children and adolescents with substance abuse, other addictions, depression, behavioral problems, trauma and other related issues. EAP Services Employee assistance counseling is provided to over 40 companies in and around the Oklahoma City area. Counseling could include individual, family, marital and group. EDUCATION & PREVENTION SERVICES Education Series, Addiction: How it affects you and your family This free, ongoing six-part program teaches about the disease of chemical dependency, codependency, enabling, treatment, family roles, and behavioral addictions. The series has a special significance for people who are concerned about the addiction of a family member, a friend, or themselves. A Chance to Succeed This pro-active program in schools provides free education for faculty and parents about substance abuse and other issues affecting students. Students are offered free prevention & early intervention groups as needed. Groups are generally conducted weekly for one or two semesters. Program Related Activities Counselors are more focused than ever on helping clients identify and work on cooccurring disorders. Many of our groups serving clients in our gambling, trauma, and substance abuse programs are for co-occurring issues. We are offering gender specific groups for women and men who have experienced trauma. It is essential to treat co-occurring issues such as depression, trauma, anxiety, in addition to addiction treatment, in order to achieve the best results. Any person who comes to ACTC for help will receive appropriate services or, if necessary, referral to other services as needed. Staff identifies several residential treatment facilities where they can refer clients. However, clients with no insurance or resources for treatment have a difficult time finding residential treatment in a reasonable time period, as there are too few beds for those who cannot afford self-payment treatment. 2

3 ACTC provides case management as an element during the treatment process. Case management services are designed to address areas of a client s life that, if not addressed, often contribute to relapse. Clients often need referrals to job resources, job skill building, sober living housing, medical care, and/or residential treatment. Recovery Support We encourage clients who suffer from addictions to take advantage of peer support, 12- Step recovery groups and other community support groups. Our clients have started Gamblers Anonymous support groups housed at ACTC. PROGRAM PARTICIPATION A Chance to Change is working with schools in the Yukon, Putnam City, Edmond, and Mustang districts to provide A Chance to SUCCEED. Last year this school based prevention and early intervention program provided: 28 groups of students who met with a counselor weekly compared to 20 last year. 301 students participated in groups versus 245 students last year. We had 975 participants in the Addiction Education Series in , compared to 1,575 in the previous year. Between July 1, 2013-June 30, 2014, ACTC served 1,189 individual clients with our various counseling programs compared to 1,144 the previous year. We provided a total of 6,575 sessions compared to 6,604 sessions the previous year. Participants came from the greater Oklahoma City metro area and the state. Types of sessions break down in terms of funding sources, as follows: # of clients # of sessions # of clients # of sessions Problem gambling A Chance to Recover Employee Assistance Medicaid Self pay/insurance Total clients In addition, we provided services through United Way funding for those impacted by the major tornadoes in the Moore area. This program continues as they need still exists. Clients served have high incidence of substance abuse in themselves or their families, as well as trauma. We have served 76 clients during this time period with this source of funding. OUTCOMES Goals and objectives are developed and monitored throughout the year as a part of ACTC s continuous effort to assess and improve services. Surveys are distributed to determine the level of satisfaction and results experienced by clients, stakeholders and others. In the last several months, we have doubling our efforts to get client surveys 3

4 completed, and have doubled the number per quarter received. We are also assessing the electronic record system to identify ways to obtain information that will help us assess the success of our counseling programs. Addiction Education Series evaluations are collected each week. Those attending report a high amount of information learned and that they were satisfied with the series. They felt speakers were knowledgeable and prepared. The A Chance to SUCCEED education and early intervention program aims to improve students lives by reducing the use of alcohol/drugs, improving school performance, improving relationships, and improving their understanding of substance use and its effects on them and their decisions. Evaluations for this period show: 92% learned more about addiction and its effects on their family 71% are making better grades this semester 77% are attending school more regularly 78% are more satisfied with their relationships 87% feel better about themselves and their future 95% feel that group had been helpful 75% stopped using or reported they were using less often To corroborate the reports from students, we asked school officials for their feedback on the effects these SUCCEED groups were having in their schools. School counselors/principals reported improvement in grades, graduation rates, test scores, and in some cases, a reduced drop-out rate. School officials are enthusiastic about the support A Chance to SUCCEED provides to the students. In addition to evaluations from program participants, ACTC sends out satisfaction surveys soliciting input from referral sources, other stakeholders, board members, and staff. Stakeholder surveys revealed that 96% those surveyed are aware of the variety of services we offer, are pleased with the referral process and feel we are providing good or excellent customer service. Client surveys reveal that 99% of clients responded positively to questions asked by answering yes definitely or yes mostly. Positive responses related to appointments being set in a reasonable time, feeling they are treated with dignity and that their cultural heritage was respected, that they had input into their goals, that the fees are fair and reasonable, counseling has focused on what is important, they have been finding ways to stay abstinent, hours and location are convenient, concerns or grievances have been addressed, their symptoms have been improving, overall satisfaction with services, developing positive attitudes, doing better at work/school, relationships are improving, and counseling has helped with emotional/mental health issues and/or addictive behaviors. One respondent was not sure if the fees were fair and reasonable. One respondent did not want to be referred to group. We had many positive comments about our counselors. Clients reported finding positive and healthy ways to meet goals, finding courage not to act defensively, getting feedback and support, finding new ways to look at things, being able to talk about issues, feel I have more confidence and love for myself, reinforce time for self, expertise of counselor, and quality of therapist. 4

5 Board surveys reveal that 96% of board members feel their talents are being adequately utilized, that membership is stimulating and rewarding, they understand their role and feel like the board is effective, they understand the agencies programs, understand the financial and legal responsibilities as a board member, have a good working relationship with other board members, have a good working relationship with the Executive Director, receive adequate information to prepare for board meetings, and the board discusses important issues and respects each other s opinions. Employee surveys reveal 94% of employees enjoy their work, feel we provide good services, are working to improve quality, have an understanding of the mission and policies, have an understanding of policies and procedures, have an understanding of client rights, feel they had an adequate orientation, feel they received adequate training to do their job, received adequate information on changes that occur at work and opportunity for input when changes occur. STAFF Quality staff is the key to providing the services that ACTC is known for in the community. ACTC currently has 19 full time and 6 part time or contract positions. Counselors have Masters Degrees and are licensed or under supervision for licensure. Most clinicians are dually licensed. ACTC also employs Certified Behavioral Health Case Managers. Nine counselors are trained to provide problem gambling treatment. A Medical Director is contracted for regular consultation. This level of staffing allows for a broad range of high quality services. Because the relationship between counselor and client, level of skill, and ethical sensitivity are of upmost importance in the therapeutic process, training and supervision of counselors are highly emphasized. FUNDING Agency income for July 1, 2013-June 30, 2014 was $1,272,255 compared to $1,353,281 the previous year. Expenses of $1,268,472 compared with$1,293,362. The cash and reserve fund balance at the end of June 30, 2014 was $904,585 compared to $788,754 the previous year. However, checks of $150,000 each for two years of donations from one donor were both included in this fiscal year, although one donation is being used the next fiscal year. The Board of Directors designates reserve funds as follows: $300,000 to Operating Reserve and the balance of reserve funds go to the Capital Fund. Our Capital Reserve fund for is $392,739, about the same as the previous year. Funding for programs comes from the following sources: Fees for services (insurance or self payment for counseling) Employee Assistance Program contracts Central Oklahoma United Way for A Chance to Recover, A Chance to SUCCEED, and Disaster Services Oklahoma Department of Mental Health and Substance Abuse Services (Problem Gambling Treatment Program) State of Oklahoma OJA grant (for A Chance to SUCCEED) 5

6 Sooner Care (Medicaid) Individual and corporate donations Special events Private foundation grants Programs by percent of revenue : Funding Source Insurance 29% 30% Gambling 25% 25% EAP 26% 23% A Chance to Recover 12% 9% Medicaid 5% 7% Self-Pay 3% 3% Programs by number of clients: Program # of clients % of Clients ACTR % EAP % Gambling 93 8% Medicaid % Self Pay/Insurance % Total % Self Pay, Insurance & EAP totals 64% of the total clients. In regards to our Employee Assistance Program, there has been a trend of utilizing insurance companies and managed care processes at lower rates, rather than contracting directly with local providers. These systems are not able to treat problem gambling. A Chance to Change s EAP provides more services per employee than the national companies. We are also accessible to provide onsite education and crisis intervention. We lost 715 employees total this period. We lost seven companies and gained one. EAP income at ACTC over the last five years: 2014 $177, $185, $194, $161, $144,717 Our contract with ODMHSAS for problem gambling treatment was $100,000 for FY

7 ACTC is providing a significant number of counseling services for clients with insurance. Blue Cross Blue Shield is the largest insurer in Oklahoma. Within the last year their reimbursement rates have risen for Blue Cross Blue Shield. However, it does not cover the cost of service provision. A Chance to Change makes an effort to accept most insurance plans, and has been accepting Sooner Care (Medicaid) since Medicaid is a reimbursement system that has its own requirements for documentation, treatment planning, and prior authorization limits. We are also approved to bill Medicare; however, Medicare limits the licenses for counselors who are allowed to work with clients, which limits the number of people we can serve. Technology Our electronic medical record has been revised, reducing duplication in paperwork and providing internal connections between forms. This decreases the amount of paperwork printed and filing that has to be done, as the majority of records are maintained in the electronic record. We continue to work towards implementation of the billing portion of the software, allowing us to electronically bill all of our services leading to efficiency and timeliness of receipt of payment from funders. FUNDRAISING AND DEVELOMENT The Addiction Education Series, A Chance to SUCCEED, and other education and prevention programs are offered free to the public. Programs like A Chance to Recover are offered at very low cost. The Board of Directors spends a great deal of time and focus on fundraising in order to continue to provide these programs. The largest fundraising event is our Celebration of Recovery Event. In addition to patrons and ticket sales, we were able to gain $7,570 dollars from table donations. (Our most recent event was March 27, 2014, honoring Dan Batchelor, and we raised $243,055 compared to $200,674 the previous year.) We received an anonymous donation of $150,000 to assist with several particular programs. Fund-raising results, which include donations, grants, memorials, and events, are as follows: $472,767 $536,246 $526,738 $520,590 $450,053 $335,979 In July 2014 the agency hired a Development Director for the first time. His activities are not a part of this reporting period. He has helped process the possibility of a capital campaign, worked on the upcoming Celebration of Recovery, and is working on goals to increase fundraising results to support ongoing programs. (The results of the 2014 end of year campaign will be reported in the next annual report. Results of that campaign were over $24,000.) 7

8 MARKETING AND PUBLIC RELATIONS We have a minimal budget for marketing, so we work hard to utilize low cost methods of marketing the agency s programs. We have maintained a web presence by consistently posting on our Facebook and Twitter as well as keeping our site up to date with key words for Search Engine Optimization. We also use Vertical Response and Constant Contact to keep in contact with our Donors, EAP s, as well as other professionals. We send out mass s on a monthly basis with a wide range of topics including upcoming events, fundraising opportunities, job openings, and new & existing programs. We continue to grow this list and now have over 5,000 contacts. This fiscal year we have received multiple calls from Fox 25, along with other media sources, giving us an opportunity to provide our professional opinion on mental health, addiction and new/popular trends in substance abuse. In 2014, we purchase the space for a month of digital weekend running billboards from Lamar Outdoor Advertising. The boards were given to use as an extremely discounted rate. Our board were designed in house and focused on both disaster services and the agency as a whole. On the print side of marketing in this fiscal year, we accomplished the design and printing of our new Stewardship Program- A Chance to Give. We also began work on revised EAP material, and launched a completely new style for our End of Year Giving Campaign. We sent this newsletter to a select few individuals, posted it social media, and incorporated it with our Just Give online donation site. Staff and volunteers provide a significant amount of outreach in the community, including professional fairs, health fairs, United Way events, and presentations at colleges, civic clubs and other organizations. Yearly we host an annual recovery workshop for professionals. September of 2013 we brought in Dr. Philip Flores for an all day workshop. Both events brought in around professionals from our field. Crossings Community Event Center has allowed us to use their building for no cost at both events. We had net revenue of $1,056 for this workshop. In March of 2013, we hosted an Ethics and Veterans Panel workshop at the Oklahoma City Community Foundation. This was a way to bring in a small profit of $2,066, but mainly allowed us to keep our name at top of mind for other professionals in our field. PARTNERSHIPS We are continuing to work in partnership with several groups related to our mission, including Oklahoma Substance Abuse Services Alliance (OSASA), NAIC in Norman, Gateway to Prevention and Recovery in Shawnee, Red Cross and United Way. We work closely with Sante Treatment Center, Valley Hope Treatment Center, Four Winds, Hazel Street, New Hope, and other residential treatment centers. 8

9 Staff also provided training and presentations to Chesapeake, Easter Seals, churches, colleges, and EAP clients, as well as other groups who request this. OTHER MANAGEMENT ISSUES Facility ACTC leases the two buildings which house approximately 8,500 square feet of offices. The warehouse is currently subleased. The agency is essentially out of space to grow. Board members have worked diligently to locate a sufficient and adequate space for our needs. They have discussed a variety of possibilities including leasing another building, purchasing another building and building a new one. We are in a two-year lease, with a 9 month out, with our current landlord. This year we have worked to locate a piece of foreclosed piece of land that would be a potential location to build. We have utilized an architect and civil engineer to help us in developing plans for the building and other construction needs. Although the Board had been considering a capital campaign and various options to build a new building, the huge drop in oil prices have impacted their thinking. Outside the reporting period, the board decided in January 2015 to look for another building to rent for approximately three years. At that time, depending on the local economic situation, the board will consider purchasing or building a new facility which will meet our long term needs. Reserve Funds which are not committed to our Operating Reserve have been set aside for capital needs. Strategic Plan In order to continually improve services, a Strategic Plan is set by the Board of Directors with staff input. Our client surveys and referral source survey information is also utilized to plan for future needs. We held a Board of Directors Retreat in January of 2014 and 2015 to help us set the direction of the agency and establish goals for the new year. Board of Directors Keeping a strong, engaged Board of Directors is extremely important. The Board Development Committee is responsible for identifying new board members on an ongoing basis. POLICY AND PERFORMANCE REVIEW Health/Safety Performance The staff has an annual Health & Safety training, covering: Bomb Threats, Fire, Natural Disaster/Severe Weather, Power failures, Workplace Violence, Blood Borne Pathogens/Infection Control. Drills for emergencies are held at least annually. Other safety measures are included in the quarterly reviews done by the management team. 9

10 Grievances and Critical Incidents There were no grievances reported. Critical incidents were followed up appropriately, with no remedial action taken and debriefings completed. Other ongoing review ACTC also tracks other areas, identifying any needed improvements, including Accessibility, Human Resources, Technology, Finance and Accounting, Risk Analysis and Management, Health and Safety, Cultural Competency and Diversity, and Corporate Compliance. There is a plan for each of these areas which are reported on quarterly by the management team. Copies of this document are available at any time. Clinical Documentation Review The electronic system has made it possible to more completely review clinical charts, documentation, deadlines, and quality oversight. This year new chart audit systems and tracking were put in place to become aware of documentation problems more quickly. Non Profit and Oversight ACTC is a 501(c) 3 not for profit agency governed by a volunteer Board of Directors. An agency wide external financial audit is performed annually. There are no audit findings or management letters. Accreditation and Certification A Chance to Change is accredited by CARF for Integrated Alcohol and Drug and Mental Health Services and Prevention. We are also certified for substance abuse and problem gambling treatment by the Oklahoma Department of Mental Health and Substance Abuse Services. ODMHSAS certified the gambling program for 3 years. ACTC meets the requirements and standards set out by national accreditation and state certification bodies. Anyone may request a copy of the agency s reports, policies and procedures, consumer handbook, and outcome reviews. This Annual Report is presented to the Board of Directors at the Annual Meeting January 20, It will be available on request from consumers, stakeholders, and the Oklahoma Department of Mental Health and Substance Abuse Services. 10

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