2019
ANNUAL IMPACT REPORT
2019 ANNUAL IMPACT REPORT
FY19 | JULY 2018 – JUNE 2019
CONTENTS
2 4 6 8 16 22 24
Our Culture + Leadership Our Financial Status Our Impact Our Services Our Stories Our Year in Review Our Locations
OUR MISSION Highlands Community Services is committed to “improving lives and discovering possibilities� by providing the highest quality continuum of behavioral health care, creating a center of excellence for all individuals seeking mental health, substance use or developmental services.
OUR VISION Highlands Community Services is dedicated to discovering, implementing and sustaining valuable services that improve lives. We will continue to operate with efficiency, financial viability and innovation.
OUR VALUES Highlands Community Services’ core values are integrity, respect, teamwork, empowerment and transparency. These values guide all that we do.
improving lives, discovering possibilities.
FROM THE DESK OF THE EXECUTIVE DIRECTOR This past year has been one defined by a multitude of large-scale, fast-paced changes across many levels here at HCS — from key retirements of tenured leaders, recruitment and transition to a new Executive Director, new mandated service implementations through STEP-VA and the removal of state funding that coincided with Medicaid expansion — this year has been an experience in strategic planning, adapting and redefining ourselves as an organization. Across this year, we have also begun to experience coverage denials via managed care organizations, resulting in direct impact on agency operations and consumer services. Additionally, we have started preparing for a complete Medicaid redesign and for implementation of our new electronic health record. Change and flexibility have become the new norm for daily operations within our service system. However, with those challenges also came the opportunity for us to face each of those seemingly insurmountable obstacles and develop creative and sustainable solutions. As one team, HCS senior leaders, program managers, providers and staff worked together to collectively launch new programs, welcome new team members, expand existing programs and work toward financial viability – all while continuing to provide quality services to our community. Despite the difficult toll this year placed upon our system, HCS managed to exemplify success. HCS continues to nurture strong community partnerships to help ensure the most vulnerable citizens continue to receive the dedicated commitment and valuable services they need to live their best and most productive lives. Simultaneously, we continue to strive to be the preferred place of employment and the provider of the highest quality behavioral health care services available to our community. Innovation, creativity, growth, collaboration, tenacity and grit continue to be traits found in abundance throughout HCS – all of which are traits required for success in today’s challenging environment. It is inspiring to see HCS staff cultivate a culture of pride and genuinely enjoy being part of an organization where they recognize how much they individually contribute to the well-being of our community, no matter which role they play. Success implies some measure of finality. While we close out this year with many accomplished goals, our work is far from complete. As we move into the next year with change and challenge remaining an ever-present expectation within daily operations, we also recognize the spirit of the HCS culture and commitment to continued success. While focusing on caring for our caretakers, the HCS family remains poised to navigate the unpredictable path ahead with character and integrity. Looking forward, we have set our sights on another successful leg of our journey. Rebecca Holmes | Executive Director
OUR CULTURE + LEADERSHIP BOARD OF DIRECTORS CHAIR William “Bill” Hartley VICE CHAIR Nancy Brown SECRETARY/TREASURER LaRue “Carter” Miles WASHINGTON COUNTY Judy Carrier Fred Newman Angie Eastridge Randy Pennington Lisa Seaborn Phillip Sprinkle CITY OF BRISTOL Emily Lee Heather Tedder David Trotter
WHO WE ARE Highlands Community Services was founded as a Virginia Community Services Board (CSB) in 1972. We provide behavioral health care to all individuals seeking mental health, substance use and developmental services in Washington County and Bristol, Virginia. Since then, HCS has become a leader in the region, providing cutting edge intervention and treatment programs in 9 locations between Bristol and Abingdon, through a comprehensive system of care for children, adolescents and adults.
OUR LEADERS We are made up of a team of over 420 employees that work in 14 departments ranging from clinical to administrative services. HCS is led by a Senior Leadership Team of 16 members of Executive and Departmental leadership. Together they help guide the direction of the organization and provide leadership for each area’s Department Directors, Program Directors, Program Managers and Individual Staff.
THE HCS TEAM Full-Time Positions – 364 Part-Time Positions – 63 Total Positions – 427
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ASSETS Cash and Cash Equivalent . . . . . . . . . . . . . . . . . . 2,945,973 Accounts Receivable . . . . . . . . . . . . . . . . . . . . . . . 4,832,993 Fixed Assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16,498,079 Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24,277,045
LIABILITIES Current Liabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,037,011 Notes Payable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14,661,703 Accrued PTO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,046,387 Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16,745,101
NET POSITION Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7,531,944
The year ending June 30, 2019 was a fiscally challenging yet successful year for HCS with total revenues increasing by 8.6% to reach nearly $28 million for the year. Fees for services remained the highest revenue category at 68% of total revenue with state funds the second highest at 17% of total revenue. Personnel expenses remained the highest expenditure category at 76% of total expenditures of $26.2 million for the year. The resulting surplus was $1,569,949 which consisted of $1,405,686 in restricted funds and $164,254 in unrestricted funds. The collective efforts of HCS staff, management and board members throughout the year resulted in continued financial stability for HCS and a 16% increase in HCS’s net position.
KATHY SIMPSON Chief Financial Officer
REVENUE
2.91% 9.30%
17.02%
State Funds . . . . . . . . . . . . . . 4,731,686
2.75%
Local Funds. . . . . . . . . . . . . . . . 763,869 Fees for Services . . . . . . . . . 18,915,791 Federal Funds. . . . . . . . . . . . 2,585,320
State Funds
Other Funds . . . . . . . . . . . . . . . . 810,240
Local Funds
Total . . . . . . . . . . . . . . . . . $27,806,906
Fees for Services Federal Funds
68.03%
Other Funds
EXPENDITURES Personnel . . . . . . . . . . . . . . . 19,941,099
8.78% 1.51%
1.87%
9.40% 2.23% 0.21%
Staff Development . . . . . .. . . 396,792 Facilities/Vehicles . . . . . . .. . 2,302,567
Personnel
Equipment/Supplies. . . . . . . . . 491,256
Staff Development
Consult/Contracts. . . . . . . . . 2,466,127
Facilities/Vehicles
Program Operations. . . . . . . . . 584,671
Equipment/Supplies
Other Expenses. . . . . . . . . . . . . . 54,445 Total. . . . . . . . . . . . . . . . . . . . 26,236,957
76.00%
Consult/Contracts Program Operations Other Expenses
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COMING TOGETHER IS A BEGINNING, STAYING TOGETHER IS PROGRESS AND WORKING TOGETHER IS SUCCESS. HENRY FORD
OUR IMPACT
FY19 | JULY 2018 - JUNE 2019
$26,236,957
TOTAL VALUE OF SERVICES during FY19 at HCS.
46
NEW EMPLOYMENT OPPORTUNITIES
provided at HCS in FY19.
$19,941,099
STAFF SALARIES AND BENEFITS earned by total workforce.
42.0% of employees have
WORKED AT HCS FOR 5+ YEARS. And 23% of those have worked at
HCS for 10+ years.
4,897
UNDUPLICATED TOTAL CONSUMERS
served agency wide.
97.3% average service satisfaction
HCS CONSUMERS GAVE ALL A’S on the annual FY19 Satisfaction Survey.
ADULT RECOVERY SERVICES HCS Adult Recovery Services provide a comprehensive community support system for people in mental health and substance use recovery. These individuals need guidance, training, considerable support in preventing hospitalization or relapse and help accessing needed resources while maintaining a natural support system through meaningful relationships.
ADULT RECOVERY SERVICES ■ Forensic Discharge Planning ■ Hospital Liaison Services ■ Mental Health Case Management ■ Peer Support Services ■ Psychosocial Rehabilitation at Stepping Stones ■ Restoration to Competency Services ■ Substance Use Disorder Case Management
ADULT RECOVERY SERVICES SERVED AN UNDUPLICATED TOTAL OF ONE THOUSAND FIVE HUNDRED AND TWELVE ADULTS THIS YEAR.
I like working at HCS because it allows me to be a part of something bigger than myself — with opportunities to challenge yourself both professionally and personally — and ultimately, by getting to be the voice for those who don’t have one.
ARIN CLARK
Program Director, Specialty Services 19 Years of Service
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CHILDREN AND FAMILY SERVICES HCS Children and Family Services serve families, children, and adolescents in multiple settings including local schools, homes, community settings and at HCS office locations. Services are comprised of several different departments and are specifically designed to meet the needs of children at risk of behavioral health concerns and their families.
CHILDREN AND FAMILY SERVICES ■ Behavior Intervention ■ Case Management ■ DREAMS After-School
Program ■ EMBRACE Sponsor Homes ■ Intensive Case Management ■ Intensive In-Home
■ Prevention & Education ■ Student Assistance
Program ■ The Interchange
School & Summer Programs ■ Therapeutic Day
Treatment ■ Transition Coordination
CHILDREN AND FAMILY SERVICES SERVED AN UNDUPLICATED TOTAL OF ONE THOUSAND TWO HUNDRED AND ONE CHILDREN AND FAMILIES THIS YEAR.
Below: Our Prevention & Education Department, along with the Virginia Foundation for Healthy Youth, provided a “Wellness Day” for the kids at our annual Summer Camp held at the Children’s Campus.
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THE CHILDREN’S ADVOCACY CENTER The Children’s Advocacy Center of Highlands Community Services leverages the efforts of law enforcement, prosecutors, medical and mental health providers, social workers and others to provide a seamless, comprehensive system of support for child victims of sexual and physical abuse, and neglect.
CAC SERVICES ■ Community Education ■ Court Preparation ■ Forensic Interviews ■ Multi-disciplinary Team
Coordination ■ Specialized Treatment & Counseling ■ Trauma Assessments ■ Victim & Family Advocacy
TWO HUNDRED AND SEVENTY NEW CASES WERE OPENED AT THE CHILDREN’S ADVOCACY CENTER THIS YEAR. 189 FORENSIC INTERVIEWS WERE COMPLETED. 127 KIDS RECEIVED COUNSELING. 125 CAREGIVERS RECEIVED FAMILY ADVOCACY AND SUPPORT SERVICES. 366 CHILD VICTIMS AND 162 CARETAKERS WERE PROVIDED WITH VICTIM SUPPORT & NAVIGATION SERVICES.
I like working at the CAC because to me — true service is doing good for someone — with no expectation of reciprocity. One of the greatest rewards of my job is being able to be a part of the united collaboration of our Multi-disciplinary teams for the common good of the children we serve.
HUNTER ADDISON Victim Navigator 1 Year of Service
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The CAC celebrated its 20th Anniversary on September 7, 2018. Several community partners, colleagues and friends gathered to honor the work of our “Champions for Children� at HCS. The CAC officially merged and became a service of HCS in 2015.
CRISIS SERVICES HCS Crisis Services are available 24 hours a day, seven days a week. They provide attentive, emergent care to consumers and families who need immediate assistance. Crisis Services staff can be found providing crisis stabilization services to children at the Safety Zone, providing crisis stabilization services to adults at the Crisis Resolution Center, as well as providing emergency services evaluations at HCS locations, the emergency department at our local hospital and our local jails.
CRISIS SERVICES ■ Crisis Consultation & Triage ■ Crisis Stabilization for Adults ■ Crisis Stabilization for Children ■ Emergency Services & Pre-admission Screenings
CRISIS SERVICES SERVED AN UNDUPLICATED TOTAL OF ONE THOUSAND TWO HUNDRED AND THIRTY-SIX ADULTS AND CHILDREN THIS YEAR.
Working at HCS allows for an incredible opportunity to help others. I admire the team approach and the fact that we have the ability to formulate a multi-faceted plan to help others. The wrap-around services we provide help link an individual to the support they need to avert a crisis.
ASMAHAN ELAYAN
Program Manager, Emergency Services 2 Years of Service
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DEVELOPMENTAL SERVICES HCS Developmental Services provide a detailed Person-Centered Plan to individuals with significant limitations both in intellectual functioning and in adaptive behavior, originating before the age of 18. Our organization believes that within every disability is ability and that a good life is possible for all individuals served.
DEVELOPMENTAL SERVICES ■ Horizons Day Support ■ Sponsor Home Residential Program ■ Support Coordinator Services ■ Infant & Toddler Connection
of the Highlands
DEVELOPMENTAL SERVICES SERVED AN UNDUPLICATED TOTAL OF FOUR HUNDRED AND SIXTY-FOUR ADULTS AND CHILDREN THIS YEAR.
Each year, our Developmental Services Team, works with individuals in the program to produce a variety show or play for their families, friends and members of the community. This year they brought the animated Disney feature “Beauty and the Beast” to life in their beloved take on this classic fairytale.
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OUTPATIENT SERVICES OUTPATIENT SERVICES ■ Comprehensive
Diagnostic Assessments ■ Consultation Services ■ Department of Juvenile Justice Treatment Services ■ Drug Court Services ■ Individual, Group & Family Therapy
■ NAVIGATE First
Episode Psychosis Services Program ■ Project Jane Domestic Violence Services ■ Specialized Trauma Treatment Services ■ Substance Use Intensive Outpatient Program
HCS received a $400,000 grant from the U.S. Department of Health and Human Services that will pay for more people to enroll in our Drug Court program. From left: U.S. Senator Tim Kaine, Chris Brown – HCS Drug Court Program Director and Delegate Israel O’Quinn.
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HCS Outpatient Services provide short-term interventions that have long-term impact. Services are designed to meet the needs of children, adolescents and adults whose substance use and/or emotional challenges have become significant, but do not warrant hospitalization. OUTPATIENT SERVICES SERVED AN UNDUPLICATED TOTAL OF THREE THOUSAND AND FIFTYFOUR ADULTS, CHILDREN AND FAMILIES THIS YEAR.
PSYCHIATRIC SERVICES Psychiatric clinic services provide appropriate medication services for qualifying HCS consumers. HCS psychiatrists, psychiatric nurse practitioners and licensed practical nurses work together as a team to serve both children and adults.
PSYCHIATRIC SERVICES PSYCHIATRIC SERVICES SERVED AN UNDUPLICATED TOTAL OF ONE THOUSAND NINE HUNDRED AND FORTY-EIGHT ADULTS AND CHILDREN THIS YEAR.
■ Medication Management ■ Psychiatric Assessment
I work with children and adolescents and feel it is very rewarding to watch them overcome their hurdles and become successful in their lives. When this happens it makes you feel like you are making a true difference for someone and that is the reward for me!
TINA GENTRY LPN
22 Years of Service
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Jeff Fox, former Executive Director of HCS, retires after almost 13 years of service.
Mr. Fox joined HCS on September 1, 2006 and as he loves to tell people, his original plan to come on board for 3 years quickly turned into a much longer tenure, lasting well over a decade.
Jeff’s retirement party was Dr. Seuss-themed and held at the Children’s Campus gymnasium. Anyone that knows Jeff knows his love of Ben & Jerry’s Ice Cream, particularly their business model, and all things Dr. Seuss. Several hundred individuals came by to honor and celebrate, with many getting up to offer well wishes and long-time stories, including many great years of memories working with Jeff – as a mentor, colleague and boss.
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Jeff with his team of Senior Managers. Top Row: Katherine “Kathie” Baker-Forester – Director of Human Resources, Lorie Horton – Director of Quality & Compliance, Sheila Tuggle – Director of Fiscal Services, Shawn Miller – Director of CommunityBased Children Services, Jerry Culberson – Director of Information Services, Allen Anderson – Director of Psychiatric Services (Retired). Bottom Row: Miranda Mingle – Director of Outpatient Services, Rebecca Holmes – Clinical Director, Kathy Simpson – CFO, Kandace Miller-Phillips – Director of Crisis Services, Rema McCue – Director of Developmental Services, Crystal Miller – Director of School-Based Children Services and Michael Keohane –Director of Adult Recovery Services
Jeff retired on July 31, 2019 leaving behind a long legacy of making great strides to turn HCS into the Center of Excellence it is today. Along with the support from his staff, the Board of Directors and many community partners, Jeff was able to execute his mission for improvement to make HCS one of the most crucial and helpful resources for Mental and Behavioral Health in the area.
It has been an honor and privilege to be a part of such a wonderful organization. I wish only the best for HCS in the future and will always help in any way I can to ensure continued success. JEFF FOX
Executive Director Emeritus, HCS improving lives, discovering possibilities | 17
TO THE HCS TEAM! Have you ever started a new position and felt like you’ve just been “thrown to the wolves?” As a CSB and behavioral health care provider, offering many wrap-around services with a multi-faceted team approach, we recognize the effect this may have on a new employee. After working diligently to come up with a new approach, on January 6, 2018, we launched an entirely revamped way of on-boarding new hires with an orientation process that engages employees and prepares them to move into their new role within the agency.
Orientation equipped me with a great deal of knowledge about HCS that might have taken me years to learn otherwise. Mike made the learning fun and the overall experience very enjoyable. MIRANDA BLEVINS
Support Specialist, Crisis Services
Mike Nash, HCS Training & Development Specialist, leads the week and a half long training that covers all of the insand-outs of what it’s like to work at HCS. Everyone is given a packet full of information that details anything and everything they should need to know about the agency while emphasizing the agency’s core values and what it means to work in a trauma-informed environment.
July 1st, 2018 – June 30th, 2019 – Total number of hires: 100 • Total number of employees who left and returned: 5 • Employment retention rate: 80% • According to The Federal Government, the federal turnover rate in behavioral health is estimated at 40%, costing providers up to $4,000 per employee.
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“The success of the orientation process is because of the total team effort that goes into each individual orientation — from the Executive Director, to all of the trainers and presenters, to the direct line staff we interact with on site tours — everyone plays a role in welcoming our new hires to the HCS Family,” says Mike Nash. Throughout the orientation, new hires get to learn about their benefit plan options, technology and business procedures, health and safety rules and regulations and
complete their online trainings needed to start their job. The interactive part of the training is unique, too, in that it prepares and certifies each new hire in First Aid, CPR, AED, Naloxone Training and MANDT. Also included are detailed site tours of all nine facilities, giving each new hire the chance to learn about other departments and programs and where each is housed. This is important due to the amount of wrap-around services we offer within the agency.
Top: Mike Nash, leading the facility tours, explaining what goes on at our Children’s Campus to the new hires. Middle Right: Angie Blevins, Human Resources Manager, going over the ins-and-outs-of each new hire’s benefits package. Bottom Right: Mike Nash, alongside Shawn Miller, talking to the new hires at the Children’s Campus.
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Every April HCS participates in efforts to honor Child Abuse Prevention month. However, this past year, our Department of Prevention and Education — along with the Children’s Advocacy Center — went the extra mile to involve the entire agency as well as community. Lisa Topshee, Program Director of Prevention & Education, and Kathi Roark, CAC Program Director, partnered to create a community campaign featuring pinwheels and yard signs that were delivered to each HCS location, allowing everyone to participate. Digital billboards were also on display throughout the month in both Abingdon and Bristol, VA. Top: Nomad, the CAC Facility Dog. Right (clockwise): CAC staff, with members of their multi-disciplinary team, hosting their annual pinwheel planting at their Sugar Hollow location; An Interchange student, at the Children’s Campus, planting a pinwheel with fellow students; Pam Tolbert and Lisa Topshee proudly standing by one of the yard signs that were distributed throughout the community; Department of Developmental Services day treatment program participating at The Annex; The Safety Zone participating; Washington County’s Commonwealth Attorney — Josh Cumbow — planting Pinwheels at the CAC with Nomad.
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Year in Review Adult Recovery Services
Communications
Outpatient Services
■ The Substance Use Disorder (SUD) Case Management program expanded from one to four case managers. ■ SUD Peers were added to the department with the potential to move from two to four peers. ■ The Regional Forensic Discharge Planner program was launched at the local and regional jails in our area.
■ Won two silver awards from the American Advertising Federation for the FY18 Annual Report and CAC 20th Anniversary Campaign. ■ Hosted 3rd Annual Wine and Chocolate Festival to benefit Children’s Services.
■ Increased partnership with District 17 probation to include services at multiple locations. ■ Added a Family Peer component to the Navigate Program. ■ An outpatient therapist was housed in Van Pelt Elementary. ■ Brought specialized EMDR training opportunities to the area. ■ In partnership with Fiscal and Case Management, successfully transitioned to providing same day access to care.
Children & Family Services ■ The Interchange program began the school year with the highest enrollment it has seen since 2006 with 60% of its students passing the SOL tests administered by the public school systems. ■ The Juvenile Competency Program exceeded expectations serving children from Grundy, Lebanon, Bristol and Washington County. ■ Prevention & Education staff provided 228 parent/caregivers with parent education, of which, 85% who completed the classes reported that they felt closer to their child and have more confidence in knowing how to take care of them. ■ Our school-based Student Assistance Program (SAP) served over 625 students in Washington County Public Schools – including elementary, middle and high school – and 40 students at Virginia Middle School.
Crisis Services ■ The new Crisis Intervention Team (CIT) was formed and the Assessment Center opened its doors for business. ■ 221 people were trained in Mental Health First Aid including 88 members of Local Law Enforcement and 45 Department of Social Services personnel.
Developmental Services ■ Support Coordination staff worked in conjunction with Washington Co. School System to develop and implement a new process for identifying and providing outreach to children and young adults in need of developmental disability services. ■ The Day Support team increased volunteer sites in the community: Habitat for Humanity Store, Saltville Food Bank, New Life Thrift Store and Faith in Action Food Bank & Thrift Store. ■ Early Intervention continued to exceed state performance indicators for service delivery.
Human Resources ■ Developed a Summer Wellness Program to challenge employees and promote a healthy lifestyle.
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Procurement & Asset Mgmt ■ Secured the location and setup of the CITAC Facility. ■ Completed a sidewalk art project at the Children’s Campus.
Psychiatric Services ■ Allen Anderson, Department Director, retired after 43 years of service with HCS. ■ Restructured and brought on a RN level director.
Quality & Compliance ■ HCS became a preferred provider with Aetna Better Health of Virginia. ■ HCS purchased Credible electronic health record. When implemented, it will provide added efficiency and functionality to both staff and consumers. ■ HCS staff advocated for our consumers by reporting to DSS 114 possible instances of abuse and/or neglect.
Top left (clockwise): CITAC Ribbon Cutting and Grand Opening Ceremony; Children’s Campus Sidewalk Art Project; Allen Anderson; Silver Addy Winner – 2018 Annual Report; Winners of the Wellness Walking Challenge – Outpatient Services Team; 3rd Annual Wine & Chocolate Festival
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Administration & Clinical Services 610 Campus Drive | Abingdon, VA Children’s Services 102 Oakview Avenue | Bristol, VA
CHILDREN’S ADVOCACY CENTER of Highlands Community Services 21451 Sugar Hollow Road | Bristol, VA
5
THE ANNEX Developmental Services 608 Campus Drive | Abingdon, VA
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Psychosocial Rehabilitation 414 Ivy Street | Abingdon, VA Children’s & Crisis Services 383 Baugh Lane | Abingdon, VA Adult Crisis Services 802 Hillman Highway | Abingdon, VA
Case Management & Clinical Services 1969 Lee Highway | Bristol, VA
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CIT Assessment Center Crisis Intervention Team Services 614 Campus Drive | Abingdon, VA
improving lives, discovering possibilities HighlandsCSB.org