DRS 2011 Annual Report

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DAYMARK RECOVERY SERVICES, INC.

Annual Report for Fiscal Year 2010-2011

This report is intended to serve as a snapshot of the people we serve and select demographic and treatmentinformation. It also describes some of our key accomplishments during the past fiscal year and identifiesimportant goals for the coming fiscal year as determined during our recent strategic planning retreat. Thefollowing is divided into several categories to facilitate the review of this report. From these categories, ouradministration and Board Members can ascertain if we are holding true to our mission, meeting the needs of thecommunities we serve, and remaining on the cutting edge of providing cost effective and evidenced basedtreatment.

Billy R. West, Jr.Billy R. West, Jr., MSW, LCSW,Executive Director

Mission Statement:

Daymark Recovery Services, Inc. is a mission driven, comprehensive community provider of culturally

sensitive mental health and substance abuse services. The Daymark goal is for skilled medical and behavioralhealthcare professionals to support citizens of all ages and their families with the greatest opportunity forrecovery, independence and the highest quality of life. We are committed to using the most current bestpractices and effective, research-based treatment programs to assist all citizens working toward achievingoptimum health and recovery.

Values Statement:

Daymark Recovery Services, Inc. serves those with the greatest needs and facing the greatest challenges witha coordinated effort of services. Services are culturally sensitive, strength based and delivered in congruencewith natural community supports and each consumer's personal support system. Services will promote safety

and recovery while always respecting the rights of self-determination.

MAJOR ACCOMPLISHMENTS DURING FISCAL YEAR 2010-11

Maintained National CARF Accreditation. Successful in lobbying for provisionally licensed employees to be permitted to continue

to practice individual and group therapy in the State of North CarolinaCont. on next page


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Daymark Recovery Services, Inc.


MAJOR ACCOMPLISHMENTS DURING FISCAL YEAR 2010-11

Expanded fully operational services to Guilford, Wake and Vance Counties in NorthCarolina

Provides psychiatric services to rural areas in Western North Carolina throughtelemedicine.

Services provided by DAYMARK are considered best practice and/or are literaturebased.

Serves as the main portal of entry for mental health and substance abuse consumers allcounties we serve and subsequently there is no wait list for entering mental health andsubstance abuse outpatient services in any of our counties.

Provided care to over 37,000 patients in FY 2010-2011. Leading public provider of telemedicine psychiatric services in the State of North

Carolina with over 20 locations linked together to pool the skills of over 25 psychiatristsfor those we serve in a more timely fashion and in some cases on demand when needed.

Provides access for walk-in crisis services to over 3,500 individuals per quarter that keepspeople from going to their local emergency room for emergent psychiatric care.

ProvidesMobile Crisis Services in eight counties to better respond to acute psychiatriccrisis in the community and keep patients out of the psychiatric hospitals when possible.

Clinics operate as an assessment site for first commitment evaluations and is successfulin diverting almost half of our citizens evaluated from psychiatric hospitalization.

Our business model sustained multiple budget and rate reductions this year withoutsignificant decrease in services to the indigent and in some areas we grew.

Added three service locations in three different counties without adding to ouradministrative overhead.

Our information technology platform was certified for Meaningful Use to comply withthe Recovery Act

SERVICE LOCATION SERVICES PROVIDED

Lexington, NCDavidson County

Walk-in CrisisMobile CrisisPsychiatry Services (also telemedicine)Indigent Medication ProgramIntensive Substance Abuse TreatmentOutpatient individual and group treatment

Salisbury, NCRowan County

Walk-in CrisisMobile CrisisPsychiatry Services (also telemedicine)

Indigent Medication ProgramIntensive Substance Abuse TreatmentOutpatient individual and group treatment


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Concord, NCCabarrus County

Walk-in CrisisMobile CrisisPsychiatry Services (also telemedicine)Indigent Medication ProgramIntensive Substance Abuse Treatment

Outpatient individual and group treatmentFacility Based Crisis and Detox (Kannapolis)Peer Support

Albemarle, NCStanly County

Walk-in CrisisMobile CrisisPsychiatry Services (also telemedicine)Indigent Medication ProgramIntensive Substance Abuse TreatmentOutpatient individual and group treatment

Monroe, NCUnion County

Walk-in CrisisMobile Crisis

Psychiatry Services (also telemedicine)Indigent Medication ProgramIntensive Substance Abuse TreatmentOutpatient individual and group treatmentFacility Based Crisis and Detox

Winston-Salem, NCForsyth County

Walk-in CrisisPsychiatric Services (also telemedicine)Intensive Substance Abuse GroupPeer SupportOutpatient individual and group treatmentMobile Crisis

Targeted Case ManagementMocksville, NCDavie County

Mobile CrisisAccess to all other services in the Forsyth Office

King and Danbury, NCStokes County

Mobile CrisisAccess to all other services in the Forsyth Office

Reidsville, NCRockingham County

Mobile CrisisPsychiatry Services (also telemedicine)Walk-in CrisisPsychosocial Club HouseAssertive Community Treatment Team\Indigent Medication Program

Intensive Substance Abuse TreatmentOutpatient individual and group treatmentTargeted Case Management

Wadesboro, NCAnson County

Walk-in CrisisPsychiatry Services (also telemedicine)Indigent Medication ProgramOutpatient individual, group treatment and community support


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Raleigh, NCWake County

Facility Based Crisis and Detox ServicesNote: This is a new service area and will not be in the 2011 data

Services and Fiscal Information

Information regarding Daymark Recovery Services, Inc. (DAYMARK) consumers served, services provided,and revenues is described in the following tables. Information is typically identified by catchment area asfollows:

Piedmont Behavioral Healthcare (PBH) catchment area consisting of Davidson, Union, Cabarrus,Rowan and Stanly Counties.

CenterPoint Human Services (CPHS) catchment area consisting of Forsyth, Stokes, Davie andRockingham Counties.

Sandhills catchment area consisting of Anson, Harnett, Hoke, Lee, Montgomery, Moore, Randolph-Asheboro, Randolph-Archdale, and Richmond Counties.

Guilford catchment area consisting of Guilford County.CONSUMERS SERVED

FY 2010-11

Catchment Area Unduplicated Consumers Unduplicated Services

PBH 16,812 158,855

CPHS 9,354 73,829

Sandhills 10,724 88,059

Guilford 256 6,919


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NUMBER OF CONSUMERS SERVED AND SERVICE STATISTICSFOR FISCAL YEARS 2009-10 AND 2010-11

Catchment

Area

Unduplicated

Consumers

FY 2009-10

Unduplicated

Consumers

FY 2010-11

Percent

Increase/

(Decrease)

Unduplicated

Services

FY 2009-10

Unduplicated

Services FY

2010-11

Percent

Increase/

(Decrease)

PBH 17,129 16,812 -1.85% 163,685 158,855 -2.95%

CPHS 9,318 9,354 0.39% 66,153 73,829 11.60%

Sandhills 10,443 10,724 2.69% 70,312 88,059 25.24%

Guilford n/a 256 n/a n/a 6,919 n/a

A review of this table reveals that the number of persons served during the last two fiscal years fluctuatedbetween catchment areas. Some factors to consider as possible causes in the fluctuations are below:

The number of DAYMARK therapist in the PBH Region decreased during this FY due to budgetreductions. This resulted in less individual therapy sessions offered and more group oriented treatmentsThis is our second year in this region offering primarily group treatment but it was our first full year ofdoing so. We assume this contributed to the 317 less patients seen and 4,830 less services beingdelivered. Our patient satisfaction scores gave some validity to this theory with some patients wantingmore individual services and not choosing group as reported in their survey.

There was a slight increase in the number of persons seen in the CPHS Area. This area experienced nobudget cuts and several other providers in the area going out of business. We attribute these factors to

our increase. We did not see an increase but a decrease in services. We attribute this to a stagnanbudget causing no new hires in the past three years yet a continually slight to moderate increase inpatients. This causes appointments to become less frequent resulting in more declined or missedappointments. Vacancies in staff leaving and finding qualified applicants to fill clinical positions havealso contributed to the slight service decrease.

While the staffing pattern at Sandhills remained stagnant we saw an increase in the number of patientsand services. We contribute this to the maturation of programming in this book of business that is lessthan three years old.


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In the CPHS catchment area (Davie, Forsyth, Stokes, and Rockingham Counties), CPHS providesassistance through their indigent medication program and through the Forsyth County Government, toprovide an on-site pharmacy in Forsyth County. These resources provide the much needed medicationsto persons served at little or no cost to consumers and no additional cost to DAYMARK. DAYMARKalso provides some sample and Medication Access and Review Program (MARP) services toRockingham County Residents.

In the PBH catchment area (Cabarrus, Davidson, Rowan, Stanly, and Union Counties), PBH providesmonetary support for DAYMARK clinics to offer sample medication to indigent persons served. Thismedication is often made available for emergency needs and/or while waiting for a consumer to becomeeligible for coverage through an indigent or entitlement funding source. MARP is an automated programthat permits consumers that cannot afford their medication, to receive medicine on an ongoing basis atno cost. It is also important to note that PBH monetarily supports our agency purchasing medicationsfor those patients that receive care in our two Facility Based Crisis Units (32 total beds).

In our Sandhills catchment area (Harnett, Lee, Montgomery, Anson, Randolph, Moore, Richmond, andHoke Counties), we have sample medication programs for persons coming out of inpatient units in needof medication immediately. We also have an indigent medication program that is funded through theSandhills LME. This allows our most high risk patients to receive the medication they need.

In our Guilford Residential Services indigent patients receive their medication through a variety ofcommunity and county sponsored programs. What we are unable to obtain from natural communitysupports and other programming is purchased at a reduced cost through a wholesale pharmacy andreimbursed by Guilford County during our budgeting process.

In our Wake County Facility Based Crisis Services Wake County provides a pharmacy service where wecan purchase medications a reduced cost and those cost are reimbursed by the Wake County LocalManagement Entity.

In our Vance County Clinic the Five County Local Management Entity monetarily supports nursingservices over and above reimbursable cost in order for medical staff to obtain sample and indigentmedication programs.

In short, our Local Management Entities make providing medication to our indigent possible through a varietyof programs. To illustrate the cost savings and impact of these funded programs we have included a snap shot ofour MARP Program in the PBH Area below:


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Daymark Recovery Services

Medication Access and Review Program (MARP)

Site Activity Report

7/1/2010 - 6/30/2011

Patients Requests Average Wholesale Price(AWP)

* Active Patients: 1,244 * Patient Requests: 883 * Average AWP: $1,674.7

** Inactive Patients: 748 ** Patient Medications: 3,518 ** Total AWP: $5,891,833.5

Total Patients: 1,992 Average Meds/Request: 3.98

*Number of Patients with Active status. *Number of Patients for whom requests were *Average Wholesale Price for medicationsgenerated during the specified time frame. requested during the specified time frame.

**Number of Patients with Inactive status. **Number of Medications requested during **Total Wholesale Price for medicationsthe specified time frame. requested during the specified time frame.

PATIENTS BY COUNTY:Rowan 471 Stanly 391

Cabarrus 359 Union 335

Davidson 436

Grand Total: 1,992


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CONSUMERS SERVED BY LOCATION

PBH CATCHMENT AREA

County Consumers Served

Cabarrus County 3,845

Davidson County 4,056

Rowan County 3,257Stanly County 1,947

Union County 3,707

CPHS CATCHMENT AREA

County Consumers Served

Davie County 108

Forsyth County 5,725

Rockingham 3,432

Stokes County 89

Sandhills CATCHMENT AREA

County Consumers ServedAnson County 742

Harnett County 1,630

Hoke County 591

Lee County 1,361

Montgomery County 747

Moore County 1,190

Randolph (Asheboro) County 2,710

Randolph (Archdale) County 781

Richmond County 972

Guilford CATCHMENT AREACounty Consumers Served

Guilford County 256


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CONSUMERS SERVED BY GENDER

Female 19,003

Male 18,143


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CONSUMERS BY CULTURE

CULTURE NUMBER OF POPULATION SERVED

White 25,011

African-American 9,153

Hispanic 1,053

Native (American or Alaskan) 413

Asian 151

Multi-racial 243

Other (did not list, aboriginal Canadians,native Hawaiian, Pacific Islander,

Cambodian)

362

Unknown (due to incomplete informationtaken during crisis intervention)

760


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Disabilities SERVED

Diagnoses* TOTAL CONSUMERS

Mental Health (MH) only 22,300

Substance Abuse (SA) only 1,088Both MH & SA 13,376

Other (not primary MH or SA but thosewith developmental disabilities, dementia

or other medical complications 382Note: Does not account for co-occurring disorders but only primary diagnosis

CONSUMERS SERVED BY AGE

AGE CONSUMERS SERVED

0-5 240

6-17 4,686

18-40 17,379

41-65 13,840

66-85 951

86+ 50


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Patient Satisfaction and Outcomes Executive Summary:Below is an executive summary of the outcome of the survey for each service location this fiscal year (FY) andlongitudinally over the past two years. Numbers indicate the overall patient satisfaction. Taken from 10%sample of all persons scheduled to be seen at each location for the month. Patient Satisfaction Questionsinclude, but not limited to, their overall satisfaction of services and being able to be in better control of theirsymptoms and life.

CUMULATIVE AVERAGES FOR EACH PROGRAM SITE BY CALENDAR YEARPROGRAM SITE AND NUMBER PARTICIPATING DURING CY

2011 SURVEY sample of 10% of appointments scheduled for clinics

and 100% of the patients in residential and day programs

CY

2007

CY

2008

CY

2009

CY

2010

CY

2011

CRC Kannapolis 97% 96% 98% 98% 100%

Richmond 93% 99%

Stanly 95% 94% 96% 96% 98%

Cabarrus 92% 93% 94% 92% 98%

CRC Union 86% 98%

Anson 95% 97%

Guilford Residential 96%

Montgomery 99% 96%

Rowan 92% 94% 95% 95% 96%

Lee 94% 96%

Union 94% 91% 93% 93% 96%

Forsyth 90% 91% 89% 92% 96%Rockingham 92% 96%

Davidson 96% 94% 90% 92% 96%

Moore 97% 95%

Harnett 95% 95%

New Bridge Academy (2007-2010 formerly Expeditions) 95% 98% 90% 100% 94%

Randolph 97% 94%

Hoke 93% 93%

CUMULATIVE AVERAGE 94% 94% 93% 94% 96%


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Executive Findings and Comments:

The consistency of the survey over a four year period give indications the survey is valid The scores indicate that consumers have been overall very satisfied with their services

GOALS FOR FISCAL YEAR 2011-2012

Expand to other counties that value professional care to both provide good care andspread out overhead cost. This allows more money to be allocated to direct care.

Retain National Accreditation. Build continuums of care for persons served in each county and increase the number of

services each of our consumers receive when medically necessary.

Add other books of business to meet community needs as CABHA rules decreaseproviders of case management, day treatment and intensive in-home services.

Increase the number of Medicaid eligible consumers in service and the number ofservices delivered to them.

Expand our co-location of behavioral health and traditional healthcare service programs. Hold true to our mission of serving the neediest in our communities with the best

treatments available.

Improve on and build peer support services. Remain cutting edge on Evidenced Based Treatments and research grants. Comply with the Recovery Act and be successful in our Meaningful Use endeavors

DAYMARK RECOVERY SERVICES, INC.BOARD OF DIRECTORS

Mr. Tim Childs, Board ChairpersonMr. Jim Cook, Board Vice-Chairperson

Mr. Dwight Wilhelm, Secretary/TreasurerMs. Debora Pershing Ms. Sharon ScottMs. Brenda Trott Ms. Barbara DavisMs. Linda Lowder Mr. Larry Johnson

Dr. Tom Appenzeller Mr. Tom HarmanHartsell and Williams, Board Attorney

Ms. Erin Cornelius, Board Clerk


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Daymark Recovery Services Inc

DAYMARK RECOVERY SERVICES, INC.

EXECUTIVE STAFF

Billy R. West, Jr., MSW, LCSW, Executive Director

Philip Nofal, MD, JD, Medical DirectorElizabeth Pekarek, MD, Medical DirectorDr. Robert Werstlein, Training DirectorDr. Lisa Brandyberry, Clinical Director

Jerold Greer, Information Systems DirectorLarry Elmore, MSW, LCSW, MPH, Quality Improvement Director

Bonnie Miller, RHIT, Quality Assurance DirectorJerry Smith, Finance Officer

Cathy Shoaf, CPUC, AIM, Human Resources Director

CONTACT

Billy R. West, Jr., MSW, LCSWExecutive DirectorDAYMARK Recovery Services, Inc.220 East First Avenue Ext.Suite 10Lexington, NC 27292Phone: 336-242-2411

[email protected]
mailto:[email protected]:[email protected]:[email protected]

DRS 2011 Annual Report

Documents

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