Annual Report 2017

Connecting Youth to Their Futures

Vision

By identifying goals and focusing on the strengths of the individual. Excelsior works alongside a youth and their family to make positive change towards a brighter future. Excelsior is a community advocate for youth who champions for families to live safer, healthier, and more satisfying lives. This is done through providing comprehensive holistic care that addresses the many needs of those we serve. We support cur compassionate and dedicated employees in continually seeking new opportunities for feedback and self-improvement in their professional skills. Our shared personal mission is to develop the necessary tools that will help create human connections with our customers. To support these efforts we foster the values of communication, professionalism, and unity within our work environment. Excelsior cherishes the privilege to assist those in the search of a better life.

Core Values

• Professionalism

• Unity

• Communication

About Us

Excelsior is a private non-profit that traces its roots back to 1893 through the Sisters of the Good Shepherd. The sisterhood was tasked with saving young women from sexual exploitation in the Pacific Northwest. This lineage has sculpted the culture of Excelsior to be an organization that protects and cares for those it serves in a compassionate and trauma informed way. Throughout the years Excelsior has adapted to the needs of the community to best serve those who are in need. As an established community provider Excelsior brings its history of behavioral health and substance use treatment to the integrated healthcare model.

Excelsior incorporates the 8-dimensions of wellness, as presented by the Substance-Abuse and Mental Health Services Administration (SAMHSA), into the programs and services we provide. Families are best served in a holistic and comprehensive approach that addresses the whole person. To meet the intellectual needs of clients Excelsior operates a fully-accredited middle school and high school on-site. Additionally, we provide a specialty integrated medical department that coordinates with behavioral health providers, licensed counselors, multi-system care coordinators, peer support specialists, and family support specialists.

We operate from a position of “Nothing about you, without you.” Excelsior’s professionals work along side families and individuals in a team approach using person centered recovery planning (PCRP) to achieve health goals. The PCRP is directed by input from the individual, which is the crucial voice towards living a healthier life.

Excelsior employs comprehensive screenings and assessments to help inform individuals of their health status and guide them towards the appropriate programs to achieve their goals. Excelsior providers engage with the individual using evidence informed and evidence based practices (EBP) to achieve the best treatment outcomes.

A unique approach of Excelsior is how therapeutic recreation and experiential education (TREE) is woven into programs and services. The 32 acre campus provides an arboretum, trails, and 20 low and high ropes course elements. The elements offer unique challenging experiences for an individual by creating symbols related to treatment and better living. This experience is either processed in a group, with the family, or a professional counselor.

Leadership Team

Board of Directors

KEVIN BENSON Secretary and Interim Chair

Owner and Principal of Bold Move Consulting

ANDREW HILL President

CEO Excelsior

ALAN BASHAM Senior Lecturer Psychology Department Eastern Washington University

TONY ANDERMAN Instructional Systems Designer at Spokane County Sheriff’s Office

DENNIS HESSION Attorney at Law

MOLLY PARISH Assistant Attorney General

REBECCA GREENE Chief Financial Officer Rosauers Stores, Inc.

Leadership Team

Kitara Johnson Vice-President Education Services

Amy Fager Vice-President Central Response

Kim Pieroni Vice-President Finance

Sara Schumacher Vice-President Operations

Jerry Schwab Vice-President Behavioral Health

Josh Martin Vice-President Human Resources

Marilyn Pitini Vice-President Mission and Initiatives

Growth Towards Healthier Living

Recovery

Support Services

Medical LRA

HEALTHCARE

Primary Medical

Early & Periodic Screening

Diagnostic Treatment

Mental Health & Substance Use

EDUCATION

Accredited Middle School & High School

Psychoeducation

Substance Use Education

Parent Education

Coordination with Community Programs

Health Education

Individual, Group & Family Therapy

Medication Management

Care Coordination

ENGAGEMENT

Family / Person

Centered Recovery Planning

Comprehensive Screening & Assessment

Psychotherapeutic Recreation

Recovery

Support Services

Wrap Around

Peer Support

COMMUNITY

Peer Support

Vocation Support

Housing Support

Healthcare Coordination

Advocacy and Self-Efficacy

Aftercare

2017 Programs and Services Overview

Hospital Diversion Programs (ages 10-21): Excelsior provides services that assist individuals in staying out of the hospital, or as a step-down from acute institutional care. Each individual is assigned to a multidisciplinary team that uses creative approaches to address the complex needs of those who use this program. The programs provide a structured residential setting with flexibility and sense of independence desired in late adolescence and young adulthood. The programs look to eliminate intensive stabilization services in adulthood with prevention through targeted interventions and community support.

In-Home Hospital Diversion Program (ages 10-21): Excelsior has developed the only Roads to Community Living program that assists youth in our region of program engages families with children, adolescents and young adults who have a chronic history of hospitalization, unwanted law enforcement encounters, and Child Protective Services interaction. In 2014 this low cost program kept 100% of participants from returning to the hospital and several families from filing for dependency with the state of Washington.

Caregiver Respite Program (ages 10-17): Excelsior provides respite services to families who are looking for a reprieve from high-intensity caregiving. Short stays in a structured residential dormitory are a therapeutic benefit to the individual and their family.

Behavioral Health Residential Services (ages 10-21): Excelsior has over 35 years of experience providing intensive and sub-acute child and adolescent behavioral health residential services. We provide intensive inpatient substance use and psychiatric residential care. We provide the State's most intensive level of care for child welfare. Our program serves youth who have a history of chronic and significant traumatizing experiences, known as adverse childhood experiences (ACE), and an absence of any familial support system. These youth receive holistic, traumainformed, gender responsive, and evidence-based care provided by Excelsior’s dedicated employees. Lengths of stay range from brief intervention to long-term psychiatric residential care. Residential services are integrated with the onsite primary medical and education services.

Co-Occurring Intensive Outpatient Program (ages 10-21): Excelsior operates an innovative co-occurring intensive outpatient program that uses a harm reduction model. The program offers a variety of engaging services including crisis resolution, counseling, peer support, medication management, therapeutic recreation, in-home consultation and other non-traditional services. 90% of the program participants are assessed at meeting criteria for inpatient or residential treatment, but those programs may not be appropriate for the individual for various reasons.

Education and Vocational Services (age 10-21): In 2017 to increase our presence in the community, Excelsior enrolled students from outpatient, inpatient, and from the community. The program is open to anyone who may benefit from comprehensive services to help address schooling concerns. Concerns related to behavior issues, individual education plans, or medication management. Our school takes pride in that no student is ever expelled or suspended, but instead uses crisis interventions to salvage as much of the learning experience as possible. The program provides credit recovery, GED prep, online learning, and vocational training.

Medical Services: Our medical clinic expanded services to offer primary care to our inpatient and outpatient clients and the community. Dr. Michael Mainer has joined the team to provide oversight and leadership. On going discussions are occurring with the University of Washington’s Physician Assistant program for intern opportunities. Medical staff are pursuing further education and licensing to increase the quantity of primary care options offered through the clinic.

Strengthen Our Vision and Mission

Partnerships & Collaborations

Excelsior’s strength comes from its heart and the long lasting pertnerships it has forged within the Spokane community. Earlier in the year when Excelsior was unfairly represented in the media, the outpouring of support from our partners and community was overwhelming and renewed our spirits with determination.

Excelsior is an employer who supports their members engagement within the community. Our employees represent us by sitting on over 30 different advisory boards and committees to include:

• Rising Strong

• Providence Sacred Heart Medical Center

• Children’s Home Society YFA Connections

• Volunteers of America

• Catholic Charities

• Cup of Cool Water

• Spokane Public Schools, District 81

• Spokane Police Department

• Spokane City Housing Stability and Community Services

• Gonzaga University

• Eastern Washington University

$700,000

$600,000

$500,000

$400,000

$300,000

$200,000

$100,000

Financial Position

Excelsior continues to see rapid growth due to its efforts to modernize and diversify operations. Overall revenue increased by 66% compared to 2016. This trend is anticipated to continue throughout FY 2018 from implementation of new initiatives and efficiency measures that were set into motion this year. Revenue projection are in excess of 50% for the next year.

The largest sectors of revenue growth were driven by third-party insurance payments (240%), and funding from donors, grants, and in-kind contributions (154%).

Excelsior Funding Sources

Enrollment in 2017

Mission Accomplished

Excelsior is a pioneer in providing behavioral health care to the youth of Washington State. For decades Excelsior has supported youth and their families through the provision of psychiatric residential care, outpatient services, and the treatment of substance use disorders. To actualize a comprehensive approach to treatment, on-site medical care and accredited education services were incorporated into the organization early on.

In 2010 the Patient Protection and Affordable Care Act mandated that states merge behavioral health and substance use services creating the initial concept of integrated care. Excelsior was ahead of the industry trend when state agencies and the administrative codes began to merge the two services and struggled to find their identity. By the year 2020 each regional behavioral health organization will merge with primary care creating a new managed care system that is completely integrated.

Excelsior continues to stay ahead of industry trends and is a model of how comprehensive health care is executed operationally. Responsiveness to the needs of the population it serves is how Excelsior maintains its edge, and how the organization will offer seamless healthcare long before the 2020 deadline.

2017 saw key areas within our organization develop into a Fully Integrated Managed Care (FIMC) organization. This change has created challenges for many. Our adaptability, patience, and resilience has remodeled our separate, unconnected services and independent programs into a seamless integrated, holistic service environment, ever mindful of our vision of “Connecting Youth [and their families] to their futures.

Department Performance Highlights

Karen Kearney Community Relations

Community relations successfully strengthened existing partnerships while building new connections within our community. Excelsior facilitated countless visits and tours from VIP’s, partner organizations, leaders, and Scokane citizens.

This year we saw the opening of Threads with the collaborative efforts from the J.C.Penney’s team. Excelsior staff and then J.C.Penney team transformed an old empty storage room into an organized and clean clothing store. The store is here to support our customers who are in need of quality new clothing. The relief and joy you observe when our customers have the opportunity to go shopping for clothes is evident . They glide the hangers along the racks, touch the clothes, bring it up to their faces and look in the mirror. We get to see them be normal teens for just a moment.

Karen Kearney worked very hard on 2 of our 3 courtyards. They have been weeded and have new plants in them. Our entrances received a face lift this spring and summer too. New perennials were planted and pots were placed at the door to greet our visitors. The residents helped Karen rake, weed, and spread bark in our front gardens. They looked great this year.

Managed Care & Insurance Relations

Bryan Stanfill

As we look to sunset systems and workflows that are increasingly less relevant, Excelsior has prioritized establishing valuable partnerships with the Managed Care Organizations that implement Medicaid coverage plans around the state. We have simultaneously phased out aging systems and expanded our private billing . This was accomplished through hiring a seasoned billing specialist from the healthcare community and implementing new software. This process requires ongoing navigation of new territories and exploring healthcare integration from an administrative and clinical perspective. We have launched a reception-desk initiative to streamline billing and payment procedures and align with private market operation standards.

Already these efforts have paid dividends for our organization. Private insurance billing has generated a 240% increase in revenue compared to 2016 for the organization.

Central Response

Amy Fager

This summer marked the launch of Central Response . This new department centralizes Excelsior’s intake, assessment, evaluation, and communication with our customers. The department creates a vertically aligned network for a single point of contact that helps eliminate barriers. Excelsior’s Central Response funnels decades of expertise and resources to better serve our customer than any other provider in our region. In three months the department successfully enrolled over 180 youth and their families, increasing admissions by 115%. Central response handled approximately 700 new admissions for 2017, making up 70% of total admissions.

Information Systems

Eric Zeissler

Excelsior overhauled its aging information technology network to support mobile. They were able to transition the server and over 150 PC units over one weekend. It is their hope this will allow the technology advances we will need into the next decade as a FIMC.

BestNotes Electronic Medical Record: 2017 saw increase in the scope and use of EMR’s. Although the transition is ongoing, the process has significantly reduced labor and printing costs associated with paper documents.

Facility Maintenance

Eric Kurtzbein

The efforts of our maintenance staff continue renovating, improving, and updating our facilities. This year we have seen updates in residential units, offices, and the school. We have added more parking spaces and have plans to add more spaces through 2018. The roof is being repaired through a $217,500 Community Development Block Grant provided by the City of Spokane. Below is just a sample of what was accomplished this year and some plans going forward.

Projects completed:

• Threads (clothing room)

• Game room

• Wings A and D remodel

• All new School and stage flooring

• 5 wings have new bathrooms

• 4 wings new multipurpose rooms

• Office renovation for Integrated Care Coordinators and staff

Working on:

• 25 new stalls of paved parking

• New roofs on wings E and F

• Grant for cafeteria and wing C roofs

• Working on plans for music room

EDUCATION PAGE INFO

Partners, Grants, and Foundation Projects

J.C.Penney Threads

Devin Codd, Peggy Jackson, and many others spent time to learn about the important role Excelsior plays in meeting the needs of marginalized and vulnerable youth in our community, most of whom are foster children. JCPenney team members were able to take our storage room full of supplies, extra equipment, and milk crates full of clothes and create a visually ap-pealing clothing store, Threads, that will serve as a basic needs resource for any foster or homeless youth in our community.

The JCPenney cultural values of loyalty, passion, courage, and service shined over the last 12 months as they volunteered their time and talents and realized a vision to provide these vulnerable youth something they truly deserve. Excelsior is ex-tremely proud to have worked with Devin Codd, Peggy Jackson and the rest of the crew. It has been a remarkable experi-ence.

Youth often come to us with the clothes on their backs and a garbage sack, or duffle bag, with the rest of all they own; often short of having a full wardrobe of clothes. We have always kept a supply of basic clothes, socks, underwear, pants, and shirts in a storeroom. After admittance into our program, taken to their new room, we assess what other items they might need. In the past, this included a trip to the storage room to find sizes and items the youth might need, by pulling clothes from milk crates, after walking through a path of storage items to the crates. Youth coming into Excelsior often times come from degrading places, coming here is traumatic enough, but then they had to feel even more deflated rummaging through other peoples' clothes just to get basic items. When Devin Codd from J. C. Penney saw how clothes and our clients were treated, he changed this one aspect and it has made a difference in the process for our children and our staff.

A crew from JCPenney came and transformed our storage room into an organized, clean, aesthetically pleasing clothing store. They first made closets with shelves along one wall to organize the supplies needed for Excelsior’s 200+ employees and clients. They painted the room, added art and mirrors to the walls, after new carpet was laid. Then the real transfor-mation came, they brought in shoe racks, clothing racks, and over 2,000 hangers to properly display all that we had in those crates. They separated the clothes by size, type, and gender specific. We now have a room that looks as good as any other clothing store. We are in the process of converting the bathroom to a proper fitting room.

The difference this has made to all of us who strive to help the children, youth, and young adults that come through our doors. We offer them a safe place from the trauma they have endured, and at an emotionally stressful time coming here, we no longer have to watch them scrap for clothes. You can see the relief and the even the joy they experience “shopping” for clothes. They glide the hangers along the racks, touch the clothes, bring it up to their faces and look in the mirror. We get to see them be normal teens for just a moment, all because of Devin and his team.

Grant Award: $16,000

Grantor: Hagan Foundation

Grantee background: The Hagan Foundation’s mission is,“...to contribute to non-profit organizations where the least amount of money will do the most good for the greatest number and provide the opportunities and tools to support education in its broadest sense with an emphasis on youth.”

Purpose: Excelsior used the $16,000 award to purchase the appliances and equipment for the new Excelsior pre-apprentice vocational program. The program teaches youth skills

Grant Award: $18,000

Grantor: Future Song Foundation

Grantee background: The Future Song Foundation’s mission is, “Ensuring our young people achieve their full potential through the power of music and mentorship.”

Purpose: Excelsior used the $18,000 award to rehabilitate an aging classroom and transform it into a recording studio and practice room for Excelsior’s youth. Instruments and sound equipment allow the youth to share their experiences through music and spoken word.

Gone but not forgotten.

IN LOVING MEMORY

Darnay Raysons

June 25th, 1992 - June 7th 2017

Darnay played a significant role in not only the history of Excelsior but was an important member of our community. He was an advocate for youth on and off our campus. The impact he has had on the youth here at Excelsior has been evident throughout the years and even more so in the past couple weeks as scores of past clients have reached out to see how he was doing, to offer support, and to make known the positive role he played in their lives.

Darnay was also a source of support, leadership, and humor for all the staff of Excelsior. Much like clients, past employees have reached out to offer their support and share how “Big D” influenced their lives. His unforgettable voice often brought smiles to faces and his mischievous laugh was contagious, easily putting someone in a better mood simply as a result of his joy. We are blessed for having known someone like Darnay. He was an individual who always treated others with dignity and respect, an individual who embodied all the values Excelsior holds. Excelsior and the Spokane community lost a very special person. The world needs more Darnay Raysons.

Gone but not forgotten.

IN LOVING MEMORY

Bill Caruthers

September 25th 1995 - February 10th 2017

Bill was a beloved staff, friend, mentor, guitar teacher, and much more...to the youth he provided a symbol of that of a big brother, uncle, father and grandfather. Most importantly he brought a sense of safety every time he was present.

Bill’s dedication and compassion towards the youth and employees of Excelsior extended far beyond what the definition of those words even mean. For 22 years, Bill was dedicated to Excelsior and our community’s youth. He served as a leader on the overnight campus management team and knew each youth individually. His steadfast commitment to improving the lives of kids was extraordinary. He was a constant beacon of support for staff coming off shift and a pillar of confidence for staff coming on shift.

In times like this, it is important that we stand together and support each other-all who feel this loss. The Maple Room has been reserved for the remainder of the day to provide a space of remembrance and support. Additional resources are available to those we serve, his colleagues, family, friends and former residents. Please don’t hesitate to contact Human Resources, Josh Martin, at joshm@4eyc.org.

Details regarding upcoming events or opportunities to memorialize Bill will be forthcoming.

Thank you Bill, for your lifelong dedication to our community; for your honesty and advocacy; for your passion of music and your commitment to providing youth hope, opportunities for success and a path towards Excellence. You will be missed. Rest assured your music legacy will live on…you’ll be proud.