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Annual Report for Fiscal Year 2012

Setting the Standard for Excellence!

Thank you for taking the time to read our Annual Report. DAYMARK Recovery Services, Inc. is a not-for-profit provider of behavioral health and substance abuse services. Our agency was formed at the onset of Public Mental Health Reform in North Carolina. We have expanded annually since inception and promoted cost effective, best practice care in our field. While many other providers have an unsupportable high cost of care, become one-dimensional with few professional services, or gone out of business, DAYMARK has thrived by producing outstanding outcomes at acceptable cost through professional and evidence based care. Fiscal Year 2012 was a year of significant growth for DAYMARK. This document serves as a snapshot of who we are, a few of our accomplishments and where we are going.

Billy R. West, Jr.

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

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 behavioral healthcare professionals to support citizens of all ages and their families with the greatest opportunity for recovery, independence and the highest quality of life. We are committed to using the most current best practices and effective, researchbased treatment programs to assist all citizens working toward achieving optimum health and recovery.


Tim Childs, Board Chairperson Jim Cook, Board ViceChairperson Dwight Wilhelm, Secretary/Treasurer Debora Pershing Sharon Scott Brenda Trott Barbara Davis Linda Lowder Larry Johnson Dr. Tom Appenzeller Tom Harman Felicia Wilson Hartsell and Williams, Board Attorney Erin Beckwith, Board Clerk

DAYMARK Recovery Services, Inc. serves those with the greatest needs and facing the greatest challenges with a coordinated effort of services. Services are culturally sensitive, strength based and delivered in congruence with natural community supports and each consumer's personal support system. Services will promote safety and recovery while always respecting the rights of self-determination.

2012 Highlights
Consumer Satisfaction scores for 2012 resulted in an average of 96% overall satisfaction. 94% of our consumers reported that, as a direct result of our services, they were better able to control their life. 97% of our consumers reported they would recommend DAYMARK to others. Our average cost per consumer for medical, counseling and crisis services is less than $900.00 per consumer, per year. Many of our competitors have an average cost exceeding $1,000 per consumer with most in the $2,000-$5,000 range. 82% of our consumers qualify for reduced or no fees for services due to their income level. Services are billed to Medicaid, Medicare, and private insurance and fees for indigent consumers are based on their income and ability to pay. DAYMARK is one of the 150 National Community Treatment Programs in the Clinical Trials Network of the National Institute of Drug Abuse. 1,128 internal and 140 external employees (a total of 1,270) attended 142 in-service trainings, most of which were with evidenced-based instruction. This constitutes an increase of 145% over those trainings provided in fiscal year 2011. During fiscal year 2012, DAYMARK expanded to include five additional service delivery areas serving 53,000 consumers, a 32% increase over fiscal year 2011, and provided 468,737 units of service, a 44% increase over fiscal year 2011. During fiscal year 2012, expansions included one Crisis Inpatient Service facility and one Residential Substance Abuse Service facility. Furthermore, we salvaged the employment of approximately 400 staff and care of 10,000 consumers from a 40 year old safety net provider that had failed. All of this within the span of a three week timeframe. We capitalized on several Federal incentives related to the American Recovery and Reinvestment Act of 2009 (ARRA) this year to improve consumer safety, consumer access, and keep our fees low. Aside from the mentioned ARRA initiatives, we invented a Crisis Command Center that provides a real-time view of all consumers currently in a crisis episode. This is available 24/7 and is integrated into our Electronic Health Record. We have increased the synergy of our medical services by linking all of our 32 locations together through telemedicine. This allows on demand psychiatry and professional services when necessary. We have been recognized by many Local Management Entities (LMEs) as an organization that can assist with beta testing, debugging and improving their information systems during Medicaid Waiver development. This type of partnership is essential for a successful Medicaid Waiver implementation. DAYMARK maintained CARF Accreditation with the maximum three-year renewal. Increased the number of employees from approximately 500 to an excess of 800 (an increase of 60%) to meet the additional demands for services. Received a $298,650 grant from the Kate B. Reynolds Foundation to assist in rebuilding psychiatric medical capacity in Tier 1 Areas (underserved areas) of Western North Carolina. DAYMARK leadership presented at several statewide and national conferences regarding sustaining public mental health services in a reformed environment and information systems in behavioral healthcare. We are also involved with most stakeholder and community groups in our catchment areas.

DAYMARK offers a variety of quality services in many locations in North Carolina:

City Albemarle Archdale Asheboro Buies Creek Concord Danbury Greensboro Henderson High Point King Lexington Mocksville Monroe Pinehurst Raeford Raleigh Reidsville Rockingham Salisbury Sanford Troy Wadesboro Winston-Salem County Stanly Randolph Randolph Harnett Cabarrus Stokes Guilford Vance Guilford Stokes Davidson Davie Union Moore Hoke Wake Rockingham Richmond Rowan Lee Montgomery Anson Forsyth

DAYMARK provides the following services delivered through evidence based, best practice, or literature based treatment. Each location varies by the type and intensity of services offered. Please visit our website for the contact information of a service site near you at:
Assertive Community Treatment Team (ACTT) Facility Based Crisis and Detoxification services Indigent Medication Program Intensive Substance Abuse Outpatient Treatment Intensive In-Home Services (IIH) Day Treatment Mobile Crisis Outpatient individual and group treatment Peer Support Psychiatric Assessment, Evaluation, and Medication Administration Psychiatric Services (also Telemedicine) Psychosocial Club House (PSR) Substance Abuse Outpatient Services Substance Abuse Residential Treatment (30, 60, 90 days) Targeted Case Management Advanced Access (Walk-in Crisis) Please note that there are other specialized treatment and research studies available in select locations


LME CATCHMENT AREA (public payer source) Cardinal Innovations Healthcare Solutions (formerly PBH) Sandhills Center CenterPoint Human Services Smoky Mountain Center Partners Behavioral Health (formerly Crossroads) Guilford Center Wake Center TOTALS UNDUPLICATED CONSUMERS UNDUPLICATED SERVICES

20,212 11,374 10,122 5,098 4,375 1,186 633 53,000

160,162 100,225 75,736 68,781 30,181 25,967 7,685 468,737

DAYMARK is committed to providing care to those persons most in need of services. This is evidenced by the percent of funds received for consumers who are indigent (State funded) and eligible for entitlement funding (Medicaid).

Revenues By Payer Source

18% State Dollars, Grants, Commercial Insurance, Donations, County Dollars for Indigent Care 82% Medicaid

DAYMARK provides a wide range of quality services to people with mental health, developmental disabilities, and substance abuse issues.

Consumers Served by Disability

70% 60% 50% 40% 30% 20% 10% 0% Mental Health Dx.



MH & SA Dual Dx. Substance Abuse Dx.

Other Dx.

DAYMARK consumers have remained consistently satisfied with services.

Cumulative Satisfaction Scores

100% 98% 96% 94% 92% 90% 88% 86% 84% 82% 80% CY 07 CY 08 CY 09 CY 10 CY 11 CY 12 Overall Satisfaction With Services I Feel Better Able to Control My Life Because of Daymark Services I would Recommend Daymark to Others

GOALS FOR FISCAL YEAR 2011-2012 Maintain CARF accreditation Maintain Critical Access Behavioral Health Agency status Mature newly acquired services Maintain presence in national research communities Continue to partner with Local Management Entities for Medicaid Waiver implementation Expand evidence based practices in each service location Expand childrens services in some underserved areas Rebuild psychiatric capacity in our Mountain counties Extend services to additional communities where unmet needs continue to exist Explore potential models for co-location or reverse colocation of primary healthcare and behavioral healthcare


Billy R. West, Jr., MSW, LCSW, Executive Director Philip Nofal, MD, JD, Medical Director Elizabeth Pekarek, MD, Medical Director Dr. Lisa Brandyberry, Clinical Director Jerry Smith, Finance Officer Dr. Robert Werstlein, Training Director Jerold Greer, Information Systems Director Larry Elmore, MSW, LCSW, MPH, Quality Improvement Director Bonnie Miller, RHIT, Quality Assurance Director Cathy Shoaf, CPUC, AIM, Human Resources Director

IF YOU HAVE QUESTIONS OR COMMENTS, PLEASE FEEL FREE TO CONTACT DAYMARKS EXECUTIVE DIRECTOR: Billy R. West, Jr., MSW, LCSW Executive Director DAYMARK Recovery Services, Inc. 220 East First Avenue Ext. Suite 10 Lexington, NC27292 Phone: 336-242-2411