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OCTOBER 2019

Annual Report 2019

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Our Mission:

“Creating Pathways to a bright

future”

Our Vision: “To be the provider of choice

for a behavioral health

continuum of care for at risk

individuals and families”

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Board of Directors Chairperson ..........................Kurt Johnson

Vice-Chair .............................Robert Ruedebusch

Secretary ..............................Danielle Hamann

Treasurer…………………………… Jon Soderholm

Board Members Dan Ahlers............................Business Owner & State Legislator

Daniel Felix, PhD……………….. Dir. Of Behavioral Health, Center for

.............................................Family Medicine

Capt. Jason Gearman ............Minnehaha County Sheriffs Dept.

Danielle Hamann, MBA ........Director of Public Policy

Avera Health

Laura Hensley .......................Attorney at Law

Dick Kelly .............................Former Minnehaha County

Commissioner

Sgt. Jason Leach ...................SRO Sergeant/Honor Guard

Sioux Falls Police Dept.

Kurt Johnson ........................Consultant

Robert Ruedebusch ..............Senior Pastor

First United Methodist Church

Jon Soderholm .....................Retired Health Care Executive

Gib Sudbeck .........................Retired DSS Director/Manager

Pam Tiede ............................Minnehaha County States Attorney

Office, Retired

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Executive Director 2019 was a very active, challenging and productive year for Carroll Institute. A year to

celebrate and a future to look forward to. Our programs and services continued to show a sincere

commitment to the more than 1,600 clients we served. All programs enjoyed success both

programmatically and financially! One of the most significant accomplishments was obtaining a

three-year accreditation from CARF International this past May. Achieving this high level of

accreditation reflects the staff’s pattern of conformance to high standards, and was due in large

part from the direction and guidance of Tiffany Butler, Director of Operations and Regulatory

Compliance. Additionally, Carroll Institute stayed focused on growth, and the commitment to meet

community needs, by actively pursuing the development of a satellite clinic in southeast Sioux

Falls; 5625 S. Southeastern Avenue. Site development began in August, with an estimated

completion of February 2020. The clinic will support six therapist offices and focus primarily on

individual and family therapy.

Carroll Institute is extremely fortunate to have a talented, resourceful and dedicated staff to

ensure service excellence in all areas of program delivery! It is my pleasure to work with them

every day. I want to thank them and the Board of Directors, for all that they have done and

continue to do in changing and often times saving the lives of those we serve! And, I want to thank

all of you for supporting Carroll Institute over the past year, so that together, we will keep fulfilling

our mission.

Gary Tuschen

Coming in February 2020

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Director of Operations

Management: • Three-year CARF Accreditation received

• Continued partnership with the South Dakota Board of Addiction and Prevention Professionals and the South Dakota Board of Examiners for Counselors and Marriage and Family Therapists to address reciprocity and supervision.

• Partnership with Center for Family Medicine to provide Medication Assisted Treatment

• Bonuses and salary increases were awarded to eligible employees

• Succession Planning beginning as suggested by CARF review team.

Outpatient:

• In March of 2019, we implemented a Mentorship Program to assist with some one-on-one training and licensure supervision for our Addiction Counselor Trainees. This has proven to be very successful so far and reports have been positive in regards to the one-on-one time ACT’s have with a Mentor.

• We had some counselor transition and our new additions have been excellent partners on our team.

• We continue to see some decrease in our traditional IOP groups due to higher referrals to CBISA and Residential programming. We will continue to evaluate our needs and adjust accordingly.

• We attempted a female jail treatment group, but numbers continued to be lower than expected. We then turned it into a case management group and this was successful, when we had enough numbers to help prepare the females for transition into the community.

• We began a Moderate Outpatient Group to address individuals that need less than IOP but more than Aftercare.

• Continued conversations both internally and externally for our expansion into insurance-based clients through a shared practice. Target date is July 1, 2019 to implement this expansion.

• Quality Assurance reviews continue to be successful.

CBISA and Drug Court:

• The CBISA program at Carroll Institute continues to set the bar for meeting client needs. This writer was asked to be involved in conversations about supplemental services to be offered to support our clients, as well as pilot changes to enhance the CBISA program and promote more successful outcomes.

• An additional CBISA group was added to the rotation of groups, and an additional counselor was identified to facilitate a CBISA group in addition to the groups he already facilitates. I’d like to acknowledge Earv Archambeau for stepping in to facilitate a CBISA group, as well as Shane Gerlach who volunteered to begin a new group at 8:00 AM on Monday, Wednesday, and Friday morning. Additionally, this writer is facilitating an evening group with Sara Cady on Monday, Wednesday, and Thursday evening. We’ve has success with retention in this

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group, so we will continue co-facilitating this group indefinitely and filling the group with 20 participants. As noted in last month’s report, we are on track to successfully complete about 65% of the original group members who started the group in July; they’re scheduled to complete 11/04/19.

• The South Dakota Legislative Research Council reviewed the effectiveness of Drug Courts; the Sioux Falls Drug Court team was one of the teams interviewed for this report. On page 9 of the report, as indicated in the compliance evaluation table, Carroll Institute is able to meet the SUD treatment needs of our clients more than 90% of the time.

• Carroll Institute hosted a Learning Collaborative presented by SAMHSA’s GAINS Center (Behavioral Health and Justice Transformation), which included on-site and virtual training.

• Five Sioux Falls Drug Court team members attended the NADCP All Rise conference in Washington, D.C. July 14-17, 2019; the conference included the NADCP celebration of 30 years in existence.

• Implementation of Mentorship in March offered additional options for supervision of counselor trainees, as well as opportunities for growth of certified/licensed counselors.

• Carroll Institute hired an outpatient Case Manager in August 2019; Tanya Steinhoff has been a valuable addition to our team. Not only does she work well with our clients to meet additional needs to support successful recovery, she’s also been open to doing intakes for both the outpatient and CBISA programs. For CBISA specifically, this allows those counselors more time for individual client sessions, and assessments. Tanya’s schedule has been slowly filling to include more case management, and her case load is building. I believe FY20 will prove to show growth in this service, and continue to helpful in supporting successful outcomes for our clients.

-Kristi Jacobsma

Arch:

• We have achieved 100% retention of our residential counseling staff throughout the past year.

• Our Case Management position at the Arch has had a positive impact on our clients and on our program as a whole.

• We successfully implemented IMT-E programming and have achieved a success rate that surpasses the state average.

• All of our residential counseling staff have been trained in CBISA and IMT-E, two have been trained in DBT.

• We have achieved 100% retention of our kitchen and maintenance staff and we have seen improved retention amongst our monitoring staff.

• We have experienced great success this past year and we continue to explore ways to improve our services and to meet the needs of our clients.

• We are hopeful to bring on another residential counselor to aid in coverage needs as we expand CBISA services within the Arch.

-Michelle Worden

New Horizons:

• This has been an amazing year at New Horizons!

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• The clients have been extremely successful and rent has been at an all-time high since Hunter Johnson took over supervision of the house

• Some of the girls have gone on to flat parole and move to different areas of the country. They occasionally touch base with staff through phone calls and letters.

• In regards to staff, we’ve never been stronger and we are extremely lucky to have such an amazing group of compassionate ladies to help supervise the program.

• This year we’ve been lucky to work with some of the foundations around town such as Bethany Christian Services. They’ve gone above and beyond to make sure some of our new mothers have the time and ability to focus on recovery, yet still know that their children are in a safe and secure environment.

-Hunter Johnson

Prevention:

• Barb DeVos trained in Threat Assessments and provided several to various school districts.

• Continued attempts to increase coalition membership. Joined forces with the SET-Free Coalition to gain more traction and increase membership.

• Sammon’s Group donation of $10,000 allowed us to provide services to Harrisburg Middle School.

• Angela Kennecke presented to the coalition to share her story of her daughter’s struggles and death due to opiate use.

• Expanded funding options announced at a March Regional Coalition meeting to help replace the Partnerships for Success Grant we have utilized for the past 5 years.

Tiffany Butler, MA, LPC

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Human Resources Carroll Institute entered into an agreement with Alternative HRD in April of 2018 and transitioned consultants from Melissa to Kayla in January of 2019.

Summary of HR Projects: • Employee Relations/HR Coaching: Provide HR support for managers and staff. • Maintaining Recruitment/Hiring/Onboarding Process • Continuing to conduct General Orientation Day 1 for new hires • ACA reporting updated through the year based on Wellmark report (compliance). • Provide mediation services when employee issues arise. • Administered Employee Engagement Survey – presented results; created action plans based

on feedback that was provided from the survey results • Facilitate monthly email from the Executive Director • Continue to review Employee Handbook for changes.

• Implemented Break Policy • Leadership/Management training topics: Conflict Resolution with Management Team,

Continual training on interviewing (phone screens, interview questions, references), conducting investigations, documentation, supervisor training, work comp, FMLA; mediations; etc.

• Implement Exit Interviews for voluntary termination process. • Leadership/Management training: Topics: Ditch the Drama/Reality Based Leadership

(Conflict Resolution training/Ditch the Drama Triangle tool). • Compensation review in 2019 to stay competitive with market • Turnover: Calculate annual turnover for 2018 in January. • Compensation Statements (will be delivered after we receive 2020 benefit rates)

Kayla Johnson

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Financial Summary

$0

$200,000

$400,000

$600,000

$800,000

$1,000,000

$1,200,000

$1,400,000

$1,600,000

$1,800,000

$2,000,000

2015 2016 2017 2018 2019

Net Income

Cash Reserves

State/Federal-$3,509,443

Client Fees-$344,480

Prefention Grant-$132,446

Minnehaha County-$84,332

School Contracts-$43,775

Tobacco Grant-$23,250

US Probation-$15,137

Investments/Misc.-$30,177

Contributions-$20,831

$0

$500,000

$1,000,000

$1,500,000

$2,000,000

$2,500,000

$3,000,000

$3,500,000

$4,000,000

$4,500,000

2015 2016 2017 2018 2019

Total Revenue

Total Revenue

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Clients Served

450426 431

526 512

278 260 251

176 187

468

402427 427 431

188

376

320

412 411

2015 2016 2017 2018 2019

Outpatient Treatment Jail Treatment Aftercare CBISA

33 30

8 0 0

69

90

82

5854

79 78

93

45 45

34

14 0 0 0

2015 2016 2017 2018 2019

IPP DUI Diversion Multiple Offender Program

368 368

465

399418

211 199 191153 150

2015 2016 2017 2018 2019

Arch Changes and Choices

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Residential Discharges

43%

6%

22%

7%

8%

9%3% 1%

Arch Discharge Breakdown FY19

Successful Detainment Walked away Self Discharge

Continued Use Non-compliance Fraternization Unsuccessful-Other

54%39%

7%

New Horizons DOC Discharge

Successful Terminated Walk Away

45%

33%

2%

0%20%

New Horizons IVC Discharge

To Inpatient To Slip Slot To Outpatient IVC Dropped Terminated

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Prevention Trends

Alcohol (30 day)Binge Drinking (30

day)Prescription Drugs

(30 dayRode with drinking

driver (30 days)Drove when

drinking (30 days)

2009/2010 32.1% 21.7% 7.8% 20.4% 8.8%

2010/2011 31.4% 21.6% 6.3% 20.0% 10.0%

2011/2012 23.3% 11.1% 7.4% 19.8% 8.8%

2012/2013 21.8% 11.7% 6.2% 10.5% 4.5%

2014/2015 24.1% 11.0% 6.8% 17.2% 4.5%

2015/2016 24.1% 14.4% 6.5% 14.3% 4.8%

2016/2017 23.5% 12.4% 4.7% 9.8% 4.3%

2017/2018 19.9% 10.0% 3.6% 10.5% 2.9%

2018/2019 20.2% 10.9% 4.3% 10.5%

32.1%

21.7%

7.8%

20.4%

8.8%

31.4%

21.6%

6.3%

20.0%

10.0%

23.3%

11.1%

7.4%

19.8%

8.8%

21.8%

11.7%

6.2%

10.5%

4.5%

24.1%

11.0%

6.8%

17.2%

4.5%

24.1%

14.4%

6.5%

14.3%

4.8%

23.5%

12.4%

4.7%

9.8%

4.3%

19.9%

10.0%

3.6%

10.5%

2.9%

20.2%

10.9%

4.3%

10.5%

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0% Rural Sioux Empire Trends

2009/2010 2010/2011 2011/2012 2012/2013 2014/2015

2015/2016 2016/2017 2017/2018 2018/2019

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Ever Tried acigarette

Smoked acigarette at

least once inthe past 30

days

Ever usedchewing/smoke

less tobacco,snuff or dip

Usedchewing/smoke

less tobacco,snuff or dip atleast once inthe past 30

days

Ever used anelectronic

vapor product

Used anelectronic

vapor productat least once in

the past 30days

2011/2012 34.1% 15.9% 19.5% 9.1% 0.0% 0.0%

2012/2013 29.3% 13.4% 16.8% 8.1% 0.0% 0.0%

2013/2014 23.5% 9.9% 13.5% 5.6% 0.0% 0.0%

2014/2015 22.3% 8.4% 12.1% 6.0% 0.0% 0.0%

2015/2016 20.3% 7.4% 11.9% 6.7% 32.2% 13.4%

2016/2017 19.4% 6.5% 10.6% 5.1% 36.2% 12.7%

2017/2018 17.3% 5.7% 8.5% 3.9% 41.1% 30.3%

2018/2019 15.1% 5.4% 9.3% 3.3% 41.8% 28.9%

34.1%

15.9%

19.5%

9.1%

0.0% 0.0%

29.3%

13.4%

16.8%

8.1%

0.0% 0.0%

23.5%

9.9%

13.5%

5.6%

0.0% 0.0%

22.3%

8.4%

12.1%

6.0%

0.0% 0.0%

20.3%

7.4%

11.9%

6.7%

32.2%

13.4%

19.4%

6.5%

10.6%

5.1%

36.2%

12.7%

17.3%

5.7%

8.5%

3.9%

41.1%

30.3%

15.1%

5.4%

9.3%

3.3%

41.8%

28.9%

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

45.0%

High School Tobacco Trends

2011/2012 2012/2013 2013/2014 2014/2015 2015/2016 2016/2017 2017/2018 2018/2019

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Ever Tried acigarette

Smoked acigarette at

least once inthe past 30

days

Ever usedchewing/smoke

less tobacco,snuff or dip

Usedchewing/smoke

less tobacco,snuff or dip atleast once inthe past 30

days

Ever used anelectronic

vapor product

Used anelectronic

vapor productat least once in

the past 30days

2011/2012 8.9% 3.2% 3.1% 1.7% 0.0% 0.0%

2012/2013 7.5% 7.6% 3.2% 1.7% 0.0% 0.0%

2013/2014 6.0% 1.7% 2.5% 0.9% 0.0% 0.0%

2014/2015 5.2% 2.2% 2.1% 1.5% 0.0% 0.0%

2015/2016 5.9% 2.3% 3.2% 1.4% 7.8% 3.6%

2016/2017 5.3% 1.0% 3.3% 1.1% 5.9% 1.9%

2017/2018 5.4% 1.8% 2.2% 0.5% 9.7% 5.4%

2018/2019 5.5% 1.9% 1.9% 0.9% 10.3% 5.1%

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

Middle School Tobacco Trends

2011/2012 2012/2013 2013/2014 2014/2015 2015/2016 2016/2017 2017/2018 2018/2019

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Stakeholder Survey

0

2

4

6

8

10

12

14

Law Enforcement Court Staff Department of SocialServices

Medical Treatment Agency

What type of stakeholder are you?

27%

73%

How familiar are you with the services that are offered by this

agency?

Familiar Very Familiar

100%

0%

This agency is supportive of client needs.

Agree Disagree

91%

5% 4%

Clients that receive services from this agency have positive

outcomes.

Agree Undecided Disagree

100%

0%

The location of services is convenient for clients.

Agree Disagree

15

84%

5%11%

The services are available at times that are convenient for

clients.

Agree Undecided Disagree

95%

5%

Staff at this agency are respectful.

Agree Undecided

95%

5%

Staff at this agency are well trained.

Agree Undecided

100%

0%

Staff at this agency are competent to deliver treatment

services.

Agree Disagree

100%

0%

This agency is responsive to the needs within the community.

Agree Disagree

100%

0%

Staff actively communicate regarding the client's treatment.

Agree Disagree

90%

10%

This agency utilizes Evidence Based or Emerging/Promising

Practices.

Agree Undecided

100%

0%

This agency provides quality services.

Agree Disagree