Sometimessuccess

can be measured

ADULT&child

2011 Annual Report

in asmile

In 1974, I was diagnosed with major depression with psychosis, PTSD and added Borderline Personality Disorder in 1980. Both of my parents died when I was 10 and I went to live with a sister and her husband. About that same time I found myelf in a sexually abusive situation. My first mental health symptoms showed up when I was 14 years old. My school counselor recommended that I get into mental health treatment. I went a number of years without treatment and began self-medicating with alcohol at age 34 instead! Up until that time, I was able to maintain myself, holding down a good job in mortgage banking and real estate for over 20 years. I have had no long term psychiatric inpatient hospital stays but have had 14 admissions into programs all over the city. I stopped drinking 10 years ago and have been sober ever since!

I started with Adult & Child in 1999, moved away, and returned to A&C in 2009, attending Pathways Clubhouse. Since the closing of Pathways, my biggest leaps in recovery have come from the HOPE Day Treatment Program and the DBT Groups, Mindfulness Group and my team (FACT Team). I started noticing a big difference when I started seeing colors in my life. Before, I was seeing only in black and white! Now, the sky is blue, the trees and the grass are green…and there are flowers! I hear birds singing and enjoy the sunshine.

In addition to my mental illness, I have chronic health issues: Type I Diabetes, Crones Disease, COPD, Asthma, various neurological disorders, and an artificial heart valve. I began attending Heartfelt Health Clinic about the same time as HOPE Day Treatment because I really didn’t have a doctor/medical home to help me with all of my health issues. Dr. Cockrell supervises all of my medications and has me in smoking cessation classes. He is able to treat some of my issues instead of sending me to specialists. Dr. Cockrell and Olvia have been very helpful. They have worked to get me enrolled in patient assistance for a medication that my insurance won’t pay for. I have a lot of trust in Dr. Cockrell and Olvia. Dr. Cockrell put me at ease the first time I saw him. He is very understanding and compassionate. This has been the best summer of my LIFE! :)

Barbara

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I’m 34 years old. I was diagnosed with Schizoaffective Disorder, Clinical Depression and PTSD at age 9 and began taking medication (10-11 different

psych meds) at that time. PTSD was due to traumatic sexual and physical abuse by some of my family members. My first psychiatric hospitalization

was at age 9 and I have been in several hospitals since then. I was hospitalized at the rehabilitation hospital in Texas for 2 ½ years, when I

was 18 years old, I went to Madison State Hospital and spent 2 years there. Then, after a couple of good years, I was hospitalized again at LaRue

Carter for 6 months. My last hospitalization was in February of 2011 and I was at Community North for only 4 days. I am very proud that, today, I

am only prescribed 3 medications!!

Adult & Child’s programs have helped me to gain and maintain employment through Job Links. My treatment team therapist and

team leader are helping me work through my child abuse issues. Dr. Parrish and I have a great relationship…he has worked with me

since I was 18! The team nurse is working with me on my weight issues (due to my medication side effects) and she is helping me

through my future bariatric surgery.

Dr. Cockrell, Olvia, and I get on great. They encourage me about losing weight…call to

check on me and are very on top of things…It has been really great to have the physical and

mental health services in one facility.

It helps me to take care of myself better.

April

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Over the past few years, A&C has developed remarkable partnerships with several area school districts. We currently provide behavioral support services to children in 6 different districts and have budgeted to add 50 NEW school based positions this fiscal year. Our partnerships with Center Grove, Lawrence Township, Perry Township, Franklin Community, Edinburgh, and Indianapolis Public School districts have supported children who struggle with behavioral concerns to better maintain themselves in the classroom.

“Partnering with Adult and Child has been terrific. They have the expertise and resources many of our children need to better manage themselves in the classroom and at home. Children can’t learn when they struggle with behavioral concerns, but with A&C’s on-site and home-based support, so many of our students have found success again!” - Vickie Carpenter MSD Perry Township

A&C’s school based teams provide a continuum of services which support children with behavioral concerns which interfere with their success. We help to bridge the gap between a child’s school and home to support them in a consistent, evidence based, and holistic fashion.

Featured Program - School Based Services

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50% of students age 14 and older who are living with a mental illness drop out of high school. This is the highest dropout rate of any disability group.*

*U.S. Department of Education, Twenty-third annual report to Congress on the implementation of the Individuals with Disabilities Education Act, Washington, D.C., 2001.

Adult and Child’s annual report includes profiles of courageous consumers who have experienced severe and long lasting behavioral health and physical healthcare challenges but are now on their journey towards recovery. Every day, the lives of Adult and Child staff are enriched by witnessing the resiliency and growth our child, adult, and older adult consumers.

Adult and Child Center, like other non-profit organizations, and families, has been challenged by the “great recession”. However, with the guidance of our Board of Directors and contributions from local, State, and national supporters, this past year has seen continued enhancements to our continuum of quality child welfare and behavioral health services. We are particularly pleased with the opening of our first primary care clinic, Heartfelt Health Alliance, and employment of Dr. Kete Cockrell, as its Medical Director. Dr. Cockrell will be providing integrated primary care and behavioral health services within Adult and Child offices. Heartfelt is a partnership between Adult and Child Center and Windrose Health Network, a Federally Qualified Health Center.

Behavioral healthcare, like healthcare in general, is in the midst of a sea of change at the local, State, and federal levels. Organizations like Adult and Child Center need to focus upon the provision of quality services as they currently exist while planning for the future. It is expected that economic challenges will continue for some time. However, health care reform will present opportunities for more holistic integrated care, elimination of disparities in access to care, increased accountability for provision of evidence based quality care, and improved and expanded continuum of services.

Adult and Child looks forward to a recovery oriented, highly accessible, evidence-based, integrated, and transforming healthcare system.

Welcome from the CEO

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School Based ServicesThis team provides individual/family therapy and skill building services to improve their level of functioning. Services are delivered in school settings, but also include a substantial amount of family and community involvement.

Chafee ProgramProvides independent living skills training for youth as they transition out of the child welfare system. Assistance can be provided both while the youth is in placement and after they transition out of the system.

Domestic Violence Program This unique team provides confidential services as one component of a coordinated community response to domestic violence. Our providers ensure each client is offered a comprehensive package of services including individual/group services and casework/victim advocacy services.

Therapeutic Foster CareThis program provides safe homes for children and sibling groups who are not able to safely remain in their homes, including those with special behavioral and/or medical needs. A&C’s strong mental health and integrated care access provides an added value, and improved quality of care, for this very fragile population of children.

Transitional Living ProgramServes an adolescent population, ages 16-21, who are transitioning into independence. Whether through scattered site apartments, foster care, or biological homes, this program is able to provide in home and community based services including case management individual/family therapy, medication management, and 24 hour on call crisis support services.

Home Based/Home RemediesProvides comprehensive assessments, focused on the holistic needs of the family, and provides treatment aimed to maximize the strengths of each family member while developing practical treatment goals directly related to their family preservation or reunification needs.

Intermediate TeamThis team provides a combination of outpatient therapy and community based support to children and youth. They have expertise in treatment to address a broad range of therapeutic needs; from brief interventions to Trauma Focused Cognitive Behavioral Therapy; often used in the treatment of sexually abused children.

CA-PRTF This federal grant program prevents and/or reduces the length of stay in Psychiatric Treatment Facilities. Eligible families are given intensive in-home supports to prevent placement and improve functioning.

Child, Adolescent, and Family Services

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Access TeamThe single point of entry for many Adult and Child consumers, this team provides access to mental health, substance abuse, and emergency services to adults and children in central Indiana.

Adult Intermediate TeamThis program focuses on the delivery of evidence-based practices in treatment. Special, research-based, treatment modalities like Dialectical Behavior Therapy (DBT), Exposure Therapy, Schema Therapy, Steps Program, and Brief Intervention may all be introduced during the treatment process.

Community Treatment TeamsMultidisciplinary teams of providers who treat consumers in the community. The team is experienced in treating a wide base of mentally ill adults using the valuable Evidence-Based Practices found in Intensive Community Treatment teams. Teams work hard to help each consumer meet their individual needs.

JobLinksUsing a supported employment model and working closely with each consumers’ treatment team, JobLinks helps consumers identify and realize their unique vocational needs and interests while helping them learn to navigate the employment market.

Intensive Community Treatment ICT consumers are provided a full continuum of services from a multi-disciplinary team. Services are person-centered, recovery-focused, and integrated into the community. ICT consumers often require the highest level of community-based care and have a history of multiple hospitalizations, homelessness, and/or over-utilization of emergency rooms or sub-acute facilities.

Integrated CareWe are proud to provide integrated primary and behavioral health care coupled with disease management training for those with co-occurring disorders.

Senior Impact ProgramA 2008 SAMHSA grant award winner, this program is working to improve access to appropriate mental health treatment for adults over the age of 65 in southern Marion and northern Johnson counties. Integration with the Countyline Family Health Center allows patients to receive affordable in-home and clinic based coordinated physical and behavioral health care.

Evidence-Based PracticesAdult and Child is a leading agency in the implementation of evidence-based practices (EBP) in adult mental health treatment and we routinely use the following EBP’s in our treatment practices:• Illness Management and

Recovery• Person Centered Planning• Dialectical Behavior Therapy• Motivational Interviewing• Integrated Dual Disorder

Treatment• Supported Employment

Adult Services

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Fully Integrated Heath Care In October 2010, Adult and Child was awarded a federal SAMHSA grant to develop and implement a Primary and Behavioral Health Care Integration project which targets the delivery of medical and behavioral health care to adults with a co-occurring mental illness and chronic physical disease.

In April of 2011, Dr. Kete Cockrell joined the Adult and Child staff to lead our integration efforts. Dr. Cockrell has delivered primary care services for over 30 years and has worked very closely with seriously mentally ill adults during those decades in primary care.

In partnership with a Nurse Care Manager, a team of Nurse Care Coordinators, and multiple clinical staff, the integrated care program, titled “Heartfelt Health Alliance”, has provided treatment for over 100 consumers in the first 5 months of operations; many of whom presented with serious and persistent mental illness, and untreated chronic diseases like diabetes, COPD, and hypertension.

We are very proud to offer integrated care services to our consumer population and have already discovered the positive impact these services will have on the general health of our population.

Transitioning Senior IMPACT ProgramIn September 2008, the Senior IMPACT Program was awarded a 3 year federal grant intended to increase access to mental health services among the older adult population. The program worked with area senior centers, physicians, and elderly care providers to educate, identify, and engage older adults who experienced the symptoms related to depression and anxiety. We quickly exceeded our established project goals and had direct contact with 254 older adults and screened 194 for depression. 85% of those screened, exhibited significant signs of depression.

A&C approaches every federal grant from the perspective of long term sustainability. Because good programs are based upon good planning, we developed and implemented a sustainability plan in the first year of the grant. The end of our federal funding period is fast approaching, and we are proud to say, the services provided by the Senior Impact Program will continue beyond the grant period.

79% of IMPACT consumers

reported feeling significantly better!

11%

79%

Improved Declined

Corporate Highlights

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Electronic Medical RecordsAs behavioral health begins to integrate services with multiple medical and social service providers, communication among those providers becomes more and more critical. For example, in order to efficiently treat a new consumer who may be homeless, diabetic, and showing signs of mental illness, we first need to know his medical history, medications, and other services he has received.

The huge benefit of using an EMR is that we can gain access to this critical shared health information; so we will know if this new consumer has a history of mental illness, if he is being treated for diabetes, when his last ER visit occurred, and what medications have worked before. The EMR will save time, allow for more efficient treatment, and improve clinical quality.

On July 1st, after months of preparation, Adult and Child Center activated Pro-Filer, our Electronic Medical Record. Adopting an electronic medical record is expected to reduce the amount of time our clinicians spend with documentation, increase the amount of time we can provide direct services, improve our ability to communicate with other providers, and simplify our ability to track and improve clinical outcomes.

Redefining the Continuum of CareThe past year brought many challenges for behavioral health care providers in Indiana, including massive changes in Medicaid service reimbursement. These funding changes challenged mental health centers across the state to restructure the services offered within the mental health continuum of care.

Once a staple of the service continuum, Assertive Community Treatment (ACT) services are vanishing from the menu of services provided Indiana Community Mental Health Centers. Funding changes eliminated a critical reimbursement code for this Evidence Based Practice, making it fiscally improbable for CMHC’s to continue operating ACT teams at fidelity.

On a more positive note, there appears to be a significant shift toward the employment of Peer Specialists by Community Mental Health Centers. Peer Specialists engage and support consumers from a “having been there” prospective. We currently employ over a dozen Peer Specialists and have found them to be very effective among the teams.

As the economy continues to struggle, states have less revenue to support services, and we move toward 2014 Health Care Reform, we expect to see continued challenges related to funding mental health care; However, Adult and Child will continue to provide recovery oriented quality, evidence-based, care.

Corporate Highlights

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We are very proud announce a new partnership with Community Hospitals of Indiana to begin providing integrated behavioral health services in CHI physician practices on the southside of Indianapolis and Johnson County.

Treating behavioral and physical health separately can be effective, however, research and best practices demonstrate that an integrated, holistic, approach to treating people with co-occurring primary and behavioral health care concerns is the optimal method to address treatment.

This partnership will encourage the opportunity for us to work side by side in developing holistic, integrated primary and behavioral health care services for our consumers.

We very much look forward to the opportunity to work with Community Hospitals.

We have been working very closely with WindRose Health Network for nearly 10 years. This partnership began with A&C embedding one behaviorist in one of WHN’s clinics and has developed into a fully integrated Federally Qualified Health Center clinic and multiple integration programs. Along the way, both agencies have learned a great deal about the daily operations of their counterpart agency.

We are very proud to offer integrated care services to our consumer population and have seen the positive impact these services have on their general health. WindRose has been a remarkable partner in helping us learn primary care, letting us teach them behavioral health, and working with us to develop a solid integrated care program.

The behavioral health industry is quickly moving toward integration and we have been fortunate enough to develop relationships which allow us to lead the industry.

Fiscal Year 2010-2011 Community Impact

Total Clients Served FY 2008-2009 FY 2009-2010 FY 2010-2011Age 1-17 2,285 2,552 2,527Age 18-59 2,297 2,386 2,204Age 60+ 554 587 601Category Total 5,136 5,525 5,332

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Fiscal Year 2010-2011 Financials

Revenue Category Revenue AmountNet Revenue from Consumer Services $18,826,716Public Support Revenue $8,350,805Other Operating Revenue $933,832Total Revenues $28,111,353

Expense Category Expense AmountSalaries, Benefits, Payroll Taxes $17,634,935Administration $573,753Other Operating Expenses $9,694,645Uncollected Service RevenueTotal Expenses $27,903,333

Net Income from Operations $208,020Net Income from Non Operations $1,036,401Net Income $1,244,421

2010-2011 Board of DirectorsA special thank you to our volunteer Board of Directors whose dedication to our mission, compassion for our

consumers, and encouragement for our staff allow us to fulfill our mission in a sensitive, responsible, and steadfast manner.

Carole Mckinney, PresidentSteve Wohlford, Vice PresidentSue Collins, SecretaryNick Hopkins, TreasurerKen Almon

Jane BlessingRev. James Carter

Jerry FrenchMargarita HartMike Kolenda

Mark LoydJoseph Matthews III

Dawn ShimpGreg TaylorKevin Tyra

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ADULT&child8320 Madison AveIndianapolis, IN 46227

8404 Siear TerraceIndianapolis, IN 46227

222 East Ohio St.Indianapolis, IN 46204

603 E. Washington St.Indianapolis, IN 46204

86 Drake Rd.Franklin, IN 46131

the sky is blue, the trees and the grass are green…

“I started seeing colors in my life...

there are flowers!”

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