February 2015

Drugs and Alcohol are Killing America

By the numbers• 68 million Americans engage in risky use of alcohol and drugs that could

lead to substance abuse or dependence • 23 million Americans meet diagnostic criteria for substance abuse or

dependence each year• Of the 23 million Americans who met diagnostic criteria for substance abuse

or dependence last year, only 10% received treatment. Every year 120,000 Americans die from substance abuse related illnesses

Its victims are getting younger• Nearly 1 in 12 high school seniors reported nonmedical use of Vicodin• 1 in 20 high school seniors reported abuse of Oxycontin• 32% of persons 12 or older in the US participate in binge drinking per year• 9.2% of persons 12 or older in the US have used an illicit drug in the past

month

Prescription drug abuse is out of control• Use of prescription stimulants increased from 5 million to 45 million users in

the last 20 years• The use of prescription opiates (such as Vicodin, Oxycontin) grew from 75.5

million to 209.5 million in the same time period

Heroin is now a mainstream drug• Currently, 75% (4.2 million) of all heroin use in the US is consumed

predominantly by suburban men and women in their twenties- Most of these individuals were introduced to heroin through prescription

drugs

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RCA’s Mission & Goal

Mission: To provide treatment for Substance Use and Mental Health disorders in every neighborhood in America

Goal: To get 1,000,000 Americans in recovery

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4DRAFT

RHODE ISLAND DRUG EPIDEMIC

Rhode Island ranks among the highest in the country for illicit drug use, non-medical use of prescription pain relievers and per capita overdose deaths. During the first three months of 2014, 72 Rhode Islanders died of overdoses. http://www.providencejournal.com/topics/special-reports/overdosed/

The Drug Overdose Prevention and Rescue Coalition, convened in 2012 by The Rhode Island Department of Health (HEALTH), has grown from a handful of advocates to more than 100 members. http://www.rimed.org/rimedicaljournal/2014/10/2014-10-34-dadt-bowman.pdf

Explosion of opiate, heroin and alcohol abuse has rendered the current provider system in our country completely inadequate. The size and scope of this problem is enormous. RCA is the first company designed to contribute to the solution on a scale commensurate with the size of the problem

The industry currently treats addiction like an acute illness. However, RCA knows it is a chronic illness and needs ongoing treatment just like diabetes, hypertension, depression and asthma

Evidence suggests that recovery is a lifelong journey • Each step in the journey is an opportunity to reinforce or jeopardize success• Patients often lose track moving from one step to another (i.e. Residential

care to Outpatient) • By combining all treatment steps in one uniform set of services delivered on

one campus, RCA creates a smooth and convenient transition, making it significantly easier for patients to succeed

RCA will target through extensive online, old media, earned media, as well as a 48 person sales force, the 90% diagnosed that did not get treatment as well the 10% who received ineffective care

Every RCA patient admission starts with a thorough evaluation (medical, substance abuse, psychiatric) and an array of clinical assessment tools including the ASI, ASAM and others

RCA collects extensive information from family, friends, professionals, work and other sources where appropriate in order to accurately assess, diagnose and develop the patients individualized treatment program

RCA treats its patients in a dignified manner

RCA’s Approach

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Impact of Mental Health Parity Act and Affordable Care Act Expands coverage for treatment

• Substance use disorder treatment is now one of the ten ‘essential health benefits’ that must be offered by all health insurance providers

• The are no exclusions for pre-existing conditions, allowing patients who have a prior history of substance abuse to continue to obtain treatment

• Coverage for youth us allowed under a parent’s health plan to 26 years of age• The Mental Health Parity and Addiction Equity Act and the Affordable Care Act

ensure that approximately 113 million Americans will now have coverage for both physical and mental health

Expands access to all US residents • 1.3 million newly insured Americans in RCA’s market area• 15 million newly insured Americans• Over 8 million people joined exchanges

Free substance abuse screening• Co-pays are no longer required for substance abuse disorder or mental health

screening

Limits co-pay costs for insured individuals

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RCA has built an industry changing platform to rollout a national series of community based, family focused, comprehensive substance abuse treatment centers

RCA has assembled a world class management team capable of scaling a multi-billion dollar, multi-site substance abuse treatment organization across the United States

• The average experience of RCA’s management team is 20 years and the combined team has operated over 800 behavioral health and over 400 other healthcare facilities

• RCA’s management team has led organizations that treated over 65,000 patients daily

• The RCA team has extensive expertise in delivering exceptional clinical care along with healthcare operations, acquisition and integration, finance and accounting, IT, sales and marketing, human resources and training

• Real estate and business, new site development and implementation including, acquisition, zoning, licensing, construction, and design procurement are also core strengths of the RCA team

RCA’s Highlights

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RCA is creating the first of its kind, comprehensive treatment centers which include inpatient/residential and various outpatient modalities, family services, mental health treatment, spiritual services and recovery support (coaches, AA, NA, NARANON, ALANON, etc.) in one location making transitions across a continuum of care easier for patients.

RCA will open 8 initial sites with 1,071 beds within the Washington D.C./Baltimore, Philadelphia/Wilmington, New York, and Boston MSA’s

RCA’s facilities incorporate the finest materials including those found in leading hotels around the world including superior quality mattresses and bedding, elegant bathrooms, spectacular meeting environments, fine food and service, and a staff dedicated to attending to RCA’s patients daily needs with warmth and enthusiasm

RCA’s Highlights (cont.)

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Hired the finest senior executive management in the industry: • Chief Operating Officer – J.P Christen

- Former VP of Finance on the Acute Care Division at Universal Health Services (Fortune 500 Company, Revenues - $8 billion, Acute Finance Revenues - $4 billion, 24 acute care hospitals in US)

- 29 years in the acute care healthcare industry, opened 6 new acute care hospitals

• Chief Clinical Officer – Deni Carise, PhD.- 30 years of experience in Substance Abuse Treatment,

Research and Policy- Currently UPENN Adjunct Clinical Professor with 200+

publications- Former Deputy Chief Clinical Officer, CRC Health (acquired

by Acadia for $1.2 billion), with over 140 treatment facilities in 21 states with over 2,400 beds and serving over 42,000 people daily (inpatient and outpatient).

- Has worked extensively as an international advisor to Brazil, China, Egypt, Mexico, Nigeria, Thailand, and the United Nations Office on Drugs and Crime

- Also frequent consultant/contributor to national publications, presentations, Huffington Post and major network news programs

• Chief Financial Officer – Kevin McClure- Former CFO of NHS Human Services (Largest Non-profit

Human Service Company in Nation, Revenues - $500 million, approximately 700 locations in 7 states)

• Chief Information Officer – Matthew Zabolotny- Former Corporate VP of Information Technology for NHS

(Revenues - $500 million, 10,000 employees, $12 million IT operation)

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United Nations

RCA Executive Team

Executive Director – New England Regional VP – Bradley Greenstein

- Former SVP of Business Development for Spectrum Health Systems (Revenues - $52 million)

Director of Licensing – Darcy Brazzle

- Former Director of Administration and Regulatory Compliance for Malvern Institute (Revenues - $30 million)

Director of Recruiting – Sean Lynch

- Former founder and owner of SEL Recruiting and Sales Training LLC.

Director of Marketing – Philadelphia Region – Jay Youtz

- Former Director of Business Development of Malvern Institute

Corporate Controller – Deanna Telese

- Former VP and Corporate Controller of NHS

Facilities/Zoning, Operations and Development - John Lombardo

- Former Director of Construction Services at Rite Aid

Director of Training – Ashley Alberta

- Former Senior Training Specialist of CRC Health Group and Phoenix House Foundation

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RCA Executive Team (cont.)

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RCA’s World Class Clinical Treatment

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RCA Continuum of Care

Intervention: Our team of trained interventionists will conduct an intervention on-site or in your home when needed. The interventionist will facilitate the intervention from start to finish. They will arrange the intervention, prepare the family and friends, and lead the discussions during the intervention. The interventionist will then do a clinical assessment, address payment options, accompany the patient to the treatment program, provide transportation via black car service if needed, and provide family counseling to begin the healing process for the patient and their loved ones.

Detoxification: upon admission all patients undergo a comprehensive medical evaluation and when indicated, receive detoxification services including medications to ensure a medically safe withdrawal and help ease the pain associated with withdraw symptoms. Patients are closely monitored 24 hours a day by physicians and other medical staff. The second goal of Detoxification is to ensure transition into the next level of care – residential or some form of outpatient. Detox alone is never considered a full course of treatment.

RCA Continuum of Care

Inpatient/Residential Treatment Assessment and ongoing Psychiatric and Medical servicesGroup therapy and education seminars every day Individual therapy sessions one or two times per weekFamily program along with family and couples counselingMultiple choices for patient to select types of additional services such as Art therapy, Music Therapy, EMDR, DBT, Relapse Prevention etc. Some required, some elective.

Partial Hospitalization/Day Program (PHP)Provides services to individuals needing extended daily treatment in an outpatient setting. Typically 5 hours/day, 5 days/week

Group therapy and education seminars every day Individual therapy sessions at least weeklyFamily therapy every 2 weeks or more if needed.

Example Schedule: Residential Treatment

TIME MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY

6:30 - 7:30Breakfast/ Meds/Gym

Breakfast/ Meds/Gym

Breakfast/ Meds/Gym

Breakfast/ Meds/Gym

Breakfast/ Meds/Gym

Color Key

7:30 - 8:00 Morning Meeting Morning Meeting Morning Meeting Morning Meeting Morning Meeting Lectures/Workshops

8:00 - 8:30 Meetings/Mutual Help

8:30 - 9:00 Morning Meeting Morning Meeting Body/CNS Calming

9:00 - 9:30 Core Groups

9:30 - 10:00 Family

10:00 - 10:30

10:30 - 11:00

11:00 - 11:30

1:00 - 1:30

1:30 - 2:00

2:00 - 2:30

2:30 - 3:00

3:00 - 3:30

3:30 - 4:00 Free Time Free Time

4:00 - 4:30

4:30 - 5:00

5:00 - 5:30

5:30 - 6:00

6:00 - 6:30

6:30 - 7:00

7:00 - 7:30

7:30 - 8:00

8:00 - 8:30

8:30 - 9:00

9:00 - 9:30

9:30 - 10:00

10:00 - 10:30

10:30 - 11:00 Lights Out Lights Out Lights Out Lights Out Lights Out Lights Out Lights Out

Mapping Your ReEntry Plan

Mapping Your Treatment Journey

Outside Recovery Meeting: AA, NA,

Docs, GA, etc.12-Step Toolkits

Psychodrama

Creative Arts & Recreation Therapies

Music Therapy

Specific Evidence-Based Practices

Challenge/Ropes Course

Anger Management Family Program

Relapse Prevention

Relapse Prevention

Stress Management

Individual Therapy / Gym / Personal

Training / Massage

Individual Therapy / Gym / Personal

Training / Massage

Individual Therapy / Gym / Personal

Training / Massage

Individual Therapy / Gym / Personal

Training / Massage

Individual Therapy / Gym / Personal

Training / Massage

11:30 - 1:00

Family Education Program

(Matrix Model)

Family Education Program

(Matrix Model)

Small Group - Group Therapy

Small Group - Group Therapy

Small Group - Psychodrama

Small Group - Group Therapy

Small Group - Group Therapy

Lunch / Personal Time

Lunch / Personal Time

Lunch / Personal Time

Lunch / Personal Time

Lunch / Personal Time

Mapping Your Treatment Plan

Getting Motivated to Change

Progressive Relaxation

Relapse Prevention

Biofeedback or Acupuncture

Meditation Group or Yoga

Breakfast/ Meds/Gym

Family Weekend Review

Art Therapy

Dance Therapy

Supporting Recovery

(w/Family)

Family Program

Biology of Addiction

(w/Family)

Family Visitation / Challenge Course

Lecture: Understanding

Grief (w/family)

Introduction to Family Weekend

Dinner / Free Time Dinner / Free Time

LGBT/ Men's/ Women's Group

Breakfast/ Meds/Gym

Improving Sleep

Dinner / Free Time

Meditation Group or Yoga

Lunch / Personal Time

Lunch / Personal Time

Movie

Dinner / Free Time

Stress Management

Medications and Recovery

(w/Family)

Topics in Mental Health (w/Family)

Dinner / Free Time

LGBT/ Men's/ Women's Group

Dinner / Free Time Dinner / Free Time

Psychodrama

In-House Recovery Meeting

Building Social Networks

Outside Recovery Meeting: AA, NA,

Docs, GA, etc.12-Step Toolkits

DBT, Young Adult / Older Adult /

MH / Pain Group

DBT, Young Adult / Older Adult /

MH / Pain Group

RCA Continuum of Care Intensive Outpatient Treatment (IOP) Provides a primary, organized treatment program to patients who are able to maintain recovery within the context of their usual daily activities.

Consists of educational and group therapy sessions 3 days/week, 3 hours/day.

Includes ongoing individual therapyFamily and couples therapy sessions as neededPsychiatric and medical services available onsite

Traditional Outpatient Treatment (OP) Includes outpatient individual, family, couples and group counseling

Patients typically attend one to three times a week in 45 minute to hour-and-a-half sessions.

Psychiatric and medical services available onsite

RCA Post-Treatment Services Self-Help Groups Also known as mutual help, mutual aid, or support groups and are comprised of groups of people who share a common problem or addiction and provide mutual support for each other to help each other to deal with, if possible to heal or to recover from, this problem.

Examples of Mutual or Self-Help Groups include: Alcoholics Anonymous, Cocaine Anonymous, Narcotics Anonymous

AlAnon/AlAteen SMART Recovery

Alumni Program is built on the foundation of offering support for those in recovery. Our program will provide you with the necessary support and resources to maintain sobriety close to home. Our services offer patients and their families a safe environment where you can come to talk, build relationships, receive continued education, participate in fun events and activities, and more.

Examples of Alumni Program activities include: Cookouts, Family Activities, Sober Events, Fundraising

RCA Training InstituteRigorous onboarding for all RCA employees.

• A Real-World Lab for clinical staff to practice and develop competencies under supervision before delivering services to patients.

• Deliver Leadership Development Training for nominated staff in all job roles across various advancement tracks.

• RCA Lecture Series • Invites researchers and innovators in the field to deliver

presentations for RCA Employees and the public.

• For RCA staff to present to our staff and the public.

• Train-The-Trainer modeling

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RCA SAFETY AND SECURITY PROTOCOLSRCA partners with Command Destinations, a consulting firm dedicated to Public Safety, Law Enforcement, and Private Security. They have associates, resources, and subject matter expert’s throughout New England and along the East Coast Maine to Florida.

Services provided:*Act as a liaison between RCA and its legal counsel regarding any and all matters of public safety *Act as a liaison with all public safety agencies of abutting cities and towns*Review the policy and procedures of RCA in respect to security of the site, the building, employees, and patients*Provide recommendations in connection with improvements or enhancements based on best practices in public safety

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RCA PATIENT SAFETY MANAGEMENT PLAN (PSMP)

POLICY: Recovery Centers of America Patient Safety Management Plan (PSMP) will provide an organized approach to safety management, promote the safety and security of its patients, staff, visitors and facilities, and comply with applicable regulations. All staff shall be knowledgeable of and comply with all aspects of this plan and to their related job duties.  PROCEDURE: The following measures are intended to help ensure security: 1. Safety & Security Rounds

a. Safety rounds are made by designated facility staff each hour 24-hours per day seven days per week and include:

i. Inspection of all building interior and exterior areasii. Locking of exterior doors per a published scheduleiii. Checking parking areas and groundsiv. Report of any unusual events to management

 2. Key & Security Card System

a. All exterior doors will be secured from the outside between the hours of 10:00 p.m. and 6:00 a.m. Staff will utilize keys or an electronic security card system to enter building during these hours. This measure is intended to prevent unauthorized entry into the building.

b. Staff is not to lend their keys or swipe card to anyone at any time.c. Staff must report stolen, lost or missing keys or swipe card to

management immediately.

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RCA PSMP  

1. Security Camera Systema. Security cameras are located throughout the interior of the building and

the exterior perimeter.b. Security cameras will record based on static and motion-detected

technology as applicable in each area. c. Camera footage will be maintained electronically for a period of no less

than 30 days.d. Security camera monitoring stations are located at each nursing statione. Cameras can be monitored 24 hours a day, 7 days a week by nursing

and/or other designated staff.  2. Patient Headcounts/Rounds

a. Patient rounds will be conducted by designated staff every hour and documented on the 24-hour patient headcount sheet.

b. Documentation of patient headcounts will include location of patient, current activity of patient and during the night shift documentation will also include the patient’s sleep/awake status.

c. Patient checks will be done more frequently than every hour when patient acuity warrants this, such as:

i. Presence of suicidal ideationii. Medical acuity

d. Each patient must be physically visible and identified during patient rounds.

e. If a patient cannot be located during patient rounds the supervisor on duty is to be notified immediately. The supervisor will then initiate a search of the building and grounds.

 3. Lighting

a. Lighting is provided throughout the facility at all exits, walkways and parking areas.

b. Staff are to report any burned out lights to the maintenance department immediately.

  

 

U.S. Has a Large “Treatment Gap”

In 2012, an estimated 23 million Americans (11% of adults; 8% of all Americans) needed treatment for a substance abuse or dependence, but only about 2.5 million people (10%) received treatment at a specialty facility.

68 million (20% of all Americans) people engage in risky use of drugs and alcohol

58 million people (17% of all Americans) reside in RCA’s primary marketplace

Therefore, RCA has between approximately 4 and 12 million potential patients in its primary marketplace

If 100% of RCA’s facilities were 100% occupied, RCA could treat over 13,000 patients, or 0.11% to 0.33% of potential patients

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