2006-2007 MANAGEMENT ANNUAL SUMMARY REPORT

PREPARED BY: GERALDINE PIPITONE, MBA, CAP CHIEF EXECUTIVE OFFICER

OUR MISSION:

House of Hope, Inc.'s mission is three fold, first, to afford equal access to a diverse population serving adults suffering from substance abuse including those with co-occurring disorders regardless of age, race, religion, ethnicity, national origin, disability, gender, sexual orientation or social status who are in need of long-term residential treatment.

Next, to provide high quality treatment services that is gender specific.

And finally, to help individuals, in Broward County, recovering from chemical dependency return to the community with a comprehensive body of knowledge that allows them to maintain stable employment, rebuild family relationships, embrace personal responsibilities and build a strong support system utilizing 12-Step programs.

ORGANIZATIONAL PHILOSOPHY

.:. The residents we serve are the most important person. They represent the purpose of our work .

• :. We aid each resident in a manner that is beneficial to their recovery . • :. We assist each resident to return to the community with a comprehensive body of knowledge, skills, attitudes and an understanding of the 12-Steps of Alcoholic Anonymous which will help their journey of recovery .

• :. Developing employee's skills and knowledge base are paramount .

• :. Treatment curriculum must be evidence/scientific based and designed to meet the needs of the residents .

• :. We believe that recovery and integration back into the community are realistic for the great majority of our residents .

• :. As an organization we strive to improve everything we do .

• :. We have a responsibility to reduce the recidivism of our residents.

I wish to thank all staff and the Board of Trustees that added to the accuracy of information and the content of this report. They have spent a tremendous amount of their personal time to perform the added functions of chairing committees and developing reports. I wish to thank them for their dedication to the quality of services that we perform, which make a difference in the lives we touch.

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It has been said that the longest journey begins with the first step.

For the House of Hope the journey began in January 1969 and is recorded within the minutes of that meeting. "Walter Warren, President urged ten men present to each contribute $10.00 toward a $100 deposit to secure a 60 day option on the house at 908 S. W. 1st Street, Ft. Lauderdale"

For Stepping Stones several dedicated women who in 1968, opened the little frame house at 901 N.E. 17th Street, Ft. Lauderdale.

From that mustard seed-like beginning a beautiful tradition of people helping people has grown.

We have come a long way from out humble beginnings and have helped thousands of individuals on the road to recovery.

This year the House of Hope and Stepping Stones have improved the quality of services as well as the aesthetics of the facilities. Listed below our some of our completed projects:

.:. Completion of the administrative offices at Stepping Stones .:. Changing all curriculum to evidence/scientific based

.:. Completion of the renovations to Crowley House (sober living facility)

.:. Completion of renovations to Stepping Stone's Kitchen, and East House .

OPERATION OF THE ORGANIZATION

GOVERANCE

A twelve (12) member Board of Trustees governs House of Hope, Inc. A minimum of seven (7) individuals must be in recovery from addiction, each of whom shall have had three (3) years of continuous sobriety immediately proceeding the term of office.

The Board is comprised of three standing committees that are appointed by the President of the Board:

.:. An executive committee, consisting of the officers of the board, one appointed trustee, plus the Chief Executive Officer .

• :. A nominating committee, to bring forward names of individuals expressing a desire to participate on the Board .

• :. A fundraising committee, to develop and implement fund raising strategies.

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The Board of Trustees meets on the second Monday of every month. The annual election of Trustees is normally held on the 2nd Monday of January.

The Board of Trustees appoints a Chief Executive Officer that oversees the implementation of the Strategic Plan as well as the Policies and Procedures and operations of the organization. The Chief Executive Officer also serves on the Executive Committee of the Board of Trustees and is a voting member of the Board. The CEO will not serve as the President of the Board.

MANAGEMENT

The Chief Executive Officer oversees the daily operations of the House of Hope, Inc. and reports directly to the Board of Trustees and operates within the framework of the organization's mission.

The administrative staff is composed of the Chief Executive Officer, Corporate Compliance Officer/Administrative Director, business services supervisor, secretary and a records custodian. Sullivan & Fengler is the organization's independent auditor and has quarterly contact with the organization. Sullivan & Fengler is also utilized concerning any substantial change in funding, whether positive or negative, to evaluate our overall fiscal picture.

Attached is an organizational chart giving an overview of the structure of the organization.

PROGRAM CAPACITY

In the past eighteen years we have made remarkable transformation from primarily being a transitional housing (halfway house) provider offering housing and support and some addiction treatment, to a comprehensive long-term treatment center for chemical dependency with an overlay of services for people with co-occurring disorders.

Presently, residents are substance abusers, with many having additional mental health and/or physical health problems.

House of Hope currently has a total of 92 male beds, Stepping Stones has 42 female beds for a total of 134 residential treatment beds. The funding for the beds is designated as follows:

.:. 53-beds/Department Of Corrections (DOC) substance abuse 6-month treatment;

.:. 22 beds/DOC dual diagnosis beds;

.:. 37 beds/Department of Children and Families (DCF) dual diagnosis beds; this includes required match beds.

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.:. 5 beds/Broward Sheriff's Office (BSO) dual diagnosis;

This leaves a total of 8 beds not being funded and are presently utilized for walk-in individuals.

Stepping Stones has 14 female beds for transitional housing, and House of Hope has 14 male beds for transitional housing. All of the transitional housing beds are self pay.

PROGRAM SERVICES AND DESIGN

Our services are reflective of the needs of the residents, designed to be holistic in nature, dealing with all aspects of recovery,

We have come to believe that our community has a gap of services to those who suffer from both substance addiction and with mental illness. This has urged us to rethink our attitude, priorities and direction the organization will move now and in the future.

The mission of the organization has not faltered from our founder's intent that it be dedicated for the recovering individuals 38 years ago. To that end the House of Hope and Stepping Stones has moved intently towards serving the least served and most difficult to fit into a substance abuse or mental health venue and has created an exceptional dual diagnosed treatment program.

In this past year we have totally revamped the curriculum of our program. All materials are research/evidenced based. The following is a list of evidence based material being use:

Gorski's Relapse Prevention

Stephanie Covington's Women's program Living In Balance first and second - Hazelton Changing Criminal Thinking - Hazelton

The use of psychologists, psychiatrists, medical personnel, seasoned substance abuse and mental health counselors that are crossed trained and behavioral health techs and peer specialist have enabled this organization to demonstrate a research/evidence based framework. The curriculum of our treatment program uses motivational interviewing, motivational enhancement therapy, cognitive-behavioral therapy, and the use of therapeutic community concepts. Services we provide include, but are not limited to:

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~ HIV/AIDS & HEP C education ~ Feeling Groups

~ Coping Skills & Life Skills training ~ Anger Management

~ Relapse Prevention (Best Practice Model) ~ Stress Management

~ Parenting classes

~ Substance Education

~ Mental Health Education

The House of Hope, Inc. believes that this will be an ever-changing list of groups, seminars and trainings reflecting the needs of our residents. As a result of their participation, the individual becomes responsible for their emotional, physical and spiritual well being. This develops socially needed skills to interact with family members, significant others and friends as well as re-integration into the community.

ORGANIZATIONAL VALUES

House of Hope and Stepping Stones embraces the values of dignity, respect, empowerment, honesty, and open-mindedness. These guiding principles are reflected in all decisions and actions of the organization.

QUALITY IMPROVEMENT COMMITTEES

The values of the organization are reflected very specifically in the Quality Improvement Committees. It is here where the most input from the community, residents, staff, Board of Trustees and consultant comes in.

There are five committees that comprise quality improvement:

Health & Safety,

•• Advocacy,

Med Management, Clinical Utilization, and Director's Committee

All Committees are made up of Clinicians, Support Staff, and Board of Trustees Members, professional staff from North Broward Hospital District as well as

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residents and outside consultants. This has proven to be an opportunity for the organization to improve the quality of treatment services.

Health &. Safety Committee

The mission of the Health and Safety Committee is to be better prepared within available resources, to meet emergencies including but not limited to fires, natural disasters, power failures, medical emergencies, pandemics, workplace threats, and acts of violence.

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The following items have been accomplished this year:

Advocacy Committee

It is the mission of the House of Hope/Stepping Stones Advocacy Committee to insure fair representation for residents, the principle that the persons we serve will have a strong voice and that their rights are safeguarded.

The Committee is committed to render every effort necessary to resolve problems in a fair and timely manner. Recent actions include:

@. Bulletin Boards installed in for each resident at both houses. @. Newspapers delivered for residents at both houses.

@. Disinfectants were purchased for residents to use in both houses (!. Hand dryers were installed in both houses.

@.. Bathroom was remodeled down stairs at Stepping Stones

<t,. Chairs for outside and inside were purchased for both houses. @: A/C installed for kitchen at Stepping Stones

Recovery Bibles, AA Books and NA Books were purchased for both houses.

@.. Recovery CD'S and DVD'S were purchased for both houses.

@" New Shower Curtains were purchased throughout the year.

@.< Music players were installed at both houses in the dining room.

@, Women were permitted to wear make-up to help build self-esteem.

@; New comforters were purchased for both House of Hope and Stepping Stones

0.' All grievances that were received were handled in a timely and fair manner.

We did not receive any formal grievances again this year. There were several complaints pertaining to the following:

  1. More variety of foods
  2. Needing eye glasses
  3. Request for more TV and phone time
  4. Better selection in the vending machines, more juices and natural foods

All the input from the CEO Forum or the weekly community meetings are addressed with the residents and a record is maintained at the AdministrativE offices. All issues presented were easily addressed.

Med Management Committee

The mission of the Med Management Committee is to ensure the provision of the highest quality medical and psychiatric services for residents.

The committee meets once every quarter. Committee members were consistent in their attendance and in providing input and strategies to address the concerns noted in the meetings.

There were six identified issues that were developed and implemented by the Committee:

  1. The Kitchen will provide snacks for diabetic residents.
  2. Receiving medication from the jails so there is a continuity an compliance in medication maintenance
  3. Implementation of visiting nurses to do glucose monitoring and giving

insulin if resident is unable or untrained.

  1. Better tracking for medications by Medication Tech.
  2. Length of time medical questionnaires are done has been reduced.
  3. New curriculum on hygiene management was developed and implemented.

Clinical Utilization Committee

The mission of the Clinical Utilization Committee is to review admissions, discharges, how services are utilized, to critique clinical documentation and to review curriculum. This committee also serves as peer review group when dealing with clinical documentation that evaluates the quality of the charts

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based on legibility, content, timeliness and compliance with generally accepted clinical practices required by government regulations. The following represents a list of the Committee's varied accomplishments:

.:. Developing new curriculum to better address the needs of the residents and the new contract requirements of the Department of Corrections Contract .

• :. Staff and resident satisfaction surveys were completed and scored with no major problems needing to be addressed.

Clinical Chart Review was achieved throughout the year. Corporate Compliance Officer will revamp the review tool to be more objective then subjective.

Directors Committee

The purpose of the Directors Committee is an oversight team that receives input from all quality assurance groups. This Committee meets on a quarterly basis and depending on the needs of the agency, will be held as a separate meeting or incorporated into the monthly Board of Trustees meeting. This eliminates unnecessary meetings and ensures that the Board is kept informed of changes that are occurring within the organization.

There were several risk management issues that were dealt with this fisca year:

  1. The new 901 building was started and finished this fiscal year and it i~ totally ADA compliant.
  2. All trainings for employees were completed this year.
  3. New plan as required by State of Florida for Infectious Disease anc Pandemic was completed.
  4. Completion of Satisfaction Surveys for residents and employees wen completed and are reported in this Management Summary.

As a result of the ever changing needs of the organization, all Directors anc the Board of Trustee will annually review the insurance needs of the organization. There are still several concerns that will need to be monitorec on a continuous basis:

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  1. Escalating health insurance costs
  2. Escalating insurance and the risk exposure by increasing out of pocket expenses.
  3. Monitoring the ever changing funding streams and the potential of managed care overseeing long term residential treatment.

This Committee's responsibility is to authorize all implementations for change and dictates an action timeline.

STATUS REPORT ON ACCESSIBILITY PLAN

This past year there were several barriers that have been eliminated listed is the description of the barrier and the solution well as unresolved barriers:

  1. The new administrative building at Stepping Stones has been completed and is totally ADA accessible.
  2. Spanish language literature was purchased and used this year. We have purchased sufficient amount of materials to supplement our curriculum in a Spanish version.
  3. For each resident a bulletin board has been installed that allows them to have personal pictures, cards etc .. , this permits residents to make their space their own. Installation was completed in February, 2007 by the Maintenance Supervisor.
  4. We have postponed ramping 909 building at this time due to the increased expense of not only ramping the front and back doors but increasing the width of the interior doors and expansion of one bathroom. We have decided at this time that next year we will go ahead and install the ramps and begin the process of expanding interior doors by the end of next year. This is the responsibility of the Maintenance Supervisor. We presently have one bedroom that is ADA compliant, which is in the 905 building; this meets any requirement for accessibility for two individuals.
  5. All trainings in this area are ongoing and are done annually. This is the responsibility of the Administrative Director.
  6. The Resident Handbook has been redone to be more sensitive of the education level of our residents. We have designed two types of handbooks that are based on the capabilities of the individual. The idea of have two types of handbooks allows all residents to understand basic concepts, rules, their rights and privacy issues. The completion of the handbooks was a group effort of the staff.

OUR VISION:

House of Hope and Stepping Stones will distinguish itself as the leader in substance abuse and co-occurring disorder treatment and will be recognized for our passion in providing quality care to individuals and the community we serve.

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In our ever-changing environment, we are dedicated to empowering the people we serve with the tools necessary to develop and maintain a concept of honesty, open-mindedness and willingness that will support them on their journey of recovery.

PROGRAM OUTCOMES

To sustain the organization's vision we believe that outcome management is the vehicle that allows the organization to review an implement any needed change(s).

There are six outcome measures that are currently utilized to evaluate our treatment program. By developing these measures we are able to assess the effectiveness of the program and to increase positive outcomes. The outcome measures are presented by facility.

  1. 60% of adult's complete treatment is the first measure. For the period of July, 1, 2006 through June 30, 2007. (357 individuals)

.:. 60.8% of the residents successfully completed treatment (220 individuals)

We have met of outcome for this category. However, next year we have increased this to 65%. This is a result of changing the curriculum for the next year and implementation of new program services.

  1. 80% of eligible persons served who are eligible are employed upon discharge - for the period from July 1, 2006 through June 30, 2007:

.:. 85.0% of eligible residents were employed at discharge.

The population in this outcome has changed. This will be the last year that this outcome will be used. Next year the outcome will reflect self-sufficiency instead of employed.

The statistics for the next two outcomes are derived from satisfaction survey that is given to residents. A lickert Scale is being used.

3. 85% of residents are satisfied with treatment services:

.:. 90% of resident are satisfied with treatment services.

We have worked diligently to achieve this percentage of persons served satisfaction. This has been accomplished by enhancing treatment components, updating present curriculum and implementing program

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changes that reflect the residents request for new services as well as the addition of the Family Program.

  1. 85% of residents are satisfied with Intensive Treatment

Component of the Program:

.:. 91% of residents were satisfied with the ITC of the Program.

This measure was attained through the addition of cross training of all staff.

  1. 90% of residents are satisfied with how complaints and

grievances are handled:

.:. 92% of resident were satisfied with how complaints and grievance were handled.

The Advocacy committee continues to review procedures for complaints and grievances with residents. There have been additional trainings for staff and resident education is ongoing in our efforts to improve this measure.

  1. 65% of completed residents remain drug free and employed 3 months plus after discharge. This is based on a six month population of completed clients. Completed clients = 90 residents 77 (86%) were successfully contacted:

.:. 92% of completed persons served have remained drug free .:. 8% of completed residents have relapsed

.:. 88% are self-sufficient

.:. 89% have a support system for their recovery

The outcome objective established to measure the success of residents post­ discharge is 65%. We have significantly exceeded this objective.

RESIDENT DEMOGRAPHICS

House of Hope and Stepping Stones accepts referrals from North Broward Hospital District, Broward House, Center One, Broward Addiction Recovery Center, and Ft. Lauderdale Hospital, Broward Sheriff's Office, Department of Correction, Department of Children & Families, Broward Health Regional Planning Council, the recovering community and walk-ins.

We serve avery diverse population that truly reflects the communities of Broward County. The demographics of the population based on race are as follows:

The House of Hope & Stepping Stones served 398 residents:

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• 96- females and 342- males .

.:. 4% Caribbean Black

The average demographic profiles of the individual's served are as follows: .:. 6% Caribbean Black

.:. 12% HIV/AIDS positive

.:. 18% Hepatitis C positive

.:. 84% of women have been sexually abuse and/or battered .:. 16% gays/lesbians

.:. 58% have children

.:. 92% are in the criminal justice system(includes those that are incompetent to proceed)

MANAGEMENT OUTCOMES

Management outcome are designed to increase the efficiency, effectiveness and the quality of the organization.

1. Employee turnover rate will not exceed 25% .

.:. 22% front desk .:. 11 % kitchen

.:. 11 %su pport staff 19% Average Total

The average rate is 19%, which is under our outcome measurement. We believe the reduction of employee turnover is due to better employment screening and a one week employee orientation to the organization and their job.

NOTE: In arriving at our over-all turn-over percentages, individuals who left within the probationary period, Three individuals resigned due to terminal illness and one individual left to return to school which was known prior to their employment.

  1. The organization will maintain or reduce administrative overhead of 12%:
.:. 2007 - 8.9%
.:. 2006 - 9.4%
.:. 2005 - 9.1%
.:. 2004 - 9.8%

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.:. 2003 - 10.1 % .:. 2002 - 9.8% .:. 2001 - 11. 7% .:. 2000 - 12.3%

Administrative overhead has remained fairly constant over the past eigh1 year's years. This is mainly due to employees performing multiple functiom and yet maintaining segregation of duties to ensure fiscal responsibility anc accountability has contributed to our achieving this outcome.

  1. Senior management will monitor escalating costs to ensure ar efficient and effective cost per day that will not exceed 10% frolT the previous year:
.:. Unaudited cost per day for 2000 -2001: $50.23

average income per Diem rate: approximately $54.92 Cost per day for meals: $4.68

.:. Unaudited cost per day from 2001-2002: $52.37

Average income per Diem rate: approximately $55.71 Cost per day for meals: $4.54

.:. Unaudited cost per day from 2002-2003: $60.55

Average income per Diem rate: approximately $74.36 Cost per day for meals: $4.00

.:. Unaudited cost per day 2003-2004: $64.75

Average income per diem rate: Approximately $69.34 Cost per day for meals: $ 3.77

.:. Unaudited cost per day 2004-2005: $70.61

Average Income per diem rate: Approximately $81.98 Cost per day for meals: $ 5.21

.:. Unaudited cost per day 2005-2006:

Average income per diem rate: Approximately Cost per day for meals: $5.34

.:. Unaudited cost per day 2006-2007:

Average income per diem rate: Approximately Cost per day for meals: $5.57

~ Effectiveness is measured based on average

./ length of stay-average length of stay is 85.4 days for 2001­ 2002

./ length of stay-average length of stay is 98.2 days for 2002­ 2003

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./ length of stay - average length of stay is 115.21 days for 2003-2004

./ length of stay - average length of stay is 120.9 days for 2004-2005

./ length of stay - average length of stay is 92.4 days for 2005-2006

./ length of stay - average length of stay is 82.04 days

for 2006/2007

The length of stay for resident has steadily decreased in the past two years. This is a reflection of the fact that on third of the population contractually only stay a maximum of 90 days. As a result it has decreased the overall length of stay for all residents.

What has resulted from these statistics is the evaluation of the 90 day residents. This has shown a completion rate that is far greater then the 6 month residents. 90 day completion rate is 76% vs. 60.8%.

Employee Demographics - These demographics are reflective of Broward County. The majority of individuals working in the field of addiction represent minority groups. The total number of employees as of June 30, 2007 was 43 the following percentages reflect this number:

.:. 36 % Black

.:. 5 % Hispanic

.:. 17 % Gays/Lesbians .:. 40 % White

The House of Hope, Inc. believes that the employees of the organization are a true reflection not only of the community but the population we serve.

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SUMMARY

We continue to work at quality and the needs of the residents. Our corporate outcomes reflect our commitment to improve the quality of the program. It has become apparent in preparing this report that we must continue to be vigilant about committee reports and follow-up surveys. We also look forward in developing a more comprehensive program designed for those individuals that have co-occurring disorders.

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