REPORT ANNUAL HEALTHWEST MISSION

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2017 ANNUAL REPORT HEALTHWEST MISSION To be a leader in integrated health care, inspiring hope and wellness in partnership with individuals, families, and the community.

The HealthWest Landscape Dear HealthWest persons served, community partners, and employees, This past year has been a time of rapid change and development as we respond to the evolving health care landscape at the federal and state levels. Our strategy is to be flexible and creative. Persons served are involved in their care and decision making in new ways and our community partnerships have expanded and deepened to an unprecedented level. With this growth and change, comes significant learning and progress. We are grateful to have so many dedicated individuals, families, coalitions and agencies to walk alongside us toward our vision of building a healthier, more informed, and inclusive community through innovation and collaboration. We are excited to share some highlights from 2017. A growing emphasis is being placed on creating truly integrated health care; building a more trauma informed community; and implementing Systems of Care in collaboration with persons served and our partners. We re collaborating more effectively to improve health outcomes in Muskegon County. Our strategic direction is outlined on the last page of this report and is founded in our mission, vision, and values. Despite what changes may occur, we know we will be ready to respond with these as our compass. I truly thank you for your partnership with HealthWest and look forward to all the future holds for our community. Julia Rupp HealthWest Executive Director Years serving the community Employees at the end of 2017 Staff completion of new 20-hour training curriculum Teams of staff serving individuals Campuses where services are delivered

Who is Utilizing HealthWest Services? Mental Illness - Adult 54% (3,070) Mental Illness - Youth 20% (1,153) Intellectual/Developmentally Disabled - Adult 15% (822) Intellectual/Developmentally Disabled - Youth 8% (449) Substance Use Disorder 3% (151) 68% Caucasian/White (3,812) 27% African American (1,502) 3,219 2,645 5% Other (286) Of those that received services in 2017, 55% were male and 45% were female.

HealthWest Financials Looking to the future and providing a more streamlined process for individuals in service, the HealthWest finance department had some innovative achievements: Revenues for commercial and Blue Cross/Blue Shield payers are up by 317% while contracts with Priority Health and Meridian Health Plan have been finalized. HealthWest is in the process of contracting with Humana, Access Health, Molina McLaren, Aetna, Cofinity, and other smaller plans. To decrease wait times, ALL the finance staff are now trained to assist individuals in services. 25 HealthWest staff are now credentialed with Medicare and four others re-credentialed. 126 HealthWest clinicians are entered into the Council for Affordable Quality Healthcare. Residential 24-Hour Supportive Living Professional & Clinical Staff Community Supports & Coordination Miscellaneous Substance Abuse Employment/Skill Building Activities Administrative Overhead Contracted Psychiatric Hospitalizations Medicaid Substance Abuse Misc. Grants & Gifts Social Security/3rd Party Dept. Of Community Health Local Match From All Sources

The Big Picture In the midst of a rapidly changing climate, HealthWest is striving to be a leader in behavioral health care, implementing innovative practices and service models that are evidence and research based. 562 Integrated Health patients and 3,009 visits in 2017 Through consistent, integrated, and compassionate care, there s been a reduction in ER visits by those seen at the Integrated Health Clinic (IHC). After one year of enrollment in the IHC, persons served reduced their ER usage by 17%. Services have also expanded to now treat teens 15 and older. The IHC is also in the final steps of adding a dental clinic. HealthWest is administering a $4 million federal Systems of Care (SOC) grant working alongside other youth serving agencies to better serve youth with complex needs and their families. The SOC structure is made up of multiple cross-system teams partnering with youth and families to redesign Muskegon s child serving systems to better serve youth with behavioral health concerns and their families. System of Care School-Based Approach Hiring mental health, wraparound and peer support staff within schools for on-site access and treatment. Orchard View, Muskegon Heights, and Reeths Puffer Phase two (2018): Montague and Holton Phase three (2019): Oakridge and Muskegon Public Youth Guided & Family Driven Cross-agency teams are working to involve youth and families served by the systems in guiding changes at the system, practice and service levels. Youth Mobile Response and Stabilization HealthWest is working with community partners to implement an evidence based model that will improve access for all, initiate treatment faster and at an intensity level that will meet immediate needs. ONE Assessment Tool SOC partners agreed to use the CANS (Child Adolescent Needs and Strengths) assessment tool across child serving systems. 2017 saw a 25% increase in Substance Use Disorder (SUD) admissions for inpatient, outpatient, and residential services. The substance most individuals sought help for was heroin, followed by alcohol and opiates. As HealthWest formed its SUD team, a new Smart Recovery group formed and partnerships also increased broadening services. Cherry Health/Muskegon Recovery Center opened in February 2017 assisting 179 individuals. As of today, they are assisting 409 individuals. HealthWest continues to partner with The Red Project. To date they have distributed 1,273 Naloxone kits in Muskegon and have had at least 43 reversals, meaning 43 people in Muskegon County who might have died from overdose, are alive today. They have also distributed 2,611 syringes as they work to reduce HIV, Hepatitis, and other diseases.

Consumer Experience HealthWest has a lot to offer in addition to clinical services. The staff care about the individuals served, their goals, needs and wellbeing. Focusing on the whole person is key to wellness and recovery, and therefore service delivery is done in a meaningful way to empower, educate, and inspire clients. Here are just a few of the ways in which individuals in service experienced and interacted with HealthWest above and beyond their clinical services. Over the past year... 100+ A partnership with Mercy Health s Seaway Run allowed individuals served an opportunity to participate for free. The result... more than 100 staff and individuals served walked, ran or volunteered. HealthWest s Supported Employment Team assisted 121 individuals find employment this past year. 55 individuals in services, staff and natural supports traveled to Lansing to meet legislators and have their voices heard during this annual Walk-a-Mile in my Shoes Rally. HealthWest is the ONLY CMH with an individual in service involved in the rally planning. More than 35 individuals in service were recognized for achievements in life, living and recovery during 3 recognition ceremonies. HealthWest in now an accredited Health Home (Patient Centered Medical Home) through CARF International. Club Interactions made significant changes to better comply with the 37 Clubhouse standards set by Clubhouse International. In November, Club Interactions was awarded a three year conditional accreditation. HealthWest enhanced wellness class offerings and groups for staff and individuals served, regularly offering 33 different class topics.

Collaboration, Prevention & Outreach HealthWest is grateful to be in a community that values partnership and collaboration. Work in the area of collaboration, prevention, and outreach yields significant outcomes in the areas of improved service delivery, education, preventing and identifying mental illness and reducing stigma. Service delivery would not be possible without the many contracts and partnerships held locally, regionally and statewide. In 2017, HealthWest contracted with 318 agencies. HealthWest staff are invested in this community! Staff are represented on nearly 30 community committees, task-forces and collaboratives. HealthWest s Health, Wellness & Recovery Fair is now the LARGEST WELLNESS EXPO of its kind! The 2017 event HEALTH, WELLNESS & RECOVERY featured more than 90 vendors, welcomed more than 1,200 guests and had one very last minute venue change due to weather. HealthWest acted as a vital partner assisting to coordinate 14 community events around diversity, substance use, health outcomes and more. Building a more trauma informed, resilient community: HealthWest provides leadership for the 1in21 Resilience Muskegon Action Team, equipping the community to prevent and effectively respond to ACEs (Adverse Childhood Experiences). Strategies Include: ACEs train the trainer and community education program Trauma Sensitive Schools Professional Learning Community Partnering with Mercy Health, Hackley Community Care and Muskegon Family Care to integrate the ACE survey into primary care practices Online resource hub Suicide prevention: HealthWest is recognized as a local, regional and statewide leader in suicide prevention. The Suicide Fatality Review Team reviews deaths to improve data collection and inform prevention. New legislation is expected to soon be introduced to bring this model to County Health Departments across the state. A Regional Youth Suicide Prevention Alliance has grown to 150 participants in just one year. The Suicide Safer Communities model (proven to reduce suicide by 50%), is being implemented at HealthWest. Number of people certified: 4,000+ 2,400+ 2,000+ Outreach booths in 2017. Individuals supported with psychological first aid to assist in a healthy recovery following a traumatic event. Individuals assisted or enrolled in market place insurance. Large community wellness event partnerships.

VISION Building a healthier, more informed, and inclusive community through innovation and collaboration. VALUES Diversity Development Excellence Integrity MISSION To be a leader in integrated health care, inspiring hope and wellness in partnership with individuals, families, and the community. Pursue innovative and collaborative models for health care reform to position for a successful future 1. Certified Community Behavioral Health Clinic (CCBHC) 5. Mobile Response and Stabilization 2. State Innovation Model (SIM) 6. Health Plan Integration Pilot 3. System of Care (SOC) for children and families 7. Expand evidence-based treatment modalities in 4. Health Home Accreditation (Patient Centered Medical Home) areas of mental health, substance use and I/DD Collaborate with staff, consumers, families and community partners to create a more recovery-oriented and trauma informed community 1. Improve focus on self care and wellness of staff 2. Community education and outreach 3. Psychological First Aid 4. ACE survey trauma informed training and consultation 5. Suicide prevention efforts including Safer Suicide Model 6. Family Psycho Education (FPE) 7. Wellness Recovery Action Planning (WRAP) 8. Peer support models 9. Consumer recognition and volunteer program Diversity 1. Increase staff knowledge in the areas of diversity, inclusion and bias through training and education 2. Ensure agency policies, practices, and allocated resources are culturally competent 3. Increase community outreach and employee recruitment to more diverse groups and locations 4. Increase staff competency in serving minority populations Development 1. Hold quarterly all-supervisor meetings to increase support and education for supervisors 2. Implementation of TBD Solutions management practices and staff mentoring program 3. Utilize improved annual evaluation and development plan for all staff 4. Increase support and resources for staff to help with self care and wellness Excellence Integrity 1. Implement internal and external communications plans 1. Transparency in hiring practices 2. Re-structure teams and fill key positions 2. Transparency in decision making 3. Offer increased training in evidence-based practices 3. Transparency in internal communications 4. Gather, analyze, and meaningfully apply data 4. Commitment to community needs 5. Electronic Health Record (EHR) implementation 6. Utilize the CANS/ANSA assessment tool and process 7. Revamp access process, utilization management, QI department and mobile stabilization