The five Champions (Debbie Sanford, Rich DeHaven, Leon Evans, Jeff Patton, and Matt Feehery) stand out, not only among their peers-the CEOs and executive directors of community mental health and addiction treatment provider organizations-but also within their professional communities and organizations, which this year include:
The National Council,
The Mental Health Corporations of America (MHCA),
The National Association of Addiction Treatment Providers (NAATP), and,
The National Association of County Behavioral Health and Developmental Disabilities Directors (NACBHDD).
And, before more is said about the 2011 Champions in the pages that follow, let me say this: for every Champion selected, I know that there are many more leaders—nominated or not—whose efforts, teams, organizations, and contributions to the field deserve recognition as well.
Thanks to all of you, and to our 2011 Champions, from all of us—the staff of Behavioral Healthcare.
In a world where CEOs commonly lead from the front, Debbie Sanford's management style stands out. She doesn't see herself as the public face of her organization, Pine Grove Behavioral Health. Instead, she works very much in the background with a style of leadership that always seeks to put other people “out front.”
While she confesses, “I don't like the limelight,” Debbie's preference for a lower-key leadership style isn't based on shyness or inability. Rather, it's based on an assessment of the strengths she sees and seeks to develop in others. For example, she says, “There are people here who are great in the public eye-great speakers, great marketers, people who are great at addressing audiences. Why not put them out there?” she asks.
Debbie believes that “staying close to the work” is essential to her effectiveness. It's a lesson she learned during her years as a medical-surgical nurse, nurse administrator, and vice president for patient care at an acute-care hospital. She respects the example of “great administrators who were really out there with their people-encouraging them to do better, to always improve and grow. I've always tried to emulate that example. I've always tried to stay close to those who are doing the work.”
Since her promotion to Pine Grove's top post in early 2006, Debbie's experience has helped to guide Pine Grove through an evolution that added new outpatient workshop services to its well-known programs. With this service addition, Pine Grove launched a series of week-long workshops providing intensive therapy and psychoeducation to hundreds each year who, Debbie explains, “don't yet need a 90-day program.” Also during this time, Pine Grove has expanded its Evaluation Center which performs comprehensive and addiction evaluations for a wide range of clients. Another new initiative within Pine Grove's services provides care for autistic children, meeting a regional need.
To keep pace with this ongoing growth, Debbie continues to rely not only on an outstanding team, but on a continued effort to identify and develop the strengths of every member of the Pine Grove staff. “I've probably focused more effort on this than anything else,” she says. Her belief in such development is rooted in personal experience: Debbie credits her parents and her education, which includes three degrees (BS Nursing, MS Nursing Administration, and MBA), with fostering in her a strong work ethic, an interest in nursing, and a passion for excellence in all aspects of patient care delivery.
Sharing that passion is part of the Pine Grove culture that Debbie has sought to build. “It's important,” she asserts, “to make sure that we're developing people at all positions to achieve excellence.” Early in her tenure, for example, she required licensure for all therapists providing clinical care.
She believes that “putting people out front,” with freedom to test their abilities and limits, is critical to developing top-notch professionals.
So too, she believes, is education. That's why, with the help of Pine Grove's strong international reputation, Debbie continues to bring in top industry figures to lead staff training programs, offer perspectives, or fill key positions. “We've got to provide the latest education right here in Hattiesburg, where our people are, if we expect to remain a top program,” she says.
To keep Pine Grove staff “out front,” Debbie participates in their daily efforts to improve processes, customer service, and quality of care. “Staff are very creative in coming up with ideas for expanding and changing programs,” she says, joking that while she loves the ideas, “they know I'm big on action plans.” These, she teaches, are the difference between “having long lists of things to do and actually doing them, even if you only accomplish a few per year.”
Like so many leaders in the field, Rich DeHaven, CEO of Aspire Indiana, could consider retirement. But, despite the rigors of 40 years, he's in no mood to go anywhere but forward. And, that's good news for Aspire Indiana (Noblesville, Ind.), the product of a 2009 merger of two well-established provider organizations that now serves the behavioral health needs of over 11,000 people annually, primarily in four central Indiana counties.
The merger was driven by two factors: financial sense and hope, says DeHaven. “My vision for this organization-this merger-is to become more diversified. We've got to look at a broader scope of services to support reintegration and recovery in our communities.”
When he began in the field, “the emphasis was on institutionalization, with community-based services just getting started” he remembers. His work-then in Fort Wayne-involved placing patients discharged from a state hospital into family-care or adult foster-care settings. But in the absence of proper community supports, DeHaven saw this “caretaking” approach too often result in “a revolving door back to the hospital.”
But after joining The Center for Mental Health in the mid-1970s, he teamed with medical director Tom Fedor, MD, to begin creating a range of needed community supports, including socialization activities, employment training, housing services, and more. “I recall saying to Tom, ‘We've got to do more if we're going to succeed. What can we do to create better opportunities for those we serve?’”
In the years since, inspired by that vision, DeHaven, his colleagues, and the entire field have delivered remarkable changes. “We've gone from deinstitutionalization to community integration and now to recovery and inclusion,” he says, crediting “wonderful, passionate people who are willing to work hard to create new programs, and see that people we work with benefit.”
For those in recovery-whether from mental health or substance-use problems, he believes that “even little gains can be enormous. It's the repeated little steps that move you in the direction you are going.” The same held true for DeHaven, who grew up in a large family, the son of a minister. He didn't really plan to get involved in the behavioral health field-his studies leaned toward higher education instead-but the work seemed right.
“I've always put a premium on relationships and grew up learning that the way to get things done was by working with others,” he says. Vital to those relationships is an inclination to develop from within. It's a trademark of organizations he has led. “There's a value in ‘home-grown’ people who know what you do, value, and want to accomplish.”
In recent years, when DeHaven and his colleagues saw that economic pressures were limiting supported employment opportunities, they created new “micro-businesses” that not only met Aspire Indiana's needs but expanded further: a vending-machine service that today supports over 100 accounts; a housekeeping business that focuses on local offices and businesses; and a 17-acre agricultural/transitional housing venture, Harvestland, that grows fresh produce for local sale and consumption.
The organization's other ventures include care-coordination and housing services for the seriously mentally ill and HIV/AIDS patients, special services for the deaf, an active housing services program for individuals and families, employment assistance, and an initiative to integrate with primary care-a first step toward what he hopes will secure Aspire Indiana a spot in a regional accountable care organization.
While the field faces many near-term challenges-integrating with primary care, finding new funding sources, advancing research and knowledge, and closing the life expectancy gap for the seriously mentally ill-DeHaven knows that meeting them comes down to one thing: attracting a new generation of professionals to continue the work.
“Because we're a human business, we've got to emphasize both the opportunities and the value of what we do to bring new people into the field. We have to make opportunities to bring our younger people along.”
Even as a boy, Leon Evans had the physical ability to overpower people, a talent that ultimately won him a wrestling scholarship to the University of Oklahoma.
But as a collegiate volunteer in the pediatric unit of Oklahoma's Central State Hospital, at a time when staff applied physical restraints to de-escalate children in psychiatric crisis, Leon found success with a different method: He took them aside and spoke gently to them. The emotional connection he felt with these young people led him, as a college sophomore, to set aside his business studies and aim for a career in behavioral health.
Some 30 years later, as state director of the community services division of the Texas Department of Mental Health and Mental Retardation (MHMR), Evans saw evidence from a colleague, Tony Fabelo, PhD, that the state's costly prison system held a disproportionate share of non-violent offenders (NVOs) with mental health or addiction problems. A similar problem plagued hospital ERs as individuals in crisis, lacking other services, found these the only available, safe alternative for care.
In 2000, when he became CEO of the Center for Health Care Services (CHCS) in San Antonio (Bexar County), Evans engaged local leaders in a program to divert NVOs from jail to short-term crisis care, treatment, and community supports. Yet, despite the scope of the problem-an overflowing 3,670-bed jail, escalating police overtime, and rising ER and detention costs-getting police officers to accept crisis intervention training and jail diversion, which skeptics called “hug a thug,” wasn't easy.
“Police officers are trained to exert a ‘command presence’ and use a ‘command voice,’” says Evans, adding that this approach “can backfire by causing overwrought people to escalate emotionally into crisis, when the use of force becomes inevitable.” Through experience, local officers came to see realize how the new approach reduced time, effort, and hazard, even as hundreds of people were diverted from costly criminal booking and detention into appropriate treatment each month.
The need for crisis stabilization-away from the jail or the ER-led to the creation of the Crisis Care Center, which Evans says “works out for a lot of people who don't need hospitalization, but do need a way to safely de-escalate,” perhaps via transitional housing, before rejoining the community.
In time, the Crisis Care Center center co-located with urgent care and expanded its services to provide medical clearances needed for psychiatric interventions, medical treatment for injured suspects, and court-ordered competency assessments that eliminated the time and expense of state hospital admissions.
Under Evans' leadership, the CHCS also opened the Restoration Center, a sobering, detox, and treatment center for individuals with substance use and co-occurring mental disorders. Together, the Crisis Care Center and the Restoration Center help more than 1,000 people per month while saving the community millions in ER, hospital treatment, and municipal court and jail detention costs.
And, more recently, thanks to major donations, the CHCS partnered in the opening of Haven of Hope, a 1,600-bed, $110 million campus that combines mental health, crisis care, addiction treatment, and residential/homeless services.
The documented success of these and other CHCS programs in addressing mental illness, substance abuse, homelessness, and inappropriate incarceration led Texas legislators to mandate the creation of jail diversion programs in all the state's counties in 2003.
In fiscal years 2009 and 2010, the operations of the Center for Health Care Services were credited with immediate cost avoidance for San Antonio and Bexar County that totaled $15.5 million.
And, as of this writing, there were 884 empty beds in the once-overflowing Bexar County jail.
Taken in as a boy by a loving aunt and uncle in rural Michigan, Jeff grew up poor in a world where he felt the sting of rejection, the belief that he wasn't smart enough to excel, and “that sense of speaking up, but not being heard.” During high school in inner-city Chicago, he experienced the “dog-eat-dog world” of violence and substance abuse and felt his life begin a downhill slide. But then, the death of his uncle, just after high school, brought Jeff back to Michigan in 1967, to his aunt's home and a factory job that he felt was as much as he might expect from life.
As he returned home one day from the factory, after years on the job, Jeff found a new book on his aunt's table: a dictionary he remembers as “crisp and white, perfect and new.” As Jeff thumbed through it, he recalled his disappointments at school, but felt the urge to learn. He enrolled in community college.
“I hated reading, but I did all my classes-and my homework,” he remembers. “I found out that I wasn't such a bad reader, and that maybe black people could learn theoretical concepts, though I'd once been told otherwise.” When he got an A grade for the course, he thought, “This can't be me! I barely got through high school.” But the experience transformed him and brought him academic honors. Jeff, who worked through graduate school as a drug and alcohol counselor, earned his MSW degree in 1978.
Through years of work as a care administrator, hospital director, and deputy state services director, Jeff sought to nurture transformation in others. But over time, he found that institutions, programs, and budgets were getting in the way, rather than helping. Only after he came to Kalamazoo Community Mental Health and Substance Abuse Services (KCMHSAS) as CEO in 2001, did he realize that “asking the question, ‘how do you want to live your life?’ and listening to the answer, is what's transformative for others.”
But that listening process wasn't easy. Through a series of staff meetings early in his tenure as CEO, Jeff says that agency professionals “found that what peers say they ‘really want’ wasn't what we thought. Peers were talking about ‘wanting money in my pocket,’ ‘hating to depend on parents or public assistance,’ and ‘wanting to make a contribution’.” Debate raged as to whether these individuals, if trained and hired in as peer support specialists, really could provide the things they said consumers wanted.
Amid his doubts, Jeff reflected on his own life. “I remembered when I said things like that, wanting to be heard. And then,” he says, “I understood.” This realization led Jeff and his growing team to launch a vibrant and growing recovery community in southwest Michigan that includes:
The grant-funded, Southwest Michigan Recovery Institute, which offers local WRAP training programs; staffs “the Sanctuary,” a local, hospital-affiliated crisis drop-in center; and partners with Kalamazoo County Community College to provide a for-credit certificate program with curriculum created and taught largely by peers.
“Kalamazoo WRAPS,” a $9 million grant funded collaboration that links schools, CMHs, child welfare agencies, and juvenile justice in delivering community and natural supports for troubled young people.
A grant-funded, mental health recovery court, administered by a WRAP-trained judge.
Proposals for a local wellness campus that would combine college classrooms, a culinary institute, a cancer-treatment center, and a local wellness-recreation center.
During his decade at KCMHSAS, Jeff has also sought to build a solid foundation for the implementation of health care reform in the region's behavioral health services. Today, KCMHSAS is the designated prepaid inpatient heath plan (PIHP) for Medicaid specialty mental health and substance use services in a multi-county region of southwest Michigan.
Growing up as the seventh of 10 children, Matt Feehery learned early how to fit in and do his part. Years after supporting the recovery of a family member in treatment and volunteering for the Palmer Drug Abuse Program in his hometown of Houston, he says that “somebody literally tapped me on the shoulder and asked me to become a counselor.”
He became a Palmer employee in 1979 and began training as a drug abuse counselor. While working his way to BA and MBA degrees, Matt rose to the top at Palmer, serving as executive director until 1989. Later, he joined a firm specializing in a different sort of recovery-“turning around” treatment centers and psychiatric hospitals that began losing money with the payer shift to managed behavioral healthcare in the early 1990s.
While these once-profitable programs “found that they didn't know how to ‘right-size’ their businesses or properly market them,” Matt did. He loved to exercise his marketing, financial, and organizing skills. He acted as adviser, evaluator, team leader, and even as temporary CEO for various turnaround efforts. His mantra: “Help great programs continue to do great work.”
After serving as CEO for Beech Hill Hospital in New Hampshire, Matt went back home to Houston to lead another turnaround effort as CEO for Memorial Hermann Prevention and Recovery Center (PaRC) in 2002. At the time, “the PaRC,” a 1999 spinoff of a now-closed psychiatric hospital, was struggling. Matt could see that the 42-bed inpatient program had “an experienced, dedicated, and talented staff” led by medical director Eugene Degner, MD. But Memorial Hermann's focus on its huge acute-care operations meant that the PaRC launched “without much of a business plan and without a complete management team.”
So, Matt got to work. Internally, he sought to drive cultural changes to build employees' confidence and leverage their experience. He based this on the PaRC's consistent, but little-known reputation for outstanding treatment. “I wanted all employees to believe that they are personally responsible for delivering exceptional customer experiences, and for developing new ways to deliver those experiences more consistently.”
He led an effort to reach out to the PaRC's referral sources, program alums, and prospects through surveys, interviews, and meetings that asked: “How can we at the PaRC better serve your needs?” His marketing program extended into the community, explaining “why we're here, what we do, and how we deliver on service quality.” Through the effort, he learned that local program closures had created a community need for more adolescent SUD treatment.
Matt and his PaRC team approached the Memorial Hermann leadership with ambitious expansion plans. Together, they made the case for a new campus:
More inpatient beds (now 182 in all) not only to serve more adult inpatients, but also to house a new 30-bed adolescent treatment unit.
A 20-bed supportive, sober living facility now known as PaRC Place.
Five new intensive outpatient treatment centers to put the PaRC's treatment capabilities within reach of more Texans.
An expanded Psychiatric Emergency Response Team capable of providing on-call mental health and substance use care to emergency centers at nine regional Memorial Hermann acute-care hospitals.
From the very beginning, Matt says he “really connected with the people I met through the 12-step fellowships” and that he “came to love everything about recovery. This is my passion and my calling. I see so many people who have lost so much come in through the front door of our treatment center. To see them leave treatment renewed and transformed is both amazing and fulfilling.”
He laughs. “People still ask me today, ‘Do you really like working with those people?’ My answer is, ‘yeah, I really do. I get to see miracles on a daily basis.’”