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Providing direction

April 1, 2009
by Douglas J. Edwards, Editor-in-Chief
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Hazelden's new president and CEO plans on growing the organization even in a troubled economy

Mark G. Mishek holds Twenty-Four Hours a Day by Richmond Walker, the first book that Hazelden published 55 years ago. Photo by Tad Saddoris

Mark G. Mishek considers himself to be a listener. “I'm always listening, listening, listening, and trying to understand what the client needs, what an employee needs, and what a donor wants,” explains Mishek who, in his role as the new president and CEO of Hazelden, has plenty of listening to do.

In November, Mishek took over the reins of one of the addiction treatment field's most well-known organizations, which celebrates its 60th anniversary this year. In addition to having treatment operations in four states, Hazelden has a graduate school to train addiction counselors, a publications and educational services arm, a research institute, and public-policy operations, among other endeavors. Hazelden's sterling reputation suffered under some unpopular moves by the former CEO, whose focus on the bottom line and relocation of Hazelden's headquarters disappointed some staff and Hazelden supporters. For much of last year Hazelden was run by a temporary CEO and without a CFO and CMO.

“People craved leadership. They were looking for direction,” Mishek recalls.

A week before he started, Hazelden's management had received the results of an employee morale survey. While employees still were committed to Hazelden and its mission, they were disengaged from the senior team. So to reconnect upper-level managers (about 35 to 40 executives) to the employee base, Mishek began “flattening” the organization by reducing the number of senior managers and giving them broader responsibilities. Every leader also must have an employee-engagement plan. To reassure everyone of the management's commitment to Hazelden's care philosophy and employees, Mishek moved Hazelden's headquarters back to its Center City, Minnesota, campus from downtown Minneapolis. And Mishek says he is “overcommunicating” with staff on Hazelden's plans, strategies, financial performance, and clinical outcomes in monthly town-hall meetings, as well as through the organization's intranet and blog.

“The hurricane from the economy that came in at the fourth quarter also made it critical that we really focus on our employee communication,” he notes.

In fact, shepherding Hazelden through the recession certainly will be one of Mishek's primary initial challenges. He acknowledges that many potential clients are wary of taking on additional debt to pay for addiction treatment, especially as credit cards are cancelled, credit limits are reduced, and job losses continue to mount. So to help people pay for treatment, the organization has relaunched its loan program. Hazelden also aims to raise more money for patient aid, expecting to generate $6 million in 2009 (8% of net patient revenue). Mishek doesn't plan on raising rates in 2010, so cutting costs this year will be essential.

“We're looking at the place top to bottom right now, finding out where we can be more efficient and where we can reduce costs,” he explains.

Hazelden also is bolstering its outpatient programs, and a new intensive outpatient program filled up quickly. Mishek points out that for some people attracted to outpatient care, paying for 28-day programs is not an issue: It's whether they'll have a job when they return to work, given the state of the economy. But he expects 28-day programs will remain core to Hazelden's treatment philosophy.

“There's always going to be a need for residential treatment of the kind that Hazelden offers,” Mishek says.

While many organizations are cutting back on growth plans in the economic downturn, Mishek has several goals for Hazelden during the next five years. He wants the publications division to embrace electronic formats (e.g.,'s Kindle electronic reader), and he expects Hazelden to be a leader in using techniques for reaching and treating people electronically, such as through Web-based education and social networking. Mishek anticipates screening and brief intervention will become a big business for Hazelden, perhaps through serving colleges and universities. He wants to double the graduate school's enrollment and relocate it into bigger space, and he plans to move Hazelden back into the Florida market in the next 12 months (Hazelden left the Sunshine State several years ago).

Mishek is relatively new to the addiction treatment business. He spent most of his career at Allina Hospitals and Clinics in the Twin Cities, where he served as chief legal officer for 21 years, turned around its home care division, helped start two outpatient chemical dependency programs and, most recently, ran a St. Paul hospital. To help him become acquainted with the field, he has turned to colleagues such as Doug Tieman, president and CEO of Caron Treatment Centers in Wernersville, Pennsylvania; John Schwarzlose, president of Betty Ford Center in Rancho Mirage, California; and his brother Charlie Mishek, who heads the chemical dependency program at Regions Hospital in St. Paul. Among his initial impressions of the field is that it is “woefully undercapitalized.”

“The capital has left the field over the years because of the lack of reimbursement,” he explains. “It's a very difficult treatment modality to get paid for. It doesn't have the capital investment and the reach that the world I came from does.”