Midvalley Recovery Facilities, Inc.
dba
Pathways

 Overall Strategic  Plan

FY 18/19

Mission Statement

Pathways is a non-profit, community based organization formed in 1974 to provide drug and alcohol treatment services to members of our community. Through integrity and compassion, Pathways offers a full continuum of care including prevention, intervention and recovery services.

Vision Statement

At Pathways, we guide individuals through a process of change, help them improve health and wellness, learn to live a self-directed life and strive to reach their full potential.

Program Overviews

Treatment Program Overview

Detoxification Services Many individuals have arrived at a place where stopping the use of drugs and/or alcohol on their own has become impossible and can be medically dangerous. The abrupt discontinuation of some substances can be life threatening, and can include seizures, auditory, visual and tactile hallucinations, respiratory failure and even death.

Pathways will provide you with a confidential assessment to determine the best course of action to help get you well again.

Our Licensed Medical staff will take every step to insure your detoxification process is as comfortable and pain free as possible.

Our team of Certified Alcohol and Drug Counselors will meet with you to help with your transition to the next step in your recovery and wellness.

Residential Treatment Program

Pathways Treatment Facility provides residential treatment to men and women over the age of 18 who suffer from drug addiction and/or alcoholism. Our goal is to provide you with a safe non-shaming, healthy environment for you to stabilize in, and from the immediate effects of your current drug or alcohol use.

The length of treatment will be individualized for each person. The typical stay is 30-90 days.

Pathways Treatment Facility believes that the clients’ time and resources are valuable, so we provide a very structured program to make the best of your time and resources.

Pathways provide:

• Individual treatment planning.
• Individual and group counseling.
• Educational groups and lectures.
• Relapse prevention and individualized discharge planning.
• A full continuum of care, providing step down services as needed, including 52 weeks of Relapse Prevention group at no additional charge will be provided to those who complete their treatment successfully.
• Family counseling and family visiting.
• Linkages to outside services.
• 12 steps and other community support meetings.
• Daily exercise.
• Spiritual activities that include church services.
• Clean comfortable living and common areas.
• Medication supervision and scheduling.
• Nutritious meals and snacks. Special dietary needs are addressed as needed.

Day (PHP) Treatment:

Pathways Treatment Facility provides Day Treatment services to men and women over the age of 18. Day treatment services are considered an outpatient type of treatment that meets Monday through Saturday from 9:00am to 4:00pm, lunch is provided.

Day Treatment services admission can be used as an alternative to residential care or as a step down program from our detoxification or residential program. Admission to Day Treatment will be determined at the time of assessment.

We will provide to you:

• Individual treatment planning.
• Individual and group counseling.
• Educational groups and lectures.
• Relapse prevention and individualized discharge planning.
• A full continuum of care, providing step down services as needed, including 52 weeks of Relapse Prevention group at no additional charge will be provided to those who complete their treatment successfully.
• Family counseling.
• Linkages to outside services.
• 12 steps and other community support.
• Lunch.

Intensive Outpatient Treatment

Pathways Treatment Facility provides Intensive Outpatient Treatment services to men and women over the age of 18. Intensive Outpatient Treatment meets five times a week for six weeks or three times a week for ten weeks, each session is three hours. Pathways can tailor this program to fit your needs and schedule.

Intensive Outpatient Treatment services admission can be used as a step down program from our Residential and Day Treatment programs, or as an individualized program for yourself. Admission into this program will be determined at the time of assessment.

We will provide to you:

• Individual treatment planning.
• Individual and group counseling.
• Educational groups and lectures.
• Relapse prevention and individualized discharge planning.
• A full continuum of care, providing step down services as needed, including 52 weeks of Relapse Prevention group at no additional charge will be provided to those who complete their treatment successfully.
• Family counseling.
• Linkages to outside services.
• 12 steps and other community support.

Outpatient Treatment

Pathways Treatment Facility provides Outpatient Treatment services to men and women over the age of 18. Outpatient Treatment meets three times a week for ten weeks, each session is one hour. Pathways can tailor this program to fit your needs and schedule.

Intensive Outpatient Treatment services admission can be used as a step down program from our Intensive Outpatient program, or as an individualized program for yourself. Admission into this program will be determined at the time of assessment.

We will provide to you:

• Individual treatment planning.
• Individual and group counseling.
• Educational groups and lectures.
• Relapse prevention and individualized discharge planning.
• A full continuum of care, providing step down services as needed, including 52 weeks of Relapse Prevention group at no additional charge will be provided to those who complete their treatment successfully.
• Linkages to outside services.
• 12 steps and other community support. 

Driving Under the Influence (DUI) Program Overview

 The Pathways Driving Under the Influence Program is a State wide educational court mandated educational program, offered to individuals that have been arrested for impaired driving while under the influence of alcohol, and or other substances. Pathways provides these services for individuals in Sutter County, Yuba County, and individuals transferring in from other California Counties.    The length of services and or programs is predetermined by the State and as identified by the referring court.

 Prevention Program Overview

The Pathways Prevention program provides education and awareness trainings to youth and community organizations throughout the Sutter Yuba metropolitan service delivery area, with information about the dangers of alcohol, tobacco, and drug use, and skills to build healthy lifestyles that will reduce, delay or eliminate the risk of future use of alcohol, tobacco and/or drugs.

Services provided include;

• Drug Awareness
• Grad Night Booths
• DUI Awareness
• Project Alert for Grades 7-8
• Brain Power! Junior Scientist Program for Grades K-5
• Character First
• Second Step
• Youth Entrepreneurship Program for Ages 14-28

 

Performance Analysis

 Financial Solvency

A priority performance indicator for Pathways continues to be diversification of multiple revenue streams.  Throughout the last several business quarters Pathways has added new funding sources form surrounding Counties, such as Butte County, Yolo County and, Nevada County.  Also negotiated increased fees for services provided to Westcare (referring clients from the State Department of Corrections). We have also increased fees for Detox and Residential Treatment clients from Sutter Yuba Behavior Health client referrals. Pathways was also successful in obtaining approval for fee increases for all Driving Under the Influence (DUI) programs from the California State Department of Health Care Services (DHCS) effective February 2019. The greatest coming impact in regards to increasing revenue, will come from certification and licensing from DHCS to provide Detox, Residential, and Intensive Outpatient services funded through California Medi-Cal Program, the Affordable Care Act, and Covered California.

Financial Oversight

Pathways Board of Directors is responsible for financial oversight, each fiscal year begins with a financial review of the fiscal year beginning July 1^st and ending June 30^th. The Executive Director prepares the Pathways Year to Date Profit and Loss and the Balance Sheet reports generated through QuickBooks; all transactions are completed through this accounting program. After a general review, an independent auditor is contracted to perform an audit. After the auditor completes the audit and meets with the Board of Directors with the results, the Operations department distributes copies of the audit to various stakeholders for contract compliance. The Board of Directors is scheduled to meet for eleven monthly board meetings during the fiscal year, minutes are taken at each board meeting, the Operations department sends each board member the following documents prior to the meeting, Board Agenda, previous Board Minutes to be reviewed and approved at the meeting, Board Members also get a copy of the financial statements that include the Balance Sheet, Pathways Profit and Loss Report, and the Monthly Board Report. Annually the Executive Director prepares a draft budget for the new fiscal year. The draft budget is assembled based on the past 12 months of financial revenue and expenses, along with any new requirements for contract compliance from funding sources, government mandates such as the State of California minimum wage increases, family leave laws, and Paid Time Off/Sick leave, all of which have a significant impact on staff compensation. The Board also conducts an annual performance review of the Executive Director.  The review is based on all areas of performance including fiscal oversight of all Pathways accounts. Goals and achievements are reviewed by the Board Personnel Committee that presents its findings to the whole board.

Increased Financial Reserves

In November of last fiscal year, Pathways sold an unimproved commercial lot enabling increased cash reserves.  Also, Pathways owns 430 Teegarden Avenue in Yuba City (Operations Office and DUI program) in addition to holds a mortgage on the 2 Ninth Street Marysville, CA Treatment Facility. Because of the sale of that property, Pathways has four months operating reserves.

Legislative Environment

During the last several years the down turn in the economy has caused significant problems with state, county and city funding. California’s severe budget cuts and the introduction of AB109 have caused major stress throughout the recovery community within the state. This law mandates non-violent felons, non-serious felons and non-sex offenders (Non/Non/Non) that are currently incarcerated in state facilities, and any future convicted felons, to be the responsibility of county jail systems and a move from the State Parole Department to each County Probation Department system.

Sutter County Community Partnership 

The Executive Director also serves as a member of the Sutter County Community Corrections Partnership,

https://www.co.sutter.ca.us/doc/government/depts/probation/ccp/ccphome

Fellow members include the Sutter County; District Attorney, Public Defender, Sheriff, Head Of Social Services, Human Services Director, County Head Of Department Of Employment, County Head of Alcohol and Substance Abuse/Mental Health, Yuba City Chief of Police, Head of County Office of Education, Chief Probation Officer and an the counties victim witness  program.

The partnership is mandated by the State of California legislation, and is a requirement for each county within the State who receives funds for substance abuse, incarcerations, as mandated by Proposition AB109 (early release programs). While Pathways received fewer referrals for treatment from Sutter County Behavior Health (SYBH), it expanded the number of northern county contracts through the State mandated County Requests for Proposal (RFP) process. With more of the surrounding counties participating in referrals to the treatment program, increased referrals from clients from the Department of Corrections/Westcare clients, Pathways has enhanced revenues from a wider revenue stream including Private individual/ Private Insurance or managed care referrals.

 

Since 1974 Midvalley Recovery Facilities, Inc. D.B.A. Pathways has created an extensive history of providing substance abuse treatment programs. While many changes have taken place throughout the years, that has included budget and funding source changes, as well as programs offering a myriad of services and facilities, have both opened and closed. However, the core principles of the organization continue to function and are in intact, healthy, and well positioned to continue providing services well into this 21st century.

Expectations of Persons Served:

Insuring that the needs of persons served is a continual priority; the Treatment Program staff accomplishes this through information gathered from within and without the treatment community. Needs Assessment is accomplished at the treatment center for each client by using information from referral sources, through parole officers, healthcare providers, and from family members. In addition to these resources, the treatment staff uses a variety of different tools during the initial assessment interview; an Addiction Severity Index (ASI) form, and an Initial Treatment Plan and Problem Document is completed. Additionally, the California Treatment Recovery Placement Indicators form is completed using the American Society of Addiction Medicine (ASAM) standards. Clients are able to have input into their treatment experience through a client Peer Counsel, weekly meetings between Case Managers and family members, and group sessions with clients and family members. During transition and discharge planning for each client’s program, a Client Satisfaction Survey is collected and examined for trends, best practices, and information relevant to improve client services, and referrals to local community and recovery services.

Expectations of other Stakeholders:  

Other stakeholders include funding sources, referring agencies, law enforcement, parole agents, probation officers, and other nonprofit organizations. Pathways accomplishes the task of networking throughout the Northern California region service delivery area in an assortment of ways. The Board of Directors consists of a group of diverse individuals that represent the community served. Currently the membership includes a nurse, bank vice president, a business owner, retired individuals, a probation department retiree, a healthcare supervisor, a commercial real estate agent, a financial advisor, and an agricultural business professional. Among these members, there are some that celebrate over 30 years of sobriety.

Pathways Executive Director is a member of the Sutter County Community Corrections Partnership (CCP). Fellow members include the Sutter County Chief Probation Officer, District Attorney, Public Defender, County Sheriff, Head of Social Services, Head of Human Services, Head of Department of Employment, Head of Alcohol and Substance Abuse and Mental Health Services, Head of Office of Education, Victim Witness Representative, County Supervisor or Chief Administrative Officer, County Court Executive Officer, and Yuba City Chief of Police. The partnership was set up through the direction of the State of California for each county to deal with the effects of AB109, which encompasses realignment of state incarcerated individuals to be returned to county control, and to divert all future arrested and convicted “non-violent felons, non-serious felons, and non-sex offenders”. Statistics clearly show that the majority of the offenders committed crimes linked to substance abuse, with this one law every county in the state will be significantly pressed to provide services with legal, medical, mental, and substance abuse treatment for a large indigent population.

Pathways is a member of Calnet, a 501(c)(3) nonprofit organization made up of 34 organizations providing treatment throughout California. Calnet negotiates in-network rates with 29 managed care health insurance companies such as Aetna Behavioral Health, Blue Cross of California, Cigna Behavioral Health, United Behavioral Health, Magellan Health Services, and Value Options.  Calnet also is very active with the state legislature in frame working State Assembly and Senate bills that have significant impact on its member agencies. Recently, Pathways’ Executive Director was elected to the Calnet Board of Directors.

Additionally, Pathways is a member agency with the Yuba Sutter United Way (YSUW).  This local United Way chapter is comprised of 26 non-profit partner agencies and affiliate organizations providing a comprehensive network of health and social services throughout Yuba and Sutter Counties.

Competitive Environment:

The competitive environment has changed significantly due to the continued downturn in the economy. As a result there are fewer treatment centers regionally and many other facilities struggling with solvency. Pathways is positioned to be a go-to choice for providing treatment services to a myriad of government, private, and other referring funding sources. As a non-profit organization, Pathways has successfully positioned itself to sponsor services to indigent clients negotiating rates far below managed care clients; however, the compensation from county or state clients has allowed the treatment program to maintain a larger census to offset the ebb and flow of managed care client enrollments.

Overview:

Pathways has actually entered into contracts with both Nevada and Butte counties.

Pathways is in the final stages of a very long arduous process in getting our drug Medi-Cal Certification which will allow us to open residential beds to low income individuals and start a Medi-Cal Outpatient Program in our community. We receive approximately 100 calls a month for these services which has been the motivation to get this implemented for our community.

We significantly increased the number of days we were able to sponsor and co-sponsor clients by opening up beds to individuals that receive SSI as their only means of income. This has been a very positive program for not only the individuals served, but for community relationships as well.

Pathways hired and assisted two new Case Managers in getting certified.

We will continue to collect data in order to better our services to the community and our stakeholders. The data collected from the last fiscal year has been very important and informative which will allow us to respond better to the needs of individuals and their families.

Pathways continues to strive to be a premier treatment program for all individuals and families to seek help. We are committed to our mission and will maintain our focus to reach our targets.

In order to stay competitive with other for-profit or government agencies that provide higher compensation, the Board of Directors has established both an employer matching 401(k) fund and a profit sharing plan for all employees. Not only is this offer a financial incentive to the staff, the hope is that it will be a good tool to help the staff be more proactive in promoting Pathways’ mission and customer service goals.

Service Area Needs:

The outcomes for treatment services are demonstrated through data collected from state, county and Pathways internal reports. Pathways is mandated to provide client information to the State of California to an Outcomes Management System (CalOMS). Reports from this system are used to provide critical information such as demographics, drug of choice, completion rates, etc. Comparisons can be made against state averages versus Pathways’ performance. When extracting data from the CalOMS system, much of the current data has not been uploaded and often lags by as much as six months. Therefore Pathways has developed a Performance Measurement Management Data Collection work sheet. This information allows Pathways to glean far more data than can be downloaded from the State CalOMS reporting system.

Stakeholder information is collected from clients, family members and other outside stakeholders, individuals, government employees, and private individuals and is used for strategic planning and performance analysis.

The Executive Director sits on the Sutter County Community Corrections Partnership (the partnership was previously of described in the “Expectation from other Stakeholders” section). As a result of information obtained through the Stakeholder Survey, and many verbal discussions with county department heads and other referral agencies.

 Relationships with External Stakeholders:

Relationships between Pathways and outside agencies are vital to the survival and growth of the organization and without these key agencies, Pathways may have difficulty performing its mission.

Calnet

This agency provides the link to private insurance carriers throughout the state. CalNet negotiates contracted rates for different level of care, and enables Pathways to be an in-network healthcare provider. Pathways Executive Director is a member of CalNet board of directors.

Westcare

After Managed Care funds, WestCare provides the largest contract source of revenue for Pathways Treatment Programs, Westcare refers clients to our treatment facility from the California State Department of Corrections.

Sutter Yuba Mental Health (SYBH)

SYBH is a bi-county organization that oversees state funding to both Yuba and Sutter Counties. In addition to that, the Director, Tony Hobson, is designated through the State of California Department of Health Care Services (DHCS) as the Bi-County Substance Abuse Administrator for both of these counties.  SYMH also refers clients to our treatment programs.

State of California Department Of Health Care Services (DHCS) 

This State regulatory agency license (Residential, Detox and Day Treatment # 580001BN), Certifies (Outpatient Certificate 580001DN) Intensive Outpatient, and Outpatient Services). DHCS also licenses Pathways’ Driving Under the Influence Program, License # 580001DN.

Yuba Sutter Chamber of Commerce

Historically Pathways membership with the chamber of commerce is decades long.

Pathways Prevention Program

This program, although limited by funding/personnel, enables Pathways to network throughout the community at a host of levels, with government agencies, education professionals, school age children, families, churches, homeless, and veteran organizations, and through community sponsored health Fairs.

Yuba Sutter United Way (a coalition of over forty nonprofit agencies.)

Pathways’ is a participating member agency receives funding through the local United Way servicing Sutter, Yuba, and Colusa Counties.

Intent Statement

To remain active throughout current community programs while expanding opportunities when feasible.

Sutter County Community Partnership 

The Executive Director also serves as a member of the Sutter County Community Corrections Partnership, https://www.co.sutter.ca.us/doc/government/depts/probation/ccp/ccphome fellow members include the  Sutter County; District Attorney, Public Defender, Sheriff, Head Of Social Services, Human Services Director, County Head Of Department Of Employment, County Head of Alcohol and Substance Abuse/Mental Health, Yuba City Chief of Police, Head of County Office of Education, Chief Probation Officer and an the counties victim witness  program. A partnership mandated by State of California legislation  requiring each county within the State receiving funds for substance abuse, incarcerations,  as mandated by Proposition AB 109 (early release programs)

 

Risk Management Plan

There are a number of issues that could affect Pathways’ exposure to risk and impact the organization in a negative way, such as the economic slowdown of the last several years, licensing, compliance, contractual, and facility upgrades, are some of the areas that are continually addressed.

Currently Pathways provides services with substance abuse recovery through three different programs: the Treatment Program, the Driving under the Influence Program, and the Prevention Program.

Should there be a significant reduction or loss of funding in any one of these programs, or if a natural disaster such as a flood, fire, or an earthquake should occur, it would significantly reduce Pathways’ ability to provide services to through its service delivery area.

The following Risk management plan addresses these issues:

 

Program Funding

There is no other single issue that receives more management attention than the subject of program funding. However, Pathways’ goals remain service oriented, providing real help to individuals, their families, and stakeholders in the community. This cannot be achieved without the funds to provide these services. Therefore the Board of Directors, the Executive Director and the Program Directors implement policies and procedures to maintain solvency to keep programs operational. Each fiscal year begins with complete review of the previous year’s Profit and Loss Statement; close attention is paid to all line item entries, and recommended changes are discussed by the Executive Director and the Program Directors prior to the annual budget being submitted for approval. The Executive Director then presents a proposed budget for the coming fiscal year to the Board of Directors. After review, the Board of Directors approves the annual budget, and monitors the budget vs. actual income on a regular basis. During the monthly Board of Directors meeting, the Executive Director reports the financial status of the corporation using the following financial reports: Balance Sheet, Year to Date Profit & Loss Statement, and the previous month’s Profit & Loss Statement. Fiscal performance, trends, organizational needs, long and short term goals are analyzed and discussed.  After the fiscal year is completed, an annual audit is performed by an independent Certified Public Accountant. The C.P.A. presents the audit to the Board of Directors with any findings or other recommendations that may apply.  At all levels, Pathways continues to develop new, or means to enhance existing revenue streams when available.

Loss or Severe Cut in Program Due to Natural Disasters

The Executive Director is responsible for the overall coordination, direction of Program Directors, directing risk management activities and response within the organization. In order to maintain services in the event of significant reduction or loss of funding, the following are the objectives for unusual incidents, emergencies and natural disasters:

Conduct ongoing emergency drills and safety inspections.

Unusual Incident Reports are reviewed at the monthly management staff meetings and analyzed annually; addressing any trends or concerns to develop, when needed, criteria and standards designed to maintain an optimum level of safe, person-centered, and quality service. Pathways has developed clear policy and procedures for both the Marysville and Yuba City locations that clearly define actions to be taken when and a disaster may occur as defined .

Maintain sufficient staffing levels to provide uninterrupted services within each program.

As a service provider, Pathways’ largest expense is payroll. Therefore, if a reduction in funding or a loss of revenue occurs, both staffing levels and expenses for that program will be reviewed and will be adjusted by the Executive Director and the Pathways Board of Directors. Historically, Pathways has successfully made necessary adjustments while maintaining all level of care as the business climate has ebbed and flowed and as funding and contracts have come and gone.

Minimum Wage Impact

State mandated minimum wages will increase annually over the next four and a half years with potential impact to health care providers. The rates are going from the current $10.50 per hour to $15.00 per hour by January of 2021. Historically nonprofit organizations perform many critical functions in our communities often serving the most at-risk and disadvantaged. These fiscal constraints will impact many nonprofits ability to provide organizations such as child care centers, home health care organizations, and senior care providers.  Pathways continues to fiscally  meet the ever increasing needs of the recovery community, through increasing the number of revenue sources and through fee for service during current contract renewals.

Strategic Goals and Targets

Pathways budgets for FY18/19 adopted by the Board of Directors is structured to meet the next round of state mandated minimum wage hike Jan , 2020 and still maintain profitability.  As stated elsewhere within this report a major factor will be the expected Medical certification and approval to provide treatment services to medical participants. This along with renewed contracts will not only ensure fiscal solvency throughout the coming fiscal year but also for the next four to five years.

Marysville Treatment Facility Natural Disaster Response

Should there be a Fire, Flood or Natural Disaster rendering any of the facilities untenable, the Office of Emergency Services directives will always take precedence. Pathways’ response will be as follows:

The residential clients will be assessed for relocation to other facilities based on the client’s source of funding. Local motels, churches, and residences may be used. All current client records will be evacuated (medical records cart) along with the clients and staff. The staff from our Treatment facility will move over to the Teegarden Facility, sharing space with DUI Staff. Outpatient activities will continue at the Yuba City facility, using the second floor offices. Staff will notify all clients of the temporary location.

The network computer is backed up daily, all data is stored by an off-site computer service and an additional copy of the backup systems is transported once a week to the Yuba City facility.

Yuba City DUI/Operations Facility Natural Disaster Response

Should there be a Fire, Flood, or Natural Disaster rendering the facility untenable:

All back-up drives, computers, financial records, and current client records will be evacuated with the clients and staff. The Operations and DUI Staff will office at the Marysville Treatment Facility on the second floor sharing offices with the Treatment Staff. DUI Classes will continue in the Board Room, the IOP office, and the Group Room. All clients will be notified by staff. The network computer is backed up daily, all data is stored by an offsite computer service and an additional copy of the backup systems is transported once a week to the Marysville facility. The Executive Director, or his designee, will handle all contacts with insurance carriers, attorneys and financial institutions. Pathways’ real estate assets may be leveraged for emergency cash if needed, and/or directed by the Board of Directors. Monitoring and re-assessment of potential loss exposure is reviewed by the Executive Director and by Program Directors at monthly meetings, during significant events, and annually with the Board of Directors, or as needed.

 

Technology and Systems Plan

Technology System Plan

Recognizing the important role that technology plays in today’s business climate, a continuing effort to maintain and improve its electronic footprint throughout the organization.  Therefore, the company has heavily invested in computer servers, networks, workstations for each employee, and electronic employee time keeping. All employee email accounts are hosted through Pathways’ website www.yspathways.net. All directors’ are provided company smart phones for ease of communication facilitating immediate and easy access between supervisors and staff, from program to program, and between program Directors and the Executive Director.

Hardware

A local IT company (Syscon Computers) is utilized for computer repairs, scheduled maintenance, and software issues as needed. The IT service cleans and inspects equipment for operating functions and identifies action/s to be taken to ensure optimum performance. An inventory list identification of the equipment is maintained by Operations, deletions and additions to the inventory are made on an ongoing basis at equipment failure and or purchasing.

Software

Pathways uses computer software in every facet of program operations, therefore a consistent effort is maintained by program staff, directors and operations to ensure the safety, validity and current upgrades are maintained. All computers use Microsoft Office software that includes Word, Excel, and Outlook and continues to use www.techsoup.org that has significantly lowered the cost for these major programs and operating systems. Treatment and the Driving under the Influence programs use Alcohol and Drug Management software (ADM).  Operations Uses QuickBooks Professional software for payroll, accounts payable, accounts receivable and banking information. The QuickBooks software is installed on the Pathways server, the Executive Director, Operations Supervisor, and the Operations Administrative Assistant’s computers and is password protected on each computer.

Security

All computers are secured in locked offices after duty hours with the exception of the treatment reception/CRA workstation which is staffed 24 hours per day seven days a week. Each employee has a work station and each employee has their own password protected profile. All password information is kept by Operations. In addition an inventory of all computers is conducted annually when a computer is retired and or a new commuter is added to the network operations’ will add or delete it from the list of serial numbers.

Confidentiality

In accordance with federal regulations 45CFR, parts 160 & 164 or by 42 CFR part 2 Pathways complies with the American Health Insurance Portability and Accountability Act of 1996  (HIPAA) to insure the confidentiality of all persons served. Therefore all and information electronic stored files are password protected and any electronic correspondence i.e.  Faxes, e-mails or e-mails containing protected client information include a confidentiality notice.

Assistive Technology

Currently there is not any identified staff or clients in need of Assistive Technology (AT).

• Intent Statement

The plan is to ensure the ability to provide assistive, adaptive, and rehabilitative devices for people with disabilities that also include a process in selecting, locating, and implementing hardware, software or workstations. Should a need arise the will require the implementation and use of this technology Pathways has identified the following website as the initial step a process http://www.atsolutions.biz/index.html  to  respond to a barrier that includes assistive, adaptive, and rehabilitative devices for people with disabilities and also includes the process used in selecting, locating, and using them. This site has a wide range of resources and links to many sites that would enable both practical and prompt solutions.

Catastrophic Recovery Preparedness

A back up of electronic files occurs nightly and weekly, both internally and off site. Each night a scheduled electronic backup is performed on the Treatment Network Server and on the Operations/DUI Network Servers. Data is stored on one of two external hard drives provided for each network server. A weekly backup of hard drives are exchanged and stored off site in the following manner; the treatment backup is stored in Operations IT room located at 430 Teegarden Avenue in Yuba City and the Operations/DUI backup is stored in the Treatment IT room located at 2 Ninth Street in Marysville.  In addition these internal backup procedures, Pathways contracts with an offsite backup service, currently the offsite HIPPA compliant backups are performed by BlueRay Concepts.com nightly.

In the event that a loss of either the Marysville of Yuba City offices or computers all data would be recovered from Pathways back up hard drives and along with any data not recovered or unattainable by going to the BlueRay Concepts services backup site. All programs, software, and data will be downloaded unto an operational computer at either the business office or an offsite Pathways computer located at the Executive Directors home and or through other means of additional procurement means.

Virus Protection

Pathways subscribes to AVG Anti-Virus Business Edition, this software is located on both the Treatment and Operations servers. Both servers have propagated this virus protection to all computers at each location. When a computer is replaced or an additional computer is added to the network when the new computer joins the network this server also propagates the virus protection to the added computer. The AVG virus protection runs a continuously and contains anti-virus, Anti-Spyware, LinkScaner, E-mail Scanner, Online Shield, and Anti-Rootkit protections. AVG also provides automatic updates on each computer and runs scans on each computer daily.

Information Management

The State of California has mandated that all treatment facilities use the California Outcomes Management System (CalOMS) to track all clients served throughout the state. Reports can be generated from this online software system that demonstrate number of people served, drug of choice, age, education and successful completion rates, at the state, county and by program level. Pathways’ also uses ADM Alcohol and Drug Management software for both the Driving under the Influence (DUI) Program and for case management for the Treatment programs.

Culturally and Linguistically Appropriate Services (CLAS)

Pathways’ is committed to providing individualized treatment for drug and alcohol addiction and serve the needs of our clients and their families throughout the recovery process. We guide individuals through a process of change, help them improve health and wellness, learn to live a self-directed life and strive to reach their full potential.

Pathways adheres to the U.S. Department of Health and Human Services Office of Minority Health’s, Culturally and Linguistically Appropriate Services (CLAS) standards in Health and Health Care. This is intended to advance health equity, improve quality and help eliminate health care disparities.

In order to adhere to these standards (CLAS) Pathways has incorporated the following procedures throughout its Treatment protocol.

1. Provides effective, equitable, understandable and respectful quality care and services that are responsive to diverse cultural health beliefs and practices, preferred languages, health literacy and other communication needs.
2. Advances and sustains organizational governance and leadership that promotes CLAS and health equity through policy, practices and allocated resources.
3. Recruits, promotes and supports culturally and linguistically diverse governance, leadership and workforces that are responsive to the population in the service area.
4. Educates and trains governance, leadership and workforce for culturally and linguistically appropriate policies and practices on an ongoing basis.
5. Offers language assistance to individuals who have limited English proficiency and/or other communication needs, at no cost to them, to facilitate timely access to all health care and services.
6. Inform all individuals of the availability for language assistance services clearly and in their preferred language, verbally and in writing.
7. Ensures the competence of the individuals providing language assistance, recognizing that the use of untrained individuals and/or minors as interpreters should be avoided.
8. Provides easy-to-understand print and multi-media materials and signage in the languages commonly used by the populations in the service area.
9. Establishes culturally and linguistically appropriate goals, policies and management accountability, and infuse them throughout the organization’s planning and operations.
10. Conducts ongoing assessments of the organization’s CLAS-related activities and integrate CLAS-related measures into assessment measurements and continuous quality improvement activities.
11. Collects and maintains accurate and reliable demographic data to monitor and evaluate the impact of CLAS on health equity and outcomes and to inform service delivery.
12. Conducts regular assessments of community health assets and needs and use the results to plan and implement services that respond to the cultural and linguistic diversity of populations in the service area.
13. Partners with the community to design, implement and evaluate policies, practices and services to ensure cultural and linguistic appropriateness.
14. Creates conflict and grievance resolution processes that are culturally and linguistically appropriate to identify, prevent and resolve conflicts or complaints.
15. Communicates the organization’s progress in implementing and sustaining CLAS to all stake-holders, constituents and the general public.

Persons Served

It is our intent at Pathways to meet the cultural requirements of all persons served. This is accomplished throughout each client’s treatment experience in all levels of care. Beginning with the admissions process, clients are interviewed by the Admissions Coordinator, assessment in the following areas are conducted; their current medical condition, psychiatric treatment history, and any need for suicide watch or evaluation, trauma experienced or witnessed such as:

• Abuse
• Neglect
• Violence
• Sexual abuse

Each client also is assessed for dietary restrictions, assistive technology, special housing, spiritual, and cultural needs, other factors such as gender, ethnicity, employment such as past, current, and future requirements. Pathways’ singular goal is to guide each individual through a process of change, helping them to improve health and wellness, learn to live a self-directed life and strive to reach their full potential. Pathways may seek outside advisors, volunteers, or paid independent contractors when a need has been identified, such as cultural issues, communication barriers, etc. to provide appropriate services to persons served.  After the client is admitted to a treatment program the staff continue to audit identified cultural competency needs through case management, group sessions, one on one counseling, and individual follow-ups that occur at intervals throughout the treatment process.

It is Pathways position that Drug and Alcohol abusing individuals develop a micro-culture of their own and this is the primary culture to address within our scope. Therefore it is common practice to employ some staff that has successfully completed a treatment program, meet state licensing guidelines and the requirements for such employment from CFR Title 9.  Currently, the Clinical Director of Treatment, the Treatment Program Supervisor, have both completed their treatment program at the Pathways. The DUI Program Director and the DUI Night Shift Supervisor have also completed treatment programs at other facilities. The staff is comprised of twenty females and six males. There are six management positions within the organization, four of these positions are held by women, and two by male employees.  Ethnically the staff is made up of twenty Caucasians, four Hispanics, and two African Americans.

Personnel

Pathways provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, physical or mental disability, marital status, ancestry, political affiliation, or status as a covered veteran in accordance with applicable federal, state and local laws. Pathways complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, placement, promotion, termination, layoff, recall and transfer, leaves of absence, compensation, and training.

Title II of the Genetic Information Nondiscrimination Act of 2008 protects applicants and employees from discrimination based on genetic information in hiring, promotion discharge, pay, fringe benefits, job training, classification, referral, and other aspects of employment. GINA also restricts employers’ acquisition of genetic information and strictly limits disclosure of genetic information. Genetic information includes information about genetic tests of applicants, employees, or their family members; the manifestation of diseases or disorders in family members (family medical history); and requests for or receipt of genetic services by applicants, employees, or their family members.

The Americans with Disabilities Act (ADA) requires employers to reasonably accommodate qualified individuals with disabilities. It is the policy of WORKLOGIC HR/Pathways to comply with all federal and state laws concerning the employment of persons with disabilities. It is WORKLOGIC HR/ Pathways’ policy not to discriminate against qualified individuals with disabilities in regard to application procedures, hiring, advancement, discharge, compensation, training, or other terms, conditions, and privileges of employment.

Pathways will reasonably accommodate qualified individuals with a temporary or long-term disability so that they can perform the essential functions of a job. An individual who can be reasonably accommodated for a job, without undue hardship, will be given the same consideration for that position as any other applicant. All employees are required to comply with safety standards. Applicants who pose a direct threat to the health or safety of other individuals in the workplace, which threat cannot be eliminated by reasonable accommodation, will not be hired. Current employees who pose a direct threat to the health or safety of the other individuals in the workplace will be placed on appropriate leave until an organizational decision has been made in regard to the employee’s immediate employment situation.

Other Stakeholders

Stakeholders are among our organization’s most valuable assets. Every employee represents Pathways to our clients and the public. The way we do our job presents an image of our entire organization. Stakeholders judge us by how they are treated with each employee contact. Therefore, one of our first business priorities is to assist any stakeholder, client or potential clients. Nothing is more important than being courteous, friendly, helpful, and prompt in the attention given to clients.

Our staff is trained to receive feedback from persons served regarding any difficulties experienced from any of their interactions with staff where they felt their beliefs or culture was not respected.

Other Stakeholder feedback is collected from vendors, counties, referring agencies, and other entities doing business with our organization in throughout our service delivery area.

After compiling all of the surveys along with the responses, 131 responses were found to be positive, 32 responses were found to be unknown. 3 negative/no responses were reported in regards to all questions question asked.

Pathways’ strives to maintain positive feedback from a wide and variety of organizations and individuals served.  Besides Stakeholder surveys Pathways compiles data from funding sources, contract compliance site visits, conducted by State Department of Health Services, Sutter Yuba Behavioral Health, Yuba County, Nevada County, WestCare, State Department Justice of  in a very positive light.

One of the surveys included an additional comment: “I hear only good comments regarding Pathways and the services they offer our community. As a community member, I am glad they are here to help those in need.

 

Unusual Incidents Summery

There have been 16 Unusual Incident reports that have taken place within FY 15/16. Of the 16 reports, 9 of them were for medical reasons, 7 was for disruptive behavior/misc. reasons/violent behavior (violent behavior is strictly prohibited at Pathways)

Of the 9 incidents that resulted in medical treatment, 3 clients were taken to our local hospital and released back to our Treatment facility. Policies and Procedures were followed and transportation was arranged as required and no further actions needed to be taken at that time. The remaining 6 medical incidents all were treated with basic first aid for minor scrapes, cuts & burns. The actions taken were reviewed and appropriate training was given as required by the Policy and Procedures Manual.

Of the remaining unusual incident reports, incidents occurred ranging from an individual coming into the DUI School stating he was having delusional thoughts, and stated he thought was going to die, staff called 911, but client ended up leaving the facility. Another of the incidents reported was a break-in at the DUI School, where nothing was reported being missing/stolen, 911 arrived on scene upon the alarm being set-off. The incident was immediately reported to the Executive Director as well as reported to our insurance agent. Other incidents include Treatment Clients being disruptive (knocking over tables and chairs as well as getting into physical altercations with other clients. Those incidents resulted in those clients being discharged from our Treatment Facility.

More information from the Strategic Plan is available when relevant to the needs of persons served, personnel and other stakeholders.