Recovery
July 1, 2017
June 30, 2018

A Year in Recovery Recovery

What we’ve learned, how we’ve grown, and what to expect going forward.

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Introduction

We have a lot to share this year.

Our 2018 Impact Report covers events, initiatives, spending, and improvements for our 2018 fiscal year: July 1, 2017-June 30, 2018. A lot has happened, good and bad. This year’s report addresses both head on.

Our purpose is to help people with mental and behavioral needs get the support they need to be well, and we’re committed to being transparent in how we do so. In this report, you’ll find detailed reporting on the year, starting with a letter from our CEO, Trey Sutten. At the end of this report, we invite you to submit your feedback so we can continue to improve.

Trey Sutten

Chief Executive Officer View Bio

“Opportunities for dramatic improvement often arrive disguised as setbacks.”

This year was filled with much-needed change for Cardinal Innovations—from the top down. Our core mission has always been to serve our members and communities with compassion and expertise. But things got cloudy at the top. Corporate spending was needlessly inflated and the focus was taken off our members, our providers, and our communities. That’s not how our organization operates, and it certainly doesn’t reflect the compassion, care, and professionalism of our employees and provider network.

In the past year, we’ve learned some hard lessons and made big changes—including a change in top leadership and overhaul of our Board of Directors. We’ve recommitted ourselves to transparency and honesty in what we say, how we operate, in our spending, initiatives, and priorities.

We have learned to be better listeners—to the ideas and input of all audiences, starting with our members and their families, as well as caregivers, providers, our community partners, government and elected officials, advocates, and more. We don’t have all the answers, but we’re not afraid to ask the questions. Especially if they lead to better, long-term health outcomes for our members.

We’ve learned it truly takes a community to serve and support people and families with empathy and grace. We salute our partners in health care, in emergency services, law enforcement, nonprofits, and so many others. The compassionate professional answering phone calls at 3 AM. The officer trained to identify when someone is in a mental health crisis as they respond to a domestic disturbance and have a split-second to assess the situation. The caring experts at a women’s shelter taking in a mom and her children. The understanding employer who helps keep a promising young person from returning to jail. We thank you.

Lastly, we have learned that even in the face of dramatic and public change, we can count on our employees to remain steadfast in their dedication to the people and communities we serve. As a result, our organization has emerged stronger, more resilient, and more member-focused than ever before.

We continue to grow, learn from our past, and prepare for the future. Our journey is far from over, and it’s a journey we are taking together.

Helping members and their families live their healthiest lives.

We exist to help people with mental and behavioral needs get care. In the past year, that focus was clouded by headlines and shifting ideals. But our organization is getting back to business—helping people live their best lives.

Renewing our priorities

Everyday, we are improving the way we serve our members, work with our communities, and support our providers.

Patricia Herrera is seen here working on one of her favorite activities, a puzzle. She also loves dancing and volunteering at her local library. Diagnosed with a developmental disability, Cardinal Innovations helps Patricia and her family manage her care, connecting her with the support that she needs while making sure she stays active and happy in her community.

Our mission is to improve the health and wellness of our members and their families.

We believe that inclusion, compassion, and respect drive a high-performing culture that supports the success of our members, our employees, and our communities. We are committed to fostering a collaborative environment that appreciates individuality and benefits from a workforce of diverse backgrounds and experience.

We are guided by our core values of:
Improvements
A Cardinal Innovations Healthcare employee helps hand out Narcan kits at an event.

How we're getting better.

Change happens from the inside out, from the top down. We’ve got new leadership in place and a renewed focus on our members and communities. Throughout the past year, we’ve worked to improve access to care, prevent crises, and combat the opioid epidemic. Here are the highlights.

Through our Community Reinvestment Initiative, we invested more than $4 million in our 20 counties, funding dozens of initiatives to improve health outcomes for our members. Working with first responders, providers, and other local partners, we conducted a series of Town Hall sessions to discuss the opioid epidemic and distributed over 12,200 Narcan kits across our communities. The Highland Avenue Center opened its doors in Forsyth County in 2018 to help ease overcrowding in hospital emergency rooms by providing care to individuals in mental health or substance use crisis. This facility is the first of its kind in North Carolina, and houses three important resources: an outpatient behavioral health clinic operated by Daymark Recovery Services, Highland Avenue Primary Care (a joint venture of Novant Health and Wake Forest Baptist Health), and Cardinal Innovations Healthcare’s Triad Community Office and Forsyth Wellness Center. We are putting enhanced supports in place as quickly as possible for youth who are at risk for abandonment, crisis episodes, or restrictive levels of care due to behavioral health needs. Together with our partners at Monarch, we helped pilot an Enhanced Crisis Response program in Mecklenburg County. This is the first program of its kind in North Carolina.
Family Centered Treatment (FCT) is a service involving direct intervention with a child and his or her family that aims to lower the rate of children being placed out of their homes for treatment. We sought to improve communications with those we serve by redesigning our website and launching a monthly member newsletter, Cardinal Innovations COMMUNITY.

Cheryl's story

Member View Story
“My friend said to me, ‘I was once you. Somebody believed in me, and I’m going to do the same for you.’”
Directors installed to our new Board in January 2018
Community organizations awarded over $4 million in grants through our Community Reinvestment Initiative
Opioid overdose reversal kits donated to partner organizations in our communities
Represents data from Fiscal Year 2018 (from July 1, 2017 to June 30, 2018).
In 2018, we held a series of town hall sessions across our region about the opioid epidemic. After the sessions, attendees helped assemble over 12,200 opioid overdose reversal kits (Narcan kits). They were distributed to 160 partner organizations throughout the region.
Financials

Putting our money where our mission is.

Our priority is to get people the care they need. We work hard so members can spend more time living healthy, independent lives, and less time being treated or hospitalized in a crisis. We also work to make sure providers are paid on time, facilities are open and accessible, and our community partners and providers are well-trained in mental and behavioral health.

It’s all about responsible money management, preventive care, and investment in our communities.

Matthew rides a bike with his dad helping him from behind.

Matthew’s parents were told by doctors he would probably not live past six months. Now in his 20s, Matthew graduated high school with a 4.0 and is a published author and classical composer. Read his full story.

Revenue

Our revenue comes from a number of sources. These dollars translate into better care, services, and support for the people we serve.

  • FY 2018 Revenue
  • FY 2017 Revenue

FY 2018 Revenue

in millions

FY 2018 Revenue

in millions

$735 million

Medicaid revenue is funding that allows us to manage Medicaid benefits. These funds are received through a contracted arrangement with the State of North Carolina.

$118 million

Non-Medicaid revenue refers to several other funding streams we manage outside of Medicaid revenue. This includes state funds, county funds, federal block grants, and more.

FY 2017 Revenue

in millions

FY 2017 Revenue

in millions

$724 million

Medicaid revenue is funding that allows us to manage Medicaid benefits. These funds are received through a contracted arrangement with the State of North Carolina.

$114 million

Non-Medicaid revenue refers to several other funding streams we manage outside of Medicaid revenue. This includes state funds, county funds, federal block grants, and more.

Expenditures

We’re putting even more money where it will do the most good: toward our members and toward our communities. Included in these expenditures are investments in our communities, including funding for special, local initiatives or one-time grants and donations.

  • FY 2018 Revenue
  • FY 2017 Revenue

FY 2018 Expenditures

in millions

FY 2018 Expenditures

in millions

$792 million

Care Costs refer to money spent directly on services that contribute to the health and wellness of our members. Examples of these care costs include inpatient and outpatient treatment, recovery services, and supported employment for people with disabilities. Also reflected within care costs are investments in improving quality, including activities to prevent hospital readmissions, wellness programs, patient-centered education, counseling, or care coordination.

$90 million

Admin & Other includes the cost of administrative and operational requirements such as personnel, property, and utilities.

FY 2017 Care Costs

in millions

FY 2017 Care Costs

in millions

$735.6 million

Care Costs refer to money spent directly on services that contribute to the health and wellness of our members. Examples of these care costs include inpatient and outpatient treatment, recovery services, and supported employment for people with disabilities. Also reflected within care costs are investments in improving quality, including activities to prevent hospital readmissions, wellness programs, patient-centered education, counseling, or care coordination.

$87 million

Admin & Other includes the cost of administrative and operational requirements such as personnel, property, and utilities.

Net Position

At the end of the day, our approach to spending is simple: put members first.


FY 2018 Total Net Position

in millions

FY 2018 Total Net Position

in millions

Net position refers to the total resources available at a point in time to support operations. Our net position is at a loss for the fiscal year 2018.

FY 17 Net Position: $259.1 million

red arrow pointing down with text: -32.6 million

FY 18 Net Position: $226.6 million

Net Loss: $32.6 million

Why is there a negative change in net position?

The loss in our net position from fiscal year 2017 to fiscal year 2018 is due to three main factors:

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Additional spending on member services

icon of two buildings

One-time transfer of Highland Avenue Center to Forsyth County

icon of a government building

Impact of legislative cuts to single-stream funding

What is single-stream funding?

Single-stream funds are state dollars that LME/MCOs use to cover behavioral health services and supports for people who do not have health insurance and do not qualify for Medicaid. In FY 2018, we provided coverage for more than 26,000 people using single-stream funds.

In FY 2016, the North Carolina General Assembly made its first significant cut to the amount of single-stream funds that LME/MCOs receive, while requiring them to keep the same level of services as the previous year (FY 2015). The North Carolina General Assembly has made additional cuts to single-stream funds in every year since, while still requiring the maintenance of FY 2015 service levels.

Legislative reductions in single-stream funds

cardinal reduction System-wide reduction
fy16 -$22,635,538 -$110,808,752
fy17 -$31,223,572 -$152,850,133
fy18 -$21,914,121 -$86,942,289
fy19 -$44,019,405 -$107,630,353
total -$119,792,636 -$458,231,527

You can find details on the most recent round of single-stream funding cuts in the 2018 State budget bill (see page 85).

Helping Members Live Well

We are entrusted with health and well-being of our members – linking people to services and supports to help them live their best lives. It’s a responsibility we don’t take lightly

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Supporting our members can mean more than connecting them to care. Watch Donna talk about the support she’s gotten for her son Ashe through Cardinal Innovations, including getting a wheelchair rack installed on her car.
People
A young girl plays outside, dancing.
Members

Healthcare made human.

We serve people with intellectual or developmental disabilities, mental health conditions, or substance use disorders (IDD/MH/SUD). In short, people.

Percentage of service requests we approved
Number of new people we helped get services for opioid use disorders (opioid addiction)
People we helped transition from adult care homes to living independently
Represents data from Fiscal Year 2018 (from July 1, 2017 to June 30, 2018).
To help the state comply with a federal settlement, we committed to helping a minimum of 130 people living, or at risk of living, in an adult care home to homes of their own in FY 2018. Our team ended the year having helped over 200 people transition to independent living in the community of their choice.

Sheila's story

Member View Story
“I never thought I’d be homeless. They gave me so much hope to let me know somebody cares.”
Scott and his mom stand side by side smiling.
Providers

Supporting our network.

We recognize that we are only as good as our providers. That’s why we’re committed to recruiting and retaining the highest quality clinicians and practices in our provider network to care for our members and families.

Number of Therapeutic Foster Care providers added to our network
Increase since FY 2017 in number of Applied Behavior Analysis providers in our network to support members with autism.
Total amount paid daily to providers
Represents data from Fiscal Year 2018 (from July 1, 2017 to June 30, 2018).
We’re committed to paying our providers in a timely and accurate manner so they are able to focus on what they do best: delivering high-quality care to our members. In Fiscal Year 2018, we paid our providers within seven days on average from receiving a claim.

Wanda's story

MOBILE CRISIS PROVIDER View Full Story
“You've got to be a very good listener...It's about listening to the person, communicating, and trying to validate what's going on.”
A mom and her young son play outside. The son rides on her back.
Community

Community partners

We believe in meeting our members where they are. When we bring local community partners and leaders together, we are able to address needs that extend beyond a doctor’s visit. It is vital to connect the dots between a member’s health and their integration into the community. We do that by supporting our communities with resources, trainings, events and initiatives. 

Total community training sessions conducted by Cardinal Innovations, (up from 297 in FY 2017)
Total number of people who attended a community training session, (up from 5,472 in FY 2017)
Number of law enforcement and first responders we trained in Crisis Intervention Team (CIT) Training
Represents data from Fiscal Year 2018 (from July 1, 2017 to June 30, 2018).
CIT is a nationally recognized course to help law enforcement and first responders better identify and respond to someone in mental health crisis.

Deputy Andrews' story

Orange County Sheriff’s Office View Story
“When you see someone truly in crisis, and you are the only thing they have to cling to, it just makes you feel human.”
A Cardinal Innovations team member stands smiling. 
Employees

A dedicated team

Our devoted staff has carried us to where we are now, and we’ll continue to rely on the strength and compassion of our team as we move forward.

Total Cardinal Innovations team members (as of June 30, 2018)
Percentage of Cardinal Innovations employees who have completed diversity and inclusion training
Number of senior leaders certified in Person-Centered Thinking (as of June 30, 2018)
Represents data from Fiscal Year 2018 (from July 1, 2017 to June 30, 2018).
The philosophy of being person-centered, recognizing a person before their diagnosis, is core to the DNA of Cardinal Innovations. Our leadership is expected to understand and practice this philosophy, regardless of department or title. It’s what we stand for.

Julie's story

integrated health nurse Manager View Full Story
“I wanted to offer more to support this population, so I took a leap of faith.”

Cardinal Innovations Healthcare is committed to fostering a collaborative environment that appreciates individuality. Our members benefit from a workforce of diverse backgrounds and experiences.

We believe that inclusion, compassion, and respect drive a high-performing culture that supports the success of our employees, our members, and our communities.

Learn more
Counties

Explore the 20 counties we serve every day.

Cardinal Innovations provides 20 counties in North Carolina with comprehensive behavioral healthcare services. We partner with nearly 1,000 doctors, hospitals, clinicians, and licensed professionals to ensure that our members receive exceptional care and support services.

Each county in Cardinal Innovation’s service area has unique strengths, needs, and demographics. We focus on partnering with providers, institutions, and non-profits in these communities to help our members access expert care and helpful resources close to home.

Our service area

Explore the map below to learn about each county we serve. Select a county to get started.

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Community Revinvestment

This year, our community reinvestment initiative helped fund an array of programs and projects.

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County Map
Moving Forward

The future of healthcare begins today.

At Cardinal Innovations, our focus is always going to be on the lifelong health and wellness of our members and their families. That’s not going to change.

What you can expect to change, and improve, is our commitment to doing it better, and with you in mind. Every day. To work with our community partners to explore better ways to combine compassion, innovation, and technology. To make sure our members and their families are at the table with us, designing their care plans. To give people access to a network of high quality providers. To do all of it with honesty and transparency. And do it together. That’s our promise.


Scott Hunt is a volunteer for Meals on Wheels, an active member of his church, and a decorated Special Olympics athlete. He received the Andy Lineberry Memorial Outstanding Athlete Award in Davidson County for his “dedication and outstanding spirit”. Read his story.