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2010 Behavioral Health Champions.

One of the most important and enjoyable responsibilities I have as editor is to participate on the team that reviews the dozens of nominations that we receive for possible recognition as Behavioral Health Champions. Personally, it gives me the opportunity to speak with these executive leaders and understand the influences, motivations, and circumstances that led them to devote their heads, hearts, and lives to improving the availability, quality, and impact of behavioral healthcare nationwide.

As we recognize our 2010 Champions, let us remember that there is more than one meaning for the word "champion." This recognition isn't about being first. It's about an older ideal: People whose lives, examples, and efforts offer understanding for the misunderstood, direction for those who might otherwise be lost, treatment and resources for those sapped by illness, and the hope of a better life--a life in the community--for all who seek it.

We hope that these stories offer continued inspiration, hope, and strength, not only as you remember the many difficulties and obstacles that you and our 2010 Champions have overcome, but also as you recall the boundless intelligence, imagination, and passion shared within the field--a resource against which no future obstacle can stand for long.

- Dennis Grantham, Senior Editor

William J. Sette

Like many young people in the 1960s, Bill Sette grew up with a social conscience and a desire "to do something" with his life. After graduating from Rutgers with an MSW degree in 1969 (he also holds an LCSW credential), he got involved in social services work in Ocean County, which--then and now--is one of New Jersey's fastest-growing counties. By 1977, the county still had only one mental health service provider, a long waiting list for services, a dearth of inpatient beds, and one of the highest admission/readmission rates to state psychiatric facilities. Additional services were desperately needed.

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Sette, seeing the problems, seized the opportunity, and with the assistance of others, established a new center, now known as Preferred Behavioral Health of New Jersey (PBH). Over the 33 years under his direction, PBH expanded and developed new services to meet community needs and now employs 450 staff, operates in over 50 locations in 13 counties, and has a budget of over $24 million. Bill is president and chief executive officer of Preferred Behavioral Health of New Jersey and its affiliates--Preferred Children's Services and Preferred Behavioral Health Consulting Group--and serves on the board of Preferred Behavioral Health Foundation.

Bill is also a founding member of Peer Partners LLC, the group that developed the Peer Collaboration model, a guide for executive-level peers to help each other find solutions to the things that "keep them awake at night." This process is being used by over 40 organizations nationally and internationally, encouraging leaders at all levels to learn from each other by sharing their knowledge and experience.

Known for his camaraderie and sense of humor, Bill has also been instrumental in establishing and supporting other community organizations, and he serves on many of their boards. He encourages his staff to participate at all levels of government and in all the major community institutions to improve the health of the communities and consumers they serve.

"Working in the non-profit sector requires business acumen, leadership skills, and a passion for a mission that can leave the world a better place as a result of your contributions," says Bill. "That passion drives my commitment and has led to a career filled with the rewards of serving others."

Bill cites the influence and support of others as a critical factor in his success. Through his involvement with public policy on the state and national level, he came to know Debra Wentz, PhD, president and CEO of the New Jersey Association of Mental Health and Addiction Agencies (NJAMHAA), whom he thanks "for her leadership, encouragement, and support." He also thanks Donald Hevey, president and CEO of the Mental Health Corporations of America (MHCA) for his support and for "developing an unparalleled membership of entrepreneurial leaders," along with PBH's administrative team and staff "for their loyalty, support, encouragement, and tireless efforts to fulfill our mission." A longtime member of The National Council, Bill commends Linda Rosenberg and her staff "for their advocacy at the national level on behalf of the community behavioral health system."

Bill serves as president of the New Jersey Mental Health Institute, as a member of the Board of Directors of NJAMHAA, and as a member of MHCA's Board of Directors. He is certified as a trainer in the Ken Blanchard model of High Performance Teams.

Position: President and CEO

Organization: Preferred Behavioral Health of New Jersey

Location: Lakewood, N.J., serving 13 counties at 50 locations

Services: 60 mental health and substance abuse programs including outpatient therapy, day treatment programs, integrated case management, medication monitoring, residential services, supported education, vocational services for adults, specialized services for seniors, and children's services including an adolescent shelter, school-based programs, supervised visitation, and foster care support

Staff: 450

Gary Van Nostrand

As a high-school student, Gary Van Nostrand watched friends and family members struggle with mental health and addiction problems and wondered, "How do these things come to be?" Through college and graduate studies in clinical neuropsychology at Tulane University, the University of Florida, and the Mayo Clinic, his curiosity grew into a fascination--and a career.

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While he published his would-be doctoral thesis, Dual functional asymmetry of the brain in visual perception, Gary never finished his doctorate. Instead, he gained many of the professional skills he would depend on every day on the job, administering multi-county drug and alcohol counseling services in Iowa, then West Virginia, before moving to a similar program at Princeton Medical Center. He even left the field for stints in HR consulting and home healthcare services, though he kept ties through a board chair at SERV Behavioral Health System, Inc.

His business acumen made him a natural choice to participate in SERV's CEO search effort in the late 1990s and then, following a leadership crisis, to step in as the organization's CEO in 2002. There were painful changes as the organization's "silos" were dissolved in favor of a team approach and voices, including his, challenged what he describes as SERV's "authoritarian" model for delivering services--especially residential services.

"We told residents when to get up, when to go to bed, when to eat, and how to behave. Every residence had a long list of 'House Rules,'" Gary recalls. "Our professional staff had the attitude that they knew best and residents should do as they were told in order to get 'better.'" Quickly, however, Gary realized that the culture wasn't working for residents. "I didn't see people developing the way I thought was possible, taking responsibility for their own lives. And I don't think you can be well and not be responsible."

With the support of board members, Gary and his team "did some research into how recovery-focused changes worked" and developed a plan and evaluation methods for a two-year shift to recovery-focused programs, starting in 2005. They got results--including one result that Gary calls "totally unexpected."

"The most interesting finding [of the recovery-focused program] was one we hadn't expected. We found a 29 percent reduction in hospitalizations compared with the period immediately preceding the program. The hospitalization rate was not a focus of our study-more of an after-thought. Clearly, however, something changed."

Gary speculates that the new focus fostered stronger relationships. "One of the major problems [for our consumers] is isolation: 'Nobody understands me.' Yet if the individual is connected to an individual or a team of individuals, there's a feeling that 'they know what's going on with me' and a trust that the team can be there at tough times."

Among the hundreds of consumers who were, or are, involved in SERV programs that transition them from illness to recovery and isolation into successful educational or employment experiences, these findings offer reassurance, says Gary.

"As some people get better, they get jobs, but then face the challenge of keeping them. They don't have the right habits," he says. "When they're having a bad week, someone can come in and help them by providing an example and offering support. It's the kind of thing that prevents an occasional setback from being a major setback."

Position: President and CEO

Organization: SERV Behavioral Health System, Inc.

Location: New Jersey

Services: Residential mental health, residential developmental disability (support for co-occurring disorders), day programs, outpatient treatment programs

Staff: 750

Denise Bertin-Epp

Though she's becoming known for her leadership in quality and process improvement in one of the country's leading substance abuse rehabilitation hospitals, Denise Bertin-Epp's most valuable training occurred outside healthcare. After leaving Greenbrook Recovery Center to become Brighton Hospital's director of nursing in 1999, Denise found that her desire to drive change was at odds with Brighton's paper-based culture. At the time, she says, it was "a bad fit." So for two years, the ISO-certified, Six Sigma Green Belt (she also holds a bachelor's in nursing and a master's in healthcare administration) served as a quality consultant to Michigan's automotive, electronics, and manufacturing industries.

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"I worked in a couple of startup companies and became an ISO auditor. I was able to look at the process improvement methods used at a lot of non-healthcare companies. My husband Jack, who's an industrial engineer, used to talk about quality indicators like scorecards, benchmarks, or process improvement methods like kaizen exercises and fishbone (problem solving) diagrams. Ten years ago, those weren't things we used in healthcare. Yet, we use them now."

Denise got a chance to put her knowledge to work at Brighton in 2003, when in the face of a declining census and growing financial concerns, she returned to take on the dual post of chief operating officer/chief nurse. The falling census led to falling revenues and pressure to cut programs. Not exactly a recipe for growth, Denise recalls. With board approval, she led efforts to stabilize operational, financial, and clinical indicators; implement creative clinical programs; revamp the hospital's organizational infrastructure; integrate medical and administrative leadership; affiliate with a nearby hospital system; and, finally, to drive 20 percent growth in each of two years.

Today, as president/chief nurse, Denise's process improvement and quality focus extend even further at Brighton, which has now implemented ISO, Lean, Six Sigma, and JCAHO certification facility-wide. "If we believe that this [addiction] is a disease, behavioral healthcare has to adopt the same standards that acute care uses--things like fall risk or suicide risk, for example. We've got to measure those indicators so that we can look at chronic illness outcomes on a quality continuum, much the same way they do in the manufacturing world. My leadership team here at Brighton are all Green Belts in Six Sigma. They've got to be able to do it."

When it came time for Brighton to develop an electronic medical records system, Bertin-Epp and her team used the same approach. "We picked an ISO-certified vendor, one that used the same quality parameters [and] the same process improvement methods that we did." While developing the EMR system, her team took on a host of concerns, including medication errors and the expense of clinical dictation. Targeted teams, using kaizen exercises, analyzed possible errors and inefficiencies, then designed processes to prevent them. With the system, which the Brighton team implemented $1.2 million under budget, medication errors fell 65 percent while template-based dictation cut clinician time dramatically. Just three years later, Brighton Hospital and Medical Communications Systems are now launching ebhr, an electronic behavioral health record system, to the behavioral health industry.

In this era of reform, when many in behavioral healthcare look warily to a future dominated by unfamiliar concepts and new terminology--EHRs, EBPs, comparative effectiveness, and more--champions like Denise show us that we have much to master, but little to fear.

Position: President/Chief Nurse

Organization: Brighton Hospital

Location: Brighton, Mich.

Services: 132-bed substance use rehabilitation hospital offering inpatient programs for individuals (co-occurring disorders, medical and legal professionals, adolescents) plus outpatient, life-long recovery, education, and research programs

Staff: 135

Franklin D. Lisnow

Raised in Brooklyn by parents who "always saw people for what they were," Frank Lisnow had three gifts that would shape his life: A desire to "give back," an ability to see the best in people, and a pragmatic, street-wise approach to solving problems.

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After earning a business degree, Frank quickly found that work as an industrial engineer "didn't seem to fit." With his wife, he moved to Vermont, taking a job at a men's correctional center in St. Johnsbury. Despite a lack of formal training, he got a job protecting and counseling these troubled individuals "because I was a big guy." Before long, "A light went off. This is what I want to do," he recalls. "I want to work with people who are in trouble."

After seeing the impact of drugs and alcohol, "by far the largest source of problems for the men at the correctional center," Frank sought a job in community drug and alcohol counseling 18 months later. Again, despite a lack of formal training, he fit in easily at Northeast Kingdom Mental Health, impressing director Vernon Barry with his street skills. "I grew up on the streets of Brooklyn," he says. "I understood the street and understood people who had those types of problems."

Looking back, he acknowledges, "I couldn't get a job today with what I had then." But it didn't matter. "[Barry] saw something in me that he was willing to take a risk on. He taught me the ropes." Inspired by Barry's confidence and his own passion for the field, Frank completed formal professional training, earning MEd and MAC degrees.

His 16 years with Barry--from 1972 to 1988--not only taught him management skills, but an eclectic, consumer-focused approach to mental health and chemical dependency treatment. Frank sees it as a combination of recovery and mental-health approaches (12 Step, pharmacology, behavioral therapies, and more) tuned to an individual's needs. He continues to practice this "person first" approach today.

Noting that 12-Step fellowship is vital, for example, Frank suggests that an anxious person needs other tools--perhaps medication and behavioral approaches--to make that fellowship successful. "Let's put the best of both worlds--recovery and behavioral health-together," he asserts. At Northeast, Frank became active in NAADAC, ultimately serving as its president from 1986 to 1988. At the time, he got to know Dave Lombard, a NAADAC board member associated with Clearbrook, a 100-bed chemical dependency center in Wilkes-Barre, Pa.

Lombard brought him to Clearbrook, where, in 16 years, Frank learned "how to run a business, when you've got to make money to pay salaries, meet expenses, and continue the mission of the organization--which is to help people." He observes that "too many non-profits run like non-profits and wonder why they've gone out of business," adding, "Compassion and good business are not incompatible."

Frank made what he calls his "final" move to the Center for Dependency, Addiction, and Rehabilitation (CeDAR) in 2005. Created by the University of Colorado Hospital, CeDAR gave Frank "the chance to practice what I thought was quality behavioral health treatment in a quality chemical dependency center. It's a place where people can get everything they need to turn their lives around." Since his arrival, CeDAR has aspired to be a top treatment center for chemical dependency and co-occurring disorders. "We can deal with more difficult patients--patients that not every facility can handle."

Calling CeDAR his "swan song," Frank reflects, "This was an opportunity to leave my mark. When I retire, I'll know that I did what my parents asked of me: I gave back."

Position: Executive Director

Organization: Center for Dependency, Addiction, and Rehabilitation (CeDAR) at the University of Colorado

Location: Aurora, Colo.

Services: Comprehensive diagnostic assessment and treatment services to help individuals and their families overcome addiction and co-occurring disorders, including residential treatment, extended care programs, family programs, and alumni and aftercare support groups

Staff: 50

Robert E. Whaley

After 11 years as chief financial officer at Southeast Behavioral Health Group, Bob Whaley earned consideration for the job of executive director when it opened up in the late 1990s. Though he was trained in accounting and finance along with his MBA credentials, he had learned much about how the organization operated, its clinical programs, and had gotten to know dozens of the consumers that it served.

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Bob got the job, but then realized something was wrong. "This agency was in trouble. We knew we were spending most of our resources on a small population of individuals affected by serious mental illness," he recalls. "Our community was saying, 'You don't have outpatient services, you don't have children's services, there's nothing for substance abuse treatment.'"

Together with his staff and board, he looked for a better way forward--a way to better balance the financial needs of consumers' care with those of the community. Research led Bob and his staff to a new approach called "recovery" that would place empowered consumers into the community, but with a framework of support.

Financially, it was perfect. It would reduce the cost of care and free up resources for other tasks. But, Bob wondered: "Was it right? Was it a responsible thing to do?" He found the answer one evening, sitting in a shopping mall, where he noted that more than a few of the shoppers looked familiar. Finally, he realized: They were consumers from the agency, accompanied by case managers. "If it weren't for the case managers," he says, "I wouldn't have known them from anyone else."

"They are just like me," he thought. "They have their days when they need support, but then, so do I. Our role is to support them in the lives they choose." With help from Ed Knight, PhD, a schizophrenia survivor and recovery advocate, Bob and his staff built a recovery-focused plan. Bob won board approval for agency-wide training and set a date for program launch in 2000.

"We figured that we could move our [120] people into the community within two years. But when they found out what we were going to do, everyone was asking, 'Can I be next?'" The moves were done in three months.

Bob says that shortly thereafter, someone asked, "Are community leaders concerned?"

"I replied that 'they really didn't notice.' And that was true. We worked with six counties, six different sheriffs, different communities, and the consumers never had problems. Our case managers kept in contact and provided help when needed, but most consumers got along fine." Today, they still do: 80 percent of those who returned to their communities in 2000 remain in them--living independently, owning their own homes, many in relationships, some married, and virtually all working or volunteering their time. "It's not your life or mine, but it's a life that works," says Bob. "It's their life."

The value of the program--beyond its immediate financial sense and consumer appeal--didn't occur to Bob until, at Ed Knight's suggestion, he presented at a conference in 2002. But it wasn't just any conference--Bob spoke to the "coercion and control" track of a national consumer conference. The response was immediate, Bob recalls. "They could see there was a better way."

"Until then," he says, "I hadn't realized that recovery was such a big deal. Then it hit me: We had a responsibility to make this work for our clients and to communicate it to others, so they could benefit, too." Joining other recovery advocates, Bob and his staff have made countless presentations since, with their own organization's success to offer as proof.

Position: Executive Director

Organization: Southeast Behavioral Health Group

Location: La Junta, Colo., serving six southeastern counties

Services: Comprehensive outpatient mental health, substance abuse, wellness services, early childhood services, and nursing home services

Staff: 75

MORE ONLINE: To read about past years' Behavioral Health Champions, visit www.behavioral.net/champions. Don't forget to visit the organizational Web sites of our Champions (listed throughout the text) and to nominate other worthy senior executive leaders, starting next spring, for recognition in 2011.
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Title Annotation:LEADERSHIP
Author:Grantham, Dennis
Publication:Behavioral Healthcare
Geographic Code:1USA
Date:Jul 1, 2010
Words:3344
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