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Grafton Integrated Health Network (PDF Download)

Grafton Integrated Health Network is a specialty behavioral health care organization serving children, adolescents, and adults with complex behavioral health challenges from multiple states.

Their multidisciplinary team includes an extensive continuum of clinical, medical, and academic specialties—physicians, nurses, teachers, psychologists, social workers, professional counselors, speech therapists, occupational therapists, direct service professionals, among others. They collaborate with communities, families, and other health care organizations to provide the best possible care and achieve improved outcomes.

Grafton’s philosophy is “…comfort versus control, helping clients thrive in the least restrictive environment consistent with achieving the best outcome. Our trauma-informed approach provides a supportive, caregiving environment sensitive to clients’ past experiences of violence and victimization.”

Employees & Individuals Served

Grafton employs over 850 individuals, with 650 direct care and education professionals—including six prescribers. Three of those prescribers are board certified child and adolescent psychiatrists.

Grafton works with the most at-risk and vulnerable populations, supporting individuals with autism, mental health challenges, intellectual and developmental disabilities (I/DD), and other co-occurring diagnoses. Grafton provides residential treatment to 180 children/adolescents and 92 adults, and provides education/day support services to 240 children/adolescents and 90 adults. Additionally, Grafton provides services to 647 infants and toddlers—as well as their families—through Infant and Toddler Connection of the Shenandoah Valley. Outpatient psychotherapy and testing services are provided to 1,073 children and 554 adults through wholly-owned subsidiary Dominion Center for Behavioral Health Services.

Service Area

Headquartered in Winchester, Virginia, Grafton provides the majority of its services in three regions throughout the state: Winchester/Berryville, Leesburg, and Richmond.

Although Grafton is located in Virginia, children in need of intensive residential treatment come from all over the country to receive care. The organization partners with local agencies in West Virginia, Maryland, Pennsylvania, Delaware, the District of Columbia, and other jurisdictions in need of its center of excellence services. Through its Ukeru Systems business line, Grafton trains and serves public schools, behavioral health entities, and hospitals in 24 states, in addition to having consulted internationally.

Service Lines

Grafton provides an integrated continuum of care—from short-term stabilization and residential services to outpatient, educational, and career and technical training—helping clients thrive in a variety of settings.

Community-based Therapeutic Day Schools

  • Provides a blended curriculum, balancing academic and functional skills, such as career and technical training, applied behavior analysis (ABA), and speech and occupational services.
  • 180 children on average per school day
  • Total revenue: $10 million

Psychiatric Residential Treatment & Educational Programs

  • Provides intensive, trauma-informed treatment—including ABA—in a large, campus-like setting for children and adolescents with co-occurring psychiatric disorders, including: Intellectual disabilities or autism, and simultaneous psychiatric conditions.
  • 75 children per residential day
  • Total revenue: $16.6 million

Therapeutic Group Homes

  • Provides community-based residences for adolescents and adults, helping them achieve improved life skills and abilities—as well as other challenges that are unable to be addressed in their home environment—in order to lead meaningful, productive lives. Grafton provides individualized supports intended to help clients in group homes enhance skills in areas such as daily living, money management, home maintenance, food preparation, personal hygiene, socialization, leisure and community safety, as well as ABA.
  • 90 children on average per day, 80 adults per day
  • Total revenue: $27.3 million

Early Intervention Services

  • Teaches, coaches, and mentors families of children who exhibit a developmental delay or mental and/or physical condition that gets in the way of their development. Services include ABA.
  • 500 unique children per year
  • Total revenue: $1.4 million

Outpatient Treatment

  • Through its wholly owned subsidiary, Dominion Center for Behavioral Health Services, Grafton provides outpatient mental health services, including behavioral, educational and clinical assessments, and consultations.
  • Payers: Private pay and commercial only
  • Total revenue: $2.2 million

Loudoun Youth Shelter

  • A public-private contract with Loudoun County Virginia to provide emergency shelter housing for children involved with the Department of Family Services, Juvenile Court Services, or Mental Health.
  • Total revenue: $1.6 million

Ukeru

  • A trauma-informed crisis management technique rooted in the belief that physical restraints are not only unnecessary, but also unproductive, and that all intervention should be built on an approach of comfort versus control.
  • Outcomes: Achieved a 99.8% reduction in the use of restraints, and completely eliminated the use of seclusion, dramatically reducing the number of injuries to clients and staff.

Financial Highlights

In 2017, Grafton had $59.1 million in revenue and $57.1 in expenses. Overall, the organization ended the year with a $2.0 million surplus and net assets of $32.0 million. Comparatively, in 2016, Grafton had $55.8 million in revenue and $55.7 million in expenses. Overall, the organization ended the year with a $.04 million surplus and net assets of $29.1 million.

65% of Grafton’s revenue is from Medicaid, 30% is education funding from individual states (District of Columbia, Delaware, Maryland, Pennsylvania, Virginia, and West Virginia), 3% is from grants and miscellaneous other forms of revenue, and 2% is from commercial insurance. For more on Grafton’s financials, see their 2017 Annual Report.Organizational Highlights

  1. Grafton has always been a provider of services for the complex consumer. Most of the population served has both intellectual, developmental, and autism spectrum disorders, along with psychiatric disability. For 60 years, their team has served individuals who have often been turned away from other provider organizations due to their acuity, their intellectual functioning level, or their developmental complexity. From the beginning, at the kitchen table of their founder, Grafton has understood that all things are possible when you start with a clear idea of the consumer’s affinities and preferences. When these are coupled with a universal trauma-informed approach, consumers can make gains that others think are impossible. When evidence-based techniques are employed in a manner that is respectful of the client’s preferences—with the assumption that the client has been traumatized as part of their experience with a disability—you can change a life.
  2. The introduction and development of the Ukeru System led to a 99.8% reduction in the use of restraints, and a 100% reduction in the use of seclusion. It also saved the organization $16 million in staff turnover, worker compensation, and lost time from 2005 to 2016. Grafton also offers its Ukero System to other behavioral health provider organizations, which is now used in 24 states by more than 100 private day and residential programs, private and public schools, psychiatric hospitals, and forensic units.
  3. Grafton has successfully implemented a formal goal mastery initiative—Reliable Evidenced Based Outcome Optimization Technologies (REBOOT)—that seeks to assure objectives established for each individual are clearly defined, meaningful, and measurable. Its structured and sustainable system identifies, monitors, and evaluates client progress, and embeds data-based decision-making into cross-disciplinary planning and treatment. Since Grafton’s goal mastery initiative was implemented, it has consistently exceeded its target goal rate of 80% across the organization. Grafton sold REBOOT via Proventa, Inc., its wholly-owned subsidiary, to Parallax Health Sciences, Inc. in September 2017.
  4. Grafton is often recognized by the industry for its innovative treatment approaches:
    1. The Negley Presidents’ Award for excellence in risk management practices
    2. International Initiative Mental Health Leadership
    3. Commission on Accreditation of Rehabilitation Facilities
    4. National Council Excellence in Behavioral Healthcare Award
    5. Finalist in Virginia Healthcare Innovator’s Award
    6. Recognition from SAMHSA on clinical best practices
    7. Completed the first official, state-wide study of Autism in Virginia, since lauded as one of the best state studies in the nation
    8. One of only four North American providers recognized by the International Initiative Mental Health Leadership as exemplifying best practices in treatment of individuals with complex disabilities

Key Executives

  1. James H. Stewart, CEO/President (since June 2016)
  2. Kent Houchins, Chief Administrative Officer
  3. Kimberly Sanders, President, Ukeru Systems
  4. Scott Zeiter, Chief Operating Officer

To learn more about Grafton Integrated Health Network, please visit: www.grafton.org/  


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