2013 Annual Report

126 Elk StreetRock Springs, WY 82901

Phone: 307 362 6029 Fax: 307 362 2379Email: ablehands@4securemail.com

Facebook: facebook.com/AbleHandsRSTwitter: @AbleHandsRS

2013 Summary Statement

Able Hands is a private for profit schedule-C Corporation owned by Josh Bellamy and Gordon Mickelson. Incorporated in December 2006, Able Hands has grown from a company with three employees, counting its owners, to a small employer serving multiple individuals with developmental disabilities and acquired brain injuries.At the close of 2013, the staff, participants, guardians, owners, and other stakeholders are proud to celebrate our achievements, excited to address our shortcomings, and look forward to the challenges and growth opportunities 2014 is certain to present us.Able Hands continues to benefit from close and collaborative relationships with the many diverse providers of services, from CARF accredited agencies to sole providers, in our community and beyond. These relationships facilitate our ability for growth, improvement, and to offer services to our participants beyond our lone capacity.

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2013 Quality Improvement Goals and Business Planning

We had set four major business goals for 2013.

GOAL 1) To purchase our group home property located at 3508 White Mountain Boulevard by December 2013GOAL 2) To remodel our current media room in to a participant friendly and useful exercise room by December 2013GOAL 3) To adapt our current financial model to reflect changes within the funding and services models driven by the Department of Health, Behavioral Health Division, Developmental Disabilities Waiver Program (Waiver)GOAL 4) To explore expansion of Able Hands as a corporation and brand

We are grateful to have the open and informal relationship with our stakeholders necessary to set and obtain our goals organically.

2013 Quality Improvement Goals and Business Planning

OUTCOMES

GOAL 1: In May 2013, we had a fair market analysis of our group home property located at 3508 White Mountain Boulevard completed. We made an offer that same month to the previous owner of the property, Randy Tabuchi, based on that analysis.Our lender, US Bank, had some staff changes. We became acquainted with our new business mortgage broker, Kaitlyn, while beginning the financing process in June 2013.In July 2013, our ducks were all in a row and the only remaining item was a signed contract from Mr. Tabuchi.We closed on 3508 White Mountain in October 2013.We were able to plan for and achieve this outcome by using careful financial planning and diversity to obtain the required financial resources needed by US Bank.

Additionally, we cannot express enough our thanks and appreciation to Randy and Kathy Tabuchi for their help and support.

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2013 Quality Improvement Goals and Business PlanningOUTCOMES---continued---

GOAL 2: In March 2013, Josh and Gordon met to design and seek input on design of a user friendly and functional exercise room. In consideration of responsible fiscal management, we set a budget for this project of $3000.After seeking bids and receiving two, we selected Ricks Remodeling and Repair (Ricks) to complete this project. While we have extensive experience with the other bidder, Monte Vista Construction, and with Ricks, the difference in estimated cost and known quality of both contractors, made Ricks the obvious choice.In August 2013, Josh and Gordon met again to review this project. Given the unknowns in future funding models and the potential negative impacts those unknowns might pose, we determined to scale back this project for 2013 with the intention of seeking alternative funding sources to realize our initial goal in 2014.When we met with our participants and staff to explain our reasoning behind our decision to scale back this project, they strongly suggested we purchase a Wii. So, in September 2013, we purchased a Wii video game system. Josh and Gordon wish to acknowledge this request as a solid and functional solution to a disappointing problem.

GOAL 3: Josh, Gordon, or both attended every Joint Labor, Health, and Social Services committee meeting, met with Chris Newman, Director of Behavioral Health, and Joe Simpson, Director of Developmental Disabilities Sections on July 1, participated as a stakeholder in the Waiver redesign, advocated with local and interested legislators from throughout our state, and disseminated all information in our possession that we were permitted to distribute to all stakeholders. We orchestrated monthly luncheons with case managers, reached out to fellow providers, and included all stakeholders in discussions regarding the changes to the Waiver model and its potential funding impacts. We included staff in discussions and voting on

possible changes to our policies on wage increases and biannual performance bonuses, that could result from the proposed changes.While the outcome has yet to be determined, expected in 2014, we do not anticipate significant impacts to our financial stability based on the latest information release in November 2013.

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2013 Quality Improvement Goals and Business PlanningOUTCOMES---continued---

GOAL 4: Resulting from the uncertainties of Waiver funding in Wyoming and from feedback provided to us from stakeholders, we determined our best course of action is to diversify our income sources. To that end, we have explored various options available to us and sought guidance from experienced business people, property developers, and realtors.We explored purchasing a triplex, a four-unit apartment, single-family homes, and other options. Given the volatility of commercial property and the unresolved Waiver funding changes, as well as using the advice of experts in this area, we decided to hold off on making such a purchase in favor of holding operating reserves.For 2014, we are exploring adding psychosocial services and seeking Medicare certification.

2014 Quality Improvement Goals and Business Planning

STAKEHOLDER PARTICIPATION

On that note, we are seeking input on our Quality Improvement Goals and Business Plans for 2014. We would like feedback from all stakeholders, ideas for diversification, and your opinion on what direction we should direct our energies in the coming year.Please write, call, email, fax, drop-in, or otherwise let us know prior to February 15, 2014 your thoughts and suggestions on these matters or anything else that is on your mind.We will hold a strategic planning meeting for all stakeholders on February 8 from 1:00 PM until 3:00 PM for anyone who would like to participate in our process. We welcome and encourage your participation in our continued improvement and success in 2014.

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Changes to the Department of Health, Behavioral Health Division, Developmental Disabilities Waiver Program Coming in

2014As we continued to communicate with you through letters, by phone, and by hosting our open informational meetings, major changes to the services funded and regulated by the Waiver are coming in 2014. Additionally, while no Waiver forum was originally scheduled for the Rock Springs or Green River area, Josh and Gordon persistently argued for the need to have one in our community. The Waiver directors graciously conceded, scheduled a forum for May, and had quite a large attendance with a majority attending being individuals with developmental disabilities. We are very proud of facilitating this opportunity for public feedback.In October 2013, the new Supports and Comprehensive Waiver documents were submitted to the Centers for Medicaid Services for review. Gordon served on the Stakeholder committee developing the new Waiver programs until September 2013. As communicated to you, our stakeholder, Governor Matt Mead, Senator Charlie Scott, Representative Harvey, Chris Newman, and Joe Simpson, he was not comfortable with the structure of or representation of the decisions made by the committee. Jamie Staunton, Communications, Policy, Research, and Training Manager, kindly continues to provide Gordon with ongoing stakeholder committee documents, in spite of his decision.Josh and Gordon have attended all Joint Labor, Health, and Social Services meetings since October 2012, met with Chris Newman and Joe Simpson, Director of Developmental Disabilities Sections in July 2013, and been in constant communication with both our local and interested legislators from throughout our state continuing to advocate for changes that will benefit recipients of Waiver services and retention of those current services that work well.We are glad to report the introduction of conflict free case management, reduction of all workshop employment services, and increased efficiency of service delivery. Governor Mead has included an increase in funding for Waiver services in his budget for the 2014 fiscal legislative session.Unfortunately, as a result of strong pushback from some providers, the changes are not as extensive as hoped for and, though a solid move in the right direction, do not bring Wyoming as far forward in delivery of Waiver services as initially hoped. Additionally, as the Waiver has not been able to finalize their funding and assessment models on schedule, we will not have information regarding the actual impact on our finances until February or March 2014.We urge all of you to continue contacting your legislative representatives, to attend any forums about the changes, and to provide public feedback in a timely manner to ensure your voice is heard in this process. Our legislative representatives are receiving more opinions on these changes than on almost any other topic. A written letter or email prior to the start of the 2014 legislative session is likely to provide a real and tangible impact on the availability of services provided within our state and to the current and future recipients of Waiver services.

For assistance in contacting your legislature, please contact us at your convenience.

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Notable Events of 2013While hesitant to write a round-robin letter, we accomplished many things this year that we feel important to share with you. 2013 was an active and exciting year. We hope to communicate our joy in our successes allowing you to participate in that joy. With that tentative beginning, we offer the following for your consideration.

Group Home Changes

Having been lived in since 2010, several of our group homes were in need of some updating. We had flooring replaced, installing laminate selected by the residents of those homes. Additionally, we spruced up the places by having new paint, fixtures, and other honey-dos completed.

Our priority in operating our homes is reflected in our use of the word home to describe them. We seek to avoid even the appearance of an institutional living situation by using single-family language, treating the people who live in the homes as true residents with the rights of renters, and conducting ourselves as guests in a home. We are committed to this not only because it is right, but in recognition of the psychosocial stressors present in any living arrangement where one lives with other renters and has the intrusion, no matter how necessary, of supports. Additionally, the environment of our group homes is created and selected by those individuals who call them home.

Further, we are committed to promoting the development of the physical and psychological skills needed to transition from a 24-hour residential care facility to a supported independent living setting. Our work in this area extends beyond staff training and monitoring, the support of participants and development of their skills, and a corporate philosophy promoting independence of all people. We reach out to and provide education to guardians to assist them in taking the courageous step to allow their participant to risk independent living.

126 Elk Street Changes

We often joke that we maintain an 11000 square foot building for ten hours use weekly. Regardless, the 6000 square feet we use for day habilitation services was starting to show the wear after four years. We had the carpeting replaced with laminate flooring, serving a dual purpose of improving the aesthetics of the building and reducing risk of tripping. Painting was completed on all areas needing a refresher.

We instituted a seasonal decorating program driven by the initiative of participants and staff. They approached us requesting a more festive and engaging environment, requesting financial support from us. We are

delighted with their commitment and efforts to keep our building looking its best.

Josh and Gordon want to thank our participants and staff for their self-directed initiative in this improvement.

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Therap

In seeking to improve our internal oversight, quality of documentation, and reduce inefficiencies, we began switching to Therap Services, a secure online documentation system, in June 2013. This was a major change in how we operate. Our staff was excellent in their commitment to our new system. While we continue to iron out the wrinkles, the efforts of staff, some of whom had never used a computer prior to our instituting Therap, are impressive.

In making this change, we positioned ourselves to comply with the requirements for digital medical records, improved our ability to provide internal oversight for billing, medication monitoring, medication safety, appointment tracking, improved outcomes management, and a slew of other benefits. The expense of subscribing to Therap has not only been offset by a reduction in need to purchase ink, paper, and replacement printers, it has resulted in a long-term cost reduction. We will continue to add new modules of service and increase our use of Therap as it is needed and beneficial to our participants, staff, and stakeholders.

Finally, implementing Therap greatly increased guardians and case managers' ability to stay current with their participants' daily activities, goal achievement, medical appointments, behavioral incidents, and related. We have offered multiple trainings to assist these stakeholders in using Therap as a tool to interact with us. We are working with the local police department and hospital to provide them with similar access. We hope to improve their ability to quickly retrieve information necessary for the health and safety of participants who might find themselves without someone to assist them in communicating in an emergency.

ActivitiesWe took many trips this year. Participants brain stormed constantly throughout the year and informed us of the places they would like to go and activities they would like to attend. Participants took shopping trips, went white water rafting, spent a week in Las Vegas, competed in Special

Olympics, visited friends within the state, attended advocacy day at our state legislature, went to MEGA Conference, and generally had an active year.

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Activities ---continued---

The 2013 MEGA Conference deserves special attention. Our corner of our state is often disparaged, unfairly. When the categories for the 2013 Bright Star Awards were announced, we reached out to our community to advocate for the people who do such great work without acknowledgment.

For the 2013 Bright Star Awards, there were six possible categories. Person with a disability, Professional working with individuals with disabilities, Large employer of individuals with disabilities, Small employer of individuals with disabilities, Educator, and Family member. We mailed nomination forms to all stakeholders, met with local community leaders, and strove to ensure people completed and returned their nominations for the people they felt deserved this honor.

For the first time in over a decade, Rock Springs was well represented, in both nominations and awards. Lorrie Travis, an independent case manager serving individuals with many different providers, won the Bright Star Award for a Professional. Wendy's, a remarkably managed business with a philosophy we hope to encourage throughout our state, won the Bright Star Award for a Small Business Employer. Sweetwater County School District #1, our community's single largest employer, won the Bright Star Award for a Large Business Employer. Most exciting of all, our own Alana Griffiths won the Bright Star Award for a Person with a disability. MEGA conference was an exciting and heady time for the folks from Rock Springs.

National Disabilities ConferenceBrian Tronquet, member of the Governor's Council on Developmental Disabilities, and Josh attended a national disabilities conference with Council staff in Washington D.C. They brought back many new ideas. Brian is currently working with Council staff and Griffin-Hamm to help bring an employment first philosophy to Wyoming.

2014

We look forward to learning what new and exciting activities we will do in 2014. As soon as our participants decide and tell us, we will let you know.

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2013 Financial SummaryAble Hands continued to expand services, provided services to more participants, and increased gross revenues by almost 15% in 2013 when compared to 2012. We are proud of the quality work done by our staff, the faith our stakeholders have in us, and the growth seen in participants, as a direct result of their hard work and commitment, which resulted in 2013 being a great year for Able Hands. With the new Waivers due to be fully realized by the mid to late summer of 2014, we predict our gross revenues in 2014 will be within 5% of 2013 revenues.As you will see on page 10, our single largest expense continues to be wages. Having stated that, we want to clarify, from our perspective, this is our single greatest business investment. Without consistent and qualified staff, Able Hands would not be the provider of quality services that ensure the continued success of our participants. As a result, investing in our staff is an investment in the future of our company.

We added four new staff at the start of 2013 and lost two to greener pastures. We are exceedingly proud we are able to continue with our 90% net staff retention rate. Our continued ability to maintaining consistent and qualified staff strongly informs our ability to assist our participants in realizing their personal aspirations and growth.

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0% 0%

3%

0% 0%

2%1%

2%1%

2%0%

3% 1%

66%

5%

0%1% 8%

1% 1% 0%

3%

2013 Expenses as a Percentage of Total Income

AmortizationAdvertisingAutomobileBank ServiceLicensesClient ExpensesContract LaborDepreciationInsuranceInterest ExpenseMeals and EntertainmentGroup Home SuppliesOffice SuppliesWagesPayroll TaxesPostageProfessional FeesRentRepairsTaxes, PropertyTravel ExpensesUtilities

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Letter from the OwnersJosh and Gordon thank you for your continued participation in the success of Able Hands. Without the ongoing input from participants, guardians, staff, fellow providers, community members, social services agencies, medical providers, and all stakeholders, Able Hands could not continue to grow as a company and would surely stagnate in future. We cannot do this without you and would not want to try.

We continue to work on improving our service quality through participating in formal accreditation and certification processes, monthly meetings with the management team, ongoing review of service delivery, use of Therap, and other efforts. In spite of our efforts, there is one single quality we have that we hold above all others. This single greatest asset is the familial and informal relationship with have with our stakeholders.

Participants, guardians, staff, and other stakeholders ongoing ability and willingness to access Josh and Gordon for concerns about services, requests for changes in service delivery and format, for things as simple as help setting up a computer, or helping community members outside of the Waiver system provides us with constant feedback, improved awareness of the needs of our extended family, and a satisfaction that extends beyond the material.

Gordon continues to serve on the Sweetwater County School District #1 Board of Trustees. Currently, he is working with the Wyoming Department of Education, Governor's Council staff, and district leadership on facilitating a pilot program in Rock Springs for an alternative diploma system to prevent individuals with disabilities being forced to receive an "attendance" diploma.

Gordon was recently appointed to the Board of Directors for the Sweetwater Community Health Center. This is an exciting opportunity to help expand medical services for our both community at large and individuals with disabilities. Josh will be joining this board soon.

As this is Gordon's last year of service on the Governor's Council, Josh has applied to fill a vacancy starting in February. We are optimistic regarding his chances of being selected. As the lead organization for recommending policy to our Governor, it is crucial we maintain this relationship.

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Josh continues to provide our company with exceptional leadership, volunteers for the local competitive traveling youth soccer club, and is active with our local Chamber of Commerce and real estate community.

Josh and Gordon continue to develop relationships with local, state, and federal elected officials. We hope to provide them with positive information regarding the need for increased independence of individuals with disabilities.

Josh and Gordon thank you for a wonderful year and look forward to more excellence in 2014.

If you have any questions or concerns about this report or anything else, as always our doors (and our phones) are always open to you.

Yours faithfully,

Josh Bellamy, Owner Gordon Mickelson, Owner307 371 6666 307 389 9169

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Able HandsServing our community and each other since 2006

Together by circumstance, family by choice

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