8 | The Alumni Advantage: Reducing Relapse & Increasing Census

most behavioral organizations focus heavily on admissions, but what happens after discharge often determines whether it's long-term recovery and the outcomes and for that matter also the future census stability. In this episode we're going to talk with Gina Thorn, who's executive director at T-PASS, treatment professionals and alumni services, to explore how intentional alumni engagement produces relapse rates, but Strenson's community trust and creates a sustainable, ethical growth engine for treatment centers. This conversation bridges clinical outcomes with community building, business stability growth and showing why alumni programs in my opinion and I know our guests as well is no longer a nice to have but a mission critical element. Welcome Gina to the Elevate Podcast. Hi Gary, it's good to be here. Thanks for having me. Absolutely. When waiting for this conversation eagerly, I know we're both very passionate about this topic, so it would love if you could maybe just tell our audience a little bit about T-PASS organization, you know objectives, etc. Well it's one of my favorite things to talk about. I have been affiliated with T-PASS, which actually stands for treatment professionals and alumni services. Very excited to say that we're celebrating our 15-year anniversary this year, and I actually had the opportunity to interview the two founding members of T-PASS this last week to talk about the origin story of how T-PASS came to be. And what's really exciting is that T-PASS was born from a place of curiosity. There was a alumni professional who was working for a program in Colorado. She was appointed into the position which most alumni coordinators are. She had no idea how to build an alumni program, which most alumni coordinators don't. And so she started making phone calls. She started calling sort of the go-to programs in the industry that were doing alumni like Betty Ford and Hazel did at the time and Karen Treatment Center and some of these other bigger organizations to inquire about what does an alumni program look like. And through her curiosity, she was connected with Leonard Bade, who was directly responsible in working with Betty Ford, who charged him and a handful of other alumni coordinators to go out and build relationships with alumni. And so Lori, who was the alumni coordinator, who was sort of looking for answers and Leonard both came together and said we should probably bring people together to start talking about this idea of collaboration engagement. So years ago we had our first what we call collaborative. It was an opportunity to bring alumni professionals together to talk about the issues and challenges that they have, but then also utilize them as teachers to address how to do the job, how to make it work. So we became teachers and learners in a space that's often considered to be in many ways very competitive. And so our goal was to find a way to help support each other and to learn from each other so that we could grow robust alumni programs. And so 15 years later, we have over 110 organizations within the behavioral health space that represent over 190 alumni professionals who are all tasked with growing and building alumni programs for their treatment facilities. Fantastic. Thanks for the overview and furthermore, thank you for the great work you're doing. I mean, I'm obviously preaching to the choir in terms of the significance of having a strong alumni program for the individual care purpose and the outcomes. And I think that's a good segue to, you know, when I speak with facility executives, we look at very much from where a growth engine for the facilities and unexplored opportunities, typically the alumni, but I always say it's not just as a way to get re-admissions or referrals and increase engagement. It's also a way to just maybe align it with the future of the industry, which I believe would be very outcome focused and secure that people have the highest probability of sustaining the recovery. So with all that said, what do you see as the common pitfalls, mistakes that treatment facilities do when you engage with them first and assess that alumni program? So it's interesting because alumni programming back in the day was always seen as an ancillary support to treatment. It was never designed or at least initially it wasn't designed as a vital part of the recovery journey. Many facilities looked at it as a, well, this is a nice thing to do. We can keep our alumni connected to us, but really, is it have any kind of power in regards to either a financial value or in many cases, just a long-term outcome recovery value? And so, oh, time, what we've been able to do at TPS is we've been able to do a significant number of studies with our alumni professionals to learn from them about the impact that they're experiencing, both from a business case standpoint, but then also from a standpoint of how are these folks doing after they leave treatment? And oh, now that the longer someone stays in the pipeline, the longer that they're more engaged in treatment or a heart continuum of care, the higher probability of them staying well and staying in sobriety. And so the concept is really built around this idea of shared community, making sure that we're building support systems, that we're offering resources and tools. And many times what we find is that when you talk to our treatment providers, they think in good faith we should start an alumni program, but what we see is often they don't know what to do. They don't know what it looks like, so that high somebody into an alumni position, and that individual will do really well but not have the bones of how to build an alumni program. What we have had to do as an organization is to help create an infrastructure to support alumni professionals and their organizations in doing their work. And back to that conversation on outcomes, what we learned was that if we can keep a client well and they're doing well in their recovery journey through the immense host or the support groups that we offer or the telephonic support that we're offering to them, then that ultimately contributes to the treatment centers outcome data. And that also allows them to go back into renegotiate rates with their third-party payers to say, "Look, my people are doing really well. They're fostering good recovery. We've built out this robust alumni program where they're staying engaged and sober longer." And third-party insurance says, "Look at that and say, "Well, if you're not seeing high recidivism and your folks are staying well, we should give you a higher reimbursement rate per day." And so that piece of it is really compelling. The second that's really compelling for a lot of business owners is the cost per admission. So where are you? White paper study in 2018, we talked with alumni professionals who were doing strong alumni programs. And what we learned was that when they did the job right and we were building strong alumni opportunities or community engagement, they were seeing that over 50% of their referrals were coming from alumni. Number one, and number two, the permission for a referral was averaging between $800 and $1,100 per admin. If you built that against a business development or a referral, those numbers are now upwards between $2,510,000. So the delta difference between the alumni referral and the business development referral was almost like, why are you not doing it? It's almost like you're money on the table if you don't do it. Oh my god, Gina. I mean, I'm almost shedding it to you here. We caught our same cloth here. Matter of fact, let me show you a quick slide that can you pull up the slide? Okay, one step ahead of me. This is what we call the elevate hierarchy of patient acquisitions. So this is basically based on current 40 facilities, but also a lot of consulting work input from our strategic partners as performance data. And to your point, alumni referrals is a no-brainer, most sustainable channel, the most successful facilities, depending on the best count, will have that upwards 50% of, and very often it's five to 10% frankly. And that's, I think, where it's really important to understand the metrics, what's driving the sensors, having track and attribution in place. And if you're not in that high in a 50, write it down, contact Gina right after this call, because not only is it ethically best for your patients and the outcomes and the future negotiations with the insurance providers, but it also is very profitable. And it compliments well with local SEO business development. And I always say like when people run ads, that's really the last portion of your marketing strategy. It's not earned, it's not owned media outlets, it's not something you can build upon. You turn off the credit card, it stops the song stops, right? So alumni is really the most sustainable long-term effective way to do it. So I just wanted to double down on what you said. I love your graphic, and I would love to, I'd love to borrow your graphic because you're exactly right. And the other thing, the other thing to point out is that your alumni are your natural brand ambassadors. So we talked outreach professionals who have to go and open new markets, or if they have to establish relationships with new referral partners that can take sometimes months to get their trust. We have an alumni that has walked the walk of your program and is walking and talking about the success of what they experienced. They're going to be your natural brand ambassadors. And that was, that's one of the primary reasons why your admissions from alumni are so low is that you're not having to put big dollars against it because they're going to talk organically about your program anyway. Some people were like your, they're like the billboards for your brand. And so we are cultivating them and their relationship piece as a relates to what they need after they leave treatment. If we're keeping sticky to our programs for at least a year, where they're utilizing your program as a part of their recovery toolbox, they will canically keep you top of mind. They will talk to you in their social influence. And at the end of the day, if they get, if they get sick or they need extra help or if they have members of their community that do, they're the first person you're going to call. So it almost seems negligent for us not to be taking care of our alumni. Almost as much as we take care of our referral partners. Yeah. Yeah. I mean, we even go to the extreme here to elevate where, you know, we have like, when initially the backstories, I went from a large agency to launching a amount of facility and pivot into, we do these like white legal planners. So in the last pages, there's like a QR code. So alumni can get connected with the app. I know you have that as a channel. And they can also leave a review for that matter because you know, it is the best and best at its three point, but it also influenced the search algorithm. And Google looks at it. It's an entity that has the expertise, experience, authority, trust from the patients. They look at it as like consumers. Like we go to Amazon and do a shop. We always look at the reviews. So I agree with you wholeheartedly. What about you, you mentioned like what is a good alumni program look like? There's different. If you were to say, give me short and a down because I know that's a lot to unpack, but like the top five ingredients, the top 10 in the alumni successful framework. It's such a great question because I get this frequently from folks that are inquiring about whether or not they want to join T pass and become a member. Will you make our program successful? And success is actually very individualized based on the nature of the program that you run. So under the umbrella of what we offer, obviously we work with any behavioral health organization. So it can be a mental health facility, eating disorder. It can be a SUD, of course. That's how we kind of cut our teeth in the early days. We look at alumni programming as being responsive to the culture of what you're creating. So it could very well. I always say once you see one alumni program, you see one alumni program because they're all going to be different. But what we try to do is we try to focus on some core areas. So the first area that we really want to focus on is obviously community engagement. We believe very strongly. People stay well in community. We know this first part that's been proven time and time again in the data that if we're building strong recovery communities, people will connect with those and they'll stay in those communities. So how do we foster a strong recovery community? It could be everything from offering support groups post treatment for your alumni to doing so for fun activities. There's a great organization that I work with where they call their sober fun activities, fire, fun and recovery events. And so every month, the alumni professionals require to do one fire event, host at least three sober support groups. And then you also have education. You have opportunities to offer a back-to-basics training or you might want to offer coaching sessions with your alumni. And so when you look at the nature of alumni, it's not just about offering bowling or going out to sober sports events because yes, those are very important. You've got alumni never done fun things in recovery and they're super anxious about how do I have fun and sobriety? So when you build an incubator like an alumni community where they can actually practice those skills and recovery, it reaffirms their ability to stay sober and learn how to do sobriety without feeling like they need to be in a social situation that could cause them to relapse. So we look at success as engagement. How engaged is your alumni in your events? How are they in picking up the phone when you're calling and talking to them and checking in and seeing how they're doing? Are they providing you with feedback? And we talk briefly about Google reviews and testimonials. When we talk about marketing, when you get an alumni that's over a year sober or doing really well, would they be willing to share their story? Would they be willing to be the face of your program and talking about the amazing impact that your program has made? So when you're alumni that are choosing to give back or choosing to make referrals that are showing for your events, it looks like. Yeah, for a marketing standpoint, just to, you know, reinforce that, that can sometimes do a marginal, a couple of percentage increase in commercial rates once we incorporate that into landing page homepage, ad copy assets, et cetera. So that's big. I think it's very interesting when you say the engagement rate. If I'm an executive for facility, what should I benchmark as a good engagement rate? It's a great question. I can tell you that if you are running a facility that's at least five to 10 years old, your referral engagement as far as people sending clients to you, whether it's a readmeat or it's a new referral coming from an alumni, that your numbers for alumni referrals should sit anywhere between 20 to 25% at as a start. Ultimately, you want to get your referral bunch marks up to about 45 to 50%. And those programs are usually the ones that have been around for ages. And I know that I've like even documented that 60% of their referrals monthly or month over month come from their alumni. So, so from an engagement standpoint, if you're seeing that more and more of your referrals are coming from your alumni, then you're definitely doing a good job staying connected. Can we look at any touch point or any response that you're alumni are having? Are they picking up the phone? And there are amazing apps that are out there now that people are using to help create efficiency in follow-all with your deny. So, you can track that data much better with real-time information versus just making a phone call and hoping that they'll pick up. So, there's apps out there that actually are able to help you connect with your alumni in a more efficient way so that you can track outcomes better. I would say if you're talking to, if I'm talking to a CEO and they're wondering whether or not does it make sense for me to start an alumni program? Ultimately, what you want to look at is your referral numbers for admissions, how many of them are making referrals or needing to come back into your program. And then from an engagement standpoint, if you're hosting even one or two events, if you're seeing at least a minimum of 10 or 15 people showing up for your events, then you know that there's a need there. There's people that are interested in either an in-person events or virtual events. Yeah, that makes sense. That's an interesting, I'm already thinking formulas, except in terms of a percentage, a certain target KPI of your discharge patients, or alumni in terms of them referring to the patients as a quality metrics. I always tell my team, people come back and expand budgets or increase, recommend, that's the biggest indicator of success, client satisfaction, in our case, this B2B, but I think even equally important when it comes to to alumni and a consumer-based focus here. I'm curious to understand a little bit like, 360-degree patient acquisition optimizations, so to speak. So it starts before at the branding, to the strategy, to the marketing, to the systems, to the patient discharge process. And all with the myriad of different apps and systems, and EHR and CRM, and your B-building software, sometimes difficult and sometimes data can get siloed. I had a very interesting conversation with an executive of a large multi-location brand, and he was, you know, we had success with adopting the alumni process already at the initial stage to get them engaged with the app. In this case, it was a sales force instance. We integrated with the health application, but whichever application can do the job, is that also your recommendation to initiate that journey already in the initial stages of the, for instance, residential treatment? Absolutely. I think that we need to be treating every client that walks in the door within the first 24 hours as an alumni of our program. And that means that we need to be cultivating those relationships with them early on. We have had cases where programs would have alumni come and sit in detox with the clients while they were detoxing, to introduce them to what life would look like after they left, to help them stay in detox when we know that detox is one of the highest levels of AMA rates. How do we help retain alumni, or how do we help retain our clients, is by bringing alumni in who have been there, who can sit with them and talk with them and let them know, like, hey, look, I've been where you are. I know how hard this is. So we try to create, I would say, touch points, if you will, with our alumni meeting with clients while they're in program, we also really encourage our alumni coordinators to have space in the treatment schedule so that they can be doing a one hour recovery coaching session with treatment with clients that are in program, not just teaching them about the alumni program itself, but also what does recovery look like after they leave? What are, you know, we have courses that we've created, we have workshops that we foster and offer for our members that give them a place where they can say, okay, I'm going to teach this week on the difference between my addiction culture versus my recovery culture, what's going to look different for me when I leave. So the moment a client steps into your program, I would even argue before they do, you could even utilize your alumni to help you with families trying to make the decision to get to your program. If you have a strong alumni program, you can invite your alumni to be a part of a phone tree to call and follow up with potential family members and talk about the program, what they went through. We've had cases where we've used alumni in that situation and then making sure that your tech stack from the moment that they arrive, whether it's through a hub spot or a sales force that we're capturing that information on the first fall, it's being pushed into the EMR when they arrive and then on discharge that they're either part of a post discharge process and/or they then get immediately pushed into a technology app that's designed exclusively for alumni to stay connected with them after they leave. So do agree with you that we need to have those touch points from the very beginning because they can learn a lot behaviorally about our alumni and what's working for them, especially if they realize and they need additional support. Yes, really just want to reinforce what you said there. I mean, so powerful to have an ambassador representing at the stage of detox where there's high AMA rates through your point and giving that aspiring hope or support that listen, this is completely normal, what you're undergoing and what to expect as the next steps and just cultivate hope, so to speak. How do you then, what would your recommendation, of course, besides signing up for within your organization and become a membership to get all the different proven best practices, what is something that a facility could do to cultivate more alumni to become brand ambassadors, like in that example? So again, we have currently a toolkit of resources to help build out alumni programs for treatment facilities and so we would hate for folks to have to do it on their own. There's been enough people before us who have trailblazed and have done trial and error on specific events and workshops that we can then help teach and coordinate with different organizations, small medium and enterprise level. And so when you're talking about building out an alumni program, what you first have to do is you have to identify the right person who can be that representative for your organization and it can't just be someone who is super bubbly and has a great personality, which has historically been how most people are selected. I mean, not to say that that person couldn't be coached into the position, but the nature of alumni professionals now, it is a much more sophisticated role that requires individuals to have really strong communication skills, has a really strong understanding of data, knows how to do metrics, understands how to do program development because there are going to be a lot of program development opportunities for them, understands how to work internally with various departments, knows how to have good team rapport and relational rapport with the teams that they're working with, clinical admissions, case management, I would even argue medical in some cases. So you really want to identify the right person for this. And also make sure that you have put resources against that position to make sure that they can be successful. Many times we hire someone and we don't give them a budget. I would argue that many of our alumni professionals that I speak to say that they might end up with $300 a month to do work in events and that's just not enough. So there needs to be a focus or an emphasis on creating an alumni department that has a substantial budget, maybe modest, I should say, maybe a modest budget to start with, but then also really important to build out a strong strategic plan. You have to, and in an effort to build a strong strategic plan, you have to know what your alumni want. And so one of the things that we spend a lot of time on with our alumni professionals is we do surveys. We we've crafted pre-made surveys that they can send out to their alumni asking for feedback on what they want. And then looking at the data from that, looking at the data from their internal teams, we ask them to sit down with their team members to talk about what does an alumni program look like for our organization, getting clear leadership, all of that data and coalesced that allows us then to start building on a strategy document with again, a budget that can help them be successful. Yeah, wow. A lot to unpack there. I mean, I think I'm not going to even remember the five questions I have now. I think just starting off with like when I speak with the alumni coordinators for facilities or the executives is kind of like, okay, this is an alumni that discharge and we like it. It's a bubbly personality to be important that they get thrown into it with no budget and you're talking about creating an ideal employee profile. What do they look like? What's the attribute? Do they have an analytical approach to a business impact and also can they resonate with alumni? How do they control the narrative events, etc. But then furthermore, you are allocating a budget to it. I think that's interesting. On our end, we have like we call it growth ROI calculator. And when you look at the budgets that people put into, you know, they're not shy of dropping $100,000 on Google ads campaign, but they're doing some like basic rudimentary event. And when you start looking at the readmissions rate, the referral rates and then the cost per acquisition related to that, it's not even rational. And I think the key element is like to your point, get them in the system, no silo data and then look at it. How do you optimize not just for better outcomes, but also especially your business as a result of that. So, so okay, so there's a lot there. I'm executive and I'm looking, I don't even know my metrics first and foremost. Like I contact Gina now, what is the typical like if you go explain with his what's going to happen normally? Obviously everything is individualized, but over the next 30, 60 days, what could I expect? So we once you're onboarded into T pass and again, we're a nonprofit membership organization. So we work with behavioral health organizations and alumni coordinators. So I say we have types of avatars. We have the macro avatar, which is the organization, and then we have the micro avatar, which is the individual. So when the once treatment center joins as a member, we then immediately schedule an onboarding call with the coordinator or anyone else in the organization that wants to be a part of it. And so our first thing is we do a due diligence assessment. We assess what are they currently doing? Do they have a program right now? Are they looking to build a program in the next 30 or 60 90 days? And then from there, we spend time collecting the data. And they say, well, we don't know what our admissions are. We don't know what our alumni referral numbers look like. Or we haven't figured out, you know, what metrics we want to capture on the front or the back end of our alumni efforts. So then we work with them and looking at it. And we have industry standard data that we've been collecting over the last 15 years that allows us to be able to help them set those benchmarks. We have job descriptions that are already in place. So maybe they haven't hired an alumni coordinator yet. But we have existing job descriptions that they can use. We have white label templates that they could use for strategic planning. And then we spend the first due through one-on-one coaching. So we do one-on-one coaching sessions with our with our members whenever they want to. But at least initial stages, we do three to four coaching sessions with expert alumni professional leaders who will help them get their initial skeleton or scaffolding of their alumni program off the ground. That includes knowing what their metrics are, understanding, you know, what the needs are for the alumni program, building out the first what we call 90-day sprint plan. And that involves things like getting them connected with other vendors for app development, making sure they have a skeleton or an overview of a budget that would work for them. So we try to put the nuts and bolts together for them. So that way they don't feel like they're doing this on their own. And when they become a member of our organization, it expedites the process for them much quicker. So they can actually see an ROI on their efforts with alumni within six months because they wouldn't have to start from scratch. They have all the resources that they're disposal. And they would be able to start calculating out what their referral numbers would look like much faster than if they would do it around. Love it. Love it. I hope you sincerely, guys, after 15 years of great work and double your membership count. I think every single facility should contact you. I always like to tell my team and people like consult for my clients is like success leaves clues. Don't try to re-invent the wheel. If there's a certain benchmark metrics you want to attain, then model it. And you could personalize optimize later on, but follow a framework, shorten the learning curve, get to that stage. And in this case, it's not metrics. It's not probability. It's actually lives we're talking about as well. So thank you again so much for this interview. I know we could talk for hours about this topic, but maybe we can have around two. On a final note. And it's been a pleasure, really. I really appreciate all the work that you do and helping us get the message out about like you mentioned, helping us to save more lives and keep people well is our number one priority. And so if there's anything that we can do to help support anyone out there who is looking to build a strong program, who feels a little lost in this journey, feel free to reach out to us. We're happy and ready to be there for you. Fantastic. What is the best way to getting contact with you guys? So right now, the easiest best way to get in contact is at tpas.org. All of our information is on our website. I am the executive director for tpas and we have a very active board that works with us. And then we also have individuals that are working with us in a voluntary capacity in some of our subcommittee work that we do. So when you join, if you're interested in being involved at a larger scale, at a national scale, in working with alumni services, we can certainly get you connected. But we would encourage you to visit us at www.tpas.org and reach out to me online at [email protected]. And I'm happy to follow up with you to talk more about this amazing organization. For now, thank you so much, jena. To everybody who's listening, I can personally endorse this is a no-brainer ROI guarantee. If you do it the right way, it will impact. So encourage you and thank you again so much, jena. Thank you, Gary. We'll be into contact soon. Okay. Thanks.