Praxis Email Jan 1 2023

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To the best team in Behavioral Health,

It’s been a heck of a year. A little company that started with little more than a dream, some shoestring,
and a fateful power washer REDACTED bought from Lowes for a hopelessly uncoordinated 27 year old to
clean the fence at Malcolm Avenue has grown to 14 locations, 952 beds, and over 10,000 graduates in
six short years. This year, I believe we set the record in our industry by opening six new inpatient
addiction treatment facilities. We launched the first centralized intake program in our industry to process
admissions in 9 states from one office. We instituted mandatory ACLS training for our nurses and BLS
training for all staff, incorporating life safety drills to ensure we are prepared to care for our patients no
matter what crises they face. We officially became a $100M company by revenue. We acquired 26 new
locations to open in the coming years to continue on our mission to save a million lives in the next
hundred years. Overall, we have had tremendous success as a team that increasingly attracts attention
from our peers and from key players in the industry. Most importantly, we have shown what it looks like
to be a company that puts patients first, practices immense clinical program integrity, and rises to the
occasions thrown at us to come out on top, no matter the odds. I am proud of us.

It has also been a hard year. Many of you have scars from the battle. Opening Mishawaka in particular
was immensely challenging. We were not prepared to open such a large building, and frankly I did a poor
job anticipating the problems we would face opening a building nearly twice as large as any we had
previously tried to open, and we were not prepared to handle the influx of patients we faced. Our
Revenue Cycle broke as a result of this lack of preparation. We faced a cash crunch as a result of not
collecting from our insurance carriers unlike any I have faced in over ten years. I know many of you faced
the anxiety of not knowing when or if your credit cards would work. I am sure many of you faced the
embarrassing prospect of having to tell vendors you could not pay them. I know some of you faced
embarrassing situations where you tried to check into your hotel and your card would not swipe. I know
many if not most of you were asked to work with limited resources, especially this fall. I know all of this
adds stress to an already stressful job. It is not fair, and it is not acceptable, and for that I am sorry.

I do have some good news. This Thursday, we were able to execute a sale of our real estate assets that
raised over $70MM for the company, we have another $40MM in transactions set to close in February,
and then another $30MM closing in April. The accounting team has been hard at work the past two days
paying off our debts. We expect this process to take another two weeks, but your credit cards will be
working on or before January 10th, once we can compile what we owe and make sure we do not double
pay invoices both at the facility level and corporate level. If you haven’t received word already, our
Controller REDACTED will be reaching out to Executive Directors to compile outstanding invoices from
our major national vendors and get them paid, so you can get back to what you do best, taking care of
the moms and dads, sons and daughters who need us to shepherd them through what is often the
lowest moment of their lives. I cannot predict the future, but I can say these transactions have allowed
us to generate the liquidity we have not had before to run our business without giving up ownership of
the company. Retaining ownership in my family is important to me, because I never want to be in a
position where I have to compromise our integrity or the quality of our care to hit a quarterly number or
make an investor happy who has no appreciation for the difficulties we face in taking care of people. We
have also substantially improved our Revenue Cycle processes and are seeing payments post regularly in
a way we were not seeing earlier in the year. While challenges are never fun, you as a team have risen to
the occasion beautifully and have only increased my confidence that we are in fact different from others.
We can and will overcome whatever challenges we face as a team, and we will and have emerged
stronger than ever.

The year ahead will bring its own challenges. We have 14 buildings to open. We will once again double in
size. We plan to open a new division of the company, Office Based Opioid Treatment. We are revising our
training program to be more effective and focus more on skills and critical thinking, rather than policies
and procedures. We are piloting an outcomes measurement program, utilizing biometric response, to
track not only if our patients are sober after treatment, but whether or not they are thriving as human
beings. There will be days that are frustrating. There will be days our patients throw us curveballs. And
there will undoubtedly be chaos as we launch new facilities, although our revised ramp periods should
alleviate some of this. After Mishawaka, we made the decision to slow the pace at which we ramp. While
my instinct is always to help as many people as possible, I think we learned that the chaos of going from
0-160 patients in three weeks hurts that ability in the long run, and so we will focus on delivering on our
promises every time, even if it means going slower than we historically have.

In the midst of all the challenges known and unknown, I ask that each of us focus first and foremost on
the humanity of those we serve. When I think of what I want to happen this year, I want all of you, at
facilities and home office, to have fun at work. Host ice cream socials. Play pick up corn hole with the
patients. Take the time to have an hour conversation about the patient’s hometown, watching her son
cross the aisle at graduation, the moments he is looking forward to being present at home, maybe for
the first time. Find the “why” that motivated the patient to pick up the phone and make a decision to
change her life. As some of you know, one of our big initiatives this year is to move from a culture of
rules to a culture of grace and context. In essence, this initiative is a shift in priority. Historically, we have
been very focused on policies and procedures. I fear in some circumstances have become enslaved to
them, and we have at times forgotten why we do this. Don’t get me wrong. Policies and procedures are
important. They help keep our patients safe. They satisfy our state regulators and the Joint Commission.
They allow us to ramp quickly and give staff clear guidelines about how to handle certain situations.
There is value in that predictability and framework. However, policies and procedures will not save a
million lives. Humans caring for other humans is what will get us there. At the end of the day, we must
be guided by our values and our principles, first among them that we always need to do what is right for
the patient in any given situation. Start with what you know is right and in line with our values, and
everything else should fall into place. I am not suggesting we abandon policy and procedure, but at times
we may need to grant flexibility to staff on the ground to solve problems that lead to experiences beyond
our clients’ wildest dreams. Sometimes, this may feel messy. Sometimes we may make mistakes. I ask
that we judge each other by our intentions when possible, and that we focus on lifting up our
teammates and coaching those around us to be better, rather than focusing on rules and KPI’s. I did not
start this company to hit a census number or a profitability metric. I started this company to honor my
mother’s victorious battle with addiction, and to help other people do the same. My mother has not
been sober for 25 years because a nurse was perfect at med pass time or a Clinical Director successfully
hit all the boxes on her ClickUp list. My mother is sober because the men and women of the Hanley
Center invested in her, believed in her, cheered her on, and gave her a glimpse of what life could be like
without alcohol. They collectively gave her hope for a better future, and she took that hope and changed
her life, and mine in due course.

In the song “Marjorie”, Taylor Swift implores, “Never be so polite you forget your power. Never wield
such power you forget to be polite.” Friends, life is a never-ending contradiction of priorities. We have to
be merciful, but we must seek justice. We must know our power without wielding it as a weapon. We
must believe we can make a difference without despairing if it looks like that difference hasn’t yet
materialized. There is so much beauty in these tensions. They are hard, and yet in these crucibles we find
out who we truly are, and who we are is always stronger and more capable than we imagine. Thank you
for the tremendous sacrifices you have made collectively to bring to life a vision I had six years ago.
Thank you for choosing to work for me. Do not doubt that I take that choice seriously each and every
day. It is among the biggest honors of my life. Do not doubt you are making a difference in the lives of
the vulnerable. Do not doubt your 9-5, or 9-7, or 9-9 is contributing to leaving the world better than you
found it. Lean in this year. Support your team. Support your patients. Have fun whenever possible.
Choose forgiveness. And never forget the journey is what matters, not the destination. We are all part of
an extraordinary journey to fight this terrible disease and emerge victorious. It is a privilege of a lifetime
to lead you in this endeavor. I am proud of what we have accomplished, and excited for what is yet to
come. Happy New Year, team.

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