Hazelden Betty Ford Foundation

Addiction Treatment for Adults, Youth and FamiliesThe goal of the Hazelden Betty Ford Foundation's love-inspired, science-powered care is to help patients and families survive substance use and mental health conditions, and thrive in lifelong recovery. We empower those we serve to initiate and sustain a process of change through which they improve their health and wellness, live a self-directed life, and strive to reach their full potential. The Foundation serves both adults and youth and approaches treatment in a holistic, person-centered way of addressing our patients' addiction, mental health and co-occurring medical conditions. Continued on Schedule O.Our comprehensive treatment integrates the use of evidence-based clinical therapies, peer support and medicine, and is individualized to meet patients' unique needs as they progress from clinical management of their disease to community-supported self-management of their recovery. Our interdisciplinary care teams consist of addiction counselors and technicians; psychologists and other mental health professionals; psychiatrists and other physicians; nurse practitioners, nurses and certified medical assistants; family specialists; spiritual care professionals; nutritionists; recovery coaches and wellness specialists. In addition to addiction treatment, available at multiple levels of care, the Hazelden Betty Ford Foundation provides assessment and evaluation services, intervention services, clinically supervised sober living options, continuing care services and mental health services. The Foundation also understands that recovery from addiction and mental health conditions involves rebuilding relationships with family members and friends who need help and support of their own. Through our family and children's programs, loved ones receive education, guidance and support to achieve healthier relationships and lives.Hazelden Betty Ford's services are available both in-person and virtually for outpatient addiction and mental health services, as well as family and children's programs. In 2022, the Foundation's physical sites were in Center City, Chaska, Maple Grove, Plymouth and St. Paul, Minnesota; Chicago, Illinois; Naples, Florida; New York, New York; Bellevue, Washington; Beaverton and Newberg, Oregon; Rancho Mirage, Los Angeles and San Diego, California; and Denver, Colorado. The organization also provided telehealth services that were accessible to people living anywhere in Arizona, California, Colorado, Florida, Idaho, Illinois, Minnesota, Missouri, Montana, New Jersey, New Mexico, New York, Oregon, Washington, Wisconsin and Wyoming. The following number of people directly benefited from Hazelden Betty Ford treatment and recovery programs in 2022: Primary Treatment Adult 5,178Intensive Outpatient Adult 3,406 Mental Health Adult 3,385Day Treatment Adult 2,559Family Program Adult 1,873 Outpatient Treatment Adult 1,488Primary Treatment Youth 752Mental Health Youth 588Renewal Center/Lodge 559 Family Program Youth 507Children's Program 436Day Treatment Youth 346Intensive Outpatient Youth 207Outpatient Treatment Youth 91 TOTAL PATIENTS SERVED 21,375 Additionally, financial assistance is available and was provided to 3,813 qualifying patients and family members at an approximate cost of $6,400,000.

Higher Education and Medical & Professional TrainingHazelden Betty Ford Graduate School of Addiction StudiesThe Hazelden Betty Ford Graduate School of Addiction Studies prepares future leaders in addiction counseling through two available degrees: Master of Arts in Addiction Counseling: Advanced Practice and Master of Arts in Addiction Studies: Integrated Recovery for Co-Occurring Disorders. The school emphasizes public engagement as a means of serving constituent communities. In 2022, students provided approximately 46,791 hours of clinical services at agencies reaching underserved and economically disadvantaged populations. Continued on Schedule O.The school offers a full scholarship each year to a student who works at Chisago County Health and Human Services, and we provide continuing education to these Chisago County professionals at no cost. In 2022, 68 students graduated from the school with master's degrees. Overall, more than 92% of graduates who seek careers in the addiction treatment field find employment in their home communities or at regional or national treatment agencies. Faculty and graduate school leaders participate in public service events throughout the United States and make research, educational and scholarly contributions to the field of addiction treatment.Medical & Professional EducationThe Professionals in Residence (PIR) program and the Summer Institute for Medical Students (SIMS) give medical students, residents, health care and legal professionals an in-depth experience with the dynamics of the disease of addiction. Intensive one-week programs blend classes presented by Hazelden Betty Ford Foundation physicians and expert clinicians with time spent interacting with patients and staff on residential and day treatment units. Participants learn about the latest research and evidence-based methods from our multidisciplinary faculty. A rotation on addiction for psychiatry, family medicine and internal medicine residents is available in Minnesota and California. A one-year Accreditation Council for Graduate Medical Education (ACGME)-accredited Addiction Medicine Fellowship is available at the Betty Ford Center in Rancho Mirage, California, and a Course on Addiction and Recovery Education (CARE) is available worldwide. The Minnesota, California and Oregon sites offer customized programming for larger groups. In 2022, our Medical and Professional Education programs trained a total of 458 participants.

Publication of Educational MaterialsHazelden Publishing is the leading publisher of state-of-the-art resources for preventing, treating and managing addiction and closely related issues. Translating research into practice, we help organizations treat the whole client by offering information, guidance, tools, and support to meet their unique needs. With 149 new offerings in 2022, our publications continue to provide inspiration, guidance and encouragement to millions around the world every day. Continued on Schedule O.In 2022, Hazelden Publishing generated 30 new publications, six new Spanish translations, two new curriculums, six new distributed products, 16 new e-books, 11 new translation rights, 11 new subscriptions, 61 new and refreshed trainings, four new videos, and two specialty gifts. If not for our mission and commitment, much of this material would not be published and available to consumers because of its limited appeal to mainstream publishers. Hazelden Publishing's materials also reach underserved populations, including many customers in the community treatment, faith-based and corrections markets. Additionally, through its BookAid program, Hazelden Publishing sent out book packages that reached people through libraries that serve programs and institutions in need. BookAid resources were sent to individuals and organizations in the United States and around the world.Hazelden Publishing's Training and Consulting Solutions team transforms organizational systems and culture, empowering educators and providers in health care, treatment and social services to deliver evidence-based, best-practice services throughout the continuum of care. The Building Assets and Reducing Risk (BARR) division - a strengths-based program that provides schools with a comprehensive approach to meeting the academic, social, and emotional needs of all students through training and coaching - trained 126 schools in 2022, impacting the lives of over 30,000 students and 3,000 educators in a diverse range of communities. In addition, our Prevention Solutions division delivered intensive education to over 50,000 students across 220 schools in 33 states and 19 countries. Consultants and trainers in the Clinical and Medical Solutions division reached approximately 4,250 professionals in 26 states in 2022, addressing stigma associated with addiction and helping communities embrace recovery as the expectation. Finally, our Summer Institute for Medical Students and Professionals in Residence programs - both managed within the Professional Education Continuum Solutions (PECS) division of Hazelden Publishing (see more under the program description for Higher Education and Medical & Professional Training). For yet another year, the Training and Consulting team is empowering professionals to be agents of hope and healing.

In meeting the Foundation's mission and underlying charitable purpose, the Foundation invests time, financial resources and energy to help people and communities understand and address addiction as a treatable chronic disease, and spread the word that recovery is possible. "Be of service" is an integral core value which the Foundation demonstrates in a variety of ways.The Foundation provides treatment services to individuals and families who seek and qualify for care but are unable to pay the full cost. The Foundation's patient aid policy provides that the Foundation will annually establish a target amount of patient financial assistance. In addition to its annual provision for charity care, the Foundation provides a variety of other benefits for the public good including:Butler Center for ResearchThe Butler Center for Research (BCR) is dedicated to improving recovery from addiction by conducting clinical and institutional research, collaborating with other research centers and communicating scientific findings. It is the Center's vision that sustained recovery for all who seek help will be achieved through advancements in knowledge and integration of research into practice. In 2022, the BCR participated in the following activities: As part of the Hazelden Betty Ford Foundation's commitment to evidence-based practice, a variety of projects were conducted to inform clinical care and academic programming, identify programmatic and treatment needs, drive data-based decision-making, and contribute to the professional and public knowledge of addiction treatment and recovery services. Projects included data collection, data analyses, research-based collaborations, published journal articles, industry trend reports, on-going consultation, and webinars, among others. In response to the global novel coronavirus pandemic, the Foundation had to pivot the majority of its in-person services to virtual in March 2020. Given that very little was currently known about the efficacy of virtual group services for addiction, the BCR undertook an evaluation of the intensive outpatient and partial hospitalization program virtual services rollouts in order to better understand what type of patients benefit from in-person or virtual addiction care. Preliminary findings from these projects have already helped inform the Foundation's approach to providing virtual care as a viable alternative to some in-person services, and have resulted in two manuscripts that are in press:- "In-Person versus Telehealth Substance Use Treatment: An Ecologically Valid Comparison" included a description of the VIOP study, and detailed the similarities and differences between patients in in-person, hybrid, and virtual IOP. It is currently in press with JMIR: Formative Research and was published in 2022.-"Telehealth Services for Substance Use Disorders During the COVID-19 Pandemic: Longitudinal Assessment of Intensive Outpatient Programming and Data Collection Practices" showed that at 3 month follow-up, self-reported outcomes related to resumption of substance use, quality of life, and well-being were similar for patients in in-person or virtual IOP, which suggests virtual outpatient care for the treatment of substance use disorders (SUDs) is a feasible alternative to in-person only programming. It is currently in press with JMIR: Mental Health and was published in 2022.Research collaborations with other industry leaders expanded in 2022 and included:-In partnership with Spark Biomedical, the BCR began the RESTORE study, funded by the National Institutes of Health HEAL Initiative. This multisite randomized clinical trial will examine how TAN (transcutaneous auricular neurostimulation) therapy, delivered by an FDA-approved non-invasive wearable device worn behind the ear, can improve relapse prevention for individuals with opioid use disorder. Recruitment began in 2022 and will continue in 2023. Findings from this study will ultimately help people stay engaged in their care, avoid returning to use, and sustain their recovery.The BCR continued their multi-year collaboration with the Mayo Clinic through three separate research projects: Funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), Mayo & BCR researchers are examining the use of acamprosate, an FDA-approved medication targeting alcohol craving. This project aims to identify biomarkers that may predict patient response to the use of the medication, with the hope of finding new genes linked to alcoholism treatment response. The project continued recruitment throughout 2022, notwithstanding continued COVID-19 restrictions, and will be ongoing in 2023. Findings from this study could have substantial impact and inform substance use treatment on a national scale.-Similarly, this group is also studying the use of naltrexone and buprenorphine, FDA-approved medications for the treatment of cravings related to opioid use disorder (OUD). In this innovative donor-funded study, the BCR and Mayo will use internally developed breakthrough technology to "reprogram" the cell lines in patient blood samples over a 6-month period to differentiate into brain region specific organoids (so-called "mini brains" in a petri dish), which will then be exposed to the medications used to treat OUD to measure how each individual brain's cells respond. Results obtained from this pilot study will be used to generate new hypotheses to better understand the molecular underpinning of OUD and response to FDA-approved therapeutic agents used in the treatment of OUD. Pain is common among adults with substance use disorders (SUD). Individuals with SUD, specifically with opioid use disorder (OUD) and co-occurring pain are at a significantly greater risk (i.e., 3-5 times more likely) of chronic substance use and relapse, in addition to the need for and consumption of greater quantities of health-related services. However, researchers have limited understanding of the diverse manifestations of pain among individuals with SUD. To fill this gap, this collaborative research between BCR and Dr. Hooten of the Mayo Clinic, aims to better understand the associated psychophysiological (linked beliefs, emotions, physiological stimuli, and sensations) symptoms associated with pain tolerance and threshold in patients struggling with OUD. Data collection continued in 2022.BCR partnered with other organizations, such as-Virginia Commonwealth University researchers on a NIAAA grant-funded study, "Genes, addiction, and personality." This research is part of a genome-wide association study to learn more about the relationships between personality, mental health, substance use and genes. Data collection continued in 2022 and will be ongoing in 2023. -University of Minnesota assessing how differences between individuals with alcohol use disorder and opioid use disorder contribute to relapse.-Recovery Research Institute at Harvard Mass General, BCR is set to begin recruitment in 2023 for a research study to examine the role and influence of social identity and social networks in the development of recovery capital and substance use outcomes for adolescents with alcohol or other drug use disorder.Research Updates continue to be written and disseminated to professionals, educators, researchers, students and other stakeholders. These brief summaries of scientific findings from the field of addiction treatment research are provided at no cost as a community benefit to policymakers, treatment professionals and the public at large. Research Updates are also available on the BCR web page at httpswwwhazeldenbettyfordorgresea... Community Education and RelationsThroughout 2022, COVID restrictions loosened and the Foundation was able to bring back many in-person events, while continuing virtual support, speaking opportunities and meetings. We continued to deliver both virtual and in-person events to our alumni and the recovery community. Between alumni events and live and recorded webinars, over 4,000 people were reached. The Speakers Bureau helped place the organization's many spokespeople at events, with 87 different employees delivering 93 presentations in 36 locations, as well as virtual presentations available globally. We also provided education and support at our free, open-to-the-public Caring Families groups, held online twice weekly for the Florida community. Educational scholarships from the Foundation totaling $5,200 were awarded to students at six high schools in the Twin Cities and Center City areas of Minnesota, as well as two western Wisconsin high schools.

Children's ProgramsThe Hazelden Betty Ford Children's Program provides prevention and education services to children and families with addiction. Programs are located in California, Minnesota and Colorado. The year began with COVID-19 restrictions still in place, preventing the ability to resume in-person Children's programming until May of 2023. Based on the success in 2021 and into 2022, the Children's Program made a bold decision to keep both Virtual and In-Person programs going forward, knowing how important it was to not only help our surrounding communities, but to extend our reach to other underserved communities in need. The Children's Program hosted 92 total programs and served 534 children both virtual and in-person. Virtual programming includes a two-day initial Virtual Children's Program, Stage II and caregiver workshops. The traditional in-person program is a 4-day comprehensive program that includes caregivers. An additional 1,415 children received support through virtual and in-person continuing care offered weekly on Wednesday evenings for alumni of the Children's Program. No child has ever been turned away because of lack of financial ability to pay: All of the virtual participants attended at no cost, due to the generous donations received through philanthropic support. Reengaging into our communities and understanding the current needs of children and families post pandemic is a top priority. The Children's staff put efforts into attending network and outreach opportunities, both in-person and virtually, across the nation last year. Collectively, the team provided program information and training through meetings, webinars and conferences to over 8000 professionals and community members. Web and Social NetworksThe corporate website, www.hazeldenbettyford.org, continued to grow in 2022 with nearly 10 million sessions, an increase of 10,000 in organic sessions over 2021. "Thought for the Day" remained the most popular feature on the website, with an average of 20,000 visitors each day. "Thought for the Day" provides daily inspirational readings from one of five Hazelden Publishing meditation books.More than 4 million people from 236 countries visited the website seeking information on a variety of addiction-related topics, including treatment, recovery, education, public advocacy and products in our online bookstore. Seventy percent of all visits to the hazeldenbettyford.org website were from a mobile device. Twenty-seven percent of sessions were from a desktop or laptop computer and only three percent were from a tablet.Hazelden Betty Ford produced 23 new episodes of our award-winning Let's Talk Addiction & Recovery educational podcast series, which generated 352,824 engagements; since July 2018, total podcast engagement is nearly 1.5 million worldwide. More than 250 Recovery Road episodes have been created with helpful excerpts from leading authors in addiction recovery and mental health, surpassing well over 200,000 downloads since the podcast began in May 2020 to provide support during the early days of the pandemic. Mobile apps provided free of charge since March 2020 have had over 300,000 downloads in that time with nearly 98% of reviews rating the apps with five stars. Weekly Living in Recovery emails continued in 2022, reaching out with nearly six million emails that shared helpful resources, news, and tools to help alumni and those in recovery continue their healing journey.TheDailyPledge.org is an online support community for people in recovery and those who care about them. It is provided free of charge by the Hazelden Betty Ford Foundation. The Daily Pledge is built around the idea of pledging to stay sober one day at a time. It also offers chat recovery meetings, forum-style discussions, and other ways for people to interact and support each other in recovery.Traffic to the site held steady in 2022. Total users topped 23,000 with over 85,000 page views. The community offered more than 900 meetings during the year with a total attendance of roughly 2,000 participants. We sent approximately 600 confirmations of attendance for those in court-ordered programs. The Hazelden Betty Ford Foundation's Facebook, Twitter, Instagram, YouTube, LinkedIn and other social media accounts, which have more than 127,000 followers (up 81.6% from 2021), along with its award-winning mobile apps - including several available at no cost - offered additional access to recovery resources, providing daily inspiration, information and fellowship.Resource CenterIn 2022, Hazelden Betty Ford's Resource Center and Referent Relations received 89,031 calls from people seeking or referring to substance use disorder and mental health treatment, as well as many more seeking information, assistance and products related to substance use and addiction.Hazelden Betty Ford LibraryIn addition to its core mission of fulfilling the informational needs of the Foundation's staff and students, our Addiction Research Library-accessible at wwwhazeldenbettyfordorgeducationb... serves the public by:-Working daily with information sharing and advocacy efforts in the regional Minitex, national Docline and international SALIS (Substance Abuse Librarians and Information Specialists) networks.-Facilitating on our website the preservation and access of archived versions of the ETOH and CORK addiction-related journal databases, free to all internet users and available nowhere else online.-Providing scholarships, via the A.A. Heckman Endowed Fellowship Fund, to help individuals study the addiction-related archives housed on our campus in Center City, Minnesota.Patient financial assistance and other costs (in thousands) to Hazelden Betty Ford Foundation of providing charity care and community benefits are as follows for the year ended December 31: Patient aid estimated cost $4,349 Minnesota Care Tax 1,592 Butler Center for Research 699 Information Center 226 Institute for Recovery Advocacy 564 Professionals in Residence, BFC Med Ed, BFC Institute 775 Children's Program 853 Graduate School scholarships 376 Total $9,434