"This is the Most Meaningful Model" — How One Provider Transformed Through Affiliation

Written by Jack Silverstein for Behavioral Health Business. 

When New Jersey-based behavioral health provider Advancing Opportunities pushed occupancy from 40% to 94%, they were hit with the shock of a lifetime: they couldn’t make payroll. The year was 2019, and the board at Advancing Opportunities acted.

They turned to the affiliation model from Inperium.

“Our census occupancy and growth trend made Advancing Opportunities a worthy organization for affiliation, I believe,” says Paul Ronollo (MSW, LSW), Advancing Opportunities Executive Director.

Post-affiliation with Inperium, Advancing Opportunities moved from a deficit in 2019 to a $600,000 surplus in their first fiscal year after affiliation and then a $1.1 million surplus the next fiscal year.

“That FY21 result is propped up by COVID dollars, but the truth is we gained these results not primarily by COVID money or rate increases but by year-over-year census growth and billing more and more bed days,” Ronollo says.

“Since the affiliation closed, everything we intended to happen has taken place, meaning viability for Advancing Opportunities is no longer an issue,” says George Contos (JD, CAP), Sr. Advisor to the Founding Chairman and CEO for Inperium, and CEO of Apis Services, a wholly owned subsidiary of Inperium, Inc. serving as the controlled employer and back-office services provider for affiliates within Inperium’s constellation.

In short, the affiliation journey for Advancing Opportunities has been hugely successful. Here’s what they’ve learned.

Shared infrastructure drives sustainability

Affiliation with Inperium reveals the power of strategic relationships with companies retaining their name, assets, local culture, legacy board and management team, gaining access to scalable, enterprise-level back-office capabilities. Those back-office capabilities were critical for Advancing Opportunities, which had attempted multiple strategies to optimize their finances.

“You cannot afford meaningful back-office infrastructure if you’re an $8 million organization,” Ronollo says, referring to Advancing Opportunities’ size at the time. “You cannot afford your own CFO, accounting manager and two fiscal clerks.”

The organization also had a three-person fundraising group that was in the red. “It was important to recognize that in order to survive and thrive we had to make it on our fees and our contracts,” he says. “We could not rely on fundraising to make ends meet.”

As an Inperium affiliate, Advancing Opportunities receives its back-office services through Apis in ways that are cost effective and efficient, and are also able to learn new best practices from both Inperium and its other affiliates.

“I’ve learned so much from working with these finance folks, and the financial planning and analysis group,” Ronollo says. “And what that all leads to is us focusing on quality and growth.”

Adds Contos: “The enterprise-level opportunities that Apis and Inperium provide to an organization like Advancing Opportunities are benefits that they would never have been able to afford or justify as a standalone and cannot be overstated.”

Strategic relationships strengthen mission impact

Advancing Opportunities is a statewide human services organization serving individuals with disabilities, primarily those in 20 New Jersey group homes, with plans to add four more. They also offer services to people with disabilities in other settings: getting around their homes, jobs or even schools for younger people, such as working with school districts to ensure that students are getting what they need from their IEPs.

“That is our mission,” Ronollo says. “It is that mission that drives us.”

Working with Inperium, that mission has been more successful than ever. Advancing Opportunities have doubled since affiliation, from $8 million in revenue to $16 million. While rate increases in New Jersey contributed to this, those changes were not the main driver of that growth.

“It’s our census — we expanded,” he says. “We had huge leaps in our census. Some years we were doing 20% more than the previous year.”

The state took notice. New Jersey has reached out to Advancing Opportunities on three separate occasions to ask them to take over failing group homes or apartment programs.

“That’s a feather in our cap — we are considered at the top of that list,” Ronollo says. “I don’t think I’m able to do that if I’m focused on administrative tasks. So, this is just a massive win for us.”

Collaboration preserves identity while elevating performance

This year, Advancing Opportunities celebrates its 75th year of work, with the name “Advancing Opportunities” nearly as old. The idea that Inperium affiliation ensures continuity of an organization’s identity was a massive selling point for the legacy provider.

“Our name means a lot to us, and it means a lot in New Jersey,” Ronollo says. “Keeping our name was something that made Inperium unique and very attractive when considering all of these bigger groups.”

With Advancing Opportunities into their seventh year of affiliation, the benefits are only growing.

“Today we foresee the additional expansion of 18 new beds,” he says. “That means that our agency will have nearly doubled in size since affiliation.”

And they’ve done it all under their own name.

“This is,” he says, “the most meaningful model.”