The cost of day care now rivals the price tag for college tuition in some parts of the U.S., according to a recent Child Care Aware of America report. Day care expenses are overshadowing the amount a family spends on housing, food and transportation.
The eye-popping figures include $16,549, which is how much parents had to pay per year on average for infant day care in Massachusetts in 2013, according to the report. Or $12,280, which was the price tag for a year of day care for a 4-year-old in New York.
In fact, the average annual cost for infant day care was higher than a year’s tuition at a four-year public college in 30 states and the District of Columbia. For parents of two children, full time day care is the highest single household expense in the Northeast, Midwest and South.
And the trend of increasing cost and increasing importance is only escalating. As the report points out, “The economic recovery will greatly benefit the day care industry. As parents and guardians, particularly females, rejoin the workforce, demand for day care services will grow. Additionally, expected increases in disposable income will allow families to spend more on child care, including high-value services such as early education programs.”
Few people are more familiar with the impact of an early and high quality preschool education than Bill and Amy Strickland, owner-operators of two locations of The Goddard School. The pair, hailing from the Southeast themselves, opened their first private preschool in Fort Mill in 2009, and a second in Rock Hill in 2013. At present, there are 10 Goddard School franchises throughout the greater Charlotte region.
“Goddard Systems, Inc. is the franchisor,” explains Bill Strickland, “and the interesting thing is, the guy who started the company—Tony Martino—was the same one that started Maaco.”
Anthony A. Martino, a well known and celebrated guru in the franchising world, took companies from the ground up and made them national brands. He was the force behind the Aamco (an acronym of his initials) Transmissions enterprise which he started up and sold, and subsequently Maaco Enterprises which he built into a 450-franchise collision repair and auto painting retail network.
Along the way he developed a franchise of tune-up shops he sold to Meineke, and also the early development child care franchise called The Goddard School.
The Goddard School concept came about in 1988, when Martino was approached by a former associate with an idea for providing upscale child care with degreed teachers at every level, he thought it could and should be duplicated. Based on an educational philosophy that emphasizes nurturing the whole child, the Goddard School focuses on emotional, social, intellectual and physical development as well as standard educational goals for children six weeks to six years.
Today, the franchise has grown to over 400 child care centers with more than 50,000 students in 35 states. It has been ranked the No. 1 childcare franchise for the last 13 years by Entrepreneur magazine, and in the Top 200 Franchise Systems (worldwide sales) by Franchise Times for the eighth year.
The Goddard School Attraction
“The Goddard Schools rely on the franchise model of offering a nurturing environment, advocating genuine learning, and collaboration with parents to help children reach their fullest potential,” says Bill. You can walk into any Goddard School and feel the uncommon level of quality, value and education—consistently.
“We’re both owner-operators of the Rock Hill and Fort Mill schools. I think what makes us work so well together is that we have complementary skills. My background is more in technology and business and consulting, while Amy’s is in retail, education, human resources and sales. As a result, we perform alternate but complementary functions.”
The couple began their journey toward becoming Goddard School franchisees in an interesting way. When first married, the Stricklands moved around the country and the world, living in places such as Atlanta, Singapore, Washington, D.C., and Cleveland. Having three daughters with Amy as a stay-at-home mom, the couple was always finding new pediatricians, orthodontists, and other care providers when they moved…including preschools.
“When we moved to a suburb just outside of Cleveland, I did what I always did and asked around for preschool recommendations,” says Amy. “Where do you hear good things, where do people seem happy? And Goddard Schools kept coming up. So I visited—just as parents visit our schools to see if we are the right fit for their families—and I just fell in love with it.”
Because the couple’s daughter was attending a Goddard School at the time, and because all Goddard Schools require on-site ownership, Amy was able to get to know the owner of her daughter’s school, learning about the challenges and rewards of franchise ownership in the process.
At the same time, Bill was getting tired of getting on an airplane every week for his consulting work, and was receptive to a small business opportunity. Together, the Stricklands found the Goddard School concept so compelling, that they decided to try it themselves as a franchisee.
“Ohio wasn’t home for us,” comments Amy. “The Southeast is more our home; we have family down here. So, we scouted a lot of locations and decided on Fort Mill. We opened our first location in January of 2009, and then expanded to a second location in Rock Hill in January of 2013.”
Bill adds, “One of the reasons we decided on the Charlotte area is because my background is in financial services consulting, so the thinking was that I could keep doing that while she was setting up and running the school. I did continue doing that for a few years, but now with two schools, I’m plenty busy.”
“Charlotte offers so much in the way of infrastructure, and the Fort Mill and Rock Hill areas are growing like weeds,” he continues. “Also, the reputation of the public schools in Fort Mill and Rock Hill is tremendous, and the Carolinas are a very pro-business environment.”
“I would also add that, in the greater Charlotte area, you’re a day trip to the beach or a day trip to the Great Smokey Mountains, you can easily get down to Savannah or Charleston or Atlanta, and the whole region has such a rich history,“ says Amy. “Also, the international airport is perfect for when you want to fly to Europe or the Bahamas. Climate is a big one too…here, you get a little bit of everything.”
“My primary focus is sales and marketing—to keep the schools full, to reach out to the community, and to set the culture for the school,” explains Amy. “I also do classroom observations. I’m heavily involved with recruiting and screening new teacher candidates, and I handle many of your typical HR issues. Bill’s approach is a little bit different.”
“My goal is to get the message out and craft the brand,” contributes Bill, “to keep reinforcing the message of education, to keep setting a higher standard for what we’re all about. I would say each school has a mission, and I’m very proud that ours is all about educational excellence—about preparing each and every child for kindergarten while becoming become independent, enthusiastic learners. In fact, lifelong learners.”
Amy explains, “Goddard’s educational philosophy is brain-based, which is learn through play. The way that I share that with families is, let’s say you’re working on letter formation. You could give a child a pencil and a piece of paper and have him or her practice writing the letter 25 times, which is not very fun.
“A more fun approach would be to take a cookie sheet and pour on a couple tablespoons of kosher salt and then have the child draw the letter in the salt with a finger. The, you shake it up or turn it and have the child repeat the exercise. You’re reinforcing the same skill, but one feels like fun and one feels like work. Play with purpose is one way I like to frame things.”
The word “preschool” means a lot of things to different people as it is often used interchangeably with “child development center” and “daycare.” The Strickland’s approach through their Goddard Schools, however, is different. The Goddard School educates children as young as seven or eight weeks old with the concept that learning begins at birth.
“Our ultimate goal for any of our learners is successful entry into any public or private kindergarten program,” explains Amy. “We use an overall approach in building skill sets, and that includes cognitive, social/emotional, gross motor skills, fine motor skills…those are all puzzle pieces that are necessary for a child to have a successful year in kindergarten.
“So, that doesn’t start at three years old…learning begins at birth. That’s why we write lesson plans in our infant classrooms. We’re trying to set up activities that foster the development of certain skills.”
Higher Standards for Higher Learning
“One of the main things that sets our schools apart,” Amy continues, “is the education level of our teachers. All of our teachers are degreed, something that isn’t common in many childcare centers. Early childhood education is all of the learning, both formal and informal, that takes place before kindergarten.
“Many people, including some universities with education programs, believe that early childhood education begins later in life at 3 years of age. We don’t agree with that, and there’s a lot of science behind the idea of having children engaged from birth. As a result, we also believe that having resources in the classroom—technological and traditional resources in the classroom—is very important.”
“Here, our teachers are working, teaching, educating each child, not just watching them,” adds Bill. “We set out at the beginning to say that we’re not going to be a daycare or a typical childcare center. We’re a preschool, and even at infant level, as Amy said, learning begins at birth.
“Research shows that if you don’t give kids a good start, they tend to fall behind sooner rather than later, and in some cases, they may never catch up. The later you wait, the harder it is for those kids to get back on track, and this can go on to affect their entire lives.”
Although Goddard Systems provides franchisees with a multitude of educational resources, Bill and Amy have found that, because many of their students were coming from homes where learning was already a part of everyday life, they needed to raise the bar. In fact, some of the local schools are taking note as graduates of Goddard Schools often crave even more education and are surpassing their peers upon entering the public school system.
“One of our philosophies is to adhere to continuous improvement. We set the bar in one place, surpass it, and then move it again,” explains Bill. “We also revamped our educational processes to embrace 21st century skills, an initiative that looks to go beyond just reading, writing and arithmetic to additionally teach critical thinking skills, creativity, communication and collaboration.
“An organization that supports 21st Century Learning (Washington, D.C.-based P21.org) visited our schools in 2012 and recognized our schools as being Exemplar in 21st Century Skills learning, one of 20 in the United States.”
Bill continues, “Today, businesses are saying to the educational community, ‘We need people who can think, not just memorize.’ When you look at it, all the information you need is available at your fingertips on the Internet these days. But, now that you have information, can you solve problems with it?
“We’ve changed how we teach, and then we started taking it up another notch and rolled out a S.T.E.M. program that focuses on science, technology, engineering and math. We have kids building robots, kids as young as three doing computer programming.”
Additionally, the Strickland’s Goddard Schools use iPads, interactive whiteboards, and other technology in the classroom in order to prepare students for the digital landscape that is unfolding before them.
“This is where Bill and I bump heads a little bit,” laughs Amy, “because I’m more old-school. I certainly recognize the value of technology, but as we often say, ‘Parents are teachers too.’ We encourage our parents to unplug from the technology for a while.
“While you’re walking the dog with your child, encourage them to find a license plate from another state or one with a certain letter or number. Identify living and non-living things. Challenge your child to find things that come in pairs in the bedroom when tucking him or her in at night. So, yes, technology is important, but so is person-to-person interaction.”
Bills adds with a smile, “And that’s one of the strengths that Amy and I have—we push each other and challenge each other, but that’s how innovation and achievement come about. Study the problem and negotiate. And that is one of the many reasons we’re successful.
“Our mission is educational excellence, and through our two Goddard Schools, we’re proud to combine our skills to complete the mission.”
“We have the opportunity to build a new city—and that happens rarely in someone’s lifetime,” says Chase Boone Saunders, a Charlotte native and fifth generation North Carolinian talking about Charlotte’s resurgent destiny as a crossroads of commerce.
“Charlotte is a work-in-progress, an Information Age City ever creating its future by coupling a mid-East location astride pre-Columbian, Indian trade routes to the energy of her people.”
Charlotte is on the threshold of another economic wave driven by its strength and location at the center of the Carolinas and the East Coast. With over 900 foreign-owned firms, its primary economic sectors include energy, banking, health care, manufacturing and logistics.
For the past two decades, businesses have been relocating around the globe for less expensive labor. As those labor costs push toward an equilibrium, businesses—especially manufacturing entities—are working to reduce their next most expensive costs of doing business…shipping and delivery.
Combined Logistical Assets Offer New Opportunities
In order to reduce those costs, advanced manufacturing, adaptive manufacturing and distribution firms will locate their facilities close to global hubs for domestic and international commerce. With the Charlotte Douglas International Airport providing non-stop flights to most major domestic population centers with over 44 million passengers a year, and the Norfolk Southern Intermodal Center with its potential capacity of nearly 600,000 containers a year, the Charlotte region provides a premier location for global businesses.
What makes Charlotte unique is its combined access to great air service as well as great highways and railways. From Charlotte, businesses can choose to move their freight/goods through any of the four major deep-water ports of Savannah, Charleston, Wilmington and Norfolk. Having so many proximate choices will drive costs down as truckers, railroads, ports and shipping companies compete for their business.
Norfolk Southern Intermodal Center
One year ago, in December 2013, Norfolk Southern moved into the new Intermodal Center between runways at the south end of the Charlotte Douglas International Airport (CDIA). The new facility is located on 170 acres with 3 pad tracks totaling 13,225 feet and 8 support tracks totaling 24,810 feet; 1,328 parking spots on site; a present capacity of 200,000 lift containers; all within easy access to major interstates I-485, I-85 and I-77.
Norfolk Southern (NS) leased this land from CDIA with the option to purchase it and adjacent land for expanding intermodal activities from domestic as well as international trade.
Crescent Corridor Initiative
NS has targeted major resources toward a Crescent Corridor Initiative serving manufactured freight along the I-85, I-77, I-485, I-40 and I-81 corridors from Pennsylvania to Alabama. The Crescent Corridor, stretching along highways from Richmond, Va., to Birmingham, Ala., is a concentrated manufacturing region that produces over $1.3 trillion of our GDP each year.
This manufacturing output is expected to double or even triple in the next 50 years. More specifically, experts expect roughly 40 percent of initial containers transiting through our intermodal center will be from international trade, while the remaining 60 percent will result from its Crescent Corridor Initiative.
Location, Location, Location
According to Brookings researcher Adie Tomer, “Along the U.S. Atlantic Coast, there is a veritable arms race between ports to dredge their harbors, roll out new cranes and obtain a bigger slice of American logistics business. Ports from Miami to Boston are making major bets—often involving upwards of a billion dollars—that they’ll be winners in the new Panamax world.”
The inland port of Charlotte, with its combined assets of CDIA and the NS Intermodal Center, offer this region a huge opportunity. NS and CSX rails provide service to each of the four major southeast ports.
To make the most of its location at the logistical center of the Carolinas along the East Coast, Charlotte must step up its game with a masterplan to not just compete, but to become the premier inland port. Unfortunately, political battles have left its significant assets sitting in limbo without the benefit of local planning for competitive development while other cities successfully move forward to service the same traffic.
Charlotte is only 644 miles south of New York City,730 miles north of Miami, 756 miles southeast of Chicago, and 714 miles northeast of New Orleans. Charlotte also happens to be at the logistical center of the southeast ports: Wilmington (198 miles), Charleston (208 miles), Savannah (252 miles), and Norfolk (323 miles).
By locating in Charlotte, businesses can reach over 60 percent of the population of the United States and more than 60 percent of the nation’s industrial base within two hours’ flight time or one day’s delivery by motor freight, and still have easy access to shipping options in major deep-water southeast ports.
The Need for an Integrated Strategy
CDIA and the city of Charlotte have begun planning for development of nearly 6,500 acres surrounding the airport and intermodal center building water lines, sewers and roads in the area known as Dixie Berryhill at a cost of roughly $45 million as part of the city’s $816 million capital improvement plan paid for by the 7.25 percent property tax increase.
In addition, the area needs expanded electrical service and other utilities. An additional 6,000 acres adjacent to the airport property is also largely undeveloped and could be improved. CDIA should also seek to expand air freight traffic. Ranked 33rd in air cargo among U.S. airports, the city can’t act soon enough.
We Need to Learn from Other Communities
When considering options for further development around CDIA and the NS Intermodal Center, there are prime examples of similar developments that ought to be studied. Three such models for development are the Alliance Global Logistics Hub in Fort Worth, Tex., the Rickenbacker Global Logistics Park in Columbus, Ohio, and the CenterPoint Intermodal Center just outside Chicago in Joliet/Elwood, Ill.
Alliance Global Logistics Park has been developed just west of Dallas by H. Ross Perot and BNSF Railroad. It operates with a capacity of 600,000 containers per year with projected growth to nearly 1,000,000 lifts serving domestic and international trade. This facility serves both BNSF and Union Pacific rail lines.
Its highway connections lead to both Mexico and Canada. It was built adjacent to the Fort Worth Airport and supports air freight for corporate as well as military needs. It operates a free trade zone with on-site customs and border protection within its 17,000-acre development.
Rickenbacker Global Logistics Park encompasses 1,576 acres surrounding the Rickenbacker International Airport and a NS Intermodal Center. Located 12 miles southeast of downtown Columbus, it has easy access to I-270, I-70, and Highways 23 and 33. It handles more than 300,000 containers per year along with its free trade zone. It provides direct double-stack service as well as next-day rail service to and from the Norfolk port.
CenterPoint Intermodal Center is North America’s largest inland port just south of Chicago. Its master-planned facilities operate on about 6,500 acres at the center of I-55, I-80 and the rail facilities of BNSF and Union Pacific. It provides readily available and flexible space solutions, plus thousands of additional acres for development.
The land around CDIA and the NS Intermodal Center can be developed into the best inland port in the United States with the proper planning and execution. While primarily undeveloped, this region can learn from the experience of other parks and build a plan to develop this acreage to fill the growing needs of cargo and trade to domestic and international markets.
Leadership in a Changing World
Gaining competitive advantage is so incredibly difficult in this age of disruption, when business survival trumps business growth. But it makes it that much more important to take full advantage of our assets and to be prepared for and take advantage of any opportunities as they arise.
Disruption has shown us, if nothing else, that where one entity does not step up, there are many others that will. What are we doing with our assets?
We benefited mightily from business leaders in the Charlotte community who recognized early on, in 1999, the potential advantages of co-locating rail and air facilities for future prosperity. Their Advantage Carolinas plan was roundly lauded and integral to the establishment of the NS Intermodal Center.
Although the region’s corporate citizens and leadership may have changed complexion, economic experts continue to believe that the true path to economic enrichment for any community—the way to raise the productivity and prosperity for all—continues to be providing access to and promoting manufacturing and those commercial flows that stimulate economic activity.
Global Vision Leaders Group
In the absence of leadership from other sectors, a grass roots group of business leaders has come together under the leadership of Tony Zeiss, Chase Saunders, Michael Gallis, and John Galles to form the Global Vision Leaders Group which has already held four major global summit meetings as well as conducted its own research and findings from meetings with each of the southeast ports and representatives of the N.C. and S.C. Departments of Commerce.
Two expert analyses in the economic development arena were also drawn upon: The Metropolitan Revolution by Bruce Katz and Jennifer Bradley, and The Coming Jobs War by Jim Clifton.
South Carolina is wooing substantial business to its port and to its real estate along I-85, most notably, the BMW plant in Greenville and Boeing in Charleston. Governor Nikki Haley is all about economic development leading the state’s charge in one unified vision to develop the state as an economic powerhouse. South Carolina wants CDIA and intermodal centers to be major players in this strategy.
Even the Port of Savannah in Georgia has a strong mission that very purposefully includes a relationship with the intermodal center and CDIA. This region is capable of becoming one of the most important hubs for global trade and commerce, yet local officials are not moving with all deliberate haste.
Hopefully, as the new Economic Development Partnership of North Carolina gets established, they will also be engaged with Charlotte and surrounding regions, even those across state lines.
Collectively, the Carolinas can become a major relocation region for three targeted groups that should be recruited: (1) Advanced and Adaptive Manufacturing that will seek to operate closer to major distribution centers; (2) International companies seeking to establish operations inside the domestic markets in the U.S.; and (3) Re-shoring companies that will return to the U.S. as wages reach a great equilibrium and as fewer workers are required.
We have the opportunity and the responsibility to exhibit a NEW Advantage Carolinas plan for businesses seeking the best location near a logistical center with great distribution capacities.
That plan can be even more successful if developed for the entire Carolinas region—one that is inclusive and integrates assets with manufacturing facilities in addition to grain, livestock and raw materials—and fully utilizes the region’s assets in a truly integrated fashion for the benefit and prosperity of all.
Improving numbers aren’t the only encouraging sign. In January 2014, Premier Sotheby’s International Realty officially opened in
Their SouthPark office is the first in
In 2013, the company recorded sales volume of $2.8 billion in more than 3,660 closed sales, an increase of 22 percent and 20 percent year over year, respectively.
With 24 locations throughout
Premier Sotheby’s International Realty is the largest
The company’s association with the reputation and heritage of a brand like Sotheby’s is a definer for their business says Judy Green, president and CEO.
“Just as Sotheby’s Auction House is known globally as a source for the world’s most valuable possessions and for the impeccable service it provides to its clients, Sotheby’s International Realty is known for the unique and distinctive properties it represents and the exceptional service it provides to its clients,” says Green. “Premier Sotheby’s International Realty continues that tradition of extraordinary service in
A Forceful Presence
Judy Green, president and CEO of Premier Sotheby’s International Realty, has been a force in the luxury real estate market for decades. Starting with a family construction and real estate business she began with her husband, Green has worked for over 30 years with realty firms, often in key executive positions.
She previously ran the Sotheby’s International Realty franchise for the Sarasota-Manatee,
“Following our vision, we have become the market leaders in the markets we serve,” says
According to Green, the company’s expansion into
The mountain community, represented by Premier Sotheby’s International Realty, is a short drive from
“The Charlotte Chamber of Commerce is doing an extraordinary job of selling the area to
“Our company does a relocation tour for businesses looking at the area, telling them about the quality of life
“And people are responding. The theme I hear is that
Green has an understanding of housing needs across all income spectrums that influences and enhances her business philosophy at Premier Sotheby’s International Realty. “It would be safe to say that the majority of properties we represent are high end,” explains Green. “Probably the median sales price of a property represented by this office is $700,000, but we represent properties less than that too.
“Right now, we have a one bedroom loft in
“When you walk into Tiffany & Co. you can buy a $150 charm or a $50,000 bracelet, but with either purchase, Tiffany will give you the prestigious packaging and exceptional service synonymous with the brand. That’s what Premier Sotheby’s International Realty is about. We’re inviting to everyone, so whether it’s a $200,000 home or a $7 million home, we give everyone the extraordinary service that’s part of our brand.”
Premier Sotheby’s International Realty and the Sotheby’s International Realty global network are also an acknowledged source for some of the most distinctive properties available anywhere.
Recent notable sales for the Sotheby’s International Realty network include a $44 million sale in
Global and Unique
Historic properties is considered a lifestyle category for Sotheby’s International Realty and their affiliates. In addition to price range and location, the company’s website allows clients to search for properties under lifestyle categories including: waterfront, skiing, equestrian, ranch and farm, golf and country club, and vineyards and wineries.
The Sotheby’s website is a popular one. With 90 million property views annually—1 million in July 2014 alone—the website can be viewed in 15 languages and 40 currencies. User viewing averages a focused 12 minutes.
“The lifestyle search is unique,” says Green. “So if you are looking for a waterfront property in the $2-3 million price range, you could see a property on
But the company didn’t rely on their widespread recognition alone when entering the
“The concept of The Premier Community Foundation relates directly to what we do as a company,” she explains. “We work relentlessly to help our customers achieve their real estate goals. By comparison, the foundation will help build stronger communities for children and families in our markets through the most effective use of funding dollars, because we know that home is where the heart is.
“The projects that The Premier Community Foundation selects for funding won’t always focus on raising money,” notes Green. “Some will focus on raising awareness around important causes. But in every case, foundation-funded projects will ultimately be about supporting and bolstering children and families in communities throughout our footprint.”
The Premier Community Foundation allows our broker associates to support whatever local charity they find important. The foundation invites community groups and tax-exempt entities to apply for various forms of support depending on their need.
“Throughout our respective histories, our company has made giving back to our communities a priority,” Green avers. “Today, as a successful and larger organization, Premier Sotheby’s International Realty further embraces our responsibility to leave situations better than we found them. By forming The Premier Community Foundation, we have solidified the ability to leverage our knowledge and resources to ensure healthy, vibrant communities for years to come.”
“So whether it’s Levine Children’s Hospital or Second Harvest Food Bank or A Child’s Place, all the money we raise here will stay in this community. Our first event was a great one. We’re going to make it an annual one.”
Penetrating the Marketplace
Premier Sotheby’s International Realty is pleased with the welcome they’ve received in
The positive response has led to plans for growth. The SouthPark office has 30 associates currently but Green expects them to double the number by year end 2015. The SouthPark office serves communities in Charlotte, Gaston and Union counties as well as the
To serve areas North, Premier Sotheby’s International Realty’s
And beyond that? “Look for us to keep expanding,” says Green.
Green admits that outside forces are a major factor in the health of the real estate market. “Mortgage rates are a huge indicator,” she explains. “And they’re still at an all-time low. But even when rates go back up, people are still going to buy real estate. Home ownership is a long-term wealth builder and I don’t think that will ever change. Real estate remains a smart investment.”
Right now Green says they’re seeing property on the market capture full asking price and more. She’s also noticed that more people want a home that’s move-in ready, a trend she thinks will grow as more millennials enter the market.
“Millennials want it now,” says Green. “They also want to live close to work. Uptown, Plaza-Midwood and NoDa would all be wise areas for investment.”
Green says out-of-area investors have also shaped the
“They’re buying properties that fit those parameters sight unseen as cash deals that close quickly. We’re also seeing individuals who are buying homes as an investment and using them as property management.
“There will always be people relocating or moving up or downsizing,” Green continues. “That’s always been the case. But when the market corrected a few years back, some people found their homes had greatly devalued. Now that those values are coming back, some people have decided that now is the time to sell.”
Along with improvements in the market in general, the luxury market has also improved. “In 2012, Premier Sotheby’s International Realty had 57 homes under contract valued at over $500,000,” Green says. “In 2014, we had 110 in the immediate
A well-respected global brand and a market comeback certainly contribute to success in a new market but Green sums it up simply. “It comes down to listening to what people want, learning to serve the needs of our customer and giving back to the community we serve,” Green explains, “and to always exceed our customer’s expectations.”
Kenneth and Sam Ayers knew a lot about buildings long before they got into the cleaning and maintenance business. Both trained engineers, the father and son duo began working together in 1999 when Kenneth joined his father in his custom home building business in
In 2006, they decided to diversify into building maintenance, buying a franchise of Kansas City-based City Wide Maintenance. By 2008, they had City Wide Maintenance of Charlotte up and running, covering the
Timing could not have been more fortuitous. “God was looking out for us,” says Sam. The construction industry, among the hardest hit by the 2008-2009 economic recession, was just beginning to reel from the loss of business that would continue to decline over the next few years.
“We had been thinking about integrating vertically, opening a cabinet ship,” contributes Kenneth, “but were lucky to get out of the building industry when we did and into a recession-resistant business.
The Cleaning Solution
City Wide Maintenance of Charlotte is a building maintenance management company that specializes in janitorial and maintenance services primarily for commercial buildings.
“Working through our network of service partners, we help folks that outsource their cleaning and maintenance needs,” explains Kenneth. “Anything that makes a building and property look better, we can do.”
Each City Wide customer utilizes janitorial services and can access as many as 20 other services as needed, including painting and dry wall repair, parking lot services such as asphalt sealing and striping, lawn care, window washing, carpet cleaning, lighting services, floor refinishing, concrete coating, pest control, pressure washing, carpet and tile installation, restroom remodeling, handyman services, picture hanging, and more.
City Wide maintains numerous types of facilities from single and multi-tenant commercial businesses to medical offices, schools and faith-based organizations. “Our target building is a 25,000-square-feet, single tenant owner-occupied building,” says Kenneth.
Area customers include Britax, with its 500,000 square feet of building space, Tindol Ford, several Charlotte Eye, Ear, Nose and Throat Associates (CEENTA) locations, Precision Steel Warehouse, Piedmont Plastics, US Leisure, The Goddard School, and Dilworth Child Development Center, to name a few.
“By partnering (sub-contracting) with small to mid-sized companies that do not have their own sales and management teams in place, we are able to provide services to customers and deliver professional management of each vendor,” says Kenneth. “It’s a win-win-win for us, for the contractors who need help in developing business, and for the customers who no longer need to manage building maintenance. It’s also a huge benefit in terms of convenience, efficiency, and financial commitment.”
“We got interested in this business because our background was in construction and the business model of City Wide was similar to what we were used to in the building business,” shares Sam. “Plus, one of the appeals of this was that it is, if not recession-proof, recession-resistant.”
City Wide Maintenance, the parent company, offers franchises in the 76 largest markets in the
Indeed, City Wide Maintenance of Charlotte has averaged annual growth of over 52 percent each year since 2009, so much so that Kenneth and Sam are willing to entertain the possibility of acquiring another market, although they insist that the
“Our 10-year goal is to continue to experience the growth we’ve achieved during the past several years,” says Kenneth.
The Father-and-Son Connection
City Wide Maintenance was started in 1961 by Frank Oddo in
Then City Wide provides leadership, mentoring and business development to ensure that its contractors provide seamless service to clients. In 2001, the company began franchising its concept and today there are 40 City Wide franchises around the country.
Kenneth and Sam both say that the fact that City Wide itself is a father-and-son venture helped to bring them into the franchise fold.
Kenneth says City Wide Maintenance of Charlotte mutually benefits from relationships with other City Wide franchises, particularly along the I-85 corridor, such as those in the Research Triangle, Greenville/Spartanburg and
“We work closely with them, sometimes talking weekly about challenges and opportunities. We also partner with them to share customers who have buildings in different markets,” says Kenneth. “We’re prospecting one right now from a
In some ways, the company operates more as a family business than a typical franchise.
“Above and beyond the janitorial services, we have autonomy to decide what we do,” says Kenneth. “In our business model, the core of the business is the janitorial and represents 75 to 80 percent of our revenue. That leaves room for us to decide what additional services to provide and how to distinguish ourselves.
“Some of that is dictated by geography. For instance, we don’t do a lot of snow removal.”
Work with the customer begins with a detailed needs analysis, describes Kenneth. That is followed by identifying the most appropriate service partners for the work involved, determined by expertise and geographic location.
“Most importantly,” says Kenneth, “each customer is provided with support from a designated facilities service manager with whom they can communicate and who will be watchful of current and upcoming needs. The facilities service managers catch things before they become big problems—for instance, frayed or damaged carpet.”
“Customers like to have someone they trust—someone that already knows the building—to call upon,” adds Sam. “This is a huge service to companies that, in many cases, have office managers trying to keep track of the needs of a huge building. Our strengths are the time savings we offer through managing services and the ability to put the right people on the job.”
City Wide boasts a retention rate of over 90 percent according to Kenneth.
“We mostly work with service companies that don’t have the staff, time or expertise to go out and market their services and negotiate contracts,” explains Kenneth. “We become their sales team and are a catalyst for their growth. A lot of these companies may not exist or be at the size they are without us.
“We feel responsible, in part, for the 125 employees that are associated with our service contractors who specialize in all the areas we might be called into.”
Since contractors are always looking for business and City Wide is always looking for contractors, the company holds an open meeting for potential contractors every four weeks or so. “We also run ads on Craigslist and get recommendations from existing contractors,” says Sam.
City Wide requires that the contractors conduct full background checks on their employees and provide that information to City Wide management. “So many people reach out to us,” says Kenneth. “We have to be very aware of their capabilities. We can’t just put anyone in one of our buildings.”
“We’re pretty proud of our Performance Plus Program,” admits Kenneth. The proprietary program outlines six steps and strategies to optimize cleaning time and focuses on preemptively attacking dirt before it comes into the building. With a commitment towards indoor air quality, the company uses high efficiency chemicals and equipment to ensure a deep clean.
City Wide considers itself to be environmentally friendly. “We don’t use toxic chemicals,” states Sam. “Everything we do is green where applicable,” says Kenneth. “All of our cleaners are green-sealed certified.” Kenneth says that they are also careful to train all workers in the proper use of chemicals and how and where to dispose of chemicals and dirty water.
The company is also guided by state regulations and OSHA requirements, particularly in settings such as schools, food distribution areas, day care centers, and ambulatory surgery centers. For instance, in day care centers, there are requirements regarding carpet cleaning, air returns and vents, and how toys are cleaned. With food distribution, there are requirements around the use of safe disinfectant cleaners. Regulations also are applied for personal protection equipment, such as steel toed shoes and safety glasses, in certain environments.
All in the Family
City Wide Maintenance of Charlotte has six management employees divided between sales associates, facility service managers (FSMs), and operations support staff. Each FSM is responsible for a number of buildings and manages a rotating schedule for visits to the property. Sam also serves as an FSM. Kenneth’s wife Catherine serves as the company’s part-time financial coordinator.
“Our office doesn’t get a lot of telephone calls; not a lot of people knocking on the door,” says Sam. Existing customers will call Kenneth, me, or their FSM directly. For prospective customers, we do the calling and door-knocking.”
“A lot of our efforts are simply out on foot canvassing buildings, stopping by or making calls and sending emails to building owners or tenants,” remarks Kenneth. “Often information regarding ownership or property management will be posted on the door.”
City Wide staff is constantly reviewing Google maps and drilling down into
City Wide has established specific metrics for their outreach, aiming at 2,000 contacts or “touches” each month. Typically, that number of contacts will generate three to five new customers. New buildings are steadily coming onto the
A native of
Over time, he grew tired of working with large companies and went full-time into the home construction industry in 1991 where he remained until the City Wide opportunity presented itself. Commuting from
Sam’s eventual retirement will be a real issue for Kenneth and the business, and the pair are beginning to work on a succession plan. “Every business partner has to plan on how to replace himself,” remarks Sam.
“Being involved in a 24/7 business means occasionally getting calls during the night. Fortunately, we have people out at night who can handle most issues,” says Kenneth. “Sometimes Sam and I get calls, but unless there is a true complaint or problem, we’re not as involved at night.”
Asked if they have any horror stories, Sam recalls, “The worst thing that has happened was one of our contractors was on his way to clean a building in
“We’ve been very fortunate,” Kenneth says nodding. “The only times cleaning could not be done on schedule was due to inclement weather.”
Overall, Kenneth and Sam say they have enjoyed working together and have managed the inherent kinks of working alongside family members.
“The great thing about it is that I know I can trust him at all times; I don’t have to worry about it,” says Kenneth.
“We’ve been working together now for 15 years and we haven’t choked or kicked one another,” laughs Sam. “It wouldn’t work with every father and son but we’ve managed to get along so far and it’s working out well.”
For most people, turning a hobby into a career is nothing more than a dream, but for one entrepreneur, it has become a reality.
Greg Higgs, founder and owner of Fab Fours, Inc., located in
“Although I thought I was heading for
“At the same time, I started writing a business plan for starting a retail off-road shop in the U.S. Providentially, circumstances came together and I met an investor, a fellow Texan—as I am from
After only three months working in
He continues, “We got that shop in
Higgs readily admits that he’s always had a fascination with bumpers. He decided to begin importing them from a manufacturer he found in
“Our supplier eventually fell through,” remarks Higgs, “but the die was already cast in my mind. I realized I could live anywhere and use drop shipping to get my products out.
“So, we moved to
“We wanted to become a nationwide, full-fledged bumper provider from the start. With that, the idea was ‘No constraints.’ If we’re going to use drop-ship manufacturers, we need to have the best manufacturers in the country. This led to having suppliers in
At the same time, Higgs’ role was focused on the sales and marketing side of things. He drove from city to city, hauling a trailer full of products, and each time he would arrive in a new place, he would pull out the Yellow Pages to look for truck and vehicle accessory shops. Door to door, he would bring proprietors out to see the products, and ultimately, convince them to do a buy-in, leading to steady growth.
“We started with a direct-to-retail market,” says Higgs, “but in early 2006, beginning with the SEMA show, the industry standard for our products, everything changed. At that time, we virtually didn’t exist. We had no phone number, no website, nothing. But starting in 2006, you could actually buy something direct from Fab Fours, and our revenue was something like $400,000.
“From ’06, ’07, ’08, we made the Inc. 500 with revenues around the $2.5 million mark,” continues Higgs. “So, selling was not the problem as we were keeping our promises of quality and consistency, which is a concern in this market.”
Higgs explains that many people who go into the after-market vehicle parts industry are enthusiasts, much like himself. Higgs believes that many of these enthusiasts are unprepared to handle the challenges that come along with growing such a business.
“That typical path begins by making parts on the side or tweaking parts until reaching a point where an enthusiast can quit their day job and become a small business owner,” says Higgs. “And then they grow that until they peak where their personal objectives have been met, but the next evolution of the business surpasses their finances, personal ability, and so on. This is why there are many competitors, but few rivals to Fab Fours.”
He continues, “My father started his own business with two other guys with $5,000 apiece in the oil and gas industry. That company now makes over $1 billion annually, so I lived through the right way to grow a company.”
The Path to Success
Fab Fours’ value proposition is “Quality…Delivered On Time,” but challenges at the
As Higgs notes, “It was still small job shops we relied on, and the quality we demanded was greater than the level they were capable of producing. The shops that could make a bumper could also make a riding mower deck or an electrical box housing. Those are parts where no one cares if they have slight defects or scratches.”
Unfortunately, Higgs says, many in the enthusiast community are all too familiar with the grainy, difficult-to-read instruction manuals, missing bolts, and parts that don’t fit that arrive three-to-five weeks later than the customer expected.
“We decided we were going to try to change this expectation. We decided to place a strong emphasis on quality parts delivered on time. Today, if you want a car seat, you can go out right now and buy a car seat from numerous places. In my industry, it’s not like that.
“Our community is small and fragmented. If you want a premium bumper, you have to order from a specialized company. However, getting a quality bumper on time is important, and we weren’t able to produce the quality we wanted in
He continues, “We’re like a Louis Vuitton purse for a guy. When we construct a bumper that you’re installing onto your pride and joy, a bumper you’re spending thousands of dollars on, it has to be perfect. So, to get that quality, we had to bring the parts to us, which was unraveling the strategy of having distant manufacturers. Now it was becoming a massive burden. The part that was made in
In order to combat this problem and further expand, Higgs reached out to individuals involved in economic development in
Over time, Higgs began feeling as though
“Our initial location in the greater
The decision was then made to move to
“This facility is 33,000 square feet and all production, from 2010 to present, and what will be all of 2015, was and will be out of this facility. However, we own a building that is about 12 miles from here that is 140,000 square feet.”
Higgs continues, “Right now, we’re using that location for sales and marketing, but it will be used for manufacturing. This location will continue to operate, possibly as an aluminum plant, as we continue to diversify our product line to include both steel and aluminum items.
“Where this building will peak at about 18 to 22 million in capacity, the new building should be good for about 85 to possibly 100 million in capacity. My view is, if the new building can get us to 100 million, and our current location can produce 20 million, that’s probably the limit that we would want to make in this region anyway.
“By the time we hit that, the other building will be our headquarters, but we’d then like to expand outside of the
Driving Into the Future
Fab Fours’ front winch bumpers are designed to be the ultimate in functionally stylish front end protection. These direct bolt-on bumpers require no cutting, grinding or welding. An engineered winch mount conceals the winch in the bumper. Fab Fours’ rear bumpers come with a variety of options including integrated receivers, tire carriers, shackle mounts, and more.
Fab Fours insists on quality construction formed and welded precisely—for example bumper tire carriers have Fab Fours’ signature “knife edge” finish. Although they are best known for their quality bumpers, Fab Fours manufactures a wide variety of vehicle accessories for the automotive aftermarket. Products come with a lifetime warranty on structure.
Regarding what the future holds for Fab Fours, Higgs says, “Right now, bumpers are the driving force, they’re what we’re synonymous with. However, starting about 18 months ago, our line did expand to include peripheral steel accessories. When you look at the outside of a vehicle, for example a super-duty truck, there’s the front and back bumpers, side steps, a headache rack, and a roof rack. So, basically anything that you can bolt to the outside to change the look and function, we’ve now hit all of those elements.
“In addition, our flagship bumper is still the most expensive on the market, but we’ve also introduced a less-expensive model that’s well suited to fleets.”
Higgs also notes that the company has turned to wholesale distribution to gain an edge.
“Because we built our brand through organic retail customers, it’s become difficult to travel far to find new customers as well as logistically challenging to ship. This led our company to become a pioneer in wholesale distribution for bumpers.
“While wholesale distribution has been around in the aftermarket industry, it’s mainly been used for small parts. Think about this…one of our steel bumpers, when packaged, weighs about 400 pounds and is about the size of a refrigerator. Through the wholesalers, anywhere in
“In the end, we aim to be the brand in the automotive aftermarket that truck and off-road enthusiasts turn to above all others. As we’re bolting together our plan, we also plan to pursue commercial, military, and international. As long as we stick to delivering quality products on time, I’m confident that we’ll get there.”
When General Manager Joey Profeta greets you at The Palm in
A 20-year veteran of The Palm, Profeta knows many of his customers by name, knows about their family, and knows what they like to eat and drink. It’s all part of the culture of a family-owned business started in
But while the scope of The Palm has grown since 1926, the key values that have contributed to the company’s success haven’t changed—a commitment to outstanding food, exemplary service, and a culture built on hospitality, generosity, and a sense of family.
Third Generation Family Business
As the story goes, John and Pio wanted to name their new restaurant after their hometown of
Because The Palm was located near the headquarters of newspaper cartoon distributor King Features Syndicate, it was frequented by many of the artists. So in trade for their meals, the artists would draw their creations on the walls, and the walls of that original location still feature the faces of Popeye, Batman, Beetle Bailey, and the characters from “A Family Circus.”
The tradition of decorating the walls with caricatures has continued over the years. Each new restaurant gets 200 to 300 likenesses of local notables on the walls and new caricatures of regular customers and local celebrities are added as time goes by to keep the walls updated and current. Many of the caricatures are personally autographed.
Ironically, while The Palm is today best known for its steaks, the original Palm didn’t even have steak on the menu. Primarily a traditional Italian restaurant, if a customer asked for steak, John Ganzi would run to a nearby butcher to buy a steak to cook to order. In time, steaks did become a regular menu item.
In the 1940s, Walter Ganzi and Bruno Bozzi took over the restaurant from their fathers; and in the early 1960s, their sons, Wally Ganzi and Bruce Bozzi Sr. began working at The Palm. In the late 1960s, Walter and Bruno retired from the business, handing the leadership over to Wally and Bruce.
When George H.W. Bush was in
In 2011, the Palm Restaurant Group undertook a brand refresh which included tableware, uniforms, signage, and an updated visual identity manifested in a new website and a new ad campaign. People did not know the chain of eateries were family-owned—they had been communicating a very corporate vibe that didn’t jibe with the restaurant’s history or roots.
A number of menu changes were made to coincide with the brand refresh.
Menus emphasize “family recipes” and there is a greater focus on making an emotional connection with loyal customers and taking much greater advantage of a rick family history. So To date, the refresh seems successful—a sign that the rewards can be rich for investment in thoughtful design.
The Palm’s growth led to
“The Palm is all I know,” says Profeta, who has managed the Charlotte Palm for almost 10 years. “My career started in the kitchens. I’m also Italian-American, so this place certainly has a special place in my heart. I love The Palm. I love the family. I love the culture. I love the business.”
A native of
In 1999, he was promoted to executive chef in
“I always said that being a chef is a very young man’s game, and after almost 10 years of that hot and sweaty work it was time for me to take a look at what was next,” says Profeta. “I really enjoyed the business end—the hospitality, the guests, and the people. So from that standpoint, it was a very easy transition to the dining room.”
Profeta had been in
“Fortunately, having that experience in the kitchen allowed me enough time to figure out what I was doing in the front of the house,” says Profeta. “There aren’t a lot of people in this business that have experience in both the kitchen and the dining room.”
“I’ve also been more than blessed with the team here,” continues Profeta. “The people that work for The Palm are truly amazing. I just started my 10th year at this location and all of my chefs and managers are the same except for one. My executive chef has been here about 12-13 years. My assistant general manager has been with The Palm for 12 years. Our entire morning kitchen crew has been here 15-plus years. I would bet that half of our hourly staff has been here longer than me. That’s simply unheard of in this business.”
While Profeta says their goal is to serve great food and provide exceptional service, he adds you could also make that same statement about many other fine dining steakhouses in
“I truly believe that the only thing that separates us from any other restaurant is our ability to build relationships,” offers Profeta. “I work at that; I take pride in that; and I enjoy that. I want to get to know you, your family, where you work, how many kids you have, your favorite table, and your favorite drink. I want you to become an extension of my family.”
Helping Profeta and his team accomplish those goals are internal information systems that keep track of customer likes, dislikes and preferences. The information is provided to servers as well as management to help the teams provide Palm customers with the best, most personalized experience possible.
The Palm also has one of the most successful loyalty reward programs in the restaurant business, their 837 Club. Profeta says he often sees patrons arguing over who gets to pay the bill, since if you pay the bill you get the 837 Club points added to your account.
The caricatures themselves are another way The Palm rewards the loyalty of their best customers, by offering the opportunity to have their likeness placed on the wall. While some patrons decline the offer, most accept and often ask to be seated near their picture when dining, especially when they are entertaining.
The Charlotte Palm also benefits from its longevity, arriving on the scene before many of its current competitors like Del Frisco’s and Ruth Chris. Because of the customer loyalty that has been built over those years, Profeta says a new generation of
“We often hear people say their father introduced them to The Palm in
A Changing Landscape
In recent years
He believes the arrival and maturation of
With the price of prime beef on the rise due to supply constraints, every restaurant is trying to find other things to put on the menu. And while there is a trend towards more seafood as customers try to make healthier choices, the vast majority of The Palm’s customers still want a big steak, so they must find the right balance on price.
“We certainly aren’t the cheapest in town, but we don’t want to be the most expensive in town either,” says Profeta. “We also don’t want to change the quality, and we still will always serve a huge steak.”
Since the Great Recession of 2008-2009, Profeta acknowledges that business dining and entertainment practices have changed and will probably never be the same again.
“I don’t think there are many employees that still have the freedom of the unlimited expense account,” admits Profeta. “But I actually think that makes for a stronger, more sustainable business. I would rather have them come in here and feel good about what they spent and come back again in a month, as opposed to only being able to come once a year.”
Instead of expanding to new cities, in recent years, The Palm has turned its attention more toward its existing locations. Should an older facility be renovated, or should it be relocated to a new site altogether? In
Technology is also changing the way restaurants do business, particularly with the advent of Web-based reservation systems like Open Table. Profeta says he is amazed how many reservations are booked on the Web via Open Table or at ThePalm.com.
“Open Table really helps us promote our business,” says Profeta. “People can jump on the Web and search for what’s open in the next hour in
But he says managing the reliability of that online reservation can be a challenge. While people who have called to make a reservation will usually call back to advise of a change in plans or a reduction in the number of diners, he says those who reserve on the Web seem to be less likely to advise of changes, making it more difficult for the restaurant to adapt to the change and plan accordingly.
Profeta also thinks it won’t be too many years before servers will be using handheld devices to take orders and automatically send that order back to the kitchen. Upcoming rules that will require all credit card swipes to be done in the presence of the customer will likely mandate some sort of mobile terminal that allows the server to process such transactions at the customer’s table.
While the restaurant landscape is always evolving, Profeta says treating his employees and customers like family will never change. Whether it’s a “family meal” for all employees prior to the start of the evening shift, or a free turkey for each team member to take home at Thanksgiving, he says preserving The Palm’s culture is a top priority.
“I’ll never take my eye off of that prize, because I think that is what has allowed us to stay so competitive for so long,” he concludes. “There are so many restaurants that people pass by when they choose to go to The Palm, so building relationships is something that we absolutely must continue to do better than anybody else.”
“If you do the math, WTVI celebrates 50 years of service to this region in 2015. And that really is what public television is all about…it’s about service and commitment to a region,” says Amy Burkett, WTVI’s general manager and host of the “Carolina Impact” program.
“I’ve been in television for nearly 25 years so far,” says Burkett. “I spent nine years in commercial television, I spent 14 years at a public television station in
WTVI, virtual channel 42 (VHF digital channel 11) and cable channel 4,5 or 9 in the
WTVI was originally owned by the Mecklenberg County Board of Education, first signing on the air in August 1965 as an instructional television station with programming meant to be viewed in classrooms. The WTVI call letters stood for tele, vision and information.
In 1982, WTVI’s license was transferred to an agency created by the school system and the county—the Charlotte-Mecklenburg Public Broadcasting Authority—turning the station into a community-owned entity.
For over two decades WTVI served the community’s needs, but beginning in 2004, revenues began to decline. The station cut back on more well-known PBS programs in favor of “alternative” shows, but after several years it was in trouble. By mid-June 2011, its long-term operation was questionable.
“Of course, after the economy went south in 2008, the ensuing years were challenging for nearly every broadcaster, including WTVI,” acknowledges Burkett.
She explains, “There’s no doubt that we faced some challenges. In a nutshell, WTVI was having a hard time meeting its budget and would have gone dark in 2012 had
Approved by the Federal Communications Commission, the acquisition of WTVI was completed by July 2012. As a result, WTVI became an educational licensee for the second time in its history and, at the time, one of seven full-time PBS member stations to be operated by a community college.
“Afterward, the former general manager retired, and CPCC conducted a national search for a replacement,” continues Burkett. “That’s where I came in. I was chosen to take the station in a little bit of a different direction. In the 16 months that I’ve been in the
WTVI has since brought back familiar PBS shows such as Downton Abbey, Nova and Nature to the schedule. Among its original shows and documentaries are Carolina Business Review, Carolina Impact, Off the Record, Charlotte Cooks, Job Ready, International Success, and Trail of History.
It reaches more than 1.1 million households in its 13-county service area in both North and
Showing and Doing
“We recently developed a tagline,” says Burkett, “‘We tell your stories, in your community, because we’re your WTVI PBS Charlotte.’ And while you can watch a multitude of cable and satellite channels, along with other public broadcasting stations, there is only one public television station serving this 13-county region, and that’s WTVI.”
“For example, Beverly Dorn-Steele, our director of educational services and community engagement, does a terrific amount of outreach including the literacy programs that she advocates and participates in—and that’s not happening at the other stations because they aren’t located here.
“In addition, we’ve enhanced the educational role of the station. Last year, we launched our STEM Awards to recognize terrific teens and teachers in the fields of science, technology, engineering and math, which is a great collaboration with CPCC and their STEM Program. They were the judges and we put on the program. We were able to recognize young people in 11 different categories, and that was an honor.
“We want to help young people see that there are a lot of jobs out there that go unfilled. In fact, last year, over 600,000 STEM jobs went unfilled because students didn’t have the technical training that an educational institution such as CPCC offers. WTVI is also working with CPCC to create an associate’s degree program in digital media studies.
“We also launched a news magazine show called “Carolina Impact” last year,” continues Burkett, “that tells the stories of this region on a weekly basis. Each week, we’re focusing on the issues, people and places that impact this region, and that’s once again all about service. So what we’ve developed over the last 16 months is a service-to-success model. The greater we serve this region, the more support we receive, and together, we’re all more successful.
“PBS stands for public broadcasting system, so it’s not a network,” Burkett is quick to point out. “Whereas a major network affiliate will broadcast network programming at certain times on certain days, we have more flexibility to broadcast programming on our schedule.
“The 150 or so independent PBS affiliates across the country carry Nature, Nova, Antiques Roadshow and Downton Abbey, for example, but we have some freedom as to when we can air these PBS programs. And we are careful to differentiate our programming so that you aren’t watching the same programs as on the other public stations in the area.
“Five nights a week, “Burkett says, “our programming is very different than the other two public broadcasting stations in the
See More Good Stuff, Really
Dorn-Steele, a 33-year veteran of WTVI, is accustomed to the spotlight as the host of WTVI’s “Ms. Beverly and Seemore Goodstuff.” But she’s also accustomed to lending her hand in the
Dorn-Steele explains, “I ended up here at WTVI quite by accident. I had applied to the school board in
“From there, I just worked my way up. I’ve learned everything from production to finance to promotions. Over time, I moved from the production side of things to the engagement and community outreach side of things.”
Burkette adds, “I like to call
“One thing I like,” Dorn-Steele remarks, “is that, for me, every day is different. Some days, at least twice a week, I’ll be out in the community conducting workshops with childcare providers, educators and parents on how they can use the power of PBS kids programming in their curriculums. These workshops can range anywhere from 45 minutes to two hours in length.
“We also provide curriculum guides that center around specific themes. For example, we have a Curious George guide that deals with science, and we’ll conduct a workshop with science teachers that want to use Curious George in their curriculums. Also, all of our guides do meet the North Carolina CORE standard, so educators really embrace the use of public television.”
Dorn-Steele continues, “We also have adult programming and documentaries where we might have a preview screening and invite community members or a targeted organization. Then, we may have a dialogue or panel or special guest to engage the group to take action.
“This past summer we conducted the ‘Cyber Chase Summer Challenge,’ where kids around the country were challenged to come up with their own math games. WTVI worked with the Johnston YMCA, and they created three games, and two of those games came in first and second place in this national contest.”
“Our kids are smart in
“Other television stations don’t have that kind of connection with people like we’re able to have here. In addition,
Beyond Public Broadcasting
Dorn-Steele and Burkett also discuss how they love the chance to connect with and empower
Dorn-Steele says, “Another great example of the educational outreach that we’re involved in is the ‘Martha Speaks Reading Buddies’ project, where we partnered with one of the area’s lowest-ranking elementary schools to pair second and third graders with kindergarteners and first graders. ‘Martha Speaks’ is about a dog that swallows a can of alphabet soup, and when he speaks, he introduces a new vocabulary word.
“It just blew my mind, watching these kids after the show, especially on parents’ night. ‘Oh, I recognize that word. Do you want to hear me use it in a sentence?!’ It was phenomenal.”
Burkett follows up, “Community engagement is one of the things that powers public media, and we just love to be a part of it.”
Ultimately responsible for operations of the station, Burkett has an impressive array of experience on which to draw. “I have a background in a little bit of everything in television including programming, fundraising and production,” she says modestly.
She grew up a small
“I learned how to do everything,” she remembers, including anchoring the 6 and 11 p.m. newscasts.” She moved on to other positions in
“At WTVI, I also host our ‘Carolina Impact’ show while working on documentaries,” she says. Like Dorn-Steele, Burkett enjoys the variety of activities her job entails. “So, my day could start out with a budget meeting, I could go on a fundraising breakfast or luncheon, and follow it up by hosting an education summit,” she describes.
“I also serve as a board member on the Charlotte Chamber of Commerce, so I’ve got a little bit of everything going on, but all of this allows me to get to know the
WTVI also has significant offerings apart from public broadcasting. Burkett says, “Production services are a big part of what we do. People can hire their public television service for a commercial or for a video, for example.
“I don’t think anyone tells stories like your public television station,” touts Burkett with pride. “So, if you’re looking for something to put on your website to connect the dots, we’re available.
“We had the good fortune to partner with Charlotte Works and the Centralina Workforce Development Board last year to create some videos showing how STEM fields are important for young people. That was a great collaboration, producing stories that are posted on various websites that educate and inspire others as to where the jobs are for the future.
“We strive to provide unique, engaging, educational, and entertaining local programming. We also seek out unique talent within the
The Centers for Disease Control and Prevention cites nearly 130 million visits to U.S. emergency rooms (ERs) in 2010. Statistically, that is around 43 visits per 100 people annually. As often the first and sometimes the last defense against medical crisis, emergency departments (EDs) are the melting pots of their communities, seeing all walks of society and adapting to technological, cultural, economic and legislative change.
Hospital EDs perform a vital and complex role for the communities they serve, and for the last 38 years, Mid-Atlantic Medical Associates, P.A. (MEMA) has played a pivotal role in emergency medicine in Charlotte and the surrounding region.
Founded in 1976, MEMA is an independent, physician-owned emergency medicine practice that provides emergency and acute medical care through its longstanding relationships with several area hospitals.
With corporate leadership including a chief operating officer, chief financial officer and a professional recruiter, and governed by an elected board of directors, MEMA currently consists of 48 physicians who are board-certified/board-eligible in emergency medicine and pediatric emergency medicine, with several physicians double-boarded. MEMA also has 24 advanced practice providers, including both physician assistants and nurse practitioners.
Partners in Health Care
MEMA President and CEO Timothy Lietz, M.D., FACEP, explains the practice’s origins.
“We’ve been at Presby [Presbyterian Hospital] 38 years,” Lietz says. “We were the first emergency department group to staff that hospital. Before that, the emergency department was staffed by community physicians who would take turns.
“MEMA was originally a group of doctors who did the majority of shifts. Then they were hired by the hospital and eventually they became an independent group of emergency medicine specialized staff that provided the service to the hospital.”
Lietz joined MEMA in 1994 to staff the then newly opened Presbyterian Matthews hospital and was medical director there for 17 years.
Since 1976, MEMA has provided the 24/7 staffing for the Novant Health Presbyterian Medical Center (formerly Presbyterian Hospital Charlotte) ED and currently also provides 24/7 ED staffing for Novant Health Matthews Medical Center and Novant Health Huntersville Medical Center.
The ED of the new Novant Mint Hill Medical Center, slated for completion in 2017, will also be staffed by MEMA when it opens.
Lietz describes the practice’s relationship with the hospitals they staff as a strong partnership involving common goals.
“We walk hand in hand with Novant Health in their goal of a remarkable patient experience,” Lietz says. “It’s our vision as well. We’re dedicated and committed to it. We had staffed other hospitals in the area but when their vision became different from ours, we went separate ways.
“Our goal is a patient-centered experience where we provide the best, highest quality emergency care. Physicians aren’t the only factor in accomplishing that. The hospital, the nursing staff, the administration and the tools available to us are all factors in making that happen.”
MEMA’s close relationship with partner hospitals is reflected in their joint work. All three Novant Health Medical Centers are certified stroke centers and accredited chest pain centers and Novant Health Presbyterian was the first hospital in the Charlotte area to open a dedicated Pediatric Emergency Department in 2003. The department was expanded in 2011 and is staffed by MEMA physicians that are board-certified in pediatric emergency medicine.
MEMA physicians are also involved in key hospital committees such as the Medical Executive Committee, Emergency Services Council and the ED Hospital Steering Committee, among others. “Innovation is collaborative between us and the hospital,” says Lietz.
One such innovation implemented last year was the Safe Sign Out Project. “One of the times most vulnerable to mistakes is when patients are turned over at the end of a shift,” Lietz explains. “If a patient is in the middle of a work up and is waiting on results from an X-ray or a CT scan, things can be miscommunicated or not properly followed up.
“To prevent these issues, we decided to institute a formal process to ensure that all information was provided to the oncoming physician. In this way, the physician taking over care of the patient has the patient’s anticipated diagnosis, pending tests and a tentative action plan. It enhances patient care at our partner hospitals and makes our practice safer.”
Commitment to Leading
The relationship between MEMA and its partner hospitals is bucking a trend. Lietz notes that MEMA is the last independent emergency group in Charlotte. “When I first came to Charlotte in 1994 there were three or four private practice emergency groups that staffed area EDs,” he explains. “Now some of the hospitals use national contract groups to provide their physician services.”
Integration, where hospitals buy private practices and physicians become employees of the hospitals, is also a long-term trend in Charlotte and nationwide. “Maintaining our independent practice status is a challenge,” says Lietz, “but we believe it is the best way for MEMA to remain a high quality practice.
“Our independent, physician-owned status allows us to hire physicians who eventually become owners of the practice and who are committed to making the practice a success,” he says. “We hire people who want to be in the Charlotte area and establish a long-term career here. National contract groups often have doctors who will work here for a few years and then move onto other regions.
“We try to develop a core group of physicians at each one of our hospitals who will spend their careers there. That way we get to know the medical staff and hospital administration and become integrated into the medical community of the Charlotte area.
“What makes us stand out is that our physicians are committed to our group, they’re committed to their hospital and they’re committed to their community.”
Leadership also makes MEMA physicians stand out. Of their current physician members, 19 are former chief residents; 11 are former attending physicians from teaching hospitals; three are past presidents of the North Carolina College of Emergency Physicians; two are current councilors of the North Carolina College of Emergency Physicians; two are current board members of the North Carolina College of Emergency Physicians; one is a current representative to the American College of Emergency Physicians, Reimbursement Committee; and Lietz currently holds the prestigious position of a member of the North Carolina Medical Board.
“It’s important for us to hire leaders in emergency medicine,” he says. “We hire people who are leaders among their peers as medical students and residents so that during their career with us they become leaders within emergency medicine in our state.”
The Charlotte community appears to also think that MEMA physicians stand out. In 2007, a MEMA doctor was named Presbyterian Healthcare Physician of the Year. In the 2013 Charlotte Business Journal list of Top ER Doctors, three of the five doctors named were MEMA members and in the 2014 Charlotte Magazine Top Emergency Doctors, five of the eight top doctors were MEMA physicians, including Lietz.
Lietz says he chose emergency medicine because he likes the high volume and high intensity of the specialty. “Every day, every shift is a new adventure,” he says. “We’re diagnosticians. We see a patient fresh. We see a set of vital signs and their chief complaint and we make a diagnosis. Other than that, it’s about trauma care, stabilization and resuscitation. Everything under the sun comes into the emergency department and we take care of it all.”
With life and death stakes as a regular part of a work day, you might think emergency medicine doctors would become emotionally detached from the crisis situations they routinely encounter and efficiently handle, but when asked about a memorable work experience, Lietz has trouble beginning—still emotionally impacted by the case years ago.
“About five years ago, I took care of an 18-year-old girl. She’d had a stroke. She was 18 years old.,” Lietz emphasizes. “She was in the emergency department all day—critical care, life support—all that stuff the whole time. We thought she was going to die.” Lietz pauses briefly to compose himself.
“About four years later, a young woman comes up to me in the ER and asks me if I remember her and tells me that I took care of her when she had a stroke. Today she works in our ER as an administration person.”
Real World Medicine
While the very nature of emergency medicine is a difficult one fraught with inherent challenges, emergency medicine today faces complex issues that can significantly impact its practice.
“Our practice mirrors what goes on in the real world,” affirms MEMA Chief Operating Officer Michael W. Icenhour. “When I started with MEMA 15 years, ago our Medicaid population was 16 percent. Now I’d estimate it to be around 25 percent.
“After the economic downturn, we saw a difference in our payer mix. Medicaid went up, self-pay went up and commercial (insurance provided by employers) went down. Our ER physicians treat patients based on acuity only, not on whether they have or don’t have insurance. But if 25 percent of our patient population is self-pay, that’s a huge issue for us from a business standpoint.”
The Congressional Budget Office estimates that through the implementation of the Patient Protection and Affordable Care Act of 2010 (PPACA) an additional 32 million Americans will have health insurance by 2019.
To date, Lietz and Icenhour say they have not seen an improvement in coverage. “The North Carolina Republican-controlled general assembly has elected not to expand Medicaid in the state so there’s a gap of people between those who can get subsidies to pay for their health insurance and those who are eligible for Medicaid,” explains Icenhour. “Those in the gap are our self-pay patients.”
“A huge challenge is taking care of all the folks who don’t have the resources to get health care,” Lietz adds. “Part of the practice of emergency medicine is taking care of the people who can’t get health care anywhere else but there’s a misconception out there.
“People don’t use hospital emergency departments as primary care because they need routine care for their diabetes or hypertension. They show up for an acute part of that illness. So a diabetic will show up in the emergency department because their sugars are out of control or in the case of hypertension, because their blood pressure is sky high. We take care of the acute phases of a chronic illness but we don’t function like a primary care physician.”
The cost of caring for the uninsured, which is absorbed by EDs, has serious financial consequences. According to the American College of Emergency Physicians (ACEP), the annual number of ED visits has increased by 23 percent from 1997 to 2007. Contemporaneously, 535 hospitals closed, 381 EDs folded operations, and available inpatient beds shrank by 134,000, exacerbating a nationwide problem of ED crowding.
“It’s a complex problem,” says Icenhour. “Even if everybody gets insurance, we don’t have enough primary care physicians to take care of all these people. I was talking to my primary care physician about this and he said he can’t find any internists to hire. They’re not out there, so people who can’t get in to see a primary care physician will still have to come our way until the crisis in primary care physicians is resolved.”
In fact, the ACEP points out, “In sum the PPACA, by increasing insurance coverage to individuals who in the past had none, and by not addressing the PCP [primary care physician] shortage, will exacerbate the problem of ED overcrowding by an influx of 13 million newly publicly insured patients.”
“For the Affordable Care Act to really work it’s going to take a culture change,” says Lietz. “It’s not just about how we pay for health care. People are going to have to change the way they think about getting their health care.
“They can choose to maintain their health instead of just using the emergency department for an acute medical crisis. That could change the role of EDs in health care, but unfortunately people are still going to have heart attacks and strokes and get into car accidents. They’re still going to need us and we’ll be here to help them.”
Most people don’t think about the possibility of needing home health care, but for one entrepreneur, the thought of assisting others became his passion.
In 1975, Mark Baiada, alongside one nurse, created BAYADA Home Health Care in order to meet the rising need for home health services in Philadelphia, Pa. Today, the company has expanded across the globe with nearly 300 locations, including five right here in Charlotte.
As a BAYADA Division Director Melinda Phillips says, “Our company was founded on the principles of compassionate care and understanding for those in need. Mark Baiada realized that medical technology advancements didn’t need to keep people confined to hospitals for long periods of time, so he set out to create a company that would allow individuals the chance to receive care at home.”
Today, BAYADA Home Health Care operates offices in 22 states and in India, providing a range of home health solutions for clients facing a variety of needs, including wound care, light housework and habilitation.
Responding to the Need
Phillips describes Baiada’s model for growth as allowing people who had proven themselves to go where they wanted and open offices to expand the business and offer compassionate care. In 1989, one of his trusted employees, Tom Mylet, decided to come to North Carolina and open an office in Winston-Salem.
“In fact,” says Phillips, “I started working with BAYADA Home Health Care as an associate at that location in 1994, allowing me to engage in my passion for service to others.”
“After some time as an associate, I became a client services manager and had my own case load. Once that grew large enough, in 1998, I presented Mark Baiada with the idea of opening a Charlotte location. I saw how we were able to help people in Winston-Salem, and I knew there were needs elsewhere in the state. He agreed and the first BAYADA Home Health Care office in Charlotte opened in the University Park Executive Drive area.”
The new office was a success from the start. Under Phillips’ leadership, the company opened more office locations in Charlotte, designating Charlotte as a division with multiple offices.
By 2009, Phillips observed that each office handling all lines of service, including pediatric home care and home health aide care, put a strain on resources and personnel. She had a logical suggestion.
“It seemed logical with multiple offices to start specializing. So now, each office in the Charlotte region specializes in a specific type of care. This allows BAYADA Home Health Care to better manage our client’s needs,” she affirms.
There are over 50 BAYADA offices across the Southeast, including North Carolina, South Carolina, Georgia, and Florida. And, as per the company’s decision to offer specialty care, each office offers a different specialty. These specialties are adult nursing care, adult personal care, pediatrics, and habilitation, which offers care for people with developmental and intellectual disabilities.
“We saw that BAYADA Home Health Care could provide a greater number of services and a better quality of care if the company were more focused,” attests Phillips.
“All of the locations I oversee each have a director, client services managers, and clinical managers who are registered nurses. The client services managers handle interviewing staff and scheduling case shifts, and the clinical managers handle oversight of the clinicians. So, across all service lines, we ensure that each base is covered.
“We’re one of the few home health companies in Charlotte that does it all,” Phillips adds. We don’t do it all from one office, but we can handle anything. If you need home care, we can get it to you.”
Phillips stresses that BAYADA Home Health Care is committed to not just providing care, but also seeing patients get better. She notes that, 30 years ago, a child who underwent a tracheostomy (a surgical procedure to create an airway into the trachea when the usual route for breathing is somehow obstructed or impaired) would be in the hospital for months, but today, through BAYADA Home Health Care, that same child can recover at home under the supervision of trained specialists.
In fact, Phillips notes, “BAYADA Home Health Care is the largest provider of pediatric home health services in Charlotte.”
Aside from traditional at-home care, BAYADA Home Health Care also offers its services to assisted living communities, and it often receives referrals from doctors and hospitals. Additionally, the company has a dedicated staffing office in Charlotte that provides medical assistance to physicians’ offices, hospitals, and other medical businesses throughout the region.
Speaking globally, Phillips says, “We’ve recently begun services in India through India Home Health Care. They wanted to adopt our model, so last year, Mark Baiada asked me to go to India and support them, give consulting, do some training. It was a great experience, and I can’t wait to see that division grow. We’re also currently working to gain an acquisition in Germany.”
Making a Difference
When asked what makes BAYADA Home Health Care different from other providers, Phillips says, “A lot of companies simply write their mission statement down. The difference is the BAYADA team is expected to live by ours. Our core values are compassion, excellence, and reliability, and our team is dedicated to living these values out in our personal and professional lives.”
Phillips recounts with some passion, “In 2004, Mark Baiada started thinking about articulating his legacy. Teaming up with Dr. Al Freedman, a teacher and psychologist, Mark described his emotions relating to client care. Dr. Freedman helped him craft The BAYADA Way, the defining set of values that we, as a company, live by today.
“Then, Mark wanted to ensure that the company’s values were uniformly supported, so he embarked on a nationwide tour of every single BAYADA Home Health Care location to speak with not only employees, but also clients.
“During this tour, Mark received feedback regarding everything from workplace happiness to client satisfaction. As a result, The BAYADA Way was finalized and distributed across all company locations. It provides a guide path to all employees regarding the dispensation of total care and compassion for clients, excellence in all that they do, and reliability in delivering professional medical services.”
Phillips emphasizes, “There are three essential things that separate us from the competition, and chief amongst them is The BAYADA Way. Our people live our core values. We truly mean it when we ascribe to compassion, excellence, and reliability.
“Second, we’re privately held, meaning we have a lot of flexibility when it comes to providing care. Mark’s heart and my heart are in this…all of our employees’ hearts are in this. While other home health care companies are bought and sold every few years, we’re not. They cater to shareholders, we cater to our clients’ needs.
“Third, is that we offer continuity of care. When you need multiple home health services, you’re going to be dealing with multiple companies, but with BAYADA Home Health Care, we have our clients covered across a range of services.”
This third point is ultimately what has made BAYADA Home Health Care as successful as it is in Charlotte and beyond. Phillips points out that the vast majority of the company’s marketing strategy has relied on word-of-mouth advertising and client referrals as well as repeat business. In addition, the company has continued to add more specialty services to its roster in order to drive business.
“In the beginning, we had basic home health care services, then we added pediatrics, and then more services were added as we saw needs grow. In fact, I remember starting out in Winston-Salem and receiving calls from Carolinas Medical Center and Baptist Hospital asking, ‘Who is going to care for these babies?’” recalls Phillips.
Phillips says that the people of Charlotte are what first drew her to the area; aside from the need in the city and its surrounding area, she says she observed the strong work ethic and the overflowing compassion that Charlotteans have.
“The people are what have made us successful in Charlotte. We’re tough on each other and hold each other accountable, but we’re all committed to the same goal: We put The BAYADA Way first. It’s not about us, it’s about the client,” smiles Phillips.
“We’ve evolved through The BAYADA Way,” Phillips continues, “but also through offering specialties. We encourage our people to find their niche, whether that be home health, pediatrics, or something else. When you put someone in a field they love, they’ll do all kinds of amazing things.”
Exceptional People; Exceptional Standards
Because home health care is such a personal industry, BAYADA Home Health Care goes out of its way to attract and work with the best. The company typically brings in new hires through recruiters and targeted ads, followed by a phone interview to assess qualifications. If they meet requirements, candidates are then brought in for an interview with office staff and a skills test. Only candidates who have at least one year of supervised experience are considered.
After that comes a thorough background check, a drug screening, and a clearance from the Office of Inspector General to ensure that candidates don’t have governmental violations. From there, successful applicants are brought in for an orientation and then spend another 30 to 48 hours in home and lab tests to further assess skills. After completion, a specialist may spend as much as 30 days with a supervising mentor in a client’s home to ensure a good fit.
Phillips explains, “Integrity is one of the most important things we look for in our employees. Because they are expected to live The BAYADA Way, we don’t cut corners in our hiring process.
“Success is measured by client satisfaction. We use a nationally-recognized outside vendor for surveys to gather satisfaction ratings. We have three key questions out of many that must be marked as 100 percent satisfactory in order to determine where we stand. If those three questions aren’t 100 percent, we investigate the problem completely.”
Phillips says that the goal is not just to manage a client, but to improve his or her health. If that isn’t happening, BAYADA Home Health Care is not doing its job.
BAYADA Home Health Care has also taken advantage of developing technology, using tablets for keeping track of patient and employee records as well as offering a physician portal on its website to allow doctors the ability to see patient chart information 24 hours a day.
In addition, the company has a simulation lab at its Charlotte office for training purposes. They use a mannequin that can simulate a variety of medical conditions. For example, anaphylactic shock—in such a case, the mannequin’s tongue actually swells to simulate a real-life reaction to an allergy. The simulation lab is also outfitted with cameras so that training staff can not only monitor trainees, but also play back video to demonstrate what went right and what went wrong.
BAYADA Home Health Care also uses technology to scour sources for government funding to cover Medicare and Medicaid patients, and in this tight economy, to find new ideas to provide more and better care at a lower cost.
“We’re committed to patient care and employee satisfaction,” says Phillips. “That’s The BAYADA Way, and it always will be.”
At any point in time, 25 to 37 percent, or more than one in four people in the United States are dealing with mental illness, according to the federal Substance Abuse and Mental Health Services Administration.
“It can—and likely will—happen to anyone during the course of their life,” says Peggy Terhune, Ph.D., CEO of Albemarle-based Monarch, which offers behavioral health services.
This statistic totally disrespects any category of wealth, poverty, race, ethnicity, gender, or economic level. Yet Terhune says that what she does not find within the population of people who turn to Monarch for help are clients and patients.
“They are no such things,” says Terhune. “We call them people. If we call them clients and patients, we’re calling them ‘other.’ You’re saying they are different from you.” Terhune is adamant that they are not. “You’re a human being—I’m a human being—with all the hopes, desires and dreams that come along with that.”
Monarch provides services for adults and children with intellectual and developmental disabilities, mental illness and substance abuse challenges. Services, treatments and resource assistance in Mecklenburg County are administered through open access centers, outpatient clinics, intensive in-home services, community support teams, assertive community treatment teams, and transitional housing for people with mental illness.
Helping People Feel Better
Terhune is especially proud of Monarch’s open access centers.
“Somewhere, someone in need is walking into an agency. It’s like urgent care for mental health. We help them on the spot,” says Terhune. Most agencies will agree to see a person immediately only if they are presenting as suicidal or of harm to others. Terhune’s response is, “Why wait? Each person should get what they need when they need it.”
People exit from Monarch’s open access centers with an assessment, a prescription if needed, and an appointment or referrals for recommended therapies. “It’s so awesome to be with an agency that can do the right thing,” says Terhune.
“Peer support services also play an important role. Relating to someone who has walked in their shoes can really help another person along,” says Terhune. She also touts the Assertive Community Treatment Team. “They even go find people in need under bridges. If you are so depressed you can’t leave your home, we can come to you.”
Additionally, other services, such as those provided by group homes, employment services, day programs, and community services for adults and children, are available in various counties across the state. Services vary from one area to the next because providers such as Monarch are not approved to provide all services utilized by any one local management entity (LME) or managed care organization (MCO).
The MCO responsible for managing Medicaid funding for mental health, intellectual and developmental disabilities and substance use/addiction services in Mecklenburg County is Cardinal Innovations Healthcare Solutions, the largest MCO in the state.
“We’re very creative and innovative,” says Terhune, citing pilot programs across the state designed to further integrative care and safely keep people out of the hospital, as well as medical consultation and teleconferencing. Monarch is responsible for bringing Mental Health First Aid, developed on a similar concept to CPR, to get the individual out of danger to North Carolina. Training is available to individuals and professionals. Monarch is also looking for new ways to provide services to veterans.
A not-for-profit, non-governmental entity, Monarch has grown into an $80 million budget aimed at providing services across much of the state of North Carolina. Thirty-thousand people were treated or assisted last year through Monarch services. The organization operates over a 100 group homes. Still, these numbers aren’t Terhune’s focus: “I don’t care about the numbers. My priority is the individual person.”
“We have lots of programs, but we try to allow people to tell us what they need versus fitting them into a program,” says Terhune. “We want to meet individual needs; craft something around what those specific needs are.”
Terhune offers up a few words that she believes describe the organization: cutting edge, mindful, holistic, proactive, and evidence-based.
Monarch, mantra “Helping Dreams Take Flight,” refuses to define people by their diagnoses. “Instead, we recognize each individual as a person of worth and value. We teach and remind people, some of whom have often been marginalized, devalued, maltreated or stigmatized, how to dream—how to live self-determined lives.”
“Individual goals vary widely, develop over time, and often have to do with some aspect of mainstream desires for a home, job or relationship,” says Terhune. “But most people seeking help, initially, just want to feel better. People who are hurting want to be able to get up in the morning, put their clothes on and have a nice day.”
Meeting the Need
Monarch operates under a volunteer board of directors. Three-fourths of the members either have, or are recovering from, a disability or mental health issue or have a family member who does. Additionally, each member brings some expertise to the board, such as finance, legal, marketing, human resources, or a specific experience, all which add up to a diversity of skills.
Members who cannot read or are otherwise unable are assigned a board buddy who helps them navigate material and discussion. “We especially want to hear from these folks; they are the ones most affected by the decisions the board makes,” emphasizes Terhune.
Monarch’s origins date back to 1958, when Albemarle was a relatively isolated locale with Charlotte a distance away. The post-WWII baby boom increased the number of children with disabilities. At that time, it was illegal for children with disabilities to attend school. They could sit in Sunday school classes, where it was witnessed that they could learn. According to Terhune, this led a group of Albemarle parents to get together and form The Association of Retarded Children.
They established the first group home. Their work led to the organization of The Arc of Stanly County, which is one of many chapters across the state and country. The organization evolved, changing its name to The Association of Retarded Citizens, then Arc Services and later Arc of Stanly County, all before becoming Monarch. The Arc of Stanly County remains as the local advocacy chapter now operated by Monarch.
During the 1960s, with states beginning to realize that they needed to take care of people with disabilities, area programs started to develop. These programs were self-managed, often with little accountability of funding and costs.
North Carolina responded by establishing local management entities which were financially responsible, but contracted out all services. They act more like insurance companies, approving services and expenses, and are referred to as MCOs. These groups have continued to be reduced in number for greater efficiency.
Today, the legislative debate is over Accountable Care Organizations (ACO) in which health care providers come together to simultaneously lower costs and raise the quality of care. This model puts a premium on integrative care which allows doctors to communicate with each other and reduces the duplicity of services, particularly diagnostic testing versus more general managed care.
These several decades have seen enormous strides in mental health care. “One of the things we know today is that one can recover from mental illness,” says Terhune. “We’ve gone from warehousing people that we thought would never get better to thinking that people can get better with appropriate services and medical intervention.”
Causes and Costs
Although much has been learned about mental illness, its exact causes still largely elude the medical research community. It is generally accepted that some mental illness can be hereditary, or genetically acquired, or caused by chemical imbalances in the brain.
Also, many medical issues carry a psychiatric component. People with chronic disease, such as diabetes or heart conditions, are more likely to have mental illness, as well. Circumstances, especially loss or trauma, can trigger mental illness. It is also believed that greater rates of diagnosis are behind the increased number of people with mental illness.
The social impact of mental illness and the stigma around it is often measured in losses—of homes, family structure, jobs, self-esteem, and overall health.
“Sufferers, if not treated, can lose everything,” says Terhune. There is also a great cost to productivity and the economy with losses of wages and tax dollars, and increased cost of services and systems—fire, police, EMS, prisons, hospitals, and schools—which are burdensome to society.
“The cost is huge,” laments Terhune. “We could so contain that cost if we had adequate, sufficient services.
Monarch obtains funds from Medicare, Medicaid, private insurances, Social Security and individual payments. Funding also comes in the form of grants, donations and in-kind contributions.
“We lose money on some services—people with no insurance—and balance that with other services,” says Terhune. “We also have to spend money on buildings, furniture and fixtures. The square foot rental cost of the restored warehouse where Monarch’s state headquarters is located is discounted by tax credits, but we can’t find that everywhere.”
Terhune’s frustrations are apparent when the discussion turns political. “Do I seriously hope that North Carolina legislature’s agrees at this point to accept the federal Medicaid expansion signed into law with the Affordable Care Act?
“Because behavioral health services are capitated, predictable and cost-effective, North Carolina needs to accept Medicaid expansion,” says Terhune, who sits on the five-member Medicaid Reform Advisory Group appointed by N.C. Gov. Pat McCrory.
“Can you imagine how many people could be helped? People express concern over Medicaid but we keep voting the same people into office. Why don’t we vote in people who get it?”
Monarch has experienced significant growth since its name change in 2008 and its expanded service offerings (beyond those for people with developmental disabilities) to include mental health programs. “People keep calling us and inviting us in. We’re in all of North Carolina’s MCOs in some way. We have the value they want,” says Terhune.
Another way Monarch has grown is by acquiring services from other organizations. “We are happy to merge with other providers; we do it all the time,” says Terhune. “We’re mostly looking for shared values, but we have taken on groups that are inept or are about to go under.”
Terhune explains that these expansions can be expensive. “Our board of directors says that we have to break even.”
One at a Time
One of Terhune’s first experiences with mental illness took place growing up in Brookfield, Ill., in the 1950s when her father, who worked in medical supplies, took her along to an orphanage of sorts that provided her with some ugly truths about how America treated people with mental illness and developmental disabilities.
The children were very sick, expected to die. Babies were housed in cribs lining the walls. Older children, ages four or five, were in cages and had not been taught any language skills. There was no visible staff. Terhune tried in vain to persuade her father to take one of the children home.
She remembers his words: “Peggy, you can’t save everyone, but when you grow up you can do whatever you want to do.”
And Terhune is doing just that. As horrific as it was, the experience solidified her desire to do something for the people represented there.
Having earned her bachelor’s degree in occupational therapy in 1974 and an M.B.A. in 1984, Terhune accepted her current post in 1995, after being second in command with a similar organization in Rochester. She has since earned her Ph.D. from The University of North Carolina at Greensboro. She has been married to “the love of her life” for the past 22 years.
Terhune loves kids. Her husband loves kids. Together, they have raised a combined family of seven children and have fostered over 100 children. They are currently serving as therapeutic foster parents.
“It’s who we are,” says Terhune. “When you do what I do, it’s your whole life; it’s your value.”
“I have the best job in the world. I am so privileged,” says Terhune. “Every day I get to come to work and save the world and do God’s work. You save the world one person at a time. Every single day one of my 1,800 staff is touching someone in need; helping dreams take flight.”