Cascade Medical Advantage

What it reported doing in 2024

Cascade Medical Advantage (CMA) provides medication-assisted treatment for people substance use disorder, primarily alcohol and opiate use disorder by specifically prescribing different medications based on the patients' needs and condition that help stabilize them and remain in recovery. This decreases mortality by 50%.Treatment is provided by physicians, nurse practitioners, physician assistants, and chemical dependency counselors and mental health counselors. When needed patients are referred to Detox (withdrawal management) centers or residential inpatient treatment facilities. We also assist patients bridge care from the regional hospitals to medication and outpatient treatment. Strengths:-CMA offers low barrier care (accepts essentially all insurances/uninsured; no penalty for missing appointments or relapsing; UDS is non-punitive; telemedicine is available).-CMA currently has on-site stock of Long-Acting Injectable Buprenorphine (LAIB - Sublocade, Brixadi) through a WA Health Care Authority grant utilizing Opioid big Pharma Lawsuit settlement funds, which assists patients getting onto long-acting treatment and overdose prevention. This decreases mortality by 50%.-We partner with the Whatcom County Health Department, and many local service agencies that provide outreach to homeless, SUD counseling, and housing. -Our Nurse Care Manager directly assists pregnant and parenting individuals access recovery. She teaches at our local hospital and around the community.-CMA has created a Community Resources for Substance Use Disorder Treatment guide which was distributed throughout the community and posted publicly on our website. -Our Perinatal Nurse Care Manager, Natalie Andrews, works in the community supporting pregnant and parenting people with opioid use disorder. She connects people to resources, including MOUD, OB care, inpatient and outpatient treatment, sober housing, and other support programs and helps them navigate complex care systems. She rounds on patients in the childbirth center of the local hospital, acting as an advocate for vulnerable families as well as a resource for the care team (physicians, nurses, and social workers). As part of her role, Natalie provides education on topics such as overdose response, stigma, trauma-informed care, and MOUD. Audiences include hospital nursing staff, community organizations, SUD providers, and college students. Natalie also participates in various committees including the PeaceHealth systemwide Perinatal SUD Workgroup, the Whatcom County Multi-Agency Coordination group to address the opioid crisis in our community, the PeaceHealth St. Joseph Medical Center's Eat, Sleep, Console committee, and the Whatcom County Perinatal Mental Health Taskforce.

Financial Efficiency

• Mission deployment rate: 93.9%; rating input score 94
• Program expense ratio: 93.3%; rating input score 93
• Fundraising efficiency: Limited

Transparency & Controls

• Consistency checks: 100%; rating input score 100; 63rd percentile among comparable filings
• Pay-setting controls: Limited
• Foreign activity oversight: Limited
• Grant itemization coverage: 100%; rating input score 100; 76th percentile among comparable filings
• Major donor itemization: Yes; rating input score 100
• Related-party transparency: Limited

Accountability

• Independent voting board: 66.7%; rating input score 67; 14th percentile among comparable filings
• Governance controls: 5 of 9 controls in place; rating input score 56
  • Conflict-of-interest policy: Pass
  • Whistleblower policy: Pass
  • Document-retention policy: Pass
  • CEO compensation review process: Pass
  • Other executive compensation review process: Fail
  • Form 990 shared with the board: Fail
  • Board meeting minutes documented: Pass
  • Audit committee oversight: Missing
  • Independent financial-statement audit: Fail

Sustainability

• Operating margin: 14%; rating input score 68; 68th percentile among comparable filings
• Total-asset coverage ratio: 2.74; rating input score 73; 73rd percentile among comparable filings
• Liabilities to assets ratio: 0.01; rating input score 71; 71st percentile among comparable filings
• Officer compensation ratio: 5.5%; rating input score 52; 52nd percentile among comparable filings

Growth

• Program expense growth: 7.8% per year; rating input score 100; 55th percentile among comparable filings
• Revenue growth: -1.9% per year; rating input score 0; 9th percentile among comparable filings
• Asset growth: 14.4% per year; rating input score 100; 71st percentile among comparable filings