2022 Annual Report

Dreams do come true at The Center. Thank you for all you do for the wonderful people who have the pleasure of living there.

Community Member

Letter from The Center for Discovery CEO Patrick H. Dollard

Dear Friends,

As I reflect on the past year, three words come to mind: progress, commitment, and compassion. These are words that drive us and are reflected in every single thing we do. As we continued to deal with the aftermath of the pandemic and keeping everyone in our care safe, we also continued to build. Our firstof-its-kind Children's Specialty Hospital began to truly take shape – its image backed by years of research, collaboration, and Center for Discovery expertise

The vision of the Specialty Hospital, a place where families can finally turn for help upon first diagnosis, received an outpouring of support that was both moving and reaffirming. Lt. Gov. Antonio Delgado, Secretary for Human Services & Mental Hygiene Jihoon Kim, Office of People with Developmental Disabilities Commissioner Kerri Neifeld, and President, CEO, and Commissioner of Empire State Development Hope Knight, all came to get a sense of the hospital's progress. We couldn't be any more grateful than we are for the support of our colleagues at the USDA whose initial belief in the project with a low interest loan turned our dream into a reality. We are full of gratitude as well to the Mother Cabrini Health Foundation whose support from day one will have a profound impact both inside and outside the Specialty Hospital.

It has also been a year of exciting developments in our partnership with Northwell Health, the largest employer in New York State. We have established mutual collaborations and a commitment to each other that touch on everything from our hospital to our farming, to our procurement. To quote Northwell Chairman and CEO Michael Dowling,“ you will learn from us, we will learn from you – and we both will be better for it.”

Our endowment campaign, to secure the future of The Center for Discovery, continues on a steady course. We are so heartened to see gifts large and small. Gifts from family members and gifts from individuals who have read about us or visited, and were simply touched by our work. We owe tremendous thanks to the MJS Foundation for their donation to our endowment and belief in our vision.

These collaborations are about only one thing however: the community of individuals we care for. When we think about making an impact, we think about them. When we think about potential, we think about ways to help them maximize it. That is why we are reimagining our Animal Assisted Intervention and Education program so we can support more people in new and advanced ways. It is why we are taking a new look at our Day Habilitation program, so that each person is not just working – but constantly thriving. And it is why the children and adults in our care burst with pride as they feed the farm animals, learn new cooking skills, ski downhill for the first time, or get up on stage in musical productions – feats their family members never thought possible

I close this letter with a few words about the compassion that defines us here at The Center. That compassion comes from our staff who get hired into a job – a job that becomes their life's work. I have never seen anything like the dedication, fearlessness, and strength that comes from our 1,700 strong. Their smiles are as wide as the residents themselves when they see a great achievement. They refuse to let weather, weariness, or any challenges brought on by the pandemic stop them. They are simply one of a kind. I spend every day thinking about how I can best support them to try and pay back a small bit of what they give, which is their all.

That goal will never end.

Thank you for your support.

“When you're at The Center for Discovery, you discover hope, positivity, and optimism. You discover compassion, and caring, and competence at the highest level. You discover entrepreneurship, and creativity.

TABLE OF CONTENTS

Program Updates

OUR MISSION

Our mission is to build a compassionate and connected community with cutting-edge care and education for the most medically and behaviorally complex individuals. Our team of innovators come from diverse disciplines in the fields of education, research, medicine, nutrition, farming, and the arts. Utilizing the latest science, data, and analytics, The Center for Discovery® has built a model that aims to improve health and enrich life for all.

Letter from The Center for Discovery President Dr. Theresa Hamlin

Last year was a year of courage, grit, adaptability, and innovation at The Center as we worked together to advance the lives of the individuals in our care and for our staff, despite the challenges that were often present. Our world is now settling with a sense of normalcy and hopefulness for the future. Our leadership team is ready with renewed energy to meet the next set of challenges. And, our staff continues to prove why they are simply the best with unwavering determination, dedication, and compassion for our entire community. They have raised the bar higher than it has ever been in our history

During the past year, we implemented two major software systems in workforce and program management that will allow us to capture data and information in real time about our finances, workforce, and the individuals in our care. With a staff of over 1,700 and growing, this information is invaluable for our continued success, future decision making, and sustainability

This year we are on course to advance our model of care by extending our behavioral health services that are desperately needed in school districts, providing online trainings to professionals and families, and opening our Children's Specialty Hospital. The hospital will be the first-of-its-kind in the nation for short term integrated medical, behavioral, and daily living care and treatment for individuals who are at risk for lifelong residential care. The goal of the hospital is to keep children at home with their families and in their local school district.

We are also developing more and deeper academic, research, government, and clinical relationships as evidenced by our formal partnership with Northwell Health, New York's largest healthcare system. Every step we take is to enhance the quality of life for all those we care for – not just our youth, but if you read the report on our model of care prepared by NORC at the University of Chicago, you will understand it is for the aging population, too. We will be building new connections and using the new state-of-the-art Alemany Learning Center at The Children's Specialty Hospital to be seen and heard. In the following pages, you will see and feel the brilliance of our staff, and be moved by the transformative stories you will read. We never stop moving – dreaming and making those dreams come true

The power and importance of our leadership was felt near and far in 2022. And, we won't slow down for a minute moving forward. We deeply appreciate your continued support.

With Gratitude,

““Moving to The Center has truly been a life changing event not only for Vincent, but our entire family. Vincent was welcomed to The Center by a compassionate, focused and well educated staff who embraced him as a member of their family as well. This made one of the most difficult and emotional decisions a family has to make something to celebrate.”

2022 Board Of Directors

Patrick H. Dollard, CEO The Center for Discovery®

Edward C. Sweeney Senior Vice President – External Affairs, NRS, Inc

, Chairperson

Edward Giancontieri Manager, ShopRite Stores (Retired)

, Vice Chairperson

Nelly Bly-Arougheti Author/Editor Treasurer William C. Myslinski, Ph.D., Principal, Economists Inc

, Vice Chairperson

Malcom J. Harkins III, Esq., Director Distinguished Health Law Scholar, Center for Health Law Studies, St. Louis University School of Law

, Director Nancy McElroy School Principal (Retired)

, Director John R. Milligan President, Banking Industry (Retired)

, Director Eileen Naughton Former Vice President of People Operations at Google

, Secretary Michael Dubilier Managing Director, Dubilier & Company

, Director Ellen Alemany Vice Chairwoman of First Citizens

, Director Norman Feinberg President and Chief Executive, Gateside Corporation

, Director Joel S. Forman, Esq. Partner, Akerman LLP

, Director Aidan Quinn Actor

Arthur L. Thompson, CFA Senior Vice President – Investments, Wells Fargo Advisors

, Director

, Director Kevin Fee Co-Founder and Managing Director, Castlerock Asset Management

, Director Allison Vella Director of Admissions, Saint David's School

“The brilliance of The Center's leadership was never more obvious than in 2022. The team monitored and responded to the infectious disease status of the world with robust data and policy, and continuously improved upon its gold standard of care and education. TCFD's steadfast preparation for the future can be seen in the development of its Children's Specialty Hospital and growth of its Endowment Fund. The future for the staff, residents, and students here is bright.”

– Edward C. Sweeney, TCFD Board Chairperson

“

The Center creates such unique opportunities for people with disabilities. It's exciting for me as a staff member to be a part of the creativity and innovation happening here. I'm so grateful to all of the families and team members that help us provide these amazing experiences.

It was a year spent working around the clock to turn The Center's dream of developing a Children's Specialty Hospital for New York State into a reality

The Children's Specialty Hospital children’s specialty hospital

AT THE CENTER FOR DISCOVERY

With construction nearly complete, TCFD will soon open a first-of-its-kind Children's Specialty Hospital that will transform the standard of care for children and adolescents with complex disabilities. The Children's Specialty Hospital will provide specialized, short-term assessment and treatment for children across the state, along with support and training for their families, caregivers, and school districts. This intensive, integrated treatment model will enable each child to transition back to their home – and into their communities – which will reduce the need for long-term residential care.

The Children's Specialty Hospital complex will include:

Twelve inpatient beds focused on complex autism

Six inpatient beds focused on medical frailties

Certified health clinic for primary, specialty, and dentistry services

Certified school program for children being treated at the hospital and in the community

The Research Institute for Brain and Body Health

Alemany Learning Center for education and training

Gymnasium designed to support clinical services

Congressionally funded Food is Medicine® Greenhouse

Café and training kitchen

Wellness Complex including outdoor recreation trails

Therapeutic Healing Gardens

Employee daycare

Education

The Center for Discovery Education Program continues to capitalize on the opportunities to gather and learn within our incredible outdoor and indoor campus environments.

Our Makers Missions, Festivals, and Learning Communities on each campus use the HealthE6® framework to present meaningful instruction that captures students' attention through motivating platforms, while sustaining engagement through thoughtful adaptation of materials and facilitation of instruction.

Our students have enjoyed the addition of the Discovery Play Park, and truly shine in their participation in activities like drama, music, sound healing, and dance - all of which supports their emotional well-being. Our Animal Assisted Intervention and Education therapy has been a tremendous addition to the many games and activities our students can engage with on a daily basis.

Our pool reopened, our vocational experiences are more plentiful since pandemic-related restrictions eased, and this has reinvigorated the creativity and excitement around independence and participation.

One class even built a park bench for campus, and another class of residential students with significant complex challenges worked hard to be in a school van together and go out into the community. The goal of creating a “snowball launcher” was the perfect motivator for a very successful trip to a home store to choose and buy building materials.

These moments, which would be a blip in the life of a similar aged young adult, are everything to us – to the students and to their parents and caregivers. This year we experienced this success and wonder daily as our team fully re-engaged with other TCFD teams on the farm and in the areas of the arts and recreation.

Total Number of Students:

300

Total Number of Community Students:

136

Total Number of Residential Students:

164

It was a year of remarkable activity for our Pediatric Residential Team.

We were on the move. We invented all kinds of adapted games. We attended concerts on campus and at Bethel Woods Center for the Performing Arts. We traveled to a baseball game and cheered on our local Minor League team. We hiked, biked, bowled, and swam. We celebrated fall at festivals. We embraced every moment of every season with energy and enthusiasm, and our residents thrived.

We also welcomed new pediatric residents to our TCFD family, which means taking great care of our new resident and his or her family members - like Sam's parents who were feeling the great loss of moving their child from our community-school program into daily living. Our team collaborated extensively with our colleagues in Psychology, Clinical Services, and Education to help Sam and his parents assimilate into their new chapters. For six weeks, our team worked daily with him – initiating the use of FaceTime and social stories so he could successfully travel back home for the holidays, and then back to campus. His trip was a wonderful success bringing great joy to Sam, his parents, and the staff.

Number of Residential Individuals:

Pediatric Residential Program 158

Number of Residential Homes: 22

Adult Residential Program

Our Adult Residential Program began an exciting new chapter this past year A new model of living – flexibly blending in-person and online group activities - led to more individualized care and growth than ever before.

Now in his 60s, Julio, medically complex and hearing impaired, sailed with Center for Discovery staff and friends in a regatta for the first time. Meticulous planning and collaboration with our colleagues from the Recreation and Occupational Therapy teams made this dream come true for a man who spent the first half of his life in an institution. Other residents hiked and biked, swam, were contestants, performers, and spectators in contests and at concerts and festivals - on and off campus all year

Our Self-Advocacy group moved full speed ahead with their “Bucket List” in 2022. Supported by our team, they made products from the farm, fundraised with a market sale, and went big with a trip to a nearby casino! They all say being able to express their desires and work towards their goals has been their very special jackpot.

178

Number of Residential Individuals: Number of Residential Homes: 25

Discovery Health Center

We have seen such incredible progress at our Discovery Health Center over this past year. Based on extensive quality metrics, the Health Center earned recognition as an NCQA level 3 Patient Centered Medical Home for the 11th consecutive year, and an accreditation as a National Exemplary Provider - eligible for Rural Health Clinic certification by Centers for Medicare and Medicaid Services (CMS), which will pave the way for future expansion of coordinated care services.

The Clinic staff provided non-stop Psychiatric, Medical, and Clinical services including COVID-19 and flu testing, vaccines and booster clinics, Dental Services and Occupational, Speech, and Physical Therapies.

This year, as every year, they simply met TCFD residents where they were. On one occasion, this meant the dental team visiting an anxious resident at his home and helping him eventually transition to visits at the Clinic In our Healthy Lifestyles Clinic, this meant our team working closely with an overwhelmed mom to create an individualized diet and exercise plan for her overweight son who was at risk for more weight gain from his medications. He lost 20 pounds.

5,903

16,163 Health Center visits in 2022 Covid Tests Performed in 2022

Occupational Therapy

Our Occupational Therapy (OT) Team pushed the bar higher than ever this year

As the pandemic restrictions eased, we raced out of the gate in 2022 with wild imaginations and equal amounts of energy. In collaboration with the Animal Assistance Intervention & Education (AAIE) team, as well as the Education team, we developed and brought mini-horse yoga to students and staff

Through creativity, passion, and incredible dedication, we saw big and small wonders daily in the classroom, during vocational task learning, in self-care, and in social situations. In our clinic, our Occupational Therapists working with Physical Therapy and Assistive Technology colleagues challenged a Pre-K child to exceed his goals for mobility with his new wheelchair. He will no longer have to travel to a different county for school. His new skills and independence gained him a spot in a kindergarten right near his home – changing the trajectory of his life.

Our OT Team sees each year as 365 opportunities to improve and develop the life skills of everyone in our community

18,500

School-Aged Occupational Therapy Sessions

Conducted in 2022

6,054

Adult Occupational Therapy Sessions

Conducted in 2022

Physical Therapy

It has been an exceptional year for our Physical Therapy (PT) Team as we worked on the national stage. In the classroom. On the farm. In the gym. In the pool - and every other space in-between helping our students and residents condition, strengthen, stretch, and move their bodies in new ways to explore their world.

In collaboration with teachers, the PT Team transformed barn chores into fun, vigorous, weight-bearing, individualized exercise. Working with Adaptive Physical Education teachers, our therapists made our new fully inclusive Discovery Dreams Play Park the most visited spot on campus and a true place of incredible personal growth.

Post-pandemic, the warm waters of our therapeutic pool proved ever more powerful. Our PTs cheered on residents like 22-year old Michael who ditched his floatable jogger vest for flippers and began swimming laps. They also designed a new research study comparing the impact of aquatic therapy vs. free swim time on behavior and mood.

Our team capped off the year successfully presenting our work to colleagues from across the country at the American Physical Therapy Association.

We are moving forward for our community – one stroke at a time.

12,463

School-Aged Physical Therapy Sessions

Conducted in 2022

6,071

Adult Physical Therapy Sessions

Conducted in 2022

Speech Therapy

With our world open again, our Speech Therapy (ST) Team in 2022 was active in every corner and a part of every activity across campus.

Our team this year integrated into and coordinated with every program to increase communication opportunities for our students and residents. This involved teaching both the students and residents as well as all their therapists, teachers, and other staff on their care team.

Visit our Thanksgiving Farm and Community School and you will see an 18 year old realizing his dream of working in a pizza place. Our team worked with him to find the language around the ingredients, cooking, ordering, and delivering, and strategized with his teachers to also include his classmates. He is now making and delivering allergy-friendly pies twice a month.

Our team members working with the Day Habilitation program initiated a new sewing program of seasonal all-day-wear T-shirt smocks using various communication skills including gestures, voice output devices, personalized communication devices and verbal language to help them choose and modify color and design, and operate specially adapted sewing machines.

Compassionate communication is the core of all we do here at The Center

16,078

School-Aged Speech Therapy Sessions

Conducted in 2022

5,061

Adult Speech Therapy Sessions

Conducted in 2022

Animal Assisted Intervention and Education

The presence of our animals makes a profound impact on our community – and opens up levels of communication and connection previously unimaginable.

We have had a year of re-imagining, evolving, and expanding our Animal Assisted Intervention & Education (AAIE) program to every level and corner of The Center.

As we worked to redevelop our Equine Assisted Therapy Program, we began to involve our miniature horses in new and exciting ways like in occupational therapy sessions, yoga classes, and to assist those more physically challenged in playing interactive games.

Through our new Bunny Buddy program, our adult residents learned how to care for new house pets. Our therapy dogs and goats remained favorites too, but this year they had competition in Miss Puff, who is literally a lap chicken.

As we explore additional professional development training and new avenues for involving our animals in our Day Habilitation program and Discovery Health Center, our team regularly pauses in awe at the relationships built, even in the most hesitant and anxious. One such student moved from arms-length interaction with one of our therapy dogs, to playing games and grooming her- to being generally calmer around sudden movements among friends.

53 AAIE Program Animals

1,827 Therapeutic Sessions in 2022

Food Exploration and Discovery 722

This past year has been one of training and collaboration for our Food Exploration and Discovery® (FED) program, which works tirelessly to turn our philosophy of Food is Medicine® into daily practice.

We not only welcomed new therapists onto our staff, we also worked closely with our colleagues on the residential and Department of Nourishment Arts® (DNA) teams to train staff in nutrition and fun ways to introduce new, healthy foods into the diet. We regularly assisted new residential students in their transition to The Center's vegetable-rich, whole foods-based menu.

At our outpatient Discovery Health Center, we celebrated many successes including that of Brendan, a community student who was weaned from his gastrostomy tube (G- tube) and began eating by mouth in 2020 This year, at the age of 20, Brendan began to independently feed himself a chopped diet. It took our staff and Brendan almost ten years to get to this miraculous point.

Determination. Dedication. Compassion. Vision. We see the possible on the FED team!

Outpatient FED Sessions Provided in 2022

Assistive Technology

It was a year of incredible growth and development for our Assistive Technology team. Within our department, our Rehabilitation Technology staff conducted more than 3,000 repair and maintenance jobs on essential medical and other adaptive equipment from complicated beds, wheelchairs, and exercise equipment, to simpler helmets. Our Seating and Mobility Clinic employees designed and facilitated production of products for seven New York State counties.

Our greatest growth this year was in our Innovation Lab wing where there is incredible collaboration with other Center teams to enhance the lives of our residents and students in unique ways and in real time. The “upper-body bike,” gives one young man a new freedom to stay in his wheelchair where he's best supported and comfortable, and get out with his friends to exercise by using his arms. Other new creations include adaptive marker holders, a wrist-talker communication device, and a station for mess-free filling of Ziploc bags – all amazing tools for our classrooms.

In 2022, our team also realized our dream of opening a full-adaptable land of outdoor adventure. The Discovery Dreams Play Park is an example of teamwork at its finest. It has proved to be endless fun. A one of a kind, safe space of exploration, self-discovery, and joy.

3,704

Rehab and Assistive Tech Work Orders

Completed in 2022

Nursing

It has been a year of shifting for our Nursing Team.

We moved steadily out of the full pandemic state, continuously monitoring our residents, students, and staff, while shifting to accommodate local, state, and federal guidelines. Our daily collection and analysis of data from our campus allowed us to transition out of the masking stage for the warmer spring and summer months and back into masks for the cold/flu season at the end of the year. It also proved invaluable in tracking other infectious diseases like influenza.

Our Covid-19 hotline remained open with reduced staff, and this year, our work required counselling and re-training of colleagues who were timid and fearful about the relaxing of restrictions. Overall, our education of staff and vigilance to infection control during this period in our history has made everyone much more aware of not only our own individual health, but the direct and immediate impact of our health on our medically complex and fragile community

132

Compassionate Center for Discovery Nurses

Integrated Arts

An exhilarating downhill ski run. A lively outdoor festival. Leading the opening of a major sporting event as a flag bearer. Taking the stage to sing and dance. Scaling a mountain. Racing on the water. Making maple syrup and fresh apple cider. Anything is possible here at TCFD.

Our Integrated Arts team of music, dance, drama, art, and recreation therapists painstakingly plan and create these “firsts” for our residents and students. In 2022, we were back in person as a tour de force – focusing on big and small moments of inclusion and achievement. This year, our oldest resident (88-years young) proved she is not slowing down one bit as she soaked in the sun and smiled with the wind in her face while sailing on the Impossible Dream Catamaran on the Hudson River!

Our team also expanded and created a Healing Arts Residential Program with rich evening and weekend programming - like a drumming class or Sound Healing with gongs and singing bowls, low lighting, and cozy yoga blankets. Pride. Achievement. Strength. Expression. Connection to self, peers, and community Our goals.

7,806

In-Person Individualized and Small Group Experiences in 2022

Psychology 24

Our compassionate model of supporting complex individuals with challenging behaviors became the prevailing new concept in the psychology field nationwide over the past year. Here at TCFD, we have always met our residents and students with difficult behaviors where they are most comfortable. We teach them coping skills for stress through our HealthE6® model. We honor their communication styles and their choices.

Case in point - Brendan. Our Psychology and Innovation Labs Team developed a simple wrist talker for Brendan. With one push of a button, he can express himself – request a break, help, or a specific item. Very quickly, Brendan went from engaging in maladaptive behavior to communicating his wants and needs, and even learned patience. Brendan now has greater control over his environment and as a result is more engaged in his life - and his mood and behavior are much better

Board Certified Behavior Analysts (BCBA) - Largest

Number in the Region

Department of Nourishment Arts®

It has been a year of expansion for our Department of Nourishment Arts!

We designed an internship program with Cornell University, and at the same time, welcomed the inaugural Anne Saxelby Legacy Fund high school apprentice to The Center to train on the farm and in our Herbal Workshop

We collaborated with our Medical Team to create guidelines for nutritional supplementation during times of viral outbreaks like COVID-19 We also developed a critical report about our HealthE6® Model that highlights a national path for wellness and medical care savings, based on our successful prevention and reversal of chronic disease here on our campus. Food is Medicine® is simply our way of life here at TCFD Our attention to dietary detail is second-to-none, and this year, with greater quality control and the cost of our food program in mind, we redesigned our Carrus café into a central kitchen responsible for the lunches and dinners of 18 TCFD locations.

The year capped off with a prestigious New York State Concord Grape Innovation Award for our new balsamic vinegar, del Sole, developed by our team and led by Chief of DNA, Cesare Casella, in consultation with renowned expert Andrea Bezzecchi. It was in short, a year to remember

Nearly

476,000

Meals Provided to Staff, Residents, and Daycare Children in 2022

Farm Operations

It was a blue-ribbon year for our farming operations team.

Most of our 50 varieties of vegetables grew very well in 2022. Despite below-average precipitation throughout the state, we had our biggest crops of potatoes, onions, cabbage and sweet potatoes to date. Our vegetables, grown on 18 acres this year, feed our residents, staff, and members of our widely popular Community Supported Agriculture (CSA) program. Excess cucumbers, cabbage, and carrots this year were also made into a record number of lacto-fermented pickles, sauerkraut, and ginger carrots for our residents.

The new Tutto Bene is home to our new stone fruit orchard. Approximately 340 peach, plum, and apricot trees were planted there this year.

In 2023, we are planning a Concorde grape vineyard at our Rock Hill location – inspired by our growing apple cider and balsamic vinegar projects and a 3rd place prize at the New York Concord Grape Innovation Awards for del Sole, a TCFD collaboration with world-renowned artisan and balsamic vinegar expert, Andrea Bezzecchi!

30,000 heads of garlic harvested in 2022

21,000 lbs of potatoes harvested in 2022

13,000

lbs winter squash harvested in 2022

Operations and Life Safety 658

Our Operations and Life Safety Teams are our unsung heroes at The Center

In 2022, we worked night and day to keep our residents, students, and staff safe and healthy. We patrolled 24/7, our seven full-time guards answered more than 4,500 calls for assistance with fire alarms, traffic situations, pickup and delivery of laboratory testing and food, and conducted regular building checks. We also held monthly and quarterly safety inspections of essential equipment.

The Environmental Management and Services teams cleaned, sanitized, fixed and maintained more than 110 buildings, including 50 residences. Equally busy were the dedicated Earth Care employees who regularly cleared 12 miles of walkways and 20 miles of driveways each snowstorm here in the snowy Catskills – saving The Center $5,000 per inch of snow! In the good weather, they landscaped, mowed, trimmed and excavated for new gardening projects on our 1,500 acres of land.

Our free Ride Share program, one of our most popular benefits, proved invaluable again. We made 5,892 pickups at staff homes and 5,788 drop-offs or 11,680 total trips! We estimate our Ride Share program saved our staff nearly $187,000 in 2022

Total Buildings

Maintained by TCFD's Environmental Services and Environmental Management Teams in 2022

Admissions

In 2022, our Admissions Team was instrumental in ushering in a new era of residential living for those with complex conditions.

Tutto Bene, an Individualized Residential Alternative (IRA), opened this year. It is the first of two such farmsteads in our Casa series of houses on working farmland with vocational and day programming opportunities, as well as community activity in the nearby and inclusive hamlet of Hurleyville. Tutto Bene rethinks the old notion of a single-family “group” home on every level.

This year, our team welcomed fourteen new families to The Center's Pediatric CRP program and seven families to the adult program from 12 New York State counties, including Niagara and Tioga to the north and several boroughs of New York City One family, calling their son's new residence “a dream come true,” reported that he had happily accomplished more on the farm in two days than the last five years at home.

While organizing, arranging, and executing these delicate, emotional, life-changing admissions and transitions, our team also continued to support our colleagues, residents, and students in the Residential, Educational, and Medical Departments of TCFD

14 Children Admitted into our Pediatric Residential Program in 2022

23

Community Students Admitted into our Day School Program in 2022

People Operations

In 2022, we became an even bigger presence in our area.

We took a new, extremely active role in our community at our Chamber of Commerce events. We engaged locally and both educated and informed the public about exciting roles at TCFD and this led to some great hires. One new employee met us at an area Blueberry Festival, left her job, and moved up from North Carolina.

In the summer, we expanded our TAZ internship program and rebranded it as DIG IT It included younger adults (14-17 yrs.) who benefitted from paid opportunities complete with classes and mentoring. Towards year's end, we added a Director of Community Relations and Talent Sourcing to our team.

Navigating in this new world with a direct-care personnel shortage has required great flexibility and compassion. This year alone our TCFD C A.R.E S program supported an additional 30 staff members and their families through hardships via our emergency assistance fund, free Wash House laundromat, and very popular Ride Share program.

So many of our employees live and work near our campus. Naturally, community is everything to us.

Staff Hired in 2022

Benefits

At The Center, our employees are our sun The energy, compassion, dedication, determination, and brilliance that emanates from them leads to our successes with our medically complex residents and students every day In 2022, our Benefits Team worked tirelessly to enrich their lives as much as they do to the lives of others.

Reducing student loan debt was one of our major focuses this year Electronic submission of more than one hundred U.S. Dept. of Education Public Service Loan Forgiveness applications (special to not-for-profit, 501(c)(3) organizations) was greatly streamlined via our Candidly platform. One employee described the assistance with her undergraduate and graduate school bills as a “huge relief” that will allow her to grow her new family and own a home. This work alone generated more than $6M in impact.

Throughout the year, The Center's self-funded health insurance plan supported our staff very well and finally, in recognition of the end of slavery, The Center added Juneteenth, to the holiday schedule, increasing the holiday benefit to 13 days a year

The Benefits department every day assists and supports employees through the many life events that impact their lives. We are very proud that those benefits are in a class of their own.

0% Increase in Contributions to Employees' Health Insurance Premium Costs for 13th Consecutive Year

Hurleyville, New York

2022 was a booming year for our little hamlet of Hurleyville, home to our Stonewall Preserve Farm as well as Thanksgiving Farm and Community School!

This small, one stoplight place has become a shining example of a truly inclusive community. This year, Main Street welcomed two new stores selling outdoor adventure equipment and retro fashions as well as a new café. The Collaborative College High School, a unique partnership between the Homestead School, TCFD, and SUNY Sullivan had a successful first full year offering students career tracks and opportunities for growth at the school and college, and in the greater community.

The Hurleyville Sentinel newspaper remained the busy workplace of several of our residents who write weather and sports columns. Our Fiber on Main hub added more communitybuilding meet-ups - all the while also sparking creative interest in our residents and Day Habilitation adults who crafted projects big and small from the wool of TCFD sheep!

John, a TCFD Main Street resident and a regular at Fiber on Main, also rebuilt some antique Singer sewing machines that had been on display at the Sullivan County Historical Society Museum up the block. This wonderful collaboration led to the new “Hurleyville Hub,” a group of businesses planning regular events and activities.

8 New Apartments

5 New Businesses

1 New Soccer Field

1 New Performance Space

DIG IT

TCFD's newly created work study program, the Discovery Innovation Green Team (DIG IT), gave a group of 30 teenagers (all children of TCFD employees) the opportunity to explore a variety of career paths while learning to care for the world around them.

DIG IT's dynamic mentorship program gave participants real-life experiences working alongside TCFD staff members in our Rehab Tech department, Daycare Program, at the Sweet Hill Farm, in our Finance office, at The Hurleyville Sentinel, Fiber on Main, with our Dance and Music Therapy teams, in our Bakery, with our researchers at the Lab School, and in our People Operations department.

Through a collaborative partnership with Arthur's Point Farm (Ghent, NY), DIG IT participants also engaged in experiences to become thoughtful stewards of our local and global environments. They learned the environmental impact of carbon sinking, regenerative agriculture, and the importance of healthy pollinator environments. The participants then put their knowledge to work, building two pollinator gardens near existing orchards, to help foster a healthier pollinator population on TCFD campuses.

DIG IT's meaningful impact on the environment, exposure to a wide variety of career and extracurricular options, as well as the ability to earn additional income, provided huge benefits to the participants, their families, and our entire community.

dig t

Strategic Outreach and Partnerships

In our office we lead, we collaborate, we listen, and we learn. Through it all, what we continued to see clearly is that “what happens here, matters everywhere.”

The Center for Discovery's groundbreaking Children's Specialty Hospital continued to transform on a daily basis. Families statewide who are impacted by disability will soon have a place to turn on first diagnosis - and it is our privilege to make sure people know that. In an almost unprecedented show of faith for the Hospital project, we were awarded a second $2 million dollar grant from the Mother Cabrini Health Foundation, and secured money with the support of Senator Charles E Schumer and our partners at the USDA for a Food Is Medicine® greenhouse at the hospital. This greenhouse will provide food and work opportunities for those being treated there.

Coming out of the pandemic, with air quality a major issue, we worked with Sullivan County to secure funding for air filtration units at the Hospital. We got the word out broadly, hosting visits and tours of the site by The State Office of People With Developmental Disabilities (OPWDD) and the team from Empire State Development, who raved about the progress.

In our development capacity, we were also honored to be the recipients of a major gift from the MJS Foundation. We are extremely thankful to Marilyn and Jim Simons and the entire team there for their support and belief in our mission. Our Annual Campaign, with the theme “Support The Vision: Support the Joy” was one of the most successful in the history of The Center.

Our model went nationwide with the publication of a report by NORC at the University of Chicago, the nation's leading statistical analysis organization. The work, funded by the John A. Hartford Foundation, found that the work at The Center was replicable and scalable for facilities of all sizes, serving all different types of populations. The paper serves as a roadmap for The Center to expand our work and help more people of all ages going forward.

In our role leading marketing and communications, we have been hosting webinars, sending newsletters, and communicating far and wide with staff and families as we emerged from the pandemic and put new protocols into place. We are extremely proud that our robust social media platforms saw growth across the board.

In the end though, it is our community, our students, residents, and their families that keep us going every minute of every day It is their progress and their happiness that fill us with so much pride in our roles at The Center for Discovery

Michael Rosen Executive VP, Marketing & Strategic Communications

Helena Le Roux Ohm, Ph.D. VP of Strategic Partnerships

Gabrielle Scott VP of Development

Courtney Gold Director of Marketing

Jessica Calabrese Development Manager

Carmen Williams Development Coordinator

Dean McManus Senior Graphic Designer

Jesse Wall Multimedia Specialist

Kevin Mesa Graphic Designer

Anna Kornilakis Development Consultant

575,000 People reached via social media

Development

Our campaign to secure a $100M endowment for The Center continued into its third year. One of the highlights of this year's campaign activity was our fall “Evening for the Endowment,” held at the Michael Ritchie Big Barn, with a special performance by Grammy award winner Christopher Jackson. The event raised over $1M for the endowment.

As of this writing, the endowment campaign is 20% to goal with $16M raised through multiyear pledge commitments and outright gifts from Center families, friends and other benefactors. We are pleased that the campaign has enabled us to build relationships with new major supporters. We have worked in creative ways with donors to help them maximize their support, by contributing through their required minimum distributions (RMDs) each year, setting up estate planning, or talking through how family members can pool their giving towards a larger commitment.

Income from the endowment helps The Center recruit, retain, and reward the incredible staff that cares for our community, and provides support for some of our most beloved programs including farming, the integrated arts, and animal assisted therapy that are not covered by state funding.

Please contact us at StrategicOutreach@tcfd.org if you would like to contribute to The Center's endowment campaign and help us get closer to our $100M goal.

1,162 Donor Gifts in 2022

The Center for Discovery Locations

Sharing TCFD’S Work on a Broader Level

In 2022, the stage was set for TCFD to share its HealthyE6® model of care with an even broader population – thanks to a key report funded by the John A Hartford Foundation and authored by NORC, a world renowned independent research institution affiliated with the University of Chicago.

After extensive in-person interviews, an onsite visit, and vast document and data reviews, including outcome assessments collected at The Center for decades, the researchers at NORC concluded that five core components of the model could be successfully employed in the care of older adults, many of whom also suffer complex, chronic conditions. The model was also found to be scalable and replicable to organizations anywhere giving new potential to the promise of providing care to wider populations.

These core components, which can be applied to a range of senior care settings, are (1) Initial and ongoing assessment of the individual's physical and mental wellbeing (Evaluation); (2) A schedule that includes physical activity and a consistent sleep routine (Schedule); (3) Meaningful socialization with staff, friends, and family (Socialization); (4) A nourishing whole foodbased diet (Nutrition); and (5) An adaptive e nv i ro n m e n t t h a t a l l ow s fo r s a fe, independent engagement (Environment).

The NORC report additionally urged The Center to explore a new chapter of community-based transitional and palliative care. See the full report at www.tcfd.org.

Strategic Partnerships and Collaborations: Government and Organizational Partnerships

Government Partnerships:

TCFD is a New York State designated Center of Excellence for complex disabilities, the largest Children's Residential Project (CRP) program in NYS, and the preeminent leader in innovative models of care. Agency partners include:

Ÿ NYS Department of Health (DOH)*

Ÿ NYS Office for People with Developmental Disabilities (OPWDD)*

Ÿ NY State Education Department (SED)*

Ÿ NYS State Office of Children and Family Services (OCFS)

Ÿ NYS Developmental Disabilities Planning Council

Ÿ Empire State Development

Ÿ NYS Department of Agriculture & Markets

Ÿ United States Department of Agriculture (USDA)

Ÿ Sullivan County Public School Districts

Ÿ Sullivan County Public Health

*Regulatory Bodies

Organizational Partnerships:

TCFD partners with various organizations to advance assistive technology, expand access to adaptive sports and recreation activities, support environmental and farmland conservation, and improve community health outcomes. Organizational partners include:

Ÿ Northwell Health (Affiliation)

Ÿ Healthcare Association of New York State (HANYS)

Ÿ SUNY Sullivan

Ÿ The Homestead Collaborative College High School

Ÿ American Portfolios

Ÿ World T.E A.M. Sports

Ÿ Open Space Institute

Ÿ Catskill Mountainkeeper

Ÿ Sullivan 180

Ÿ Cornell Center of Excellence for Food and Agriculture

TCFD Family Member

The ongoing outstanding work of The Center serves as a model for this country!

Strategic Partnerships and Collaborations; Academic and Research Partnerships

The Center for Discovery® has engaged in groundbreaking research for more than a decade. Current areas of study include: the microbiome and gut health as it relates to autism; the influence diet has on complex disabilities; learning about sleep in complex patients with the use of advanced sensors and technologies; the effect that exercise, movement, and balance have on the brain; and virtual reality content for training and autism awareness. Academic and research partners include:

Jeffrey Lombardo, PharmD, BCOP, Associate Director of the Empire State Patient Safety Assurance Network, Research Assistant Professor at the University at Buffalo

George Todd, M.D. Professor | Vascular Surgery Mount Sinai

Eric London, M.D. Psychiatrist The Center for Discovery

Gari Clifford, Ph.D., Biomedical Informatics at Emory University and Biomedical Engineering, Georgia Institute of Technology

Sridevi Devaraj, PhD, DABCC, FAACC, FRSC, CCRP, Director, Clinical Chemistry and Point of Care Testing, Texas Children's Hospital

Orrin Devinsky, M.D , Director of the NYU Comprehensive Epilepsy Center and the Saint Barnabas Institute of Neurology and Neurosurgery (INN)

Juergen Hahn, Ph.D , Professor & Department Head, Biomedical Engineering, Rensselaer Polytechnic Institute

Terry Katz, Ph.D , Department of Pediatrics, University of Colorado School of Medicine

Ruth Ann Luna, PhD, Assistant Professor, Pathology and Immunology, Baylor College of Medicine and Director of Medical Metagenomics, Texas Children's Hospital

Kara G. Margolis, M.D. Associate Professor, New York University; Associate Director for Clinical and Translational Research; Director for GutBrain Science, NYU Pain Research Center

Stephan Rechtschaffen, M.D, Cofounder, OMEGA Institute; CEO, Blue Spirit

Tor Savidge, PhD, Associate Professor, Pathology & Immunology and Pediatrics, Baylor College of Medicine and Principal Investigator, Neuroimmune-Microbe Interactions, Texas Children's Hospital

Rune Simeonsson, Ph.D , MS.PH., Professor and Chair of Psychology Department, University of North Carolina Chapel Hill

Nicole Withrow, Ph.D , MS, RD, Nutrition and Dietetics, University of Northern Colorado

2022 Expenses and Revenue:

3%-OtherPrograms

2%-Clinic

4%-Fundraising/Grants

6%-DayHabilitation

23%-Education

Program

2022REVENUE

62%-Pediatric/ AdultResidential Program

11%-OtherThan PersonalServices (OTPS)

2022TOTALEXPENSES

83%-Personal Services/Fringe toSupport Programs

6%Depreciation/ Amortization/ Interest *These numbers have not been audited.

The supportive environment and care given to all employees make it possible to give supportive and loving care to the children and adults we serve. A simple but great concept. Thank you, TCFD.

TCFD Staff Member

Thank You to Our 2022 Champions

Michael Arougheti and Nelly Bly Arougheti

Craig Chesley and Eileen Naughton

Hearst Foundations

MJS Foundation

Mother Cabrini Health Foundation

Matthew and Julie Richardson

David and Jill Robbins

Paul and Maura Robinson

The Taft Foundation

Norman and Arline Feinberg

Friends Of Will, Inc

In Honor of Will

Kenneth and Kim Raisler

Douglas Rodriguez and Caroline Bienstock

Peter and Nancy Saretsky

Allison and Richard Vella

The Wilkinson-Gregory Family

Bob and Susan Wright Anonymous

Bloomberg Philanthropies

In Honor of Lorraine Bracco and the Quinn Family

Joseph Faber and Sumy Daeufer

The Gartenstein Family

Andreas Hildebrand and Katie Wright

Glenn Kaplan and Evelyn Rodstein

The Kushlefsky/Weiner Family

Benjamin and Carol Monderer

Northwell Health

Aidan and Elizabeth Quinn

Eric Shapiro and Jill Faber

Lawrence Becker and Jane Weber

Google Foundation

Fundraisers by Emma Chesley & Justin Forman

Ari and Andrea Greenburg

Jeffrey and Eva Kittay

Thomas and Nancy Lancia

Long Island Employee Benefits Group Ltd.

Mary and Kathleen Harriman Foundation

Mary W. Harriman Foundation

Scott and Randi Pomerantz

Richard Rosen and Orly Adelson

Timothy Ross and Anna Kornilakis

Andy Saines and Emily Gerson Saines

David Shire and Didi Conn

Daniel and Alison Singer

Jeffrey and Deborah Stevenson

S. Donald Sussman

George and Alice Todd

Daniel and Patricia Abelson

Alfred E. Smith Memorial Foundation

Bonita Beattie

Lorraine Bracco

Emma Chesley

Joan Chess and Ann Engelland

John and Melanie Clarke

Cornell University

Robert and Ann Cowen

Crystal Family Foundation

Cuddy Law Firm, PC, Stephen and Linda Daffron

The David R. and Patricia D. Atkinson Foundation

In Honor of Arthur and Denise Thompson

Michael and Barbara deMarco

Vincent and John DiCalogero

Lon and Debra Dolber

James and Marianne Egan

The Emma and Georgina Bloomberg Foundation

Jason and Eliza Factor

Kevin and Kathleen Fee

Susan First

Joel Forman and Monica Belag Forman

Kristopher Hartner and Susanna Gotsch

Brian and Mary Hartnett

Doug and Noreen Herzog

In Honor of Grace and Hugh

Philip and Patricia Holland

Paul Hutter and Marguerite Wagner Hutter

The Hyman Levine Family Foundation: L'Dor V'Dor

In Honor of Matthew

Geoffrey Garin and Debbie Berkowitz

Christopher and Susan George

Denis Goldenberg

Maria Gotsch

Peter Gotsch and Jana French

Diane Greble

Steven and Cindy Kief

Thomas and Robyn Levine

Richard Levy

Sarah Lewis

Robert and Denise Lombardi

Eric and Karen London

Jacqueline Mackay

Patrick Mackay

Marsal Family Foundation

Elliott and Bonnie Mayefsky

Tony and Nancy McElroy

Michael P. Bennett Foundation Inc

In Honor of Ronan

John Milligan and Rob Gravis

Mutual of America Foundation

Matching gift via Marguerite Wagner

Bill and Barbara Myslinski

Netflix

Matching gift via The Hyman Levine Family Foundation

Network for Good

Donations from various Facebook Family Fundraisers

New York Life Insurance Company

Matching gift via John and Vincent DiCalogero

Ellen Orlando

Ramsey Leatherman Cloud Fund

Hal Reiter and Brenda Malloy

Irwin and Joan Robinson

In Honor of Grace and Hugh

Carole Robinson and Mark Palermo

In Honor of Grace and Hugh

Michael and Jane Rosen

Laura Scherr Saggese and Edward Saggese

Melissa Salten

Marti and Lisa Sassi

Marjorie Schnader

James and Joanne Schoonmaker

Vernon and Lynn Schwartz

Stanley and Anne Silverstein

Ilene Smith

Regina Stem

Dolores Storch

In Honor of the DeCarluccio Family

Stuntz Family Foundation

In Honor of Zoe and Tommy

David and Debra Sullivan

Michael and Judith Sullivan

Tiffany and Company

William and Helen Travers

Stephen and Kristina Tober

The Viola Foundation

John and Maureen Verre

Wilson and Emily Warren

Eugene Weiss

Fred Wistow

In Honor of Grace and Hugh

Kenny and Shiri Zuckerman

““It is a great joy to see my son and his housemates living their best lives at The Center for Discovery. I have seen firsthand how the innovative, holistic approach to health and wellness dramatically improves the lives of so many individuals. The Center is a dream come true for our family.”

““The Center pursues new insights and datadriven solutions while surrounding their residents with boundless warmth and understanding, no matter how difficult and challenging their problems may be”