The recipient entity's physical address:
           745 Olive Street Suite 202
Shreveport, LA 71104

The recipient entity's mailing address (if different):
           745 Olive Street Suite 202
Shreveport, LA 71104

Type of Entity (for instance, a nonprofit corporation):  Non-Profit Corporation

If the entity is a corporation, list the names of the incorporators:
          Kathryn Thomas, President/CEO
Dr. Luke Baudoin, MD, Vice President

The last four digits of the entity's taxpayer ID number:  3711

What is the dollar amount of the request?  $300,000

What type of request is this?  General Appropriation

Is this entity in good standing with the Secretary of State?  Yes

Provide the name of each member of the recipient entity's governing board and officers:
           Kathryn Thomas, President
745 Olive Street Suite 202
Shreveport, LA 71104

Dr. Luke Baudoin, MD, Vice President
745 Olive Street Suite 202
Shreveport, LA 71104

Larry Daniels, MD
745 Olive Street Suite 202
Shreveport, LA 71104

Dr. John George, MD
745 Olive Street Suite 202
Shreveport, LA 71104

Provide a summary of the project or program:
           To connect individuals affected by opioid addiction with treatment, recovery resources, practical support and a compassionate community so they can acheive lasting recovery, stregthen their families and rediscover purpose, opportunity and hope.

Opioid addiction can affect individuals families, contribute to involvement within law enforcement and courts, affect employment and place additional demand on childcare. It also cause depression, anxiety, post traumatic stress, grief, chronic health conditions, unstable housing, unemployment and social isolation.

We envision working collaboratively with healthcare providers, hospitals, emergency departments, mental health professionals, federally qualified heakth centers, pharmacies, recovery organizations, housing agencies, workforce -development progrmams, veterans services, criminal-justice and diversion programs, child and family services, transportation providers, faith communities and other nonprofit oganizations.

What is the budget relative to the project for which funding is requested?:
          Salaries. . . . . . . . . . . . . $53,000
          Professional Services. . . $182,000
          Contracts . . . . . . . . . . . $36,000
          Acquisitions . . . . . . . . . $0
          Major Repairs . . . . . . . $0
          Operating Services. . . . $29,000
          Other Charges. . . . . . . $0

Does your organization have any outstanding audit issues or findings?  No

If 'Yes' is your organization working with the appropriate governmental agencies to resolve those issues or findings?
          

What is the entity's public purpose, sought to be achieved through the use of state monies?
          The purpose of this initiative is to expand access to evidence-based treatment for Louisiana residents who are unable to obtain or maintain OUD treatment because of financial hardship, lack of insurance, unstable housing, unemployment, behavioral health needs, stigma, or other barriers to care.

Potential Plus will utilize a whole-person treatment apporach designed to address both opioid use disorder and the medical, behavioral, and social factors that can interfere with recovery.

What are the goals and objectives for achieving such purpose?
          The primary goal of the Potential Plus program is to provide accessible, evidence-based outpatient OUD treatment to 100 indigent Louisiana residents during the 12-month funding period while establishng a sustainable treatment model that can continue beyond the state grant.

What is the proposed length of time estimated by the entity to accomplish the purpose?
           1 Year

If any elected or appointed state official or an immediate family member of such an official is an officer, director, trustee, or employee of the recipient entity who receives compensation or holds any ownership interest therein:
     (a) If an elected or appointed state official, the name and address of the official and the office held by such person:
                 None
    
     (b) If an immediate family member of an elected or appointed state official, the name and address of such person; the name, address, and office of the official to whom the person is related; and the nature of the relationship:
                 None

     (c) The percentage of the official's or immediate family member's ownership interest in the recipient entity, if any:
                 0%

     (d) The position, if any, held by the official or immediate family member in the recipient entity:
                  None

If the recipient entity has a contract with any elected or appointed state official or an immediate family member of such an official or with the state or any political subdivision of the state:
(a) If the contract is with an elected or appointed state official, provide the name and address of the official and the office held by such person: 
               None

(b) If the contract is with an immediate family member of an elected or appointed state official:
          Provide the name and address of such person:
               None

          Provide the name, address, and office of the official to whom the person is related:
                None

          What is the nature of the relationship?  None

(c) If the contract is with the state or a political subdivision of the state, provide the name and address of the state entity or political subdivision of the state:
                 None

(d) The nature of the contract, including a description of the goods or services provided or to be provided pursuant to the contract:
               None


Contact Information
name:  Kathryn Thomas 
                                       address:  745 Olive Street
Shreveport, LA 71104
                                       phone:  318.227.4088
                                       fax:  318.227.4086
                                       e-mail:  kthomas@thehealingclinics.com
                                       relationship to entity:  President/CEO