NCNC + AMCS Behavioral Health
National Build-Out Business Plan
A Strategic Multi-State Expansion Initiative
2025–2031
Executive Summary
The Vision
We're building a fully integrated behavioral health network that owns the complete client journey—from medical detoxification through residential recovery, outpatient treatment, workforce reentry, and stable housing. This comprehensive approach addresses the fragmentation that undermines traditional care models.
Operating Structure
Clinical services will be delivered through AMCS Behavioral Health, ensuring medical excellence and regulatory compliance. New Chance New Choice serves as our nonprofit partner, driving community engagement and workforce development initiatives that strengthen client outcomes.
Our commitment is threefold: deliver clinical quality at scale, operate with unwavering ethical standards, and ensure rapid repayment to our benefactor. Every operational decision flows from this purpose-driven framework.
Capital Structure and Repayment Philosophy
Facility Target
$75 Million in total capital to fund multi-state expansion, property acquisitions, and operational infrastructure
Annual Interest
$5–6 Million confirmed obligation, representing an effective rate of 6.7–8.0% annually
Conservative Ramp
Disciplined growth protects 90–120 day cash reserves while comfortably covering interest obligations
Our Cultural Rule: Pay the benefactor first, expand second. Principal reduction accelerates through free cash flow and strategic property refinancing once sites stabilize.
Phase 1 Infrastructure Scope
01
Clinical Footprint
10–12 outpatient sites across 3–4 states by end of Phase 2, with Arizona serving as anchor market
02
Detoxification Centers
2–3 facilities offering medically supervised 5–7 day episodes with seamless transitions to next care level
03
Residential Housing
16–20 group homes and transitional properties, purchased where practical for long-term stability and refinancing opportunities
04
Support Operations
Integrated transportation and catering services scaled to attendance needs, creating dignified employment for program graduates
Revenue Model and Coverage Analysis
Steady-State Financial Projections
Base case consolidated revenue reaches $80–112 million annually across all service lines including clinics, detoxification, housing, and support operations.
Operating margins after clinical payroll and overhead stabilize at 20–25%, generating $16–28 million in operating profit. This provides substantial interest coverage with meaningful room for risk mitigation.
Beginning Year 3, we allocate at least 50% of free cash flow to principal reduction, supplemented by real estate refinancing that systematically lowers our blended cost of capital.
$96M
Midpoint Revenue Target
$22M
Operating Profit (Mid)
3.7x
Interest Coverage Ratio
Legal Separation Strategy

Media and Personal Brand Firewall
All book publishing, podcast production, and speaking engagements will be conducted through Cruse Consulting LLC. This structure maintains clear separation between personal commentary and clinical operations, limiting liability exposure to AMCS and NCNC entities while preserving leadership visibility.
Mission, Vision, and Market Problem
Our Mission
Deliver compassionate, evidence-based behavioral healthcare that sustains engagement long enough to achieve meaningful recovery. We eliminate handoffs, reduce friction, and build stable pathways for housing and employment so clinical progress can endure.
Vision Statement
Create a multi-state network where detoxification, housing, therapy, employment support, and long-term community integration function as a unified system. Clients remain connected to care for up to three years, dramatically reducing relapse risk while families experience sustained stability within a financially sound, ethically managed framework.
The Problem We Solve
Care fragmentation drives the revolving door. Clients cycle endlessly between emergency departments, brief detox episodes, and unstructured home periods. Each handoff multiplies relapse probability. Public systems pay repeatedly without achieving durable outcomes. Providers lacking housing and transportation cannot secure attendance, depressing both clinical results and revenue—frustrating clients and wasting payer resources.
Market Opportunity Analysis
Strong Demand Signals
  • Persistent need for detox, MAT linkage, intensive outpatient programming, and supportive housing across western and southwestern states
  • Courts, correctional facilities, hospitals, and county agencies actively seeking reliable capacity with predictable documentation
  • Payers increasingly rewarding sustained engagement and measurable outcomes
Programs that document thoroughly, staff ethically, and maintain high attendance can scale without sacrificing quality—creating sustainable competitive advantage.
Our Integrated Solution Framework
1
Clinical Continuum Under One Roof
Detoxification, group homes, outpatient and IOP services, plus telehealth connections to primary care and psychiatry where regulations permit
2
Housing That Stabilizes Attendance
Dignified homes near clinic locations with integrated transportation eliminating last-mile barriers to consistent engagement
3
Workforce and Community Supports
Training programs, job placement assistance, and social services navigation delivered through NCNC as nonprofit partner
4
Data, Documentation, and Compliance
Robust EHR utilization, supervision protocols where required, comprehensive HIPAA program, and consistent utilization review processes
5
Financial Discipline
Cost controls, conservative staffing ratios, and interest coverage thresholds that automatically pause expansion if financial metrics weaken
Licensing and Compliance Roadmap
Required Licenses and Permits
  • Outpatient behavioral health clinic license
  • Detox and withdrawal management license (ASAM-aligned)
  • Residential or group home license
  • Local business, zoning, and occupancy approvals
  • Transportation and food service permits where applicable
Accreditation Strategy
We will pursue single primary track for all sites—either Joint Commission or CARF—ensuring consistency. URAC for telehealth added only if enterprise contracts require it.
1
Year 1
Core state licenses, HIPAA/Part 2 programs live, security risk analysis, LegitScript application, accreditation gap assessment
2
Year 2
SOC 2 Type II, HITRUST validated assessment, first accreditation surveys at anchor sites, affiliate pilot launch
3
Year 3
Certifications scaled to new sites, mature affiliate quality audits, full compliance infrastructure operational
Privacy, Security, and Data Governance
HIPAA and Part 2 Baseline
Mandatory compliance with HIPAA privacy and security rules plus 42 CFR Part 2 for substance use disorder records
Information Sharing Protocols
HITECH Act and Cures Act procedures enabling appropriate data exchange while protecting patient rights
Advanced Certifications
HITRUST and SOC 2 pursued in phases to satisfy payer requirements and lender due diligence standards
LegitScript Certification
Required certification enabling compliant advertising for substance use disorder treatment services
Vendor Risk Management
Comprehensive Business Associate Agreements, SOC reports review, and annual vendor assessments
Affiliate Program: Controlled Expansion
Entry Requirements
Investor-partnered homes can join the NCNC network after rigorous vetting. Applicants must demonstrate:
  • Proof of required licenses and insurance
  • Qualified staffing and EHR participation
  • Modest entry fee (approximately $15,000)
  • Ongoing quality audit participation
Quality Standards and Oversight
  • BAAs and Part 2 safeguards required
  • Quarterly quality audits with scorecards
  • Corrective action protocols
  • Approved marketing claims only
  • Monthly quality fees tied to oversight costs
We expand this program cautiously to protect brand integrity and minimize compliance risk.
Core Clinical Programs
Detox and Stabilization
2–3 centers with 24/7 nursing coverage, average 5–7 day episodes, and direct handoff to appropriate next level of care
Outpatient and IOP
Individual, group, and family therapy using evidence-based approaches for co-occurring SUD and mental health conditions, with attendance supported through integrated transportation
Care Coordination
Strategic linkages to hospitals, courts, probation/parole, employers, and community primary care providers and psychiatrists where available
Telehealth Services
Virtual follow-ups and group sessions protecting attendance continuity and extending reach into rural counties with limited access
Housing, Transportation, and Support Operations
Residential Housing Strategy
16–20 group homes scaled to census requirements. Housing assignments match stage of change and clinical acuity. Length of stay driven by measurable clinical progress and readiness assessment.
Owned properties are strategically refinanced after stabilization to recycle capital for continued expansion while maintaining operational control.
Support Operations Creating Jobs
Transportation: Door-to-door service aligned with clinic schedules ensures reliable attendance
Catering and Nutrition: Safe, respectful meal service removes barriers to participation
Both operations create dignified employment opportunities for program graduates, reinforcing recovery pathways.
Dual-Track Marketing Strategy
B2C Marketing (Lead: James Sesay)
Objective: Generate qualified self-referred intakes at sustainable cost, then improve show rates and length of stay through education
  • High-trust website with clear service descriptions
  • LegitScript-compliant search and social campaigns
  • Educational content explaining care pathways
  • Community events and family nights via NCNC
Key Metrics: Cost per lead, show rate, length of stay, conversion rates by channel
B2B Business Development (Lead: Darren Thompson)
Objective: Lock in predictable referral volume and payer access through formal institutional relationships
  • Hospital discharge planner partnerships
  • Court and probation MOUs
  • County behavioral health contracts
  • Employer return-to-work programs
Key Metrics: New MOUs signed, referrals per source, payer panels won, claim approval rates
These distinct motions prevent channel conflict, maintain compliance for each audience, and enable clean measurement of cost, quality, and risk.
SWOT Analysis: Strategic Position
Strengths
  • Fully integrated continuum from detox through housing
  • Clear cash waterfall prioritizing interest service
  • Experienced leadership with defined roles
  • Real estate strategy enabling refinancing
  • Strong compliance posture from day one
  • NCNC nonprofit partnership strengthening community access
Opportunities
  • Strong demand from courts, hospitals, and payers
  • Contracted referral streams reducing volatility
  • Telehealth extension into rural markets
  • Real estate value creation through acquisition and improvement
  • Capital-light affiliate expansion model
Weaknesses
  • Lean early-stage leadership requiring bench depth
  • Licensing and credentialing lag creating delays
  • Documentation quality requiring training investment
  • Housing and transport operational complexity
  • Single lender concentration creating covenant risk
Threats
  • Reimbursement rate cuts or policy changes
  • Clinician shortages increasing labor costs
  • Regulatory compliance findings
  • Claim denials and clawback risk
  • Cyber and privacy event exposure
  • Cost inflation pressuring margins
Leadership Team and Governance
Gino Cruse, CEO
Strategic direction, capital program execution, multi-state relationship development, and final risk decisions
Darol Lucas, Operations & Compliance
Licensing oversight, supervision plans, SOPs, IT infrastructure, EHR management, HIPAA program, KPI dashboards
Darryl Johnson, Finance & Capital Strategy
Cash management, lender interface, interest coverage monitoring, asset refinance program execution
Shayla Estrada, Administrative Operations & Billing
Credentialing calendar, claims processing, denial management, AR follow-up, staff training
James Sesay, B2C Marketing
Funnel optimization, creative development, advertising campaigns, conversion measurement
Darren Thompson, B2B Business Development
Hospital and court relationships, MOUs, payer panel development

Governance Structure: NCNC operates as nonprofit partner for community programming. AMCS serves as clinical operator and billing entity. Real estate holding companies lease to operating entities at fair market values. Cruse Consulting LLC remains fully separate for media and speaking activities.
Capital Deployment and Use of Funds
Draws are staged and precisely aligned to site acquisitions, build-out timelines, and credentialing milestones to optimize capital efficiency and minimize idle cash.
Financial Projections and Three-Year Roadmap
1
Year 1: Foundation
Run-rate revenue: $35–45M
Focus: Arizona anchor establishment, one expansion state, core licensing, HIPAA/Part 2 programs operational
Coverage target: ≥1.5x interest coverage by year-end
2
Year 2: Expansion
Run-rate revenue: $60–80M
Focus: Third and fourth state additions, SOC 2 Type II, first accreditation surveys, quality controls proven
Coverage target: ≥2.0x interest coverage
3
Year 3: Optimization
Run-rate revenue: $80–112M
Focus: Margin improvement, first principal reductions ($6–10M), selective capacity additions, refinancing program
Coverage target: ≥2.5x with accelerating principal paydown
Operational Excellence Targets
  • AR days below 40 at steady state
  • Denial rate below 6% through documentation quality
  • Site-level EBITDA tracked monthly with variance analysis
Growth Discipline
  • Add sites only where payer contracts and staffing secured
  • Close underperforming locations to protect coverage
  • Freeze expansion if interest coverage drops below 1.7x for two consecutive quarters
Investment Opportunity: Risk-Managed Growth
A Differentiated Approach to Behavioral Health
This plan represents more than facility expansion—it's a blueprint for transforming fragmented behavioral health delivery into an integrated, sustainable model that serves clients, communities, and capital partners.
Financial Discipline
Conservative underwriting protects 90–120 day reserves. Interest serviced first. Minimum 50% of free cash flow to principal from Year 3. Quarterly reporting to benefactor with full transparency.
Operational Rigor
Best-in-class documentation, compliance from day one, experienced leadership, and site-level financial accountability with clear escalation protocols.
Market Validation
Strong demand from institutional referral sources. Proven reimbursement models. Real estate strategy enabling refinancing and capital recycling.
Mission Alignment
Clinical excellence and ethical scaling create sustainable competitive advantage while delivering measurable community impact through the NCNC partnership.
The Bottom Line: We're building a network that changes lives while delivering predictable returns. Strong coverage, clear controls, and values-driven leadership position this initiative for long-term success.