NCNC and AMCS: Building a Scalable Recovery Ecosystem
A comprehensive operating model for Year 1 buildout and Year 2 scale, designed to create measurable outcomes through integrated clinical care, recovery support, and workforce development.
Foundation
Two Entities, One Mission
New Chance New Choice (NCNC)
The mission-driven nonprofit layer that stabilizes lives through wraparound programming, housing pathways, recovery supports, and workforce development. Focused on reducing relapse and recidivism while creating long-term outcomes for clients and families.
AMCS Clinic
The clinical delivery layer providing licensed, compliant, reimbursable behavioral health services. Delivers outpatient treatment, assessments, therapy, care coordination, and clinically governed recovery programming that scales across locations and states.
The Measurable Pipeline
The combined outcome goal extends far beyond treatment alone. This model creates an investable, scalable pipeline that transforms lives through structured progression.
1
Stabilization & Treatment
Clinical intervention and assessment
2
Recovery Support
Structured programming and peer support
3
Housing Stability
Pathway to secure living situations
4
Workforce Readiness
Trade pathways and skill development
5
Job Placement
Employment and retention support
6
Sustained Outcomes
Reduced relapse and recidivism
Operating Principles
Non-Negotiable Foundations
Clinical Governance
The clinic must be led by licensed clinical leadership. Business entities support the clinic but do not practice medicine.
One Operating System
Single source of truth for priorities, owners, timelines, budgets, and KPIs across all entities.
Finance Discipline
Spend controls and reporting must be real from day one, especially under a large capital program.
Separate Risk
Nonprofit funds, clinic funds, and management company funds cannot be blended casually.
Workforce Outcomes
A person without income pathways is more likely to relapse. Workforce development is essential to rehabilitation.
Entity Structure: Built for Scale
NCNC Holdings, Inc. (C Corp)
Parent company for capital coordination, ownership of non-clinical shared assets, and investment-level governance.
NCNC Management Services, LLC (MSO)
Management services organization employing non-clinical staff and providing back-office services across the ecosystem under formal agreements.
New Chance New Choice (501(c)(3))
Mission programming, recovery support, housing pathways, community partnerships, workforce development, grants, and philanthropic funding.
AMCS Clinic (Licensed Entity)
Clinical service delivery, payer enrollment, credentialing, treatment delivery, and clinical compliance.
This structure allows NCNC and AMCS to stay clean and compliant while the MSO builds the operational engine. It creates a home for marketing, business development, operations, technology, finance, HR, and facilities functions, supporting multi-state expansion through standardized site launches.
Critical Documentation Stack
These documents protect the buildout and prevent drift. Each agreement defines clear boundaries, responsibilities, and decision rights.
1
Master Management Services Agreement
Between AMCS Clinic and NCNC Management Services, LLC. Defines scope, pricing methodology, service levels, reporting, and decision rights.
2
Shared Services Agreement
Defines which back-office services are provided to the nonprofit and under what terms.
3
Executive Service Agreements
For key leaders operating via LLCs where applicable, establishing clear engagement terms.
4
Procurement and Approval Policy
With thresholds and sign-off authority to control spending and maintain accountability.
5
Budget and Runway Memo
Clearly defines the first 24 months of operating capacity and financial projections.
6
Operating Cadence Charter
Weekly meetings, KPI reporting, and escalation rules to maintain operational rhythm.
Leadership
Executive Team Structure
Gino Cruse
Founder and Executive Director (NCNC)
Firm salary: $300,000
Mission leadership, strategic vision, and stakeholder relationships
Darol Lucas
VP, Operations and Technology
Firm salary: $200,000
MSO executive leadership, operational systems, and technology infrastructure
Darryl Johnson
VP, Staff and Finance
Firm salary: $200,000
Chief of Staff function plus capital and finance discipline
Growth and Production Partners
These roles are internalized as core functions, not optional add-ons. Each drives critical revenue and partnership pipelines.
James Sesay
B2C Marketing Lead
Brand, demand generation, recruitment, and retention. Internal leader via MSO, W-2 or contracted through The LUSÉ Group.
Darren Thompson
B2B Business Development Lead
Referral networks, payers, partners, and expansion pipeline. Internal leader via MSO, W-2 or contracted through POKR Consulting.
Joshua Barnes
Videography and Content Production
Partner retainer under Marketing with clear monthly deliverables for consistent, credible content.
Why Marketing and Business Development Must Be Separated
B2C Marketing
Drives the public-facing demand engine: families, individuals seeking help, program recruitment, community trust, and brand credibility.
  • Consumer awareness campaigns
  • Admissions inquiries
  • Community engagement
  • Brand reputation management
B2B Business Development
Drives the institutional engine: referral pipelines, payer relationships, employer partners, workforce placement partners, facility partnerships, and expansion partnerships.
  • Referral network development
  • Payer contracting
  • Strategic partnerships
  • Multi-site expansion

If one person is expected to do both, both will underperform. These are distinct skill sets requiring dedicated focus and different relationship-building approaches.
Organizational Structure
Departmental Overview
The minimum department stack needed to run NCNC and AMCS as a real multi-site operation.
The Company Engine
  • Administration and People Operations
  • Staff Office (Chief of Staff function)
  • Finance and Accounting
  • Compliance and Risk
  • Operations and Facilities
  • Project Management (site launch discipline)
  • Technology and Data
The Growth Engine
  • B2C Marketing (James)
  • B2B Business Development (Darren)
  • Communications and Content Production (Joshua Barnes)
The Service Delivery Engines
  • AMCS Clinic Operations (clinical delivery)
  • NCNC Program Operations (nonprofit programming)
  • Revenue Cycle and Billing (clinic critical)
  • Workforce Development, Trade Pathways, and Employment Placement (NCNC Works)
Administration and People Operations
Mission: Build the internal backbone through hiring, onboarding, culture, policies, scheduling, and people systems so execution remains stable as headcount grows.
Core Deliverables
  • Hiring roadmap by department and site
  • Onboarding system for staff and contractors
  • Policy framework (confidentiality, code of conduct, training)
  • Contractor versus W-2 discipline
  • Performance expectations and review cadence
  • Staff training coordination and documentation tracking
Staffing Model
Year 1: People Operations Manager, Executive Administrator and Office Manager
Year 2: Add HR Coordinator, Training and Compliance Documentation Coordinator, Recruiting Ops Specialist
$140K
HR Manager Median
National median pay per BLS
In Year 1, choose a slightly lower-cost People Ops Manager and outsource the rest.
Finance, Compliance, and Operations
Finance and Accounting (MSO led)
Mission: Track money with discipline, prevent uncontrolled spend, protect runway, and produce investor-grade reporting.
Key deliverables: Budget build by entity, monthly close and financial reporting pack, AP/AR and procurement controls, burn rate and runway reporting, site-level P&L visibility.
Year 1 staffing: Finance Director or Controller, Bookkeeper or Staff Accountant. National median for Financial Managers: $161,700.
Compliance and Risk (shared)
Mission: Protect licensure, patient privacy, payers, and prevent compliance failure from derailing the buildout.
Key compliance lanes: HIPAA privacy and security, 42 CFR Part 2, clinical documentation standards, credentialing and payer enrollment, incident response, vendor compliance and BAAs, audit readiness.
Year 1 staffing: Compliance Officer or Manager, Credentialing Specialist (outsourced initially). National median: $78,420.
Operations and Facilities (MSO led, Darol oversight)
Mission: Build repeatable operational systems across sites through facilities readiness, procurement, vendor control, logistics, and SOP discipline.
Key deliverables: SOP library for every department, vendor onboarding and performance management, facilities readiness checklist per location, asset tracking and purchasing workflow, site launch operational playbook.
Year 1 staffing: Operations Director, Facilities and Logistics Coordinator.
Technology and Project Management
Technology and Data (MSO led, Darol oversight)
Mission: Build the operational tech stack that makes multi-site scale possible through identity, access, device management, reporting, security, and workflow enablement.
Core deliverables:
  • Microsoft 365 and identity governance
  • Device management and security baseline
  • Access control by entity and role
  • Reporting dashboards (financial, operational, clinical KPIs)
  • Vendor integrations for EHR, billing, CRM, HRIS
  • Data governance and retention standards
Year 1: Systems Administrator/IT Generalist, Data and Reporting Analyst. National median for IT Managers: $171,200.
Project Management Office (PMO)
Mission: Prevent chaos, enforce timelines, and ensure every site launch has a charter, timeline, budget lane, and owner.
Core deliverables:
  • Site launch templates (charter, RACI, scope, schedule, budget)
  • Weekly project status reporting
  • Cross-department dependency management
  • Launch retrospectives and playbook improvements
Year 1: Program Manager for Site Launch, Project Coordinator
Year 2: Add second Program Manager, Internal PM for back-office systems
Growth Engines
B2C Marketing and B2B Business Development
B2C Marketing (James)
Mission: Build public trust and consistent demand through admissions inquiries, brand authority, and community visibility across markets.
Deliverables: Brand system and messaging, demand generation campaigns, community engagement strategy, content calendar and distribution, conversion tracking from inquiry to intake.
Year 1: Marketing Lead (James), Content Coordinator, Graphic Designer (fractional), Videography partner (Joshua Barnes). National median: $156,580.
B2B Business Development (Darren)
Mission: Build the institutional pipeline that sustains scale through referrals, partnerships, payer relationships, employers, and trade placement partners.
Deliverables: Referral network build (courts, probation, hospitals, shelters, community orgs), workforce partners (employers, unions, trade schools), expansion pipeline, strategic partnership agreements, partnership performance reporting.
Year 1: BD Lead (Darren), Partnerships Coordinator. National median for Sales Managers: $138,060.
Clinical and Revenue Cycle Operations
These departments represent the core service delivery and financial sustainability of the model. Clinical excellence without revenue cycle discipline leads to cash flow crisis.
AMCS Clinic Operations
Mission: Deliver licensed behavioral health services with clinical quality and reimbursement discipline while maintaining compliance and documentation standards.
Core deliverables: Intake and assessment workflow, scheduling and capacity management, clinical documentation standards, clinical supervision and QA, coordination with billing and authorization, discharge planning tied to workforce and housing pathways.
Staffing: Clinical Director (licensed), Program Manager for Outpatient Services, Intake Coordinators, Care Coordinators, Therapists and counselors, Peer support specialists.
Revenue Cycle and Billing
Mission: Turn services into cash predictably, reduce denials, control AR days, and protect margins.
Core deliverables: Credentialing and payer enrollment workflow, claims submission discipline, denials management and appeals, AR aging control and weekly AR huddles, copay and patient responsibility workflows, monthly revenue cycle reporting.
Year 1: Revenue Cycle Manager, Billing Specialist, Credentialing (outsourced or fractional initially). Year 2: Add Denials Specialist and additional billing support by volume.

This is where many buildouts fail. If intake, scheduling, documentation, and billing are not engineered as one system, clinical care can be strong but the business will collapse.
NCNC Program Operations
Mission: Run the recovery support layer that makes outcomes durable through housing pathway support, life skills, case management, family support, and community reintegration.
Core Deliverables
  • Case management workflows
  • Housing partnerships and placement coordination
  • Recovery support programming
  • Community partner coordination
  • Outcome tracking for grant readiness and reporting
Staffing Model
Program Director, Case Managers, Housing Navigator, Peer Support and Recovery Coaches
Day-to-Day Operations
Daily: Client follow-up, placement coordination, documentation
Weekly: Case review meeting, partner coordination meeting
Monthly: Outcomes reporting and improvement planning
NCNC Works
Workforce Development and Trade Pathways
Mission: Create real post-recovery opportunity through trade exposure, training pathways, certifications, apprenticeships, placement, and retention support.
Priority Trade Pathways
HVAC, Plumbing, Electrical, Carpentry, Welding, Commercial driving (CDL), Roofing, Solar installation, Facilities maintenance and building engineering, Culinary and food service pathways for rapid employment options.
Partnership Model
Start with partnerships to prove outcomes quickly through trade schools, unions, and employer partners. Build toward an NCNC-controlled trade school model once volume and funding justify it.
Core Deliverables
Partner MOUs for training seats and referral process, employer partner agreements for interviews and placement, participant readiness assessment and pathway mapping, job readiness training and retention coaching, placement tracking and 90-day, 180-day retention reporting.
Year 1 staffing: Workforce Development Director, Employer Partnerships Coordinator (can be shared with BD early). Year 2: Add Career Coaches, Training Coordinator, Employer Partner Manager by region.
Company-Wide Operating Rhythm
1
Daily
  • Intake and scheduling huddle (clinic)
  • Revenue cycle work queue review (billing)
  • Operations ticket review (facilities, tech, procurement)
  • Marketing inbound and content execution check
2
Weekly
  • Executive leadership meeting (KPIs, risks, decisions, funding discipline)
  • Clinic operations meeting (capacity, documentation compliance, outcomes)
  • Revenue cycle meeting (AR, denials, payer issues)
  • Marketing and BD alignment meeting (lead flow, partner pipeline, workforce pipeline)
3
Monthly
  • Financial close and executive reporting pack
  • Compliance sampling results and corrective action plan
  • Workforce outcomes scorecard (placements and retention)
  • Site readiness review for any expansion timeline
This cadence ensures alignment, accountability, and rapid issue resolution across all departments and entities.
Critical Considerations
Operational Shortcomings That Must Be Addressed
These categories make benefactors nervous because they have seen them destroy otherwise good missions.
B2C and B2B Separation
If one function tries to cover both, you will leak leads, lose partners, and fail to scale predictably. These require distinct skill sets and dedicated focus.
Revenue Cycle Weakness
A great clinical program with weak billing becomes a cash flow crisis. This must be staffed and measured from day one.
Compliance Cannot Be Afterthought
HIPAA, record handling, credentialing, documentation, and vendor BAAs must be organized early or expansion will stall.
PMO for National Buildout
Multi-site expansion without project discipline becomes delayed openings, uncontrolled spend, and inconsistent quality.
Consistent Content Production
If Gino's vision includes visibility, speaking, thought leadership, and public trust building, videography cannot be occasional. Joshua Barnes should be treated as a real production capacity partner with weekly deliverable rhythm.
Strategic Capital Request
NCNC and AMCS are seeking a $100 Million capital injection (structured as a committed facility with staged draws) to accelerate a national buildout of a full, end-to-end behavioral health continuum. This capital is crucial for buying time, speed, scale, and certainty.
Our Operating Thesis
1
Speed Matters
Licensing, staffing, real estate, and payer contracting are inherently slow without significant upfront capital to accelerate processes.
2
Control Matters
Outcomes and profit improve significantly when clients remain within our integrated system for all services, from detox to workforce placement.
3
Discipline Matters
Large-scale operations require rigorous spending controls, clear dashboards, and defined ownership to prevent operational and financial risks.
Dual Build Tracks
Income Engine Build
Establish clinics, detox facilities, housing, and support services designed to generate predictable monthly cash flow from day one.
Controls & Visibility Build
Implement robust finance controls, compliance frameworks, detailed reporting dashboards, and executive accountability for transparent tracking.
Strategic Rollout: The First 90 Days
Our phased approach ensures rapid deployment of foundational elements, controlled execution, and early proof points.
1
First 30 Days: Foundation & Controls
  • Finalize entity structure & intercompany agreements.
  • Establish robust finance controls (approvals, budgets, expense workflows).
  • Build monthly benefactor reporting package template.
  • Confirm internal leaders for Ops/Tech, Finance, Compliance, B2C Marketing, B2B BD, and Content.
  • Create 12-month execution roadmap with site, licensing, staffing, occupancy, and billing milestones.
2
First 60 Days: Build Motion & Execution
  • Launch marketing & admissions engine (intake, call standards, CRM).
  • Initiate B2B pipeline build (referral mapping, payer talks, partnership outreach).
  • Begin facility & housing pipeline (property shortlisting, due diligence, negotiations).
  • Stand up core technology stack for dashboards and access control.
  • Start licensing sequencing for next expansion target.
3
First 90 Days: Measurable Outcomes & Proof Points
  • Stabilize first operational footprint with visible KPIs (admissions, occupancy, staffing, billing).
  • Deliver first monthly benefactor reporting package on schedule.
  • Draft first “replicable playbook” (SOPs, training, compliance, site launch checklist).
  • Initiate NCNC Works partnerships (trade school, referral/placement, first participant pathway).
This structured timeline ensures we hit critical milestones and build a scalable recovery ecosystem with precision and accountability.