the intersection of hope and help RACSB believes in a community where everyone has the opportunity to achieve maximum potential and receive maximum respect.
To realize this vision, we roll up our sleeves to lend a hand. We work at the intersection of hope and help to provide support services across the full life-cycle of complex behavioral health needs. Through collaboration, we empower individuals in our community with the tools, services, supports, and care they need to meet and surpass personal expectations. We are strongest when all of our neighbors are healthy, happy, and harmonious. Regardless of causes, conditions, or financial means, anyone who walks through our doors will find a little lift or a lifetime of support. Together, we can take the first step toward stabilizing day-to-days and defining tomorrows.
individuals received services through RACSB in FY 2019 What do you do? I hear that question nearly every day. Our work at Rappahannock Area Community Services Board is complex and difficult to describe. Instead, I offer the short answer: We start hope. The individuals we serve face daunting challenges— whether it’s a parent worried because their baby hasn’t started crawling or an elderly woman with mental illness scared to leave the safety of a state hospital. We walk alongside these individuals and help them find a first spark of hope that motivates them to keep going. We don’t deal in easy cures or fast fixes. The individuals who come to us often have a long journey ahead of them. Sometimes, we try to elicit first words from a toddler who later comes to our group homes as an adult who still doesn’t speak. Some of the individuals in our substance abuse groups return to the allure of opiates. People who come to us in crisis return in another crisis. Hope may be hidden in these situations but it is not extinct. We work to help individuals achieve their fullest potential. We help them unlock hidden hope for whenever they are ready to fan the spark. Fiscal Year 2019 has been a challenging one for community services boards across the state, with budget cuts, growing needs, and new demands. Through these obstacles, I uncovered many sparks of hope: • The growing acceptance of peer support. Each peer specialist who works at RACSB has a remarkable story of overcoming hopelessness. They show us the way forward and inspire individuals who are starting their recovery journey. • Community support for individuals with mental illness. For example, many first responders learn to handle mental health emergencies with compassion through Crisis Intervention Training. In FY19, we were able to expand the hours of our Crisis Assessment Center at Mary Washington Hospital, which means more individuals will receive emergency assessments
in a calmer setting and more law enforcement officers will be able to patrol the streets. • Reducing the state hospital census. State psychiatric facilities have been overflowing in 2019, often filling all of their beds. We have been able to keep a relatively low census of individuals in state hospitals. This comes from the dedicated work of our emergency services therapists who are devoted to finding the best treatment options for people in crisis. And, our hospital liaisons do an amazing job of getting individuals out of the hospital and into appropriate community settings, which is no easy task. • The outings and celebrations of individuals in our residential and day programs for adults with developmental disability. Staff have supported them on volunteer excursions, beach trips, shopping, and so much more. • The successes of individuals in our intermediate care facilities, which serve individuals with developmental disability who have significant behavioral and/or medical needs. Many of these individuals have lived in institutional care since childhood and we get to witness so many of their firsts. • A commitment to integrated care. Mental health and physical health go hand in hand. This year, Anthem partnered with us to create a program that treats individuals holistically. • The dedicated staff of RACSB. Their compassion allows them to stay committed to our mission despite ongoing regulatory challenges and stronger documentation requirements. Their work is not easy but they believe in changing lives and providing hope not just for the individuals they serve but also for each other, something we see each month in the Board of Directors meeting. For the segment where we hand out awards for length of service, the meeting often becomes standing room only as so many employees show up to support their coworkers. And so many employees go above and beyond, by staying abreast of the latest information and advancing their education and by participating in weekend events to support community collaboration and to increase brand awareness.
jane mcdonald yaun
hope is here EMERGENCY SERVICES
Fredericksburg, Spotsylvania and Stafford: 540-373-6876 Caroline: 804-633-4148 King George: 540-775-5064
The Gathering Place (RAAI) 19254 Rogers Clark Boulevard Ruther Glen, VA 22546 804-633-5721
ADMINISTRATION
Spotsylvania County RAAI 7424 Brock Road Spotsylvania, VA 22553 540-582-7200
CONSUMER AFFAIRS ADVOCATE
Stafford County RAAI 15 Hope Road Stafford, VA 22554 540-659-8527
OUTPATIENT & CASE MANAGEMENT Fredericksburg Clinic
King George County (RAAI) 8479 St. Anthony’s Road King George, VA 22485 540-775-6590
600 Jackson Street Fredericksburg, VA 22401 540-373-3223 V/TTY
540-899-4616
600 Jackson Street Fredericksburg, VA 22401 540-373-3223 V/TTY
Spotsylvania County Clinic 7424 Brock Road Spotsylvania, VA 225523 540-582-3980 V/TTY
Stafford County Clinic 15 Hope Road Stafford, VA 22554 540-659-2725 V/TTY
Caroline County Clinic
19524 Rogers Clark Boulevard Ruther Glen, VA 22546
Kenmore Club 632 Kenmore Avenue Fredericksburg, VA 22401 540-373-7737 EARLY INTERVENTION Parent Education-Infant Development Program 700 Kenmore Avenue Fredericksburg, VA 22401 Infant and Toddler Connection of the Rappahannock Area 540-372-3561 877-268-4169 (toll-free)
King George County Clinic
PREVENTION SERVICES 10825 Tidewater Trail Fredericksburg, VA 22408 540-374-3337
DAY SUPPORT SERVICES Rappahannock Adult Activities 750 Kings Highway Fredericksburg, VA 22405 540-373-7643
Rappahannock Area Kids on the Block 540-940-2325
8479 St. Anthony’s Road King George, VA 22485 540-775-9879
Project LINK 600 Jackson Street Fredericksburg, VA 22401 540-891-3132 Healthy Families Rappahannock Area 418 Carr Drive Fredericksburg, VA 22408 540-374-3366
RESIDENTIAL SERVICES Crisis Stabilization Program Sunshine Lady House 615 Wolfe Street Fredericksburg, VA 22401 Mental Health Supportive Residential Services 401 Bridgewater Street Fredericksburg, VA 22401 Developmental Disability Residential Services 10825 Tidewater Trail Fredericksburg, VA 22408 540-899-4368 Sponsored Placement Program 10825 Tidewater Trail Fredericksburg, VA 22408 540-899-4436 RESPITE SERVICES Myers Drive Respite Group Home 10 Myers Drive Fredericksburg, VA 22405 540-899-467SPECIALIZED TRANSPORTATION 460 Lendall Lane Fredericksburg, VA 22405 540-899-4670
hope by the sea At 60, Jeffrey had never been to a beach. He grew up in a training center for individuals with significant disability, where “vacations” were just visits to other parts of the campus. A few years ago, Jeffrey came to live in one of our intermediate care facilities. These are like group homes, but for individuals with significant behavioral or healthcare needs. At an ICF, individuals receive all of the services they received at a training center, just in a smaller, homier setting. Many families weren’t so sure about ICFs at first. Training centers weren’t ideal—but they were safe. For decades, experts believed training centers were the only way to serve individuals who had severe needs that required round-the-clock nursing, therapies and more. In the past 10 years, the tide had been turning. Now, the theory was that individuals were best served in their communities. Through trial and error, service providers learned that individuals could receive the same standard of care—and in some cases, better—for less money in the community. So we started ICFs as a way to provide that care, here in the greater Fredericksburg area. Families were understandably nervous. But they took leaps of faith and allowed us to care for their loved ones. And we are so honored and grateful for the privilege.
There are so many things to love about community-based care. It provides an opportunity to truly individualize care for each person. And that takes us to the beach. For most of us, a beach trip is a simple enough excursion. But when you have a significant disability, it requires a lot of planning and support. At RACSB, we practice person-centered planning, which means that the individual receiving services is the most important part of the plan. We don’t look at what supports we have and decide which ones fit a person. We first look at what they need to lead their ideal life. So when a beach trip came up for Jeffrey, our direct service professionals jumped in and did the hard work to make it a reality. And that provided us with an amazing opportunity—to witness Jeffrey feel waves tickle his feet for the first time. As you can see, he wasn’t so sure at first. But that hesitance didn’t last long. Jeffrey was soon lounging on the sand and chilling by the pool.
The individuals who live at Ruffin’s Pond and Churchill Drive group homes developed a case of puppy love. Lambert visits twice a month, and the residents can’t wait to play fetch and feed treats to the therapy dog. They also love grooming the gorgeous pup. Lambert brings along his owner, Ruth Jaquith, for two hour-long visits each month. They volunteer their time to bring hope and joy.
comfort & hope
Our Sponsored Placement program allows adults with a developmental disability the chance to be part of a loving family and a vibrant community. We tailor supports to meet individual needs, which helped a woman who had both intellectual disability and mental illness. She was at Western State Hospital, but couldn't be discharged until she had the right community services in place. Her situation
required sensitivity and a lot of planning, but she successfully moved into her new home and is doing well. Our Sponsored Placement team has attended trainings and worked diligently to gain a better understanding of dual diagnosis and how we can open our homes and doors further to individuals who have both intellectual disability and mental health needs.
individuals received sponsored placement services
individuals received developmental disability residential services in FY 19
Our residential programs offer an array of services to fit a wide range of needs, including supervised apartments, group homes, intermediate care facilities, sponsored placement, and respite care. We are so honored to be a home base for these individuals and their families.
hope in bloom Our annual Garden Party featured food, fun, and flowers—and the opportunity to help adults with developmental disability flourish in our community.
Each year, we kick off our Spring Plant Sale with a party at our greenhouse. Ticket and plant sales support our day support program, which allows adults with developmental disabilities to remain in their community, and the money from the Garden Party offered opportunities for exercise, education and excursions. "Our goal is to make sure each person in our program gets to do the things they want and love to do and to explore and discover new interests and passions,� said Lacey Fisher, coordinator of day support services. For more than 40 years, RAAI day support services have helped caregivers be able to
maintain jobs and hobbies, while providing adults with developmental disability chances to develop hobbies and friendships. In FY19, we added a Community Only Program to support individuals who like to be on the go. With supports tailored to each individual, our day support program serves individuals with varying levels of developmental disability. RAAI employees diligently explore opportunities in the community to meet the desires of program participants. Whether it’s taking a train enthusiast to the railroad museum or an animal-lover to the petting zoo, our day support program helps individuals pursue their passions.
"
Our goal is to make sure each person in our program gets to do the things they want and love to do and to explore and discover new interests and passions. Lacey Fisher
hope for the day participated in our day support program for adults with developmental disability
hours were spent in community engagement
Dan struggled at day support. His loud noises and behaviors often kept him from participating in activities and sometimes disturbed his friends. In early FY 2019, Rappahannock Adult Activities launched a Community Only Program and Dan was one of the first participants signed up. The new initiative takes adults with developmental disability directly into community settings for working out, volunteering, and exploring hobbies. The group is on the go all day long, never stopping at a day support site. They go out to eat, go shopping, help at the SPCA, garden, take day trips, and more. Since starting the Community Only Program, Dan has thrived. He’s volunteered to help individuals who are homeless and pets needing families, visited pools and amusement parks, and spent the day in a botanical garden.
individuals received mental health residential services
hope at home
In Fiscal Year 2019, eight individuals left Western State Hospital to live in our mental health residential program. These adults were able to focus on recovery in their own home, while receiving support and strength. Three individuals also moved out of our residential program. They have been successful living on their own.
We also saw one individual who had frequent hospitalizations in the past stay out of the hospital after he moved into our boarding house for adults with mental illness. Our mental health residential programs give individuals the hope of their own place in our community, both literally and figuratively.
individuals received mental health case management services
hopes come true
Melinda always dreamed of living in the countryside with her family. But those hopes seemed dashed when mental illness made it challenging for Melinda to care for herself or her young daughter. Her mom had custody of the little girl while Melinda spent seven months in Western State Hospital and then moved into her own apartment. Melinda took care of her mental health,
attending appointments, keeping track of her medications, and participating in counseling. After a few years, she felt ready to take care of her daughter and regained custody. Melinda now lives in a house in the country with her mom and her daughter. She is able to spend every day with the ones she loves most.
"
I could not have wished for a better crew of people to help me through this trying time in my life...I just want to say THANK YOU to each and every person of SLH. I now know that my family has grown much bigger now that I have y'all in my life. I truly am blessed to be so lucky to come here." Sunshine Lady House Guest
guests stayed at the Sunshine Lady House for Mental Health Wellbeing & Recovery
hope sweet hope
A former guest stopped by our crisis stabilization program with a sweet thank you. The Sunshine Lady House for Mental Health Wellbeing and Recovery helps individuals stay in the community during a crisis by offering a two-week stay with wrap around services. The program offers Wellness Action Recovery Plans, 12-step programs, group and individual counseling, yoga, art therapy and many other services.
responding with hope
Crisis Intervention Team training teaches law enforcement to respond to emotional crises with compassion and understanding. Class members learn about mental illness, how to recognize the signs of a behavioral health crisis, and about community supports that are available. At the end of the week-long course, they test their new skills through simulations based on real-life scenarios. This collaboration also allows law enforcement and emergency services therapists to develop a strong working relationship, which helps individuals in crisis.
adventures in hope members belonged to the Kenmore Club, a psychosocial rehabilitation program for adults with severe and persistent mental illness Our clubhouse is more than a place to go during the day—it’s a community. At Kenmore Club, individuals with severe and persistent mental illness come for psychosocial rehabilitation. By focusing on each individual’s strengths, we help members pursue passions and build friendships.
Members and staff work side by side to do the daily tasks involved in operating the clubhouse.
The day-to-day operation of Kenmore Club offers members the chance to contribute in significant ways, which helps them gain confidence, build self-esteem, learn job-related skills, and work with others toward a common goal. We also help members get jobs, develop hobbies, and participate in community activities.
expressions of hope Nearly one in five American adults live with mental illness—and each one has a deeply personal, unique path to recovery. Each year, the Art of Recovery exhibit allows a glimpse of what mental illness and recovery look like. The pieces range from serene, bucolic landscapes to dark, tormented portraits. Artists use a wide array of media and techniques to depict their very intimate journeys. “Kenmore Club, a mental health program under the RACSB, organizes the annual Art of Recovery,” said Amy Rippy, Kenmore Club coordinator. “The Art of Recovery, now in its 15th year, provides an opportunity for individuals living with mental health challenges to combat stigma and align with the community in promoting recovery. Artists from across the state participate in the annual art show. RACSB is fortunate to benefit from statewide participation and the exceptional partnership of Gabe and Scarlet Pons.” The Pons own the PONSHOP Studio and Gallery on Caroline Street, which has hosted the event since 2011.
“There’s a certain degree of bravery and vulnerability that comes with creativity,” Gabe Pons said. “Bravery in the sense that one has to venture into the unknown and uncharted territory when working on piece-a challenge
“There’s a certain degree of bravery and vulnerability that comes with being creative.” Gabe Pons that will force an artist be confronted with their own aptitude as well as the limits of the materials. Vulnerability arises when the work is complete and presented in the public realm. This is the eighth year that PONSHOP has hosted The Art of Recovery exhibit and we applaud the participating artists for their willingness to share their artistic journey with the public and look forward to their voices being heard.” Artists have praised the show for providing them with a venue for expression and for helping them to educate the community about mental illness. One artist said he was contemplating suicide, but the exhibit gave him a goal to work toward. Each story is unique, and each work is different, but they all share one thing in common: A spark of hope and an illustration of resiliency.
individuals received Medication Assisted Treatment for opioid use disorders
hope for a future Fifteen years ago, Charles filed for bankruptcy. For the intervening years, he didn’t think about his future. He couldn’t see past getting high. Didn’t think beyond how to feed his addiction.
Charles caught a glimpse of where his path would lead and wanted a new destination. So he enrolled in Medication Assisted Treatment. He started MAT 10 days after his overdose.
Then on Jan. 27, Charles died. He overdosed on opioids and was revived after 27 minutes.
“It’s the best thing that’s happened to me,” he said with a smile.
That experience woke him up. Charles realized his substance use disorder had taken over his life. His world was built around using drugs and his relationships, employment, and credit suffered.
These days, he’s working on small goals to get to his big goals. Charles now has a full-time job with benefits. He’s repairing his relationships and his credit. He hopes to save money and buy a vehicle and a home. He’s gone from chasing the next high to chasing the American dream. And the MAT team is cheering him on as he journeys to tomorrow.
"
MAT has helped tremendously mentally. I have met so many amazing people and they have helped me. I highly recommend it. It has given me so much more hope in my recovery. MAT participant
seeds of hope mothers participated in Project LINK Project LINK aims to provide intervention, prevention, and case management services to pregnant and parenting women—plus those who are of childbearing age—who are impacted by Substance Use Disorders as well as Co-occurring Disorders. In May, Project LINK hosted Seeds of Hope, a "Mother’s Day” event featuring lunch and the opportunity to plant herbs. Each mom took their flower pots home and watched their plant blossom and grow as a symbol of how they grow in hope throughout the recovery process.
speaking of hope
A mom recently thanked us because her daughter was disturbing other diners in a restaurant. When her toddler started getting speech therapy with our Parent Education-Infant Development program, she didn't speak. Now her parents can't get her to stop talking. And that's just how they like it! The PEID program helps babies and toddlers with developmental delays. We work with tiny tykes to help them grow to their fullest potential.
infants and toddlers received services through the Parent Education-Infant Development Program
a spirit of hope The holidays are a season of hope, and Healthy Families Rappahannock Area makes it magical for the children who receive services through the home visiting program. More than 200 individuals came to a festive party, where children ate, met Mr. and Mrs. Claus, and received presents.
HFRA works magic year-round, too—helping parents learn about child development, positive parenting, and health care. We work to help children have the brightest future possible. In FY 2019, that work included about 59,000 miles of travel to conduct 2,491 home visits across five localities.
families received services through Healthy Families Rappahannock Area
individuals received prevention services
Prevention Services work to reduce individual, family, and environmental risk factors while increasing resiliency and enhancing protective factors. We recognize that achieving comprehensive community wellness requires a collaborative approach. Services include youth programs, suicide prevention, REVIVE! opioid overdose reversal training, Understanding Adverse Childhood Experiences, and community collaborations.
moments of hope Recently a 3-year old girl requested yogurt for breakfast, telling her mom it was a healthy choice for her body. She had just completed the HALO (Healthy Alternatives for Little Ones) program, an evidence based program that focuses on how the body works and how to maintain a healthy life journey through healthy choices. Hopefully this little girl will continue to make healthy body choices throughout her life’s journey. Two young siblings who also completed HALO saw a man smoking on the sidewalk and told their mom, “Smoking is an adult choice. It is not a choice for my body. It is not a healthy choice for anyone.” Hopefully these two will continue to make positive life choices throughout their own life’s journey. A mother of three recently graduated from the DARE To Be You parenting program found a full-time job with benefits and permanent housing. By completing the DARE To Be You parenting program she was able to show the courts that she was willing and able to become her daughters' full-time parent once more.
A new stepfather had an "aha" moment when he realized that giving his stepdaughter practice making positive choices when she was little would help her continue to make positive choices throughout her life. He also learned that a parent needs to give up control every once in a while so their child can discover who they are and what they will become.
expanding hope
Looking ahead to Fiscal Year 2020: RACSB adds a new property As Fiscal Year 2019 ended, we bought Roxbury Farm & Garden Center to expand supports to area residents. For nearly 50 years, we have served individuals in the Greater Fredericksburg community, offering support to thousands of individuals with behavioral health or developmental concerns and their families. As new needs arise, we have grown services, programs and staff. But this led to some growing pains. Mainly, we were running out of space. So, when a cherished neighbor put some land on the market, our board of directors jumped at the opportunity. “On behalf of everyone on the Board, we are excited about the Roxbury purchase as this will allow RACSB to expand, evolve, and diversify our services,” Chairwoman Debbie Draper said. Roxbury Farm and Garden Center, which sat on the corner of Lafayette Boulevard and Jackson Street and near the Ronald W. Branscome Building, announced it was closing in February. “The Farm and Garden Center has been a terrific community partner over the years, so we were sad to learn it was closing,” Executive Director Jane McDonald Yaun said. “But we also saw a chance to help more people and to better serve the public. We were fortunate to gain both the property and the garden center’s general manager, Andy Lynn, who is now running our horticulture program for adults with developmental disability.” The new land offers an opportunity to grow our horticulture services and to create employment for adults with developmental disability. Our administrative staff could also move out of its current location at 600 Jackson Street, giving room to expand outpatient behavioral health services at the Fredericksburg Clinic. While the land acquisition offers several new opportunities for RACSB, the agency also hopes to hold onto some of the property’s history. Our agency leaders
have met with an architect to explore options for keeping the 31-foot-wide mural on the back of one of the garden center’s warehouses. “Nearly 300 volunteers came together in 2007 to tell a colorful story about our region’s diversity,” said the Rev. Lawrence Davies, a former Fredericksburg City mayor who sits on our board of directors. “This beloved mural sprang from that collaboration, and its richness comes from the various items volunteers brought to place in the artwork. This is not unlike RACSB, which partners with the community to help individuals live to their fullest potential.” Yaun was also cognizant of the connection between the land’s history and its future. “For 90 years, Roxbury Farm and Garden has helped our community thrive and bloom,” she said. “We look forward to continuing that tradition by using this land to help our neighbors flourish in spite of challenges they may face.”
hope for the future
Looking ahead to Fiscal Year 2020: RACSB adds a new service The 2019 tally of homeless individuals in the Fredericksburg area found 36 men and women who were chronically homeless and had a serious mental illness. In the past year, 12 individuals could not leave a state psychiatric facility because they lacked stable housing. Additionally, 25 inmates of Rappahannock Regional Jail were both homeless and severely mentally ill. In the Fredericksburg area and across the nation, the connection between homelessness and mental illness is fairly clear. About 25 percent of homeless individuals have a serious mental illness, compared to 4 percent of the general population. Rappahannock Area Community Services Board has a new tool to help individuals with serious mental illness find and keep stable housing, thanks to a grant from the Virginia Department of Behavioral Health and Developmental Services. The $819,577 grant for permanent supportive housing will enable RACSB to hire a housing coordinator and a case manager to help individuals with severe mental illness navigate the process of renting a home. This would include assistance with costs, helping with tenancy issues, and connecting resources. “Evidence overwhelmingly shows that stable housing helps individuals with severe mental illness stay out of hospitals and jail,” said RACSB Executive Director Jane McDonald Yaun. “We want to keep these individuals in the
community where they can get the consistent treatment and support needed to thrive.” DBHDS has been providing money for permanent supportive housing for adults with serious mental illness since 2016. Research found that in one year of providing assistance, the state saved nearly $1.8 million in hospitalization costs. Individuals receiving permanent supportive housing services spent less time in jail, emergency departments, and institutional care settings. This research echoes national research that shows that permanent supportive housing saves an average of $6,000 annually per person in healthcare costs. “Permanent supportive housing makes sense financially and, at the same time, it also improves the lives of the folks who need mental health treatment,” said Joe Wickens, director of community support services. RACSB’s permanent supportive housing program will work with its Program for Assertive Community Treatment, which provides psychiatric treatment, medication management, housing assistance, employment help, and more to individuals in their homes. Often called a “hospital without walls,” PACT literally meets clients where they are. Of the program’s 82 participants, 13 are homeless or at risk of losing their housing. This money will help these individuals achieve the stability needed to continue on their journey to recovery.
“We want to keep these individuals in the community where they can get the consistent treatment and support needed to thrive.” Jane McDonald Yaun, executive director
supporting hope Whenever you need help, we are here. We offer 24/7 emergency services. We also have Same Day Access hours at our five outpatient clinics and drop-in peer-run support groups. Drop-in Substance Use Disorder support groups include: Hunger for Hope, Fridays from 3:30-4:30 p.m., 600 Jackson Street in Fredericksburg Remodeled Recovery, Mondays from 12:30-1:30 p.m. 600 Jackson Street in Fredericksburg Serenity Sisters (for women), Tuesdays from 12:30-1:30 p.m. starting Nov. 12, 600 Jackson Street in Fredericksburg Same Day Access hours are: Fredericksburg Clinic, Monday, Wednesday, and Thursday, 8:30 a.m. to 2:30 p.m. and Tuesday, 9:30 a.m. to 2:30 p.m. Caroline County Clinic, Tuesday and Thursday, 8 a.m. to 11:30 a.m. King George County Clinic, Tuesday, 1:30-5 p.m. and Wednesday, 8:30 a.m. to 2:30 p.m. Spotsylvania County Clinic, Monday, Wednesday, and Thursday, 9 a.m. to 2 p.m. Stafford County Clinic, Tuesday and Thursday, 9 a.m. to noon.
“It takes a great deal of courage for individuals and their families to take those first steps on their journey to recovery. We are ready to meet them as soon as they choose to embark on this lifesaving path.� Jacque Kobuchi Clinical Services Director
RAPPAHANNOCK AREA COMMUNITY SERVICES BOARD 600 JACKSON STREET FREDERICKSBURG, VA 22401
WWW.RAPPAHANNOCKAREACSB.ORG
US Postage Paid Non-Profit Org. Fredericksburg, VA Permit No. 210
