Helen Farabee Centers Board of Trustees Minutes - 12/07/2006 HELEN FARABEE REGIONAL MHMR CENTERS
BOARD OF TRUSTEES
• December 7,2006
Ats:\ 11:00 AM
Staley Conference Room
500 Broad
Wichita Falls,Texas
Board of Trustee Ken Andrews, Chair; Robert Clement; Bill Coombs,Vice-Chair; Michael
Members Present: Ezell; Bobby McGough; Sue Nunn, Secretary/Treasurer; Shelley Owen; Bobby
Smith
Board of Trustee Jo Ann Marquart;
Members Absent:
Senior Roddy Atkins, Executive Director; Rod Brennan, Chief Financial Officer; Jeff
Management Staff Dresbach, Human Resources and Risk Management Director; Gianna Harris,
Present: Essential Services and Clinical Accountability Director; Lynn Hartje, Mental
Health Services Director; Connie Johnston, Community and Consumer Support
Director
Other Staff and Linda Ammons,City of Wichita Falls Liaison; Jan West, Administrative
Guests Present: Assistant/Board Liaison, Recorder
AGENDA TOPICS
120706-1 CALL TO ORDER
Ken Andrews, Chair called the meeting to order in open session at 11:00 AM. A quorum of Board of
Trustee members was present.
A)Introduction of Guests •
Linda Ammons, City Commissioner was introduced as a guest.
120706-2 PRESENTATIONS _
A) Open Citizen Comment to the Board
No citizen comment was offered.
120706-3 APPROVAL OF MINUTES
The Board of Trustees approves the minutes of the November 02, 2006 Board of Trustees meeting.
Motion: Ms. Nunn Affirmative: 5
Second: Mr. McGough Negative: 0
Citizen Comment: None
120706-4 TRAINING
A)Medical Services
Dr. Lauren Parsons, Medical Director asked that her training be deferred until 1:30 p.m.
120706-5 RECOMMENDATIONS
A. BOARD OF TRUSTEES
No Agenda Items
11:05 AM Shelley Owen arrived at the meeting
RECEIVED IN
CITY CLERK'S OFFICE
Board of Trustee Meeting Minutes Date _01 1
December 7,2006 Time M
By
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B. BUDGET AND FINANCE
1)Financial Statements
RECOMMENDED ACTION:That the Board of Trustees approve the financial statements for October
2006.
Rod Brennan, Chief Financial Officer distributed and presented the financial statements for October
2006 (on file).
Roddy Atkins, Executive Director discussed the State Hospital Bed Utilization. We received a bill for
our over utilization for$212,000.00. We sent a letter of response. We contested $223,000.00 over county
of residence issues and bed day charges made by the hospital against our recommendation. Rod, Gianna,
Charlie Martin and I went to Austin yesterday to meet with staff from the Department of State Health
Services, Joe Vesowate (Assistant Commissioner, Community Mental Health and Substance Abuse
Services, Department of State Health Services), Kenny Dudley (Texas Department of State Health
Services, Mental Health and Substance Abuse Service, Hospital Section), and staff from Contracts
Management. They were willing to accept the $123,000.00 over the county of residence issues and they
will strongly consider the admissions we did not recommend. They will let us know after the first of the
year what the final tally is. My estimate is $90,000.00. The State Hospital physicians have a tight
interpretation of EMTALA (Emergency Medical Treatment and Labor Act)which says that we can not
deny admission. This is exaggerated because clients are taken directly to the State Hospital rather than
going througn us first. Of the 47 admissions we are questioning, only two are not from Wichita Falls.
The rural sites are better about going through us for admissions because of the time and money for
transportation. Law enforcement here in Wichita Falls often pick someone up and take them directly to
North Texas State Hospital where a Psychiatrist is called for evaluaton and they are admitted. We have
done a lot of work recently with the police force. The state's stance is there is just so many resources for
the State Hospitals and they have to have controls to manage the resources. State Hospitals have a 96.4%
occupancy rate. We need to make sure the individuals need to be there. It is convenient for the local
police to drop them off, and if they are not admitted then they send someone to pick them up. We do not
want anything to cause the situation to be contentious with the local police or the State Hospital. We will
be working on this problem with the Director of Facility Services and Jim Smith,North Texas State
Hospital Superintendent. We have been discussing setting up a screening office on the State Hospital
grounds. A designated place outside of Admissions. The state is trying to help, they are talking about
leasing us a room for$1.00 per year. Another option would be to designate the Crisis Respite Unit for
screening. But that would necessitate another trip by the police officer if they have to be admitted. We
will have to look at the cost of maning an office at the hospital.
The Board of Trustees approved the financial statements for October 2006.
Motion: Mr. Coombs Affirmative: 6
Second: Ms. Nunn Negative: 0
Citizen Comment: None
THE BOARD OF TRUSTEES RECESSED FOR LUNCH AT 11:50 AM.
THE MEETING WAS RECONVENED BY JUDGE ANDREWS AT 12:35 PM.
C. CONTRACTS AND PLANS
No Agenda Items
Board of Trustee Meeting Minutes 2
December 7,2006
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•
D. FACILITIES AND EQUIPMENT
1)Broad Avenue Entrance Canopy
RECOMMENDED ACTION: That the Board of Trustees approve replacement of the entrance canopy at
500 Broad Avenue at a cost not to exceed$8,977.
Rod Brennan, Chief Financial Officer presented the bids for the entrance canopy (on file) with the
recommendation of accepting Chavez Contracting as the low bidder.
Michael Ezell asked to abstain from the vote due to a close personal friendship with one of the vendors.
The Board of Trustees approved replacement of the entrance canopy at 500 Broad Avenue at a cost not to
exceed$8,977 from Chavez Contracting as the low bidder.
Motion: Ms. Owen Affirmative: 5
Second: Mr. Smith Negative: 0
Abstain: Mr. Ezell Abstention: 1
Citizen Comment:None
2) Outstanding Bonds
RECOMMENDED ACTION: That the Board of Trustees approve paying off the remaining balance on the
Denver facility bonds at a cost of approximately $75,000 and authorize the Board Chair and Secretary to sign
the attached resolution and to sign the escrow agreement,when finalized.
Rod Brennan, Chief Financial Officer presented the information on the Denver facility bonds (on file).
The Board of Trustees approved paying off the remaining balance on the Denver facility bonds at a cost of
approximately$75,000 and authorized the Board Chair and Secretary to sign the attached resolution and to
sign the escrow agreement,when finalized.
Motion: Ms. Owen Affirmative: 6
Second: Mr. Ezell Negative: 0
Citizen Comment: None
E. POLICIES AND PROCEDURES
No Agenda Items
F. PROGRAM AND PERSONNEL
No Agenda Items
120706-6 QUARTERLY REPORTS
A. PLANNING AND NETWORK ADVISORY COMMITTEE
No Agenda Items
B.ESSENTIAL SERVICES AND CLINICAL ACCOUNTABILITY
Ms. Harris was not present at this time so item was deferred until later on the agenda
Board of Trustee Meeting Minutes 3
December 7,2006
•
120706-7 EXECUTIVE DIRECTOR'S REPORT
Provider of Last Resort
The Negotiated Rule Making Process Group around Provider of Last Resort is meeting with the
stakeholders. Our representatives on the workgroup are Sandy Skelton, Chief Executive Officer,Texas
Council of Community Mental Health and Mental Retardation Centers, Inc. and Cindy Sill, Executive
Director, Tri-County MHMR Services. They have been meeting feverishly and have presented a rough
draft. The real issue is around the language, whether Community Centers must contract out services or be
providers. The language in the current draft says if two private providers in a given area can meet 100%
of the contract targets, then the Community Centers can not be providers. That is some progress made;
initially we could not provide services at all. We still do not know what will happen when the Private
Provider goes out of business and the Community Centers are not equipped or staffed to provide the
services. There will be a draft in place by December 15th for review. There is a lot of language around
trying to prove consumer choice. My main concern is still the administrative infrastructure and the cost to
manage. Our Planning and Network Advisory Committee felt like we were contracting enough out, any
more and we could not manage. The authority question will be resolved by the Negotiated Rule Process
Group or the Legislators and will be phased in over the next two years.
Legislative Session
The Legislative Session starts on January 9th. Our meeting with our Legislators went well, and we
received good feedback. We will receive good support from them. It is possible we will receive
additional money for Crisis Services, and we will possible get the equity issue off our back. We are at the
point where demand is catching up with us; we do not have a lot of room to work. We will have
community discussion about how to spread our resources out to address our needs. We are moving into a
situation where we will be faced with prioritization. The only thing that will change that is additional
funds. If the state does not do any new funding, we will have to look locally for funds or prioritize
services. The State Hospital utilization and funding is a community issues. It is a difficult balancing act;
we have done well so we will have some flexibility. The State Hospital utilization issue will cost us
money one way or another. We have to decide if there is a better way to spend $100,000.00 to save
$300,000.00.
Physicians
We are still looking for physicians, we are currently 1.5 short. We are specifically looking for a child
focused physician. We are using Local Tenens for short term relief. We currently have one physician
who is working one day per month for the Child and Adolescent Services. We have been marketing to
Texas Medical students and Texas License holders.
County Judges
We had a turn over in our County Judges with six new ones in our catchment area. I will be making a
presentation to the new judges on January 3rd at NorTex to educate them about Helen Farabee Regional
MHMR and the services we provide.
1:05 PM Robert Clement arrived at the meeting
Board of Trustee Meeting Minutes 4
December 7,2006
•
B.ESSENTIAL SERVICES AND CLINICAL ACCOUNTABILITY
1) Fourth Quarter Report
RECOMMENDED ACTION: Information item only.
Gianna Harris, Essential Services and Clinical Accountability Director presented the fourth quarter
Essential Services and Clinical Accountability report (on file).
No action required, for information only.
Citizen Comment:None
2)Department of State Health Services Access to Services Mystery Caller Study
RECOMMENDED ACTION: Information item only.
Gianna Harris, Essential Services and Clinical Accountability Director reported the Department of State
Health Services had conducted a study where they made mystery calls to facilities to see how soon we
were able to get individuals in for assessment. The prior study we had done poorly because they were
only able to get through to voice mail so they had stated it was 365 days. After that study we put
procedures in place to assure the telephones were answered. This study they were able to get an
appointment within three days. The standards state we have to see them within fourteen days.
No action required, for information only.
ICI
Citizen Comment: None
3)Fiscal Year 2005 and Fiscal Year 2006 CORE Medicaid Audit
RECOMMENDED ACTION: Information item only.
Gianna Harris, Essential Services and Clinical Accountability Director presented the Fiscal Year 2005
and Fiscal Year 2006 CORE Medicaid Audit report (on file).
No action required, for information only.
Citizen Comment: None
120706-4 TRAINING
A)Medical Services
Dr. Lauren Parsons, Medical Director had not arrived;training will be rescheduled at a later meeting.
120706-8 ANNOUNCEMENTS
A. Next Meeting
Ken Andrews announced the next meeting will be at 11 A.M.,Thursday, January 04, 2007, Child and
Adolescent Services, 516 Denver, Wichita Falls.
Bill Coombs will provide home made chili for lunch.
Board of Trustee Meeting Minutes 5
December 7,2006
120706-9 OTHER BUSINESS
None
120706-10 ADJOURN
The Board of Trustees' meeting adjourned at 1:40 PM.
Approved as presented: Approved as corrected:
January 04, 2007
Board of Trustee Meeting Minutes 6
December 7,2006
NI
HELEN FARABEE
REGIONAL MHMR CENTERS Wichita Falls Administrative Offic
P.O.Box 8266 1000 Brook Street Wichita Falls,Texas 76307-826
Phone (940) 397-3100 Fax (940) 397-315
January 08, 2007
Darron Leiker
City Manager
City of Wichita Falls
P.O. Box 1431
Wichita Falls, Texas 76307-1431
Dear Mr. Leiker:
In accordance with the provisions of Senate Bill 112, a copy of the minutes of the Board of
Trustees of Helen Farabee Regional MHMR Centers is enclosed for the regularly scheduled
meeting held on December 07, 2006. These minutes were approved by the Board at its meeting
held on January 04, 2007.
Sincerely,
an
Admi istrative Assistant/Board Liaison
/jw
enclosure