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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 • 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 • • 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