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Helen Farabee Centers Board of Trustees Minutes - 02/02/2006 HELEN FARABEE REGIONAL MHMR CENTERS BOARD OF TRUSTEES • February 02,2006 $\ 11:00 AM Child and Adolescent Services 516 Denver Avenue Wichita Falls,Texas Board of Trustee Ken Andrews, Chair; Robert Clement; Bill Coombs, Vice-Chair; Michael Members Present: Ezell; Jo Ann Marquart; Bobby McGough; Sue Nunn, Secretary/Treasurer; Board of Trustee Shelley Owen, Bobby Smith Members Absent: Senior Roddy Atkins, Executive Director; Jeff Dresbach, Human Resources and Risk Management Staff Management Director; Kelly Franklin, Privacy Officer; Lynn Hartje, Mental Present: Health Services Director; Connie Johnston, Community and Consumer Support Director; Susan Thompson, Child and Adolescent Services Director; Ralph Whaite, Management Information Services Director Other Staff and George Clay, High Plains Health Providers; Sherry Janes, Substance Abuse Guests Present: Services; Barbara Lingle, Representative David Farabee's Office; Sheryl Mahon, Mental Retardation Services, Social Services Worker; Jana Simpson, Chief Accountant; Marcy Thomas, Substance Abuse Services; Jan West, Administrative Assistant/Board Liaison, Recorder Luncheon Guests: I Barbara Lingle AGENDA TOPICS 020206-1 CALL TO ORDER Ken Andrews, Chair called the meeting to order in open session at 11:05 AM. A quorum of Board of Trustee members was present. A) Introduction of Guests Barbara Lingle, Representative David Farabee's Office; was introduced as a guest. 020206-2 PRESENTATIONS A) Open Citizen Comment to the Board No citizen comment was offered. B) Child and Adolescent Services Susan Thompson, Child and Adolescent Services Director, when I last spoke with you as a caseworker in Graham we had 353 patients in the Child and Adolescent Services. We currently have 399; we have grown one full case load. Our primary diagnosis is ADHD (Attention Deficit and Hyperactive Disorder) which is no surprise. Our second diagnosis is Oppositional Defiant Disorder. Our primary focus is getting the communication out to the sources. We are putting together a packet for the parents and teenagers on ADHD and Oppositional Defiant Disorder(on file)to help educate. Communication and education are our greatest tools. We re working on the engagement process, encouraging our patients to come back. The last time we visited you asked if we had any needs, especially in the outlying counties we need card games and board games for the patients. Roddy Atkins stated Child and Adolescent Services hit their benchmarks in January for the first time in a while. This was due in part to Susan's leadership. RECEIVED IN CIDate TY CLERK'S OFFICE Board of Trustee Meeting Minutes J l February 02,2006 By C)Mental Retardation Services Intake and HCS Interest List Sheryl Mahon, Mental Retardation Services, Social Services Worker, reported that the Mental Retardation Services Intake process is initiated by the legally authorized representative, individual, or actively involved person when they contact us for services. We go over with them the individual needs and services and address any additional needs they have. The unmet needs are then referred. We complete an Initial Identification Of Preferences Form (on file) where we note if they request the HCS (Home and Community Services) interest list, Respite, In Home and Family Support, etc. We have a brochure (on file) we give them on HCS that tells them of eligibility requirements and services available. We get consent for documentation of eligibility. They are eligible for services if they test with an IQ of 69 or lower or have related conditions with evidence that this occurred during the developmental years. We have to find a source that can identify when the testing was done. We then refer them to a Psychologist who does a DMR(Determination of Mental Retardation). Every case is individual, and every new case is an adventure. George Clay, High Plains Health Providers arrived and asked if we requested consent to share information with other providers early on, mostly for those interested in HCS (Home and Community Services) or ICF/MR (Intermediate Care Facility for persons with Mental Retardation) programs. Do you do the consents as part of intake? Ms. Mahon, First we make sure we know their needs. We make them aware of the services we can provide including assistance with residential placement. Once we get the preference form, we give them the web site with all the providers. If they request residential services, then we get consents for the providers they are interested in, if it gets to that point. The second area I wanted to talk about is the HCS (Home and Community Services) interest list. HCS is a Medicaid waiver program and we maintain an interest list. Once an individual is placed on the HCS interest list we have to make annual contact with them to see if they are still interested and to address their current needs. The benefits of the HCS program are(1) once a person is offered a slot they can move anywhere in the state of Texas and the slot goes with them and (2) they have more choices. Services can be provided in three settings, in their own home, in their families' home, or in a residential setting. That setting can change dependent on their needs. Individual wait ten years or more on the interest list before a slot becomes available. We currently have 395 on our interest list. Once they have received an HCS slot, the slot is theirs until death. Mr. Atkins once they receive their slot, they can go anywhere and the slot goes with them. There is a CAP on the number of HCS slots we can have, and we are currently at our CAP, so we can not offer ourselves as providers. If an individual insists on us being their provider, they can appeal and it can happen. There are currently 29,000 people on the HCS interest list state wide. It is growing due to the baby boomers, the parents have taken care of them and as they are aging they are looking at HCS for residential services. Some are getting on the list in anticipation of the ten year wait. 11:30 AM Robert Clement arrived at the meeting D) Substance Abuse Services Marcy Thomas, Substance Abuse Services Director, I have been in the Substance abuse field since 1982 both as a nurse and as a Substance Abuse Counselor. We have been contracted to serve 78 outpatient slots in Wichita County. We have license for 16 adolescent out patients at Wichita Falls High School; 15 adult out patients at Broad Street; 15 adolescent out patients at Broad Street; 16 adult out patients at Parole; and 16 adult out patients at Probation. We provide twelve hours of treatment with one individual session every other week. We have applied to be a Clinical Training Institution. We are fortunate to have a graduate level intern, Mary McGregor. Sherry Janes will tell you about the intervention services she provides. Board of Trustee Meeting Minutes 2 February 02,2006 Sherry Janes, Case manager, Substance Abuse Services, I provide intervention services in conjunction with Judge Little's truancy court. Last year we served 400. We do drug testing and needs determination. If they test positive for drugs then I refer them to an adolescent counselor set up at Wichita Falls High School. We do bus students from Rider High School and Hirschi High School. If they test negative for drugs we refer them to STAR Connection and other services. We are working on an intervention grant so that we can get reimbursed for these services. Of those we test from truancy court, 40% test positive for drugs. These services re provided in Wichita County only. Mr. Atkins, We did not get notified of this contract until December and they already have the program up and running. A) Open Citizen Comment to the Board George Clay, High Plains Health Providers arrived and asked that he be allowed to make a Citizens Comment to the Board. Judge Andrews gave Mr. Clay permission to proceed. Mr. Clay stated he would like to report that he had talked to the school district and to several individual and asked that they send him copies of what they gave to the consumers. It was not mentioned in any of the documentation about the private providers. This is in direct violation of the law. Ms. Mahon mentioned that they gave the web site information,but some of our consumers do not have computer access. They need a piece of paper with the providers listed. When I talked to the diagnostician at Rider High School she did not have a clue who we were. This is not an effective way to give consumer's choices. The perception is that when Helen Farabee Regional MHMR Centers sees a consumer, they only contact the private providers when they have a problem child they do not want. The system is not fixed. In all the materials I received High Plains Health Providers is not mentioned. Mr. Atkins stated DADS (Department of Aging and Disability Services) requires we use a list that is pulled down from CARE. It is not a good way to do business because it lists every provider in the state of Texas that states they provide services in our area. There are a lot of providers that state they serve the entire state when in reality they do not provide services in our area. Mr. Clay asked if we could not just give them the names of the agencies that actually provide services in our area. Mr. Atkins stated we can not; we are required to give them all of the providers that say they serve our area, which is hundreds of names. Mr. Clay stated according to the information I have, you do not. Mr. Atkins stated this is not an issue of the Board of Trustees. We need to get together and address these concerns so we can get all the players present and discuss details. Mr. Clay stated I have not been successful in dealing with this agency. There is a problem; there is a lack of cooperation with the private ICF/MR providers in Wichita Falls. There is a perceived conflict of interest when the keeper of the gate also provides the same services as I do so they get first choice and we do not even get any referrals. Ms. Nunn stated we appreciate your coming here today and bring this to our attention. You and Mr. Atkins need to get together. Mr. Atkins stated I will report back to the Board of Trustees the results of our meeting. I want to make sure it is fair and I want to work it out. Jeff Dresbach, Human Resources and Risk Management Director asked to address the Board of Trustees. Judge Andrews gave Mr. Dresbach permission to proceed. Mr. Dresbach, some of you toured this facility last month after the meeting and saw the efforts being made. These staff, Rod Turner, Jim Wickersham, Reese Curfew, Charlene Dyess, Kim Beck, and Jimmy Barrells put in lots of hours resulting in the changes you will see today. They have done a tremendous amount of work. We have always had good planners,but our success is due to their effort and execution. Mr. Atkins they have done an incredible job. Board of Trustee Meeting Minutes 3 February 02,2006 k • a THE BOARD OF TRUSTEES RECESSED FOR LUNCH AT 11:40 AM. THE NEXT ITEM ON THE AGENDA WAS ANNUAL TRAINING AND DID NOT REQUIRE A VOTE OR APPROVAL. THE BOARD OF TRUSTEES ELECTED TO PROCEEED WITH THE TRAINING. THE MEETING WAS RECONVENED BY JUDGE ANDREWS AT 12:35 PM. 020206-3 APPROVAL OF MINUTES The Board of Trustees approves the minutes of the January 05, 2006 Board of Trustees meeting. Motion: Ms. Nunn Affirmative: 6 Second: Mr. Coombs Negative: 0 Citizen Comment: None 020206-4 TRAINING A)Health Insurance Portability Accountability Act (HIPAA) Kelly Franklin, Privacy Officer presented the Health Insurance Portability Accountability Act Training (on file). B)Required Board of Trustee Training for Substance Abuse Services Contract MarcyThomas, Substance Abuse Services Directorpresented the required trainingfor the Substance q Abuse Contract that is available on CD-ROM. 020206-5 RECOMMENDATIONS A. BOARD OF TRUSTEES 1)Member Center Notification of Action Inconsistent with the Texas Council's Legislative Agenda RECOMMENDED ACTION: Information item only. Ken Andrews stated the Texas Council of Community MHMR Centers Board of Directors at their meeting on January 21,2006 did adopt the"Member Center Notification of Action Inconsistent with the Texas Council's Legislative Agenda"Policy. Roddy Atkins, Executive Director, stated the Board of Trustees might want to formally adopt the Policy titled: "Member Center Notification of Action Inconsistent with the Texas Council's Legislative Agenda". Judge Andrews asked that this item be placed on the agenda for the next meeting. 2)Membership in Texas Council of Community MHMR Centers RECOMMENDED ACTION: Information item only. Roddy Atkins, stated we have not at this point elected to withdraw Helen Farabee Regional MHMR Centers from membership in the Texas Council of Community MHMR Centers. A 1987 Position Paper on Equalization(on file) was distributed at the Texas Council Board of Directors meeting and will be discussed by them at a later date. The Texas Council appears to be moving in a positive direction,possible helped or nudged along by us. No action required, for information only. Board of Trustee Meeting Minutes 4 February 02,2006 • 3)Mental Retardation Services RECOMMENDED ACTION: Information item only. Roddy Atkins, a letter was mailed to Mr. Clay and every effort will be make to meet with him and resolve his issues. I will report the results of our meeting back to the Board of Trustees. No action required, for information only. B. BUDGET AND FINANCE 1) Financial Statements RECOMMENDED ACTION: That the Board of Trustees approve the financial statements for December, 2005. Jana Simpson, Chief Accountant presented the financial statements for December 2005 (on file). Roddy Atkins, previously we asked the Board of Trustee approval for training from David Lloyd through MTM Services even though it did not require Board of Trustee approval. In conjunction with Mr. Lloyd we have decided that we need additional training. Do you want us to bring the projected additional amount for your review and approval? Sue Nunn, Since the original request was brought to us, I would like to review the projected additional amount. Roddy Atkins, this is a break down of the renovation and construction costs for Denver Street (on file). Bill Coombs, on page 15, Item E states "Because implementation of the fee for service methodology may be delayed, the Board of Trustees may choose not to see the latter two slides on a monthly basis". Even though it may be two years, I would like to continue to see this information. The Board of Trustees approves the financial statements for December 2005. Motion: Mr. Clement Affirmative: 6 Second: Mr. Coombs Negative: 0 Citizen Comment: None 2)Retirement Funds RECOMMENDED ACTION: Information item only. Jana Simpson, Chief Accountant presented the Retirement Funds information (on file). No action required, for information only. C. CONTRACTS AND PLANS No Agenda Items D. FACILITIES AND EQUIPMENT No Agenda Items Board of Trustee Meeting Minutes 5 February 02,2006 E. POLICIES AND PROCEDURES No Agenda Items 1 F. PROGRAM AND PERSONNEL 1) Congnitive Behavioral Therapy Data Gathering Initiative RECOMMENDED ACTION: That the Board of Trustees allow an exception to the current policy and approve participation in the Cognitive-Behavioral Therapy (CBT) data gathering initiative, "Project Expect" in partnership with the Department of State Health Services. Lynn Hartje, Mental Health Services Director presented the information on the Cognitive-Behavioral Therapy (CBT) data gathering initiative,"Project Expect"which will be completed in partnership with the Department of State Health Services(on file). This is not experimental and is not research, it is data gathering. The Board of Trustees approved the allowance of an exception to the current policy and approved participation in the Cognitive-Behavioral Therapy(CBT) data gathering initiative, "Project Expect"in partnership with the Department of State Health Services. Motion: Mr. Clement Affirmative: 6 Second: Mr. Ezell Negative: 0 Citizen Comment: None 2) Status of Implementation of Mental Health Resiliency and Disease Management RECOMMENDED ACTION: Information item only. Lynn Hartje, Mental Health Services Director distributed and discussed the Service Package percentages (on file) for July through January. No action required, for information only. Citizen Comment: None 3) Pecan Valley MHMR Region Interagency Agreement RECOMMENDED ACTION: Information item only. Ralph Whaite, Management Information Services Director reported on the current status of the Pecan Valley MHMR Region Interagency Agreement. He distributed a map (on file) of the new Pecan Valley Service Area. No action required, for information only. Citizen Comment: None 020206-6 QUARTERLY REPORTS A. PLANNING AND NETWORK ADVISORY COMMITTEE No Agenda Items Board of Trustee Meeting Minutes 6 February 02,2006 B. MANAGEMENT REPORTS No Agenda Items 2:45 PM Robert Clement left the meeting 020206-7 EXECUTIVE DIRECTOR'S REPORT Legislative Retreat A memo inviting Board of Trustee members to the Texas Council Legislative Retreat (on file) scheduled for Saturday, March 4th in Austin was distributed and discussed. This is an opportunity to crystallize our Legislative Agenda for the next Legislative Session. Members interested in attending were encouraged to contact Jan West so she could make the necessary arrangements. Texas Council of Community MHMR Centers Executive Directors'and Board of Directors'Meetings The Texas Council has hired a Legislative Communications Firm and a Lobbyist. I think they will do well. This will results in a one time dues increase. We are looking at a creative way to pay for this with some money we will be getting in that we were not expecting. The lobbyist, Todd Smith, is well known and has been a lobbyist for the PPAT(Private Providers Associate of Texas). He is not pretty, but he is a pit bull and does not like to lose. Finances We are doing well financially. We hope to bring an agenda item to the Board of Trustees asking for an increase in our current insurance stipend from $200.00 a month to $300.00. We are also looking at providing insurance. We were in a self insured fund and it blew up. We have been making inquiries into what it would take to offer full insurance. There is a lot to consider. The issue is, if it is available, how do we handle the debate that some of our employees are already insured through their spouse, etc and do not want or need additional insurance. When we enlist in a group insurance they require a certain percentage of employee participation. We have to continue to look. Within our resources we are targeting increases for staff based on their performance and market value. We want to be able to attract good employees. We are looking at reinvesting in our staff. 020206-8 ANNOUNCEMENTS A. Facility Tour Following Meeting Roddy Atkins encouraged all members to take the opportunity to tour the Child and Adolescent Services facility and see the changes. B. Next Meeting Ken Andrews announced the next meeting will be at 11 A.M., Thursday, March 02, 2006, at the Montague County Mental Health Center, Bowie. 020206-9 OTHER BUSINESS None 020206-10 ADJOURN The Board of Trustees' meeting adjourned at 3:00 PM. __ Approved as presented: Approved as corrected: �l U March 02, 2006 Board of Trustee Meeting Minutes 7 February 02,2006 ►h 7 HELEN FARABEE REGIONAL MHMR CENTERS Wichita Falls Administrative Offic \d _ P.O.Box 8266 1000 Brook Street Wichita Falls,Texas 76307-826 Phone (940) 397-3100 Fax (940) 397-315 March 06, 2006 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 February 02, 2006. These minutes were approved by the Board at its meeting held on March 02, 2006. Sincerely, Jan W t Administrative Assistant/Board Liaison /jw enclosure RECEIVED IN CITY CLERK'S OFFICE Date ®5"1�"� / -C& By Time L