Helen Farabee Centers Board of Trustees Minutes - 11/03/2005 HELEN FARABEE REGIONAL MHMR CENTERS
,,Z�� BOARD OF TRUSTEES
November 03,2005
A4r\� 11:00 AM
First Baptist Church
601 South Main Street
Quanah,Texas
Board of Trustee Ken Andrews, Chair; Bill Coombs,Vice-Chair; Michael Ezell; Bobby
Members Present: McGough; Sue Nunn, Secretary/Treasurer; Bobby Smith
Board of Trustee Robert Clement; Shelley Owen
Members Absent:
Senior Roddy Atkins, Executive Director; Rod Brennan, Chief Financial Officer;
Management Staff Gianna Harris, Essential Services and Clinical Accountability Director; Lynn
Present: Hartje, Behavioral Health Services Director; Connie Johnston, Community and
Consumer Support Director; Ralph Whaite, Management Information Services
Director
Other Staff and Sarah Anderson,Board of Trustee Applicant; Jeff Graham, Social Services
Guests Present: Worker, Quanah Mental Health Center; Debbie Key, Continuity of Care
Coordinator, Mental Retardation Services; Gloria Simmons, Center Manager,
Quanah and Vernon; Jan West, Administrative Assistant/Board Liaison,
Recorder; _
Luncheon Guests: None
AGENDA TOPICS
110305-1 CALL TO ORDER
Judge Andrews 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
Sarah Anderson,Board of Trustee Applicant was introduced as a guest. _
110305-2 PRESENTATIONS
A) Open Citizen Comment to the Board
No citizen comment was offered. _
B)Behavioral Health Services
Gloria Simmons, Center Manager, Hardeman and Foard County Mental Health Center and
Wilbarger County Mental Health Center reported they are currently serving 61 adults. Jeff Graham is
the case manager for the adult clients and he is holding three or four groups per week. Darrol Groth has
31 child and adolescent clients he sees over the region and spends a lot of time on the road. Their clients
see Dr. Vachhani for their medication needs and they have three nurses that visit. Jaime Mathews is their
Secretary. Gloria serves as the Center Manager for Quanah and Vernon and as the LPHA (Licensed
Practitioner for the Healing Arts) for Childress.
RECEIVED IN
CITY CLERK'S OFFICE
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Board of Trustee Meeting Minutes By r Time 43',6o ik 1
November 03,2005
C) Continuity of Care Services
Debbie Key, Continuity of Care Coordinator stated she has worked for Helen Farabee Regional
MHMR Centers for two and a half years. They have enrolled 40 individuals in the HCS (Home and
Community Services)program this year. The most ever enrolled per year previously was twenty. Out of
the 40 enrollments, 26 were from general revenue; 11 were PI (Promoting Independence) slots,
individuals in the large ICF-MR (Intermediate Care Facilities for Persons with Mental Retardation); and
three were enrolled with slots from the State Hospital. Continuity services were provided to 12
individuals at the State Hospital,meeting with the treatment team on the Multiple Disabilities Unit at the
state Hospital two—three times during the consumer's stay and coordinate services upon discharge. We
currently have 89 consumers in State Schools that we have to maintain contact with and work on
community placement when the recommendation is made that they are ready. We do Permanency
Planning for 28 individuals that are 22 years of age or younger and are living in a group setting. These
have to be seen every six months. We are currently capped on our HCS slots and can not take any more.
Roddy Atkins—As you may recall we had to return $425,000.00 of Mental Retardation General Revenue
because we were unable to spend it within their guidelines. This money was used to refinance those on
the HCS waiting list (Interest List). We were able to enroll approximately 25 individuals and we still
have 376 on the Interest List. Even though we were not able to enroll those consumers in our services
because of the caps, we were able to keep the money in our region for our consumers.
110305-3 APPROVAL OF MINUTES
The Board of Trustees approves the minutes of the October 06, 2005 Board of Trustees meeting.
Motion: Ms. Nunn Affirmative: 5
Second: Mr. McGough Negative: 0
Citizen Comment: None
110305-4 TRAINING
A)Behavioral Health Services
Lynn Hartje, Behavioral Health Services Director provided Board of Trustee training (on file). Mr.
Hartje stated staffs deserve a pat on the back for results demonstrated on the DSHS (Department of State
Health Services) Business Objects Outcomes Data.
110305-5 RECOMMENDATIONS
A. BOARD OF TRUSTEES
I)Appointment of Planning and Network Advisory Committee Member
RECOMMENDED ACTION: That the Board of Trustees consider and appoint Ms. Shirley Kissner and
Ms. Cindy Allison to membership on the Planning and Network Advisory Committee.
Connie Johnston,Community and Consumer Support Director stated according to the Performance
Contract we are required to have equal representation from Behavioral Health Services consumers and/or
family members and Mental Retardation Services consumers and/or family members on our Planning and
Network Advisory Committee. These appointments will result in that equalization.
The Board of Trustees appointed Ms. Shirley Kissner and Ms. Cindy Allison to membership on the
Planning and Network Advisory Committee.
Motion: Mr. Smith Affirmative: 5
Second: Mr. Coombs Negative: 0
Citizen Comment: None
Board of Trustee Meeting Minutes 2
November 03,2005
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2)Risk Management Fund Board of Trustees Election
RECOMMENDED ACTION: That the Board of Trustees select three candidates from the four nominees
to serve on the Board of the Texas Council Risk Management Fund and authorize the Chair to sign the
election ballot.
Rod Brennan, Chief Financial Officer recommends that the three incumbents, Gus Harris, J. C.
Whitten, and Dale McFarland be selected.
The Board of Trustees select three candidates, Gus Harris, J. C. Whitten, and Dale McFarland to serve on
the Board of the Texas Council Risk Management Fund and authorize the Chair to sign the election ballot.
Motion: Ms. Nunn Affirmative: 5
Second: Mr. Coombs Negative: 0
Citizen Comment: None
THE BOARD OF TRUSTEES RECESSED FOR LUNCH AT 11:50 AM AND WAS
RECONVENED BY JUDGE ANDREWS AT 12:45 PM
3)Board of Trustee Candidate
RECOMMENDED ACTION: Information item only.
Judge Andrews stated the four applicants had been interviewed.
Sue Nunn asked that the three applicants not recommended for appointment be notified.
No action required, for information only.
Citizen Comment: None
B. BUDGET AND FINANCE
1)Financial Statements
RECOMMENDED ACTION:That the Board of Trustees approve the financial statements for September
2005.
Rod Brennanpresented the financial statements for September 2005 (on file).
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The Board of Trustees approves the financial statements for September 2005.
Motion: Ms.Nunn Affirmative: 5
Second: Mr. Coombs Negative: 0
Citizen Comment: None
Board of Trustee Meeting Minutes 3
November 03,2005
2) Signature for Merrill Lynch Account
RECOMMENDED ACTION:That the Board of Trustees authorize the Chair, Secretary, Chief Financial
Officer and Chief Accountant to be named as representatives and authorized to give instructions for
transactions in the Merrill Lynch account.
Rod Brennan, Chief Financial Officer presented the information on the Merrill Lynch account(on file).
The Board of Trustees authorized the Chair, Secretary, Chief Financial Officer and Chief Accountant to be
named as representatives and authorized them to give instructions for transactions in the Merrill Lynch
account.
Motion: Mr. McGough Affirmative: 5
Second: Mr. Smith Negative: 0
Citizen Comment: None
3) Review of Retirement Funds
RECOMMENDED ACTION: Information item only.
Rod Brennan, Chief Financial Officer presented the information on the Retirement Funds (on file).
No action required, for information only.
Citizen Comment: None
C. CONTRACTS AND PLANS
No Agenda Items
D. FACILITIES AND EQUIPMENT
No Agenda Items
E. POLICIES AND PROCEDURES
No Agenda Items
Board of Trustee Meeting Minutes 4
November 03,2005
F. PROGRAM AND PERSONNEL
1) Texas Home Living Waiver Program
RECOMMENDED ACTION: Information item only.
Roddy Atkins,Executive Director, as reported we lost $5,000.00 on the Texas Home Living Waiver
Program in September and an almost$80,000.00 loss last fiscal year. I am not ready at this time to
recommend we pull the plug on this program. We arelosing money because of the poor rates. Since we
can not increase our cost, we have to look at ways to decrease our expenses. I would like to give the
consultants MTM Services Project Management an opportunity to assist our Mental Retardation Services
Staff to look for ways to reduce our expenses.
Bill Coombs —I would like to receive a report every other month on the Texas Home Living Waiver
Program to look for spikes in cost.
Roddy Atkins—I am willing to give the consultants and staff the time to see how far we can bring our
costs down rather than have 26 individuals not eligible for services.
No action required, for information only.
Citizen Comment: None
2) Computer and Network Security
RECOMMENDED ACTION: Information item only.
I '
Ralph Whaite,Management Information Services Director,reported on types of threats our systems
face and what we are doing to keep our system and data safe(on file).
No action required, for information only.
Citizen Comment: None
110305-6 QUARTERLY REPORTS
A. PLANNING AND NETWORK ADVISORY COMMITTEE
No Agenda Items
B. MANAGEMENT REPORTS
1) Update on First Quarter Fiscal Year 2005 Data Verification Results
Gianna Harris,Essential Services and Clinical Accountability Director stated the Plan of Correction
has been submitted for the Data Verification Review Report FY 2005 1st Quarter Results that were
discussed at the September meeting and we are waiting to see if we will receive any sanctions.
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1)Data Verification Second Quarter Fiscal Year 2005
Gianna Harris, Essential Services and Clinical Accountability Director went over the Data
Verification Review Report FY 2005 2nd Quarter Results (on file) documents.
Board of Trustee Meeting Minutes 5
November 03,2005
110305-7 EXECUTIVE DIRECTOR'S REPORT
Texas Council Executive Directors' Consortium and Board of Directors Meetings
I am providing you with several handouts I received at the Texas Council Executive Director's
Consortium and Board of Directors Meetings last week.
• Review of Terms Key to Speaking with One Voice in Development of Texas Council Legislative
Agenda(on file)
• Legal Opinion from Brian Crews, General Counsel, Texas Council and Michael R. Crowe, Brown and
Mc Carroll, L. L. P. (on file)
• DRAFT Texas Council of Community Mental Health and Mental Retardation Centers Inc. Resolution
of the Board of Directors (on file)
• Texas Department of State Health Services Funding Equity in the Texas Mental Health System (on
file)
• Texas Department of Aging and Disability Services Redistribution of MR Funds FY 06 Equity
Calculation (on file)
Provider versus Authority
The Review of Terms Key to Speaking with One Voice in Development of Texas Council Legislative
Agenda defines some terms we often hear and use when discussing the conflict of provider versus
authority. The letters are requesting a legal opinion on whether the provisions of House Bill 2292 apply
to Mental Health Services. The veto of House Bill 2572 dictated issue that we have to look at. As the
results of a law suit the state designated the Community Mental Health and Mental Retardation Centers as
an authority so there would be a single accountable entity to ensure that consumers would not fall through
the crack. The authorities were delegated the functions for planning and oversight. For some the belief is
that a Community Mental Health and Mental Retardation Center who is designated as an authority can not
be objective about who provides services. My argument is we do not play the authority role. We do not
have local control over funds. We do not have control over general revenue,just local funds. There are
centers who believe they are authorities and want to control funds. They do not want to lose their
Authority Function because they think it will diminish their role. The Community Mental Health and
Mental Retardation Center were established to provide services. The conflict is because things were not
well operationally defined. We are a specialty care provider. There are certain essential services that are
provider services and not authority functions, such as crisis and intake.
Equity Rider
There has been a rider attached to the state Appropriations Bill for the last four sessions addressing equity
of funding. The rider has more teeth this Legislative Session. Before it stated the state needs to look at its
plan for equity of funding and that any new money would be used for equalization. There are all sorts of
reasons why the inequity exists. The new rider instructed the Department of State Health Services and the
Department of Aging and Disability Services to plan in fiscal Year 2006 to implement equity by moving
up to 5% to ultimately achieve equity in there was no new money involved. The Department of Aging
and Disability Services implemented their equity funding plan by moving$83,000.00 from our Mental
Retardation Services General Revenue. Workgroups who have studies equity funding in the past have
said that Texas is so under funded that we are essentially robbing from the poor to pay the poor and equity
should only be achieved with new money. The rider was changed at the push from Harris County. There
were nineteen affected facilities that had a conference call. The Texas Council of Community MHMR
Centers has never had a formal stance pertaining to equity. Their informal stance has been that they do
not support the achievement of equity through the moving of funds,only with new dollars. As the results
of the conference call letters were drafted to Eduardo J. Sanchez, M.D., M.P.H., Commissioner of Health,
Department of State Health Services and Texas Department of Aging and Disability Services
Commissioner Jim Hine stating that we think equity is bad policy and Robin Hood. We do not believe
that a mentally ill person in Haskell,Texas is any less sick that an individual in Houston,Texas. The state
Board of Trustee Meeting Minutes 6
November 03,2005
goal is to get mental health funding to $1 5.00 per individual served. We currently have a range from
$27.00 to $9.00 per individual served. The national average is $74.00 per individual served. I was
involved in crafting a letter to Sandy Skelton and Louella Tate, Texas Council Board of Directors, Chair
requesting that they formalize their stance they have informally taken on equity of funding. It was sent to
them with the expectation that it would be considered. The Executive Committee of the Texas Council
met and decided it was to controversial and recommended that it be tabled until January. The Executive
Director's Consortium looked at it and recommended that it be tabled. The Texas Cuoncil having orno
have a formal position on equity would not change the state law. I was invited to a meeting Thursday
afternoon hosted by Representative John Davis. There were four Community Center Executie Director's
there along with representatives from Representative Gattis' office, the Governor's office, the Lieutenant
Governor's office,the Senate Appropriations Committee, the Legislative Budget Board, and Texas
Department of Aging and Disability Services Commissioner Jim Hine,Addie Horn (Deputy
Commissioner, Texas Department of Aging and Disability Services), Eduardo J. Sanchez, M.D.,M.P.H.,
Commissioner of Health, Department of State Health Services, and Deputy Commissioner, Department of
State Health Services Joe Vesowait. Representative even though he is from Houston is not a proponent of
j the Equity Rider. He asked the Commissioners of Department of State Health Services and Department
of Aging and Disability Services to explain how they are handling the equity rider. My stance is that it is
bad policy. The issue is that services are underfunded and the real issue is how do we bring parity to
funding. The Texas Council was offended by my being present at the meeting. The Texas Council Board
of Directors' feelings are that I work for the Board and the Texaas Council does not have a stance so I can
not have a stance. I went to outline my views of equity and to try to get it resolved. I would like to
propose to draft a letter from the Board of Trustees stating our policy on equity and our dissatisfaction for
not formalizing their stance around this issue. I am not sure we are getting represented at the Texas
Council, it is being dominated by the larger centers. The Texas Council does not have much credibility at
the state level. There are a lot of egos in play at the Texas Council. The Board of Directors asked Sandy
(Skelton)how the Executive Directors' could send letters to Commissioners Sanchez and Hine. We do
not work for the Texas Council. In my opinion I was placed on the Texas Council Legislative Committee
as a way to co-oped (to be brought into line). I am preceived to have a connection with the Governor's
Office. I would like to have an Agenda Item for the next Board of Trustees meeting. I will craft a letter
for your review. I will not do anything that this Board of Trustees does not support. My stance is this
Board of Trustees should not support equity with current funds, only parity through new funds. I am
disappointed that the Texas Council could not take that stance. Are there any questions?
Bobby McGough—The$83,000.00 is now gone. Is there any documentation as to what losing that
money will do to services in thie area?
Roddy Atkins—We can not change the law at this time. The figures I gave you in the hand outs came
from the meeting at the Capitol. I find it sad that our trade association can not stand beside us. I will
construct a letter for you rto review.
Pecan Valley MHMR Region
I want to end with a good piece of news. Pecan Valley MHMR Region Board of Trustees approved us to
begin Information Management Services for them as well as billing. They are excited about the
prospects. This will give us more developmental resources for Information Services. We have been
working with Pecan Valley MHMR Region on this for awhile,but I think our joining them in the North
Central Texas Coalition made them more confident.
Grants
We have submitted a Grant Application for Substance Abuse Services. Lynn is currently working on a
COPSD (Co-Ocurring Psychiatric and Substance Use Disorder) Grant.
Board of Trustee Meeting Minutes 7
November 03,2005
110305-8 ANNOUNCEMENTS
A. Facility Tour Following Meeting
Mr. Atkins announced that there will be a tour of the Hardeman and Foard County Mental Health Center
following the meeting.
B. Next Meeting
Mr. Atkins announced the next meeting will be at 11 A.M., Thursday, December 01; 2005, in Wichita
Falls at the Staley Conference Room.
110305-9 OTHER BUSINESS
None
110305-10 ADJOURN
The Board of Trustees' meeting adjourned at 2:15 PM.
Approved as presented: Approved as corrected:
December 01, 2005
Board of Trustee Meeting Minutes 8
November 03,2005
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HELEN FARABEE
REGIONAL MHMR CENTERS Wichita Falls Administrative Offic
P.O.Box 8266 1000 Brook Street Wichita Falls,Texas 76307-82(
Phone (940) 397-3100 Fax (940) 397-315
December 06, 2005
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 November 03, 2005. These minutes were approved by the Board at its meeting
held on December 01, 2005.
Sincerely,
)/I1A1-
an t
Ad istrative Assistant/Board Liaison
/jw
enclosure