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Helen Farabee Centers Board of Trustees Minutes - 08/02/2007 • HELEN FARABEE REGIONAL MHMR CENTERS QJ� BOARD OF TRUSTEES • August 2,2007 $\.y' 11:00 AM Child and Adolescent Services 516 Denver Street Wichita Falls,Texas Board of Trustee Ken Andrews, Chair; Robert Clement; Bill Coombs, Vice-Chair; Bobby Members Present: 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; Connie Johnston; Community and Consumer Support Director; Ralph Whaite, Management of Information Systems Director Other Staff and Amanda Snodgrass, Outreach; Jan West, Administrative Assistant/Board Guests Present: Liaison, Recorder L AGENDA TOPICS FOT3-0207-1 CALL TO ORDER Ken Andrews, Chair called the meeting to order in open session at 11:08 AM with a quorum of five Board of Trustee members present. A)Introduction of Guests There were no guests present. 080207-2 PRESENTATIONS A) Open Citizen Comment to the Board No citizen comment was offered. 080207-3 APPROVAL OF MINUTES The Board of Trustees approves the minutes of the July 12, 2007 Board of Trustees meeting. Motion: Ms.Nunn Affirmative: 4 Second: Mr. Smith Negative: 0 Citizen Comment:None 11:18 AM Shelley Owen arrived at the meeting 080207-4 TRAINING A)Management Information Systems Ralph Whaite, Management of Information Systems Director distributed and discussed the training on Clinical Management for Behavioral Health Services Impact on Community Mental Health Centers (on file). Board of Trustee Meeting Minutes 1 August 2,2007 080207-5 RECOMMENDATIONS A. BOARD OF TRUSTEES 1) Slate of Officers RECOMMENDED ACTION: That the Board of Trustees re-elect the current slate of officers,Chair Ken Andrews;Vice-Chair Bill Coombs, and Secretary/Treasurer Sue Nunn, for Fiscal Year 2008 (September 2007 through August 2008). Bill Coombs, Vice-Chair stated the nominating committee met and recommends the re-election of the current slate of officers. The Board of Trustees re-elect the current slate of officers, Chair Ken Andrews;Vice-Chair Bill Coombs, and Secretary/Treasurer Sue Nunn,for Fiscal Year 2008 (September 2007 through August 2008). Motion: Judge McGough Affirmative: 5 Second: Mr. Smith Negative: 0 Citizen Comment: None 2)Planning and Network Advisory Committee Reappointments RECOMMENDED ACTION: That the Board of Trustees approve the reappointment of members of the Planning and Network Advisory Committee per the reappointment schedule for a two year term, ending August 31, 2009. Connie Johnston;Community and Consumer Support Director reported one member had requested that she be removed from membership due to family concerns and asked that the Board of Trustees reappointment the remaining seven members. The Board of Trustees approved the reappointment of members of the Planning and Network Advisory Committee per the reappointment schedule for a two year term, ending August 31,2009. Motion: Ms.Nunn Affirmative: 5 Second: Mr. Coombs Negative: 0 Citizen Comment: None 3)Board of Trustee Candidate RECOMMENDED ACTION: Information item only. Item was deferred due to the absence of Robert Clement. Board of Trustee Meeting Minutes 2 August 2,2007 , B. BUDGET AND FINANCE 1) Financial Statements RECOMMENDED ACTION:That the Board of Trustees approve the financial statements for June 2007. Rod Brennan, Chief Financial Officer pre e ted the financial statements for June 2007 (on file). The Board of Trustees approved the financial statements for June 2007. Motion: Ms. Owen Affirmative: 5 Second: Judge McGough Negative: 0 Citizen Comment:None THE BOARD OF TRUSTEES RECESSED FOR LUNCH AT 11:40 AM. 11:45 AM Robert Clement arrived at the meeting THE MEETING WAS RECONVENED BY JUDGE ANDREWS AT 12:20 PM WITH SEVEN IN ATTENDANCE. rA. BOARD OF TRUSTEES 3)Board of Trustee Candidate RECOMMENDED ACTION: Information item only. Robert Clement presented the information on the Board of Trustee Candidate(on file). No action required, for information only. Citizen Comment: None B. BUDGET AND FINANCE 2)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 3 August 2,2007 F. PROGRAM AND PERSONNEL 1)Holiday Schedule for Fiscal Year 2008 RECOMMENDED ACTION: That the Board of Trustees approve the Holiday Schedule for fiscal year 2008 beginning September 1, 2007. Jeff Dresbach, Human Resources and Risk Management Director presented the proposed Holiday Schedule for fiscal year 2008 (on file). The Board of Trustees approved the Holiday Schedule for fiscal year 2008 beginning September 1, 2007. Motion: Ms.Nunn Affirmative: 6 Second: Mr. Smith Negative: 0 Citizen Comment: None 080207-6 QUARTERLY REPORTS A. PLANNING AND NETWORK ADVISORY COMMITTEE No Agenda items B.ESSENTIAL SERVICES AND CLINICAL ACCOUNTABILITY No Agenda items C. EXTERNAL AUDITS 1) Third Quarter Report RECOMMENDED ACTION: Information item only. Jeff Dresbach, Human Resources and Risk Management Director presented the Third Quarter External Audits for Rose Wilson, Mental Retardation Services Director as she was busy with the Medicaid Billing Audit. Intermediate Care Facilities for Persons with Mental Retardation (ICF/MR) We had two audits in April from DHS (Department of Human Services)reviewers. The Extended Living Facility was the first week and the Horizon house was the fourth week. There were no programmatic or life safety tags. MRA (Mental Retardation Authority) Audit and Texas Home Living Authority Audit This audit was on May 22nd through the 24t. We had three reviewers from Austin. For the Texas Home Living Authority Audit they had three findings. (1) Consumer Record the MRA (Mental Retardation Authority)must provide record of current Person Directed PIan,Individual Plan of Care, and MR/R C assessment. They could not find evidence (cover letter) that copies were forwarded. (2) Service Coordinator Assurances there was one Person Directed Plan that indicated nursing requested four additional hours and it should have been three. The Quarterly Review for two consumers did not reflect the intervention, lack of nursing services or progress or lack of service for community supports. (3)Person Directed Plan at least 30 days prior to expiration of the Individual Plan of Care, Service Coordinator must update the Person Directed Plan. One chart indicated timeline was not met. The Mental Retardation Authority had findings in eight areas. (1)Authority Functions Service Coordinator should not perform provider functions. One chart indicated the Service Coordinator was providing instruction on rights and another time provided transportation for a consumer. (2)Data there Board of Trustee Meeting Minutes 4 August 2,2007 was a disparity in the monthly Encounter Data between the first billed payer and the Medicaid Encounter Data. (3) Interest List Maintenance When services were not provided within 30 days, the consumer was not placed on an interest list; change of preference forms not always completed when the family changed their minds about services. (4) In Home and Family Support A program of last resort; no evidence legacy DHS (Department of Human Services) was not contacted to verify if a consumer received Respite through that agency. One plan did not include quanity, duration and frequency for Respite services. (5) Notification one consumer only had one Rights and notification of reporting Abuse and Neglect, they needed to see annual notification. (6) Person Directed Planning one consumer approved and signed Person Directed Plan and approved revisions to Plan by phone,but could not find that evidence in record in the progress notes. Service Objectives were used for Suported Employment and should have been Training Objectives. (7) Legal Issues one record did not have evidence of current guardianship. Service Coordinator needs to address any lapse of guardianship, calling judge if needed. There was a lengthy discussion about our involvement and responsibilities pertaining to consumers guardianship. We were instructed by the Board of Trustees to get guidance from our attorney before we became involved. (8) Provision of Mental Retardation Services there was one parent who expressed an interest in several services which were not addressed until months later. Services were not placed on the interest list as soon as the Preference Form was received. The family moved and could not be located. We now have a follow up process in place. The Plan of Correcion with the Final Corrections is due August 24`h. We have not received the Final Report from DADS (the Department of Aging and Disability Services). No action required, for information only. Citizen Comment: None 080207-7 EXECUTIVE DIRECTOR'S REPORT Disaster Mental Health Services We have been and will continue to be actively involved in Disaster Mental Health Services in Wichita and Archer Counties. We are involved with the County and the City in their Disaster Response Plan. When the state declares one of our counties a disaster we are contracted with DSHS (Department of State Health Services) to provide disaster mental health services. Then when the Federal Government declares one of our counties a disaster we are required by FEMA (Federal Emergency Management Agency)to manage the Mental Health Response and Grant money. Jeff Dresbach has done an excellent job of coordinating our response. We have had a wonderful job of coverage from our"non productive"clinical staff. We had a couple who went above and beyond the call of duty by providing heavy duty intensive case management, Lynn Hartje and Valarie Johnson. They made a significant difference in the life of these individuals and were responsible for shedding a good light on the Center. Jeff Dresbach I want to introduce Amanda Snodgrass, who has been temporairly hired by us until the end of August to provide FEMA (Federal Emergency Management Agency) funded Outreach Services for the organization. I have a meeting schedule with one of the City Councilors and will be involved in a scheduled Town Meeting. There are many things that are not coverd by FEMA (Federal Emergency Management Agency). Case Management is one of them,but our boss says we will do it because it is important to our community and the people in our communiites. We were first advised of the flooding issue on the last day of June. On the first day of July we contacted our essentuial team members. On July 2nd we began staffing the disaster shelters with two shifts per day. On July 5th and 6th we expanded those services to include the Resource Center. We saw 300 people and entered two into services. On July 13th the FEMA (Federal Emergency Management Agency) Disaster Recovery Center was opened and we staffed that from 9 a.m. until 6 p.m., six days per week. We were released from that responsibility on July 27`h. We saw 275 individuals and 15 received services. We did a ton of case management. We were fortunate to Board of Trustee Meeting Minutes 5 August 2,2007 have bi-lingual staff that was able to assist us. Most of the people we saw were not Mental Health issues, but those caused by the temporary displacement. We did see some Substance Abuse issues,Physical Abuse issue, and Abandonment Issues. The charitable organizations did a great job. We have now contracted to provide outreach services. This is as significant as the preiovious services provided. There are still those in need of services that are in danger of dropping through the cracks. There is a lot of work to do. 1 am somewhat skeptical about the need for conseling,but 1 know there is need for education and training. Sue Nunn On behalf of the Board of Trustees I want to thank you; we are pleased that you jumped in and you represented us well. Robert Clement Thank you Jeff for lining everything up and making it happen. Mental Retardation Services We also had an instance recently where we had to provide emergency Respite services for a young individual. Brigit Puchalski, Sherrye Nail and some of our male staff were able to provide Respite services for this individual in a motel room and give the dad a much needed break. They did a tremendous job and the community got the benefit of their good service. Performance Contracts We just received the DADS (the Department of Aging and Disability Services) Performance Contract and are still awaiting the DSHS (Department of State Health Services) Performance Contract. We will have them ready to present at the September meeting for ratification. There will not be any changes to the Performance Contract due to Crisis Redesign yet, they will amend the contract after the first of September to address Crisis Redesign. The initial contract will be based on this year's money. They are also working on the Provider of Last Resort which is now called Network Development. They have divided the Centers into three groups to develop their Network Development Plan. We are in the last group. We will have to decide whether we are going to provide services or contract them out. As you will remember recently we tried to find out who was interested in providing Mental Retardation Services and we got no response. I am not sure how much interest there will be in Mental Heath Services. The Provider of Last Resort Rule impacts Rehab Medicaid Services. There could be some private therapist or physicians that are interested in providing services and The Wood Group may be interested in expanding their role. We will nave to determine if it is cost efficient so that we can offer choices to our consumers. This will have a larger impact in the metropolitan areas. For us, there would have to be two entities that say they can provide services in our 19 county catchment area. We might find that in Wichita Falls but not in our 19 counties. The Rule was designed to settle the discussion about the role of the Centers and to justify why we are allowed to render services in addition to being an author__ ___ 080207-8 ANNOUNCEMENTS A. Next Meeting Ken Andrews announced the next meeting will be at 11 A.M.,Thursday, September 06, 2007, in Wichita Falls. Sue Nunn stated she would not be able to attend the September meeting. Board of Trustee Meeting Minutes 6 August 2,2007 t • , 080207-9 OTHER BUSINESS None 080207-10 ADJOURN The Board of Trustees' meeting adjourned at 1:15 PM. Approy d as presented: Approved as corrected: Septemb 6, 2007 Board of Trustee Meeting Minutes 7 August 2,2007 { HELEN FARABEE ,a REGIONAL MHMR CENTERS Wichita Falls Administrative Office P.O.Box 8266 1000 Brook Street Wichita Falls,Texas 76307-8261 Phone (940) 397-3100 Fax (940) 397-3151 September 10, 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 August 02, 2007. These minutes were approved by the Board at its meeting held on September 06, 2007. Since - Jan ' est/ Adminis ative Assistant/Board Liaison /jw enclosure RECEIVED IN CITY CLERK'S OFFICE Date By Time