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Helen Farabee Centers Board of Trustees Minutes - 06/02/2011 v HELEN FARABEE CENTERS BOARD OF TRUSTEES • June 2, 2011 411� 11:00 AM Child and Adolescent Services 516 Denver Street Wichita Falls, Texas Board of Trustee Ken Andrews, Chair; Carla Kay Ainsworth; Robert Clement; Verner Members Present: Hayhurst; Sue Nunn, Secretary/Treasurer; Shelley Owen,Vice-Chair; Sara Rugeley; Bobby Smith; Billye Ruth White Board of Trustee None Members Absent: Senior Roddy Atkins, Executive Director; Rod Brennan,Chief Financial Officer; Management Staff Connie Johnston,Community and Consumer Support Director; Ralph Whaite, Present: Management Information Systems Director; Rose Wilson, Intellectual and Developmental Disability Services Director Other Staff and Tim Ingle, City Council Liaison; Valerie Mandela,Director of Intellectual and Guests Present: Developmental Disabilities Service Coordination; Jennifer Rhone, Representative Lanham Lyne's Office; Jan West,Administrative Assistant/Board Liaison, Recorder AGENDA TOPICS 060211-1 CALL TO ORDER Ken Andrews, Chair called the meeting to order in open session at 11:08 AM with a quorum of eight present. A)Introduction of Guests Tim Ingle, City Council Liaison and Jennifer Rhone, Representative Lanham Lyne's Office were introduced as guests. 060211-2 PRESENTATIONS A) Open Citizen Comment to the Board No citizen comment was offered. 060211-3 APPROVAL OF MINUTES RECOMMENDED ACTION: That the Board of Trustees approves the minutes of the May 05, 2011 Board of Trustees meeting. The Board of Trustees approved the minutes of the May 05, 2011 Board of Trustees meeting. Motion: Ms. Nunn Affirmative: 7 Second: Mr. Hayhurst Negative: 0 Citizen Comment: None 060211-4 TRAINING A) Community and Consumer Support Connie Johnston, Community and Consumer Support Director providedkr& t ry and Consumer Support Training(on file). CITY CLERKS OFFICE f ' DATE: �I /d Board of Trustee Meeting Minutes BY: ��rit'" TIME O June 2,2011 060211-5 RECOMMENDATIONS A. BOARD OF TRUSTEES No Agenda Items B. BUDGET AND FINANCE 1)Financial Statements RECOMMENDED ACTION: That the Board of Trustees approve the financial statements for April 2011. Rod Brennan, Chief Financial Officer presented the financial statements for April 2011 (on file). The Board of Trustees approved the financial statements for April 2011. Motion: Ms. Rugeley Affirmative: 7 Second: Ms. Owen Negative: 0 Citizen Comment: None 2)Auditor's Letter of Engagement RECOMMENDED ACTION: That the Board of Trustees accept the attached Letter of Engagement from Davis Kinard&Co,PC and authorize the Chair to sign the letter. Rod Brennan, Chief Financial Officer presented the Letter of Engagement from Davis Kinard&Co,PC (on file). The Board of Trustees accepted the Letter of Engagement from Davis Kinard &Co,PC and authorized the Chair to sign the letter. Motion: Ms. White Affirmative: 7 Second: Ms. Rugeley Negative: 0 Citizen Comment: None THE BOARD OF TRUSTEES RECESSED FOR LUNCH AT 11:41 AM. 11:44 AM Carla Kay Ainsworth left the meeting 12:09 AM Robert Clement arrived at the meeting THE MEETING WAS RECONVENED BY KEN ANDREWS AT 12:15 PM WITH EIGHT BOARD OF TRUSTEE MEMBERS IN ATTENDANCE. C. CONTRACTS AND PLANS No Agenda Items Board of Trustee Meeting Minutes 2 June 2,2011 D. FACILITIES AND EQUIPMENT 1)Meaningful Use Upgrades For CMHC/Netsmart Products RECOMMENDED ACTION: That the Board of Trustees approve the purchase of software,hardware and services to enhance our CMHC/NetSmart implementation at a cost not to exceed $80,000. Ralph Whaite,Management Information Systems Director presented the information on the purchase of software,hardware and services to enhance our CMHC/NetSmart implementation (on file). The Board of Trustees approved the purchase of software,hardware and services to enhance our CMHC/NetSmart implementation at a cost not to exceed$80,000. Motion: Ms. Owen Affirmative: 7 Second: Ms. Rugeley Negative: 0 Citizen Comment: None 2)Air Conditioner Compressor RECOMMENDED ACTION: That the Board of Trustees ratify the purchase of an air conditioner compressor for 500 Broad at a cost not to exceed$4,263 from James Lane. Rod Brennan, Chief Financial Officer presented the information on the purchase of an air conditioner compressor for 500 Broad (on file). The Board of Trustees ratified the purchase of an air conditioner compressor for 500 Broad at a cost not to exceed$4,263 from James Lane. Motion: Ms. Rugeley Affirmative: 7 Second: Ms. White _ Negative: 0 Citizen Comment: None E. POLICIES AND PROCEDURES No Agenda Items F. PROGRAM AND PERSONNEL No Agenda Items 060211-6 QUARTERLY REPORTS A. ESSENTIAL SERVICES AND CLINICAL ACCOUNTABILITY No Agenda Items B. PLANNING AND NETWORK ADVISORY COMMITTEE No Agenda Items Board of Trustee Meeting Minutes 3 June 2,2011 C. EXTERNAL AUDITS 1)Second Quarter Report Home and Community—Based Services(HCS)Medicaid Billing Audit RECOMMENDED ACTION: Information item only. Rose Wilson, Intellectual and Developmental Disability Services Director presented the report on the Home and Community—Based Services (HCS)Medicaid Billing Audit(on file). No action required, for information only. Citizen Comment: None 2)Second Quarter Report Department of Aging and Disability Services(DADS) Financial Review RECOMMENDED ACTION: Information item only. Rod Brennan, Chief Financial Officer presented the report on the Department of Aging and Disability Services (DADS)Financial Review (on file). No action required, for information only. Citizen Comment: None D.TEXAS COUNCIL BOARD OF DIRECTORS'MEETING No Agenda Items 060211-7 EXECUTIVE DIRECTOR'S REPORT 1)Legislative Session A Legislative Update from the Texas Council of Community Centers (on file) was distributed and discussed. We have a final Appropriations Bill;however, it is still subject to Legislative consensus for education funding formula. There was a ton of Legislation,but there were four or five issues that I paid close attention to. One was Senate Bill 773 which will provide discounts for connectivity. Years ago a Bill passed that required discount connectivity rates for Universities, Schools; and also included us. That allowed us to have T1 lines for Video intakes at an affordable price because of the House Bill Rates. That Legislation was due to expire January 2012. If that occurred we would have to go to commercial rates and that would be a significant increase. I worked with the Texas Council and our local legislative delegation to help push Senate Bill 773 through. The Bill passed with a slight increase in cost, it was cost plus 5% and they increased it to cost plus 10%. Senate Bill 773 extends telecommunications discounts for Community Centers and other entities until January 1, 2016. Status of Appropriations and Funding Strategies for IDD (Intellectual and Developmental Disabilities), for Intake,Access, and Eligibility there were no funding decreases. HCS (Home and Community—Based Services)had the first major cuts. We deliver services to 50 in HCS (Home and Community—Based Services) and oversee services to 217. There was a 2%rate decrease February 1st and an additional 1% September 1st for a 3%total decrease. There are various Medicaid Waiver Programs: HCS (Home and Community— Based Services), Texas Home Living, CLASS (Community Living Assistance Program and Supported Services Program). They have varying rates; they want them to be more consistent. The decrease in Board of Trustee Meeting Minutes 4 June 2,2011 Community Support Services, which includes Supported Home Living and Community Support, will bring them down closer to the CLASS (Community Living Assistance Program and Supported Services Program) rate. There also will be a targeted rate reduction to Foster Care and Supported Home Living, a cut to administrative costs. It was not as bad as we first thought due to a lot of work and a lot of discussion. Texas Home Living Waiver and MR Community Services strategies involves funding of folks not eligible for Texas Home Living Waiver; HCS (Home and Community—Based Services); and ICF/MR (Intermediate Care Facilities for Persons with Mental Retardation) who are on the waiting lists. They will pull 27% of our GR (General Revenue) to refinance these individuals into the Texas Home Living Waiver. As you will recall we dropped our Texas Home Living Waiver program because of the poor rates. We have reapplied to be a Texas Home Living Waiver provider. They are looking to refinance up to 5,000 people into the Texas Home Living Waiver program. The Texas Home Living Waiver program has a very poor rate. This will impact our rural areas with few people. That will exagerate the actual cost. It will be a challenge to find someone who can deliver the services. This is an attempt by the Senate to bring in more Medicaid funds. That is why we contract for Day Hab Services because of the volume and the financial viability of providing services. They do not face the same challenges in Dallas, Austin or Houston. We can not increase our staffing. They rolled In Home and Family Support into one pile, so that will be a $36,000.00 per year cut for us. In Home and Family Support is to provide home modifications for individuals so they can stay in the home and to provide respite for the family. ICF/MR(Intermediate Care Facilities for Persons with Mental Retardation)had a 43%reduction. They will be delaying payments as a way to balance the budget. Delay payments until next Legislative Session. The real rate reduction overall is 3%. That will not all come back. Status of Appropriations and Funding Strategies for DSHS (Department of State Health Services) and TCOOMMI (Texas Correctional Office on Offenders with Medical and Mental Impairments), Mental Health Adults Strategy is 4%different. FMAP (Federal Medical Assistance Percentages) stimulus money on Medicaid will not have a large impact on us. There will be no additional rate reductions to Medicaid. We are waiting on a response to counseling services. The maintenance of the Veterans Mental Health Grant is positive. The Community Mental Health Children's strategy shows no increase, stable for the kids. Mental Health Crisis and Transitional Services strategies, there is no change. Substance Use Disorder strategy, cut but our treatment money is not going anywhere. Their cut is to OSARS (Outreach, Screening, Assessment, and Referral) which we do not utilize and candidly is a waste of time. Mental Health State Hospital strategy there is no cut. There were two caveats. One RIDR is to investigate the possibility of privitizing one State Hospital. Oversite is to complete a Request For Proposal that will have to be approved by leadership. That will provide a 10%savings over five years. I do not think North Texas State Hospital will be the one,but I do not make that determination. The State Hospital System has been operating with a ten million dollar funding short fall. This was done three or four sessions ago. The State Hospital System has done two things to make up for this short fall. Effective March 1st they took 120 beds off line to create residential beds. Residential beds will require less staffing and less psychiatrist. They identified 120 long term patients that were not management issues to transfer to residential beds to save money. Losing those 120 bedswill cut into our civil commitment capacity. The other thing they are planning to do to make up for the short fall is when they discharge a patient from the State Hospital, they currently send a 14 day supply of medications with the patient. The discussion is to move to a seven day supply of medications with a 30 day prescription. We will end up paying for the week of medication. In general the State Hospital System is intact. Hopefully there will be no issues. They are frequently on diversion. The nice thing is there are no additional bed cuts. In general we did well, considering how other agencies faired. Our Community and Legislative folks understand that if we can not take care of our folks, then it comes back to cost more in the long run. The bottom line is our system came out better than other entities across the state. All of the folks who interacted with us, including our Legislative folks understand what happens if they don't adequately fund us. TCOOMMI (Texas Correctional Office on Offenders with Medical and Mental Impairments) Board of Trustee Meeting Minutes 5 June 2,2011 strategy had a 7% decrease that won't impact our program. The budget challenge will be for IDDS (Intellectual and Developmental Disabilities Services). The Local Service Planning RIDR that the Texas Council and I worked on with Senator Estes is a funding strategy that will allow us to move money across strategies. Currently we have to spend the money or send it back. This RIDR will give Centers the flexibility they need. Each Centers' needs are unique. The RIDR will give the Centers the ability, with Board of Trustee and Planning and Network Advisory Committee permission, to move money from one startegy to another. This is a positive thing. The Respectful Language bill passed and has been signed by the Governor. It will eliminate the use of MR and Retardation in State Statues. There were a lot of good things accomplished. There were a lot of bullets dodged thanks to the Texas Council and our local legislative delegation. There was a lot of good work. 2)Behavioral Health Services • We are looking at a joint project with Midwestern State University. We have been working with Dr. Susan Sportsman, Dean of Health Science Center and Karen Palvado, Family Nurse Practitioner Program. The overriding theme for Health Care Reform is the integeration of Physical Health and Behavioral Health. Mostof our patients will not go for Primary Care. We are talking about using the Nursing Students to do Health and Wellness with our patients. They are wanting to place a Family Nurse Practitioner here to do primary care and to supervise the students. They are requesting data; then they will write a proposal and look at Grants. 3) Behavioral Health Services We are preparing to implement Open Access for Intakes. Currently when an individual calls for services we set an appointment which is 7 to 14 days out. We are experiencing a high no show rate,partially because by that time their issue has passed and they do not show up for their appointment. We are planning on implementing Open Access the end of June. When they call for an appointment we will utilize virtual connectivity. 4)Disaster Services Andy Martin and Kirk Findley attended a two—three day Disaster Behavioral Health Training in prepartion for Hurricane and Wildfire Seasons. In case of a disaster, even if we are not involved, our staff could be called on to assist. 5) Veterans Services We co-sponsored a wonderful workshop "Caring For Those Who Serve", for people in the community who work with our Veterans on how to work with a Veteran. We had approximately 80 in attendance. Kymm (Putnam) and Kirk (Findley)pulled it all together. There were some Veterans present who shared their experiences. It helped us to understand how war treatment has changed. They now put Mental Health Services on the front line. Military are now deployed differently. There was no team cohesion. Currently they go in and leave as a unit. They place Behavioral Health care on the front line,because they do not do well when they are seperated from their unit. It was a real successful day. We were granted $70,000.00 over a two year period. We are getting a lot of bang for our buck. We were glad to host the training. 060310-8 CLOSED SESSION In accordance with Chapter 551.074 of the Government Code, the Board of Trustees will now meet in closed session for the purpose of discussion of personnel matters. Review and Discussion of Executive Director Evaluation Board of Trustee Meeting Minutes 6 June 2,2011 060310-9 OPEN SESSION No action was taken in Closed Session. Ken Andrews made a motion that the Executive Director's Contract of Employment be amended to reflect a salary increase of$10,000.00 annually, with an effective date of June 16,2011. The Board of Trustees amends the Executive Director's Contract of Employment to reflect a salary increase of$10,000.00 annually, with an effective date of June 16,2011. Motion: Mr. Andrews Affirmative: 7 Second: Mr. Hayhurst Negative: 0 Citizen Comment: None 060211-10 ANNOUNCEMENTS A)Next Meeting Ken Andrews announced the next meeting is scheduled for 11 A.M., Thursday, July 7, 2011, at Child and Adolescent Services, 516 Denver Street in Wichita Falls. 060211-11 OTHER BUSINESS None 060211-12 ADJOURN The Board of Trustees' meeting adjourned at 1:46 PM. Approved as presented: Approved as corrected: July 07, 2011 Board of Trustee Meeting Minutes 7 June 2,2011 C®Yl ti r� 'v Wichita Falls Administrative Office A H E LE N FARAB E E P. O. Box 8266, Wichita Falls, TX 76307-8266 1000 Brook Street, Wichita Falls, TX 76301 # 0 Tfr CENTERS PhFax (940) 397-31one (940) 050 www.helenfarabee.org July 11, 2011 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 Centers is enclosed for the regularly scheduled meeting held on June 02, 2011. These minutes were approved by the Board at its meeting held on July 07, 2011. Sincerel Yfrit an e Admini rative Assistant/Board Liaison /jw enclosure Providing Behavioral Health,Intellectual and Developmental Disabilities,and Substance Abuse Outpatient Services