Helen Farabee Centers Board of Trustees Minutes - 10/06/2011 HELEN FARABEE CENTERS
BOARD OF TRUSTEES
V October 06, 2011
11:00 AM
• Wise County Mental Health Center
4°\,� 407 Park West Court
Decatur,Texas
Via Televideo
Sue Nunn Conference Room
1000 Brook
Wichita Falls,Texas
OR
Childress County Mental Health Center
8150 US Highway 287
Childress, Texas
Board of Trustee Robert Clement(via Televideo from Wichita Falls); Verner Hayhurst, Chair;
Members Present: Sue Nunn, Secretary/Treasurer; Isabelle O'Brien; Shelley Owen,Vice-Chair;
Sara Rugeley; Billye Ruth White (via Televideo from Childress)
Board of Trustee Carla Kay Ainsworth
Members Absent:
Senior Roddy Atkins, Executive Director; Ralph Whaite, Management Information
Management Staff Systems Director(via Televideo from Wichita Falls)
Present: _
Other Staff and Andy Martin, Director of Essential Services; Debbie Moore, Regional
Guests Present: Services Manager for the Southern Region, Intellectual and Developmental
Disability Services; Denise Truax, Acting Center Manager, Wise County
Mental Health Center; Jan West, Administrative Assistant/Board Liaison,
Recorder
AGENDA TOPICS
100611-1 CALL TO ORDER
Verner Hayhurst, Chair called the meeting to order in open session at 11:02 AM with a quorum of six
present. (Four physically present in Decatur).
A)Introduction of New Board of Trustee Member
Isabelle O'Brien was introduced and welcomed as the new Place 3 Board of Trustee member
representing Throckmorton and Young Counties.
B)Introduction of Guests
Caryl Chambliss, Contracts Manager, Department of State Health Services was introduced as a guest and
welcomed to the meeting.
RECEIVED IN
CITY CLERK'S OF !CFI
DATE:
BY TIME: IY1
Board of Trustee Meeting Minutes 1
October 6,2011
C) Wise County Mental Health Center
Denise Truax,Acting Center Manager, stated I came to work in Decatur in February 1997, after
graduation from Midwestern State University. I became the supervisor in Bowie in September, 1999. I
have been helping in Decatur since June. Sally Antcliff is our receptionist, she is new she started June
st. Peggy Fettkether is our Licensed Vocational Nurse, she has been with us a year. Dr. Ed Luke does
Telemedicine Psychiatry from Decatur. Kacie Bosley is our Child and Adolescent Caseworker; she has
been with us three years. Julie Brezina is our Adult Service Package 1 worker; she has been with us for
three years. Stacy Strassman is our Adult Service Package 3 and 4 worker; she has been with us for three
years and was just selected as the new Center Manager. She will assume that position October 17th. She
just received her Master's in May and is working on her LPC (Licensed Professional Counselor). She
has a lot to offer. Christi Bishop is our Registered Nurse and she has been with us for six years. Julie
Torres is our Medication Secretary and she has been with us for nine years. Dr. Art Smith is our
Psychiatrist he has been with us for 12 years. Barbara McDougal is our Supported Employment worker
and she has been with us for 13 years. Judy Sanders is our Benefits Coordinator, and she has been with
us for 21 years. Tamie Winters has been with us for 22 years, although she has quit and come right back
within two weeks three times. We currently have 477 Clients, 70 kids and 407 active adults; we have
one new adult pending today. We are short staffed having vacancies for a Child and Adolescent Services
worker; a Service Package 1 worker; Service Package 3 worker; and a Crisis Response worker. Staff
have a very good moral.
11:20 AM Shelley Owen arrived at the meeting
D)Intellectual and Developmental Disabilities Services in Decatur
Debbie Moore,Regional Services Manager for the Southern Region stated, we do not have any
consumers presently seeking employment assistance in this area. We have one General Revenue
consumer employed that requires a job coach on his job to ensure he meets the employer's specifications
for that position. We are currently serving three individuals through the Department of Assistive and
Rehabilitative Services (DARS). Within the past three weeks,we have billed the Department of
Assistive and Rehabilitative Services (DARS) for $1,850.00 worth of services. In Decatur Day
Habilitation Center we have one Home and Community—Based Services (HCS) staff; two General
Revenue staff; one Supported Home Living staff; one Community Support staff; and one and a half staff
vacancies to assist with Texas Home Living. We serve 12 General Revenue clients; five Texas Home
Living clients; nine Home and Community—Based Services (HCS) clients; two Home and Community—
Based Services (HCS) from Day Break; 16 clients get General Revenue Community Support Services;
five clients get Texas Home Living Community Support; two clients get Supported Home Living; and
two clients have a contract for transportation where they y pay us $5.00 a day.
100611-3 APPROVAL OF MINUTES
RECOMMENDED ACTION: That the Board of Trustees approves the minutes of the September 01,
2011 Board of Trustees meeting.
The Board of Trustees approved the minutes of the September 01,2011 Board of Trustees meeting.
Motion: Ms. Owen Affirmative: 6
Second: Ms. Nunn Negative: 0
Citizen Comment: None
100611-2 PRESENTATIONS
A) Open Citizen Comment to the Board
No citizen comment was offered.
Board of Trustee Meeting Minutes 2
October 6,2011
100611-4 TRAINING
A) Executive Director's Board of Trustee Training
Roddy Atkins, Executive Director presented the training (on file).
THE BOARD OF TRUSTEES RECESSED FOR LUNCH AT 11:50 AM.
THE MEETING WAS RECONVENED BY VERNER HAYHURST AT 12:25 PM WITH SIX
BOARD OF TRUSTEE MEMBERS IN ATTENDANCE. (FIVE PHYSICALLY PRESENT IN
DECATUR).
Before returning to the agenda Roddy Atkins, Executive Director explained we have several members of
the Senior Management Staff that normally are in attendance that are not here today. Rod Brennan,
Chief Financial Officer is in Austin attending the Chief Financial Officers' Consortium. Gianna Harris,
Associate Executive Director of Operations is on a Managed Care Conference Call. Jeff Dresbach,
Human Resources and Risk Management Director is in the hospital recouperating from Open Heart
Surgery last Thursday. He is doing well and anticipates being discharged today. He will be out of the
office for several weeks. Members asked that we express their get well wished to him.
100611-5 RECOMMENDATIONS
A. BOARD OF TRUSTEES
1)Risk Management Fund Election
RECOMMENDED ACTION: That the Board of Trustees select three candidates to serve on the Risk
Management Fund (RMF) Board of Trustees.
Roddy Atkins, Executive Director presented the information on the four candidates for Risk
Management Fund(RMF) Board of Trustees (on file).
The Board of Trustees selected the three current members,Gus Harris,J.C. Whitten and Van L.York,to
serve on the Risk Management Fund(RMF)Board of Trustees.
Motion: Ms. Rugeley Affirmative: 5
Second: Ms. Owen Negative: 0
Citizen Comment: None
2) Board of Trustee Candidates
RECOMMENDED ACTION: Information item only.
Jan West reported the recommendation for appointment for the Place 4 vacancy were sent to the Baylor,
Haskell, and Knox County Judges on September 14th and we are awaiting notification of appointment.
No action required, for information only.
Board of Trustee Meeting Minutes 3
October 6,2011
B. BUDGET AND FINANCE
1)Financial Statements
RECOMMENDED ACTION: That the Board of Trustees approve the financial statements for August
2011.
Roddy Atkins, Executive Director presented the financial statements for August 2011 (on file).
Billye Ruth White asked,Why is there was no income recorded on page 38 from Cottle County?
Roddy Atkins, Executive Director stated,I am not sure where that income is recorded. I will ask Rod
Brennan to address that at the next meeting.
The Board of Trustees approved the financial statements for August 2011.
Motion: Ms.Nunn Affirmative: 5
Second: Ms. Rugeley Negative: 0
Citizen Comment: None
C. CONTRACTS AND PLANS
1) CMHC Annual Maintenance Contract
RECOMMENDED ACTION: That the Board of Trustees ratify the annual Netsmart Technologies
Maintenance contract for the CMHC/MIS software for$77,825.32.
Ralph Whaite, Management Information Systems Director(via Televideo from Wichita Falls)presented
the information on the annual Netsmart Technologies Maintenance contract for the CMHC/MIS software
The Board of Trustees ratified the annual Netsmart Technologies Maintenance contract for the CMHC/MIS
software for$77,825.32.
Motion: Ms. Billye Ruth White Affirmative: 5
Second: Ms. Rugeley Negative: 0
Citizen Comment: None
D. FACILITIES AND EQUIPMENT
No Agenda Items
E. POLICIES AND PROCEDURES
No Agenda Items
F. PROGRAM AND PERSONNEL
No Agenda hems
Board of Trustee Meeting Minutes 4
October 6,2011
100611-6 QUARTERLY REPORTS
A. ESSENTIAL SERVICES AND CLINICAL ACCOUNTABILITY
1)Fourth Quarter Fiscal Year 2011 Report
RECOMMENDED ACTION: Information item only.
Andy Martin, Director of Essential Services gave the fourth quarter fiscal year 2011 report findings (on
file).
No action required, for information only.
Citizen Comment: None
B. PLANNING AND NETWORK ADVISORY COMMITTEE
iNo Agenda Items
IC. EXTERNAL AUDITS
No Agenda Items
1:20 PM Robert Clement returned to the meeting
100611-7 EXECUTIVE DIRECTOR'S REPORT
1)Behavioral Health Services
I have asked Andy Martin to give you an update on Open Access, so I will let him do that now.
Andy Martin, Director of Essential Services, We started a new process of receiving Open Access
Intakes on September 1st. Previously when an individual called they were given an appointment. The
standards were that they be able to access services within 14 days of contact. We were having issues
meeting that standard. There was a waiting time of up to 30 days or more. When we moved to Open
Access the caller is told to come to the Center. We have had good results so far. The first day the
average wait time was two hours, that has gone down to a half hour or less. They can walk into any
clinic and wait to see someone either live or via televideo. They were told in August that we would not
make an appointment for them but beginning September 1st they could walk in to any clinic for an intake
interview. We have the process ironed out. There was a 50 to 60 percent no show rate for clinicians with
the schedules. The direct service time was averaging 34 hours. We want it to be 100 hours. Since
August it has gone up 22 percent to 81 hours. We are also tracking the rate that we are giving a non
target diagnosis. We did not want to see a huge increase in the number we are serving. The percentage
with a non target diagnosis is staying the same. By implementing the Open Access we have improved
the LPHA' (Licensed Practitioner of the Healing Arts') service time and the wait time has gone down. It
has been good all the way around.
Roddy Atkins We are unique with doing intakes virtually. We came up with a plan and executed it well.
The plan is more consumer and community friendly. They often seek services in a moment of crisis and
when the crisis is over they do not make their appointments. This process gets them into care earlier.
Board of Trustee Meeting Minutes 5
October 6,2011
2)Behavioral Health Services
We are continung the work on a project with Wilbarger General Hospital in Vernon. We have been
having a discussion with the Hospital's Chief Executive Officer about a walk in clinic for physical health
in our Mental Health Clinic. I have visited with the County Judge and they are willing to help with
supplies for the needed remodeling. I will be going to Vernon to talk with their Board of Trustees.
Things are moving slow, but they are moving. The goal is to serve the indigent in a One Stop Shop.
This is how we will be evolving Behavioral Health into a Primary Care setting. It could grow into a neat
project as a forefront for how things will be going. It will enhance the quality of care for our consumer
base. Wilbarger General Hospital will be happy to have the Mental Health Services because we share a
lot of folks.
3) Budget
We are looking at a budget that projects a$280,000.00 short fall for this fiscal year. We are looking at a
4%reduction in Adult Mental Health Services at$180,000.00; a$35,000.00 reduction in Children
Services General Revenue; a$36,000.00 reduction in Crisis and Transitional Services; Department of
State Health Services (DSHS) is making cuts to fund five Outpatient Competency Restoration Facilities;
as well as some rate cuts. For the Department of Aging and Disability Services (DADS) the biggest cut
is the refinancing loss to General Revenue for the Texas Home Living Services. We will not get dollar
for dollar back. We are looking at how we can maximize our income and revenue.
4)Disaster Services
We have responded to some County requests for Disaster Services. There was a major car accident in
Quanah that involved high school students and resulted in the death of one student. We were asked by
the County Judge to do Critical Incident Stress Management with the First Responders. Marcy Thomas
and Sheryl Harrington provided that service for them and they were very appreciative. We also made
contact with the High School to offer our services. The outcome of that visit according to the County
Judge was team bonding of the group of First Responders that had not been evident previously. We also
responded to a request from Bowie Independent School District who experienced the suicide of a teenage
student.
5) Intellectual and Developmental Disability Services
We have enrolled 52 individuals into the Texas Home Living Waiver Services. They are refinanced with
General Revenue. Things are moving forward. There are major changes in how we bill under the new
Service Coordination Requirements with Department of Aging and Disability Services (DADS). We no
longer bill through TMHP (Texas Medicaid and Healthcare Partnership); we bill through the Department
of Aging and Disability Services (DADS). It has been extremely challenging but they have the process
up and running.
6)Local Planning and Network Development
We are beginning the local planning process. We have completed a Staff Satisfaction Survey. We are
completing the analysis. We will be starting a Consumer Satisfaction Survey. Once we have finished the
analysis we will share the results with our stakeholders. We are starting work on our consolidated Local
Plan which will include the Crisis and Jail Diversion Plans. We will bring it to the Board of Trustee once
the review process is completed.
Board of Trustee Meeting Minutes 6
October 6,2011
7)North Texas CEO Group
We talked previously about a Regional Board Retreat; it was determined that we are not prepared to do it
at this time. The North Texas CEO Group was made up initially of the Community Centers that admit to
North Texas State Hospital and North Texas State Hospital. That included Helen Farabee Centers;
Denton County MHMR Center; Pecan Valley Centers for Behavioral & Developmental HealthCare;
LifePath Systems; Texoma Community Center; MHMR of Tarrant County; and Texas Panhandle
Centers. Some times Betty Hardwick Center and Lubbock Regional MHMR Center participate. We
want to continue to discuss how we can partner. For instance we provide Pecan Valley Centers for
Behavioral & Developmental HealthCare with Information Management Services and as of September
1S`we provide Texoma Community Center with Medical Director Services. We are specifically
discussing joint pharmacy and credentialing services. We are looking to expand the group to include
West Texas Centers; Permian Basin Community Centers; Heart of Texas Region MHMR Center; and
Center for Life Resources. We are looking at the ETBHN framework. On Wednesday before the
Executive Directors' Consortium the North Texas CEO Group and ETBHN are meeting to see who
wants to partner and where we want to go. This is all driven by Healthcare Reform and the expansion of
Managed Care into Medicaid. All adults with Medicaid in 2013 will be under Managed Care. We will
no longer bill TMHP (Texas Medicaid and Healthcare Partnership). We will bill according to their plan.
Consumers will have choices. Wise County has been under managed care for awhile; we bill Bravo or
Amerigroup. The other 18 counties will come on board March 1s1 of 2012. It can be a very cumbersome,
difficult process working through intake to billing. We hosted a Managed Care Readiness Training in
Graham. Melissa Rowan from the Texas Council did the training. We are truly in a changing venue.
8)Staff Appreciation
Renee'Beasley and her staff through the PAP (Pharmacy Assistance Program)were responsible for
obtaining 5.5 million dollars in free medications. That is based on what we would have had to pay for
the medications from US Scripts. That is 1.5 million dollars more than we received last year. We are
able to serve more individuals because of their efficiency. If we had to pay for that medication we could
not serve the numbers we are able to serve. They were able to generate more for us in comparison to
other Centers.
9) Texas Council Board of Directors and Executive Directors'Consortium
I distributed copies of a Community Center Readiness Guide(on file) that was a part of the Healthcare
Opportunities Workgroup. It outlines the things we need to be prepared to do and the changes we can
expect in business practices. It is not a very long document and I would encourage you to look at it.
10) Veterans Services
Our Texas Veterans Sevices Grant was cut from $70,000.00 to $60,000.00. We can survive with that cut
but it will not leave us any training dollars. We have applied for additional funds so we can increase the
number of volunteers. We are working to establish a Female Support Group. My plan is to talk to the
Priddy Foundation about Veteran Service and Peer Provider Services. The Peer Provider Services is
working well but they can not be certified without a job offer and we do not have the funding to pay their
salaries. I am also going to approach the Priddy Foundation about the partnership with Midwestern State
University and bringing Physical Health into the Behavioral Health Facilities.
Board of Trustee Meeting Minutes 7
October 6,2011
11)Service Volume by County Report
Service Volume by County FY 2011 Quarter 4 Report(on file) was distributed.
This is the report that we share with our legislative delegation and our sponsoring agencies each quarter.
It gives a snapshot of what is happening by County.
Page One shows the Unduplicated Client Count; Count of Events; and Duration of Events by county for
Adult and Child and Adolescent Mental Health Services.
Page Two is Substance Abuse Services which are provided in Wichita County only. For Adult Services
we have the Unduplicated Client Count of 166; SAFP is Substance Abuse Felony Placement for those
individuals on Parole count of 25; and COPSD is those individuals with Co-occurring Psychiatric and
Substance Use Disorders count of 39. For Adolescent Services we have the Unduplicated Client Count
of 145; United Way @ Risk Prog is our United Way Grant in partnership with Communities and Schools
where we serve at risk clients at Wichita Falls High School with a count of 62; Truancy Court is our
referrals from Judge Little's Truancy Court with a count of 931; and COPSD is those adolescents with
Co-occurring Psychiatric and Substance Use Disorders with a count of 21.
Page Three is IDD, Intellectual and Developmental Disabilities Services. Non Residential are those
individuals who live in the community or those that we only provide Case Management Services for with
a count of 921. The Residential includes those in our ICF/MR (Intermediate Care Facilities for Persons
with Mental Retardation) Group Homes; HCS (Home and Community—Based Services) Group Homes;
and HCS (Home and Community—Based Services) Foster Care with a count of 82.
Page Four is number of Hotline calls and number of cases activated which resulted in a face to face
screening broken down by Adult and Child and Adolescent Services by County,by call.
Page Five In Response to Crisis is the number of Hotline calls that result in more than an Assessment by
County.
Page Six CRU Admissions and Crisis Residential is the number of admission to our Crisis Respite Unit
and the bed day count. This is a 16 bed unit we use for diversion from the State Hospital.
Page Seven is the number of State Hospital admissions by county. We had 230 admissions to the State
Hospital as compared to the 1001 admissions to the Crisis Respite Unit. We use the Red River Hospital
as an alternative to an admission to the State Hospital. We contract with them for bed days. We had 75
Red River Hospital admissions.
Page Eight is the number of admissions to Red River Hospital from the counties we serve for Adult
Services and for Childrens Services.
This gives the big picture of services we provide by county and is a tool that is available for use with our
stakeholders.
100611-8 ANNOUNCEMENTS
A)Next Meeting
Verner Hayhurst announced The next meeting is scheduled for 11 A.M., Thursday,November 3, 2011,
in Quanah.
Jan West stated I was told earlier this week that we will not be able to hold the meeting at the Hardeman
County Mental Health Center so we will not be able to connect via televidea.
Board of Trustee Meeting Minutes 8
October 6,2011
100611-9 OTHER BUSINESS J
None 1
100611-10 ADJOURN
The Board of Trustees' meeting adjourned at 1:35 PM.
Approved as presented: Approved as corrected:
(-Nr—
November 03, 2011
Board of Trustee Meeting Minutes 9
October 6,2011
Wichita Falls Administrative Office
W."
HELEN FARABEE P. O. Box 8266, Wichita Falls, TX 76307-8266
ok Street, Wichita Falls, TX 76301
CENTERS 1000 Bro Phone(940) 397-3100
Fax (940) 397-3150
www.helenfarabee.org
November 07, 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
October 06, 2011. These minutes were approved by the Board at its meeting held on November
03, 2011.
Sincerely,
X&14--
st
Adminis tive Assistant/Board Liaison
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enclosure
Providing Behavioral Health, Intellectual and Developmental Disabilities,and Substance Abuse Outpatient Services