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Helen Farabee Centers Board of Trustees Minutes - 07/01/2010 HELEN FARABEE REGIONAL MHMR CENTERS 4,Z\ecL BOARD OF TRUSTEES • July 1,2010 .14,\� 11:00 AM Red Rooster Restaurant 1006 South Avenue E I Haskell,Texas Board of Trustee Ken Andrews, Chair; Kay Ainsworth; Bill Coombs, Vice-Chair; Sue Nunn, Members Present: Secretary/Treasurer; Bobby Smith; Billye Ruth White Board of Trustee Robert Clement; Shelley Owen; Sara Rugeley Members Absent: Senior Roddy Atkins, Executive Director; Rod Brennan, Chief Financial Officer; Management Staff Lynn Hartje, Behavioral Health Services Director Present: Other Staff and Honorable David Davis, Haskell County Judge; J. H. Dulaney,Rolling Plains Guests Present: Jail; Joni Manske, Case Manager, Headstream Mental Health Center; Andy Martin, Utilization Manager; Honorable Bobby McGough, Stonewall County Judge; Debbie Moore, Day Habilitation, Intellectual and Developmental Disability Services; Cris Turner,Rolling Plains Jail; Sheri Urbanczyk, Center Manager, Headstream Mental Health Center; Jan West, Administrative Assistant/Board Liaison, Recorder AGENDA TOPICS 070110-1 CALL TO ORDER Ken Andrews, Chair called the meeting to order in open session at 11:03 AM with a quorum of five 'resent. A)Introduction of Guests The Honorable David Davis was introduced as a guest. J. H. Dulaney, Cris Turner, and the Honorable Bobby McGough arrived later and were welcomed upon their arrival. 070110-2 PRESENTATIONS A) Open Citizen Comment to the Board No citizen comment was offered. B) Headstream Mental Health Center Sheri Urbanczyk, Center Manager, Headstream Mental Health Center reported we currently have 152 adults enrolled in services in Haskell and 50 adults enrolled in services in Seymour. We are serving 19 children. Our staff consists of Juli Penman, Jason Stewart, and Joni Manske. Jason, our Child and Adolescent Services Case Worker is working with our schools to teach a program on bullying and other school issues. They are all doing a wonderful job. C)Intellectual and Developmental Disabilities Services in Haskell Debbie Moore, Day Habilitation, Intellectual and Developmental Disability Services, reported we have ten individuals who are benefiting from one or more of our services at this time. We have six individuals who attend the Haskell Day Habilitation Center;three are General Revenue funded; two are Home and Community—Based Services (HCS) funded and one is a contracted individual from Day Break who is Home and Community—Based Services (HCS) funded. We serve three Home and Community—Based Services (HCS) individuals with Supported Home Living. This includes transportation, training in their homes, and outings in the community. We serve four General Revenue individuals with Community Support. This includes transportation,training in their homes, and outings in the community. We serve one individual who is contracted from Day Break and is funded by the Texas Home Living Waiver by Board of Trustee Meeting Minutes . 1 July 1,2010 providing her training in her home. We have four individuals in Supported Employment. We have one client who lives in Knox City that is employed at the Band as well as the Golf Course in Knox City. We have a client who lives in Rochester that is employed at the Hospital in Knox City and the Haskell Country Club. We have a client from Rochester that is employed at Dr. William Mc Smith's office. We have a client who lives in Seymour that is employed at the Seymour Hospital. We do not have anyone with Employment Assistance in this are at this time. We have a brand new, state of the art bathroom that will accommodate any wheel chair that was put in by the city. We are very proud of it. 070110-3 APPROVAL OF MINUTES The Board of Trustees approved the minutes of the June 03, 2010 Board of Trustees meeting. Motion: Ms.Nunn Affirmative: 4 Second: Mr. Smith Negative: 0 Citizen Comment: None 070110-4 TRAINING No Agenda Items 070110-5 RECOMMENDATIONS A. BOARD OF TRUSTEES 1)Meeting Schedule for Fiscal Year 2011 RECOMMENDED ACTION: That the Board of Trustees approve the Board of Trustee meeting schedule for fiscal year 2011. Roddy Atkins, Executive Director presented the information on the the proposed meeting schedule for next fiscal year(on file). The Board of Trustees approved the Board of Trustee meeting schedule for fiscal year 2011. Motion: Mr. Coombs Affirmative: 4 Second: Ms. Ainsworth Negative: 0 Citizen Comment: None 2)Slate of Officers RECOMMENDED ACTION: That the Board of Trustees Chair appoint an ad-hoc committee to recommend a slate of officers for fiscal year 2011. Ken Andrews, Chair appointed Bobby Smith, Kay Ainsworth and Robert Clement to recommend a slate of officers for fiscal year 2011. 3)Board of Trustee Candidates RECOMMENDED ACTION: That the Chairman of the Board of Trustees appoint a three member sub- committee to interview the applicants and make a recommendation. Ken Andrews, Chair appointed Sue Nunn, Sara Rugeley and Robert Clement to interview the applicants and make a recommendation to the Commissioner's Courts. Board of Trustee Meeting Minutes 2 July 1,2010 B. BUDGET AND FINANCE 11:26 AM Billye Ruth White arrived at the meeting 1)Financial Statements RECOMMENDED ACTION: That the Board of Trustees approve the financial statements for May 2010. Rod Brennan, Chief Financial Officer presented the financial statements for May 2010 (on file). In addition, ICF and HCS Total Funding Status was distributed and discussed. The Board of Trustees approved the financial statements for May 2010. Motion: Mr. Smith Affirmative: 5 Second: Mr. Coombs Negative: 0 Citizen Comment: None A) Open Citizen Comment to the Board J. H. Dulaney, Rolling Plains Jail, was allowed to address the Board of Trustees before recessing for lunch. J. H. Dulaney,Rolling Plains Jail, stated we would like to discuss some of the rule changes. We have been told that there are now certain types of medications that will not be paid for by Helen Farabee Regional MHMR Centers. We have been asked to assume that exorbitant cost. We have an inmate that was receiving Seroquel, which we were asked to pay for. He was seen by Dr. Luke who increased the dose. The inmate is not compliant with the medication and refuses to take it. Before our physician would adjust the dosage, to help reduce our costs, he asked to see a copy of the physician's report. We were told we could not have it: Our question is, if we sent an inmate to you for a consultation, are we not entitled to the information? Roddy Atkins, Executive Director, there are two issues. First you should be able to get the records. Second, if this is an open consumer of ours, we take responsibility for the medication for our consumers. If they are in your facility and they reside outside of our 19 county catchment area or they are INS (Immigration and Naturalization Service)detainees then we can not provide their medications. We will talk to our Nurse and take care of it. Sheri Urbanczyk, Center Manager, Headstream Mental Health Center, we were told that we can not pay for Seroquel because of PAP (Pharmacy Assistance Program). Roddy Atkins, Lynn (Hartje, Behavioral Health Director), please follow up on this. THE BOARD OF TRUSTEES RECESSED FOR LUNCH AT 11:35 AM. THE MEETING WAS RECONVENED BY KEN ANDREWS AT 12:15 PM WITH SIX BOARD OF TRUSTEE MEMBERS IN ATTENDANCE. 2)Status of Investments RECOMMENDED ACTION: That the Board of Trustees approve the status of Investments. Rod Brennan, Chief Financial Officer presented the information on the status of Investments (on file). The Board of Trustees approved the status of Investments. Motion: Ms. White Affirmative: 5 Second: Mr. Coombs Negative: 0 Citizen Comment: None Board of Trustee Meeting Minutes 3 July 1,2010 C. CONTRACTS AND PLANS No Agenda Items D. FACILITIES AND EQUIPMENT No Agenda Items E. POLICIES AND PROCEDURES No Agenda Items F. PROGRAM AND PERSONNEL 1)Holiday Schedule for Fiscal Year 2011 RECOMMENDED ACTION: That the Board Of Trustees approve the Holiday Schedule for Fiscal Year 2011 beginning September 1, 2010. Roddy Atkins, Executive Director,presented the proposed Holiday Schedule for Fiscal Year 2011 (on ' file). The Board of Trustees approved the Holiday Schedule for Fiscal Year 2011. Motion: Mr. Smith Affirmative: 5 Second: Ms.Nunn Negative: 0 Citizen Comment:None 070110-6 QUARTERLY REPORTS A. ESSENTIAL SERVICES AND CLINICAL ACCOUNTABILITY 1) Third Quarter Fiscal Year 2010 Report RECOMMENDED ACTION: Information item only. Andy Martin,Utilization Manager reported on the third quarter fiscal year 2010 report findings (on file). No action required, for information only. Citizen Comment: None B. PLANNING AND NETWORK ADVISORY COMMITTEE No Agenda Items C. EXTERNAL AUDITS FNo Agenda Items D. TEXAS COUNCIL RISK MANAGEMENT FUND MEETING No Agenda Items E. OUTPATIENT MEASURES ADULT SUBSTANCE ABUSE SERVICES No Agenda Items Board of Trustee Meeting Minutes 4 July 1,2010 070110-7 EXECUTIVE DIRECTOR'S REPORT 1)Hardeman and Foard County MHMR Center The foundation work on the Hardeman and Foard County MHMR Center has been delayed due to the rain but should be completed within the next two weeks. The County has replaced the roof. Everyone is happy with the work done so far. 2)Pharmacy Security We have installed three cameras, closed the entrances through the kitchen and Medical Records, and installed a locking bar on the rear entrance. The rear entrance can not be permanently closed as we need two exits to meet the fire and safety regulations. We have obtained an initial cost estimate of$3,500.00 to install a card swipe system to access the pharmacy through the front two doors. We will continue to discuss this option. We also changed the locks and keys and limited the keys to five. We have sought the assistance of an attorney to protest the denial of the claim from the Risk Management Fund. 3) Behavioral Health Services The Childress County Mental Health Facility flooded again last week. We are in the process of hiring a contractor to do the work to solve the problem. The contractor who advised us on what we needed to do to fix the problem declined to bid on the job,he was from Wichita Falls. We have found two contractos in Childress. There will be two separate projects. The first project will be to build a walkway at the back of the building and slope it toward the side of the building and then have the water drain toward the front of the building and the highway. We will also have this contractor build a retaining wall that will stop water from running down the slope and diretly into the building. The cost for this project will be $2,890.00. The second project will involve dirt work to clean out the drainage ditch at the back of the property and change the banks to channel the water toward the highway and not toward our building. This bid is $1,000.00. 4)Safety Van Training Staff have received Van Driver Training with the exception of two. They will be trainied with the New Employee Orientation next month. 5)Budget HHS (Health and Human Services) as part of their initial budget cuts recommended cutting 150 State Hospital beds including 50 from the Wichita Falls Campus of North Texas State Hospital. Judge Gossom wrote a letter to our legislative delegation expressing his concern about this proposed cut. They evidently received a ton of pressure not to cut the state hospital beds; so that cut was not in their final request. You can expect contract utilization and a resulting contract cost increase in July. We have one physician leaving in July so we will be expanding our use of JSA Health while we continue to look for a physician. In addition our drug budget will continue to increase as were are averaging serving 2,630 adults where historically we served 2,000. Our numbers are going up ad there is only so much PAP (Pharmacy Assistance Program) can do. Our drug costs are going up but our Medicaid numbers are not going up. Board of Trustee Meeting Minutes 5 July 1,2010 6) Crisis Services/Intellectual and Developmental Disabilities Services/Mental Health Services/Substance Abuse Services The Service Volume by County report(on file) for 3`i Quarter Fiscal Year 2010 was distributed as well as a copy provided via e-mail to all our sponsoring entities and our legislative delegation. It reflects that the number we served is going up as well as our use of CRU (Crisis Respite Unit) is going up. Our Mental Retardation numbers changed because we inherited the 140 HCS (Home and Community—Based Services) individuals. This report provides a snapshot of what we are doing by county. 7)Disaster Services We have been put on notice for possible Hurricane Alex flooding disaster services. We have seven staff who have had CISM (Critical Incident Stress Management) training. If needed, we will send two staff at a time for a week; for a maximum of four staff. 8)Local Planning and Network Development The Planning and Network Advisory Committee(PNAC) reviewed and approved the draft Local Network Development Plan last week. We will also present it to the Focus Group for feedback. Then we will finalize it and post it on our web site. 9)Behavioral Health Services The Annual Staff and Trustee Training presented by the Texas Council was held two weeks ago in the Woodlands. It was a very good training. One of the topics of discussion was the integration of Behavioral Health and Physical Health. We have been looking at developing a plan with the Federally Qualified Health Care Provider in Wichita Falls. 10)HCS(Home and Community—Based Services) Case Management Conversion The HCS (Home and Community—Based Services) Transition went into effect on June 1st with 140 to 150 private provider clients being transferred to us for Case Management. Things have gone smoothly with only a few hassels. We had a couple of Quanah consumers who did not want us to do their Case Management. DADS (Department of Aging and Disability Services) was contacted and stated they must allow us to do the Case Management or they would not be eligible for the HCS (Home and Community— Based Services) program. We have been holding a montly meeting with the Private Providers. Val Mandela and her staff are doing a good job. 11)Budget Previously we talked about a mandate from the state leadership, Governor, Lieutenant Governor, and Speaker, for state agencies to reduce an additional 5% from their budgets for each year of the biennium , (FY 2010 and FY 2011). In addition, State Leadership has asked State Agencies to begin there baseline Legsilative Appropriations Request (LAR) for FYI 2012 and 2013 with an addtional 10%reduction. Community Centers and the State Hospitals were not impacted by the original reduction to the Fiscal Year 2010 -2011 budgets. Now going into the legislative session the budget baseline will be 10%lower. I am concerned about the Department of State Health Services (DSHS) cuts,not as worried about the Department of Aging and Disabilities Services (DADS) because of the monitoring system they have in place. For the Department of State Health Services (DSHS) 10%, State Hospital bed days and Community Services cuts will be back on the table. I am not sure to what extent. Everybody will be fighting for money. Last Legislative session taxes were cut because of the stimulus money that is no longer available. They are looking at an 18 billion dollar shortfall. They are also looking at redistricting. We need to stay on top of everything and make our decisions early. I received a reply to my e-mail from Judge McElhaney, Wise County Judge, asking if there is anything they need to do right now, Resolution or letters. The Texas Council is working on a Resolution that we will request the Commissioner Courts Board of Trustee Meeting Minutes 6 July 1,2010 and County Judges to complete. We need to make sure the Commissioner's Courts, County Judges, TAC (Texas Association of Counties), and the Sheriff's Associations are aware than any additional cuts to the State Hospitals and Mental Health Services we will be paying for in a bad way,through over crowding of prisons,jails and emergency rooms. There is no place else for them to go. We need to make sure they hear the same, consistent message. Our system is fragile. A ten percent reduction in general revenue will amount to $800,000.00 We do not have 10% fat left in our budget. It will have to impact services. We have to do our part to make sure the legislative decisions are hard and that they know the consequences. I am hoping in early September we can pull together an invitation for our Legislative delegation so we can talk with them about our issues and services. 070110-10 ANNOUNCEMENTS A)Next Meeting Ken Andrews announced the next meeting is scheduled for 11 A.M., Thursday, August 5, 2010, Child and Adolescent Services, 516 Denver, Wichita Falls 070110-11 OTHER BUSINESS None 070110-12 ADJOURN The Board of Trustees' meeting adjourned at 12:46 PM. Approved as presented: Approved as corrected: .? August 05, 2010 Board of Trustee Meeting Minutes 7 July 1,2010 a H E L E N FA RA B E Echita Falls Administrative ls TX -8266 P.P. O.O. Box 8266, Wichita Falls, TX 76307 8266 A 1000 Brook Street, Wichita Falls, TX 76301 Regional MHMR Centers Phone (940) 397-3100 Fax (940) 397-3150 August 09, 2010 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 July 01, 2010. These minutes were approved by the Board at its meeting held on August 05, 2010. Sincer-1 , )1"-- an eil Admin trative Assistant/Board Liaison /jw enclosure il _ - -.-_. __ CITY CLERKS OFFICE Date /.2