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Helen Farabee Centers Board of Trustees Minutes - 12/02/2010 HELEN FARABEE REGIONAL MHMR CENTERS �� BOARD OF TRUSTEES • December 2,2010 -��-ao)1 11:00AM g��D ct Bowie Senior Citizens Center 501 Pelham Street Bowie,Texas Board of Trustee Ken Andrews, Chair; Verner Hayhurst; Sue Nunn, Secretary/Treasurer; Members Present: Shelley Owen, Vice-Chair; Sara Rugeley Board of Trustee Kay Ainsworth; Robert Clement; Bobby Smith; Billye Ruth White Members Absent: Senior Roddy Atkins, Executive Director; Rod Brennan, Chief Financial Officer; Management Staff Gianna Harris, Associate Executive Director of Operations; Rose Wilson, Present: Intellectual and Developmental Disability Services Director Other Staff and Patrina Hein, Case Manager, Child and Adolescent Services; Debbie Moore, Guests Present: Regional Service Manager for the Southern Region, Intellectual and Developmental Disability Services; Denise Truax, Center Manager, Montague County Mental Health Center; Susan Thompson,Director of Child and Adolescent Services; Mike Vasquez, Case Manager, Montague County Mental Health Center; Jan West, Administrative Assistant/Board Liaison, Recorder AGENDA TOPICS 120210-1 CALL TO ORDER Ken Andrews, Chair called the meeting to order in open session at 11:04 AM with a quorum of five present. A)Introduction of Guests There were no guests present. 120210-2 PRESENTATIONS A) Open Citizen Comment to the Board No citizen comment was offered. B)Montague County Mental Health Center Denise Truax, Center Manager, Montague County Mental Health Center distributed a list of current staff (on file) and reported we currently have 252 adults enrolled in services and are serving 34 children. Our staff consists of Renee' Beasley, Patient Assistance Coordinator; Joellen Stark, Patient Assistance Coordinator; Cindy Hanks, Service Package 3 Provider; Ruth Davis, Budget Analyst; Mike Vasquez, Adult Caseworker; Jeni Fathree, Child and Adolescent Worker; Lee Bramlett, Licensed Practitioner of the Healing Arts; Anne Vowell, Medication Secretary; Tonya Mowery, Receptionist; Michael Deweber, Crisis Intervention and Relapse Specialist; and Dr. Sarah Strebeck, psychiatrist. Kathy Neal, RN sees our consumers every Wednesday for Medication Checks and Cindy Smiley draws labs every Tuesday. We are currently short one caseworker and are interviewing for that position. We have a very good working relationship with our community stakeholders. We were proud to be able to contribute to the Legislative Open House and Luncheon by having our County Sheriff, Chief of Police and a consumer involved in the presentation. C)Intellectual and Developmental Disabilities Services in Bowie Debbie Moore, Regional Servicer Manager for the Southern Region, Intellectual and Developmental Disability Services, reported we have two General Revenue individuals in employment assistance, one individual in Supported Home Living and one in Supported Employment. We have 41 individuals who are benefiting from one or more of our services at this time. We have 27 individuals who participate in Board of Trustee Meeting Minutes 1 December 2,2010 Day Habilitation; 19 are General Revenue funded and eight are Home and Community—Based Services (HcS) funded. We take them on a lot of outings, there is a lot of drining involved.We have one General Revenue individual working in Nocona and one General Revenue individual who is looking for employment. We have two Home and Community—Based Services (HCS)individuals who are waiting on DARS (Department of Assistive and Rehabilitative Services) the old Texas Rehabilitation Commission. We have three individuals in Foster Homes, one in Bowie, one in Decatur, and one in Sunset. We also had a consumer speak at the Legislative Open House and Luncheon. She is very proud of the Thank You Cards she received as a result of that presentation and has shared them with everyone on several occasions. 120210-3 APPROVAL OF MINUTES The Board of Trustees approved the minutes of the November 04, 2010 Board of Trustees meeting. Motion: Ms. Rugeley Affirmative: 4 Second: Ms. Owen Negative: 0 Citizen Comment: None 120210-4 TRAINING A) Child and Adolescent Services Susan Thompson, Director of Child and Adolescent Services introduced Patrina Hein. Patrina come to us as an Intern and was hired upon completion of her training. She is a positive asset, skilled at mentoring and volunteering in the community. Patrina Hein,Case Manager, Child and Adolescent Services stated I currently serve 40 clients within the three to 17 year old range. We work on issues defined on their Treatment Plan such as anger issues and problem solving. We do this through Play Therapy. Some of the tools we use are Actions and Consequences for Teens; Wait and Win Recommended for Children with ADHD or Other Behavioral Problems;Family Communication Skills Dos and Don'ts; and Face It(on file). Most of our services take place in the schools. I have patients in Burkburnett, Iowa Park, Henrietta, and Wichita Falls. I schedule five per day. We do see some in their homes. Most of our referrals are word of mouth walk ins, from the schools, and a few from CPS (Child Protective Services) and STAR. 120210-5 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 October 2010. Rod Brennan, Chief Financial Officer presented the financial statements for October 2010 (on file). The Board of Trustees approved the financial statements for October 2010. Motion: Ms. Nunn Affirmative: 4 Second: Ms. Rugeley Negative: 0 Citizen Comment: None THE BOARD OF TRUSTEES RECESSED FOR LUNCH AT 11:53 AM. Board of Trustee Meeting Minutes 2 December 2,2010 TH,E MEETING WAS RECONVENED BY KEN ANDREWS AT 12:40 PM WITH FIVE BOARD , OF TRUSTEE MEMBERS IN ATTENDANCE. 2)Request For Proposal For Annual Audit Firm RECOMMENDED ACTION: That the Board of Trustees review the list of potential audit firms and make any additions or deletions. Rod Brennan, Chief Financial Officer presented the information on the list of potential audit firms(on file). There are nine firms we will submit Request for Proposals to, let me know if you have any additional firms you would like for us to contact. C. CONTRACTS AND PLANS No Agenda Items D. FACILITIES AND EQUIPMENT No Agenda Items E. POLICIES AND PROCEDURES 1)Investment Policy and Procedure RECOMMENDED ACTION: That the Board of Trustees review the attached ADMINISTRATION POLICY 101.1,BOARD OF TRUSTEE POLICY STATEMENT and ADMINISTRATION PROCEDURE 101.1.9,RESERVE FUNDS AND INVESTMENTS,recommend any changes, and authorize the Chair to sign the attached Resolution. Rod Brennan, Chief Financial Officer,presented the Administration Policy and Procedure on Reserve Funds and Investments (on file). The Board of Trustees approved the ADMINISTRATION POLICY 101.1,BOARD OF TRUSTEE POLICY STATEMENT and ADMINISTRATION PROCEDURE 101.1.9,RESERVE FUNDS AND i INVESTMENTS as presented and authorize the Chair to sign the Resolution. Motion: Ms. Owen Affirmative: 4 Second: Mr. Hayhurst Negative: 0 Citizen Comment: None F. PROGRAM AND PERSONNEL No Agenda Items 120210-6 QUARTERLY REPORTS A. PLANNING AND NETWORK ADVISORY COMMITTEE No Agenda Items B. ESSENTIAL SERVICES AND CLINICAL ACCOUNTABILITY No Agenda Items Board of Trustee Meeting Minutes 3 December 2,2010 C. EXTERNAL AUDITS 1)Fourth Quarter Report—Intellectual and Developmental Disabilities—Intermediate Care Facilities for Persons with Mental Retardation RECOMMENDED ACTION: Information item only. Rose Wilson, Intellectual and Developmental Disability Services Director reported on the audits findings for the Fourth Quarter—Intellectual and Developmental Disabilities—Intermediate Care Facilities for Persons with Mental Retardation (on file). No action required, for information only. Citizen Comment: None 2)Fourth Quarter Report—Intellectual and Developmentaql Disabilities—Home and Community— Based Services RECOMMENDED ACTION: Information item only. Rose Wilson, Intellectual and Developmental Disability Services Director reported on the audits findings for the Fourth Quarter—Intellectual and Developmental Disabilities—Home and Community—Based Services (on file). No action required, for information only. Citizen Comment: None 120210-7 EXECUTIVE DIRECTOR'S REPORT 1) Organizational Structure After Lynn submitted his resignation I began to evaluate that position's role and function. I then made the decision not to rehire his position. I want to encourage our younger staff to take more of a leadership role. So we have reallocaetd the functions as outlines in this handout and Table of Organization (on file). This gives several very bright staff an opportunity to step up and expand their roles and develop them to assume new roles. 2)Helen Farabee Regional MHMR Centers Name Change A Federal Law, Rosa's Law has passed that will eliminate the use of the term Mental Retardation in Federal Law and Statues. Lifewise, the first bill filed this legislative session is to eliminate the term Mental Retardation in State Statute. Those facilites with MR or Mental Retardation in their name are moving to change their names. This has been a big issue pushed by Arc. We need to begin the process of looking at a name change. We will come to you with a proposal in January or February. It will require a legal name change so there will be some cost involved. 3) Texas Council Board of Directors and Executive Directors'Consortium The biggest hot topic at the Texas Council is the 13 to 25 billion dollar short fall. There is an anticipated two billlion dollar short fall this biennium. We are still not sure about cuts. January 11t'we can expect the Comptrollers forecast. Managed Care Companies are saying they can save the state money. The Legislature has threatened to pull Texas out of Medicaid. There is talk about doing away with some State Agencies. I am working on a report for our Legislative Delegation to show them what the local impact could be. When we break down the projected cuts, for Intellectual and Developmental Board of Trustee Meeting Minutes 4 December 2,2010 Disabilities Services we are looking at a 37.7 million dollar cut to General Revenue. Our percentage of that will be 277,000 dollars. They have proposed cutting In Home and Family Support in half, a 5.7 millon dollar cut in General Revenue. That would be a 18,000 dollar cut for us. They have proposed a 7.28%cut in Home and Community- Based Services (HCS) that could result in a 73,000 dollar cut for us. A 3.54%rate reduction for Intermediate Care Facilties for Persons with Mental Retardation (ICF/MR) could result in a 31,000 dollar loss in revenue for us. We have to cover overhead costs for Home and Community- Based Services (HCS) and Intermediate Care Facilties for Persons with Mental Retardation (ICF/MR) now. There will be implications for folks in General Rvenue Services. This will have a significant impack on our ability to serve. The question is can we continue to provide Home and Community- Based Services (HCS). Home and Community- Based Services (HCS) funded by the stimulus funds are at risk for continued service. I asked Val (Mandela, Director of Intellectual and Developmental Disabilities Service Coodination) to look at the number of enrollees for the last two years and we have roughly 90 to 100 who are at risk of losing Home and Community- Based Services (HCS). It is anticipated that the rate cut will put 30% of providers out of the Home and Community- Based Services (HCS) business. The good news is they will probable not be able to cut Home and Community -Based Services (HCS) funding because of Federal Government rules. For Mental Health Services there are three areas of impact. We are looking at a 22.8 million dollar cut to General Revenuefor Crisis Continuity of Care. Our cut will be 69,584 dollars. Adult and Child and Adolescent Services is looking at a 51.4 million dollar cut which will result in 569,740 dollar loss in revenue for us. We estimate that will impact our ability to serve 300 individuals per month. Most at risk are the smaller rural areas where the cost of delivery of services is greater. There is a proposed 45.2 million dollar cut to State Hospital Facilities. The impact to us will depend on how the cuts are allocated. We are looking at a total financial impact of 1.1 million dollars. Our Substance Abuse Services will not be affected because they are mostly Federal funds. I am not sure how the cuts will affect TCOOMMI(Texas Correctional Office on Offenders with Medical and Mental Impairments or SAFP (Substance Abuse Felony Placement). Some of the impact will depend on where the cuts are directed. I am putting together a quick look for our Legislative delegation of the proposed cuts. The Legislators' have to set priorities. They know the folks we treat will not disappear. I know this all sounds dark and glummy. We may have to talk about using our own rainy day funds. The Legislative Session will end May 30`h 4)Behavioral Health Services The Health and Human Services Commission has proposed that Medicaid be moved under Managed Care. For Wise County that will be STAR Plus. Every Medicaid adult will have to select a health care, they will either choose or one will be assigned. This will impact card services for our physicians. Bravo Health is one of the subcontractors. They are working with the Community Centers. They are working to reduce the cost by keeping the individuals out of the costly venues of care. They will contract with us to provide services for folks who do not fit our priority population. The other subcontractor is Amerigroup. All card services will not be paid for by TMHP (Texas Medicaid and Healthcare Partnership) but by managed care. The Health and Human Services proposal is to move pharmacy benefits to Managed Care. Individuals 133%of poverty level will be eligible for Medicaid. That will impact 80%of our adults. We will help define what the Community Centers role will be. This could be a nice collision between Behavioral Health and Physical Health. There is a ton of stuff on healthcare. 5) Texas Council Board of Directors and Executive Directors'Consortium So much is coming down the road that the Texas Council Board of Directors has contracted with a health Care Organization. This will increase contract expenses. The Texas Councl is looking at hiring an expert in Healthcare and Managed Care. This had the unanamous support of the Executive Directors. The Texas Council Board of Directors moved forward with a dues increase of$2,100.00 per year. With a Managed Care Expert this issue will not get lost. Board of Trustee Meeting Minutes 5 December 2,2010 6) Texas Council Board of Directors and Executive Directors'Consortium Gjarnia and I attended the Executive Directors' Consortium meeting and on Friday afternoon visited with our Legislator's offices. Since Senator Estes is on the Senate Finance Committee that is especially important. Sam Carlson,his aid who tracks the Legislative Requests was not available so we left some informaton for her. 7)Behavioral Health Services The Department of State Health Services is holding a small round table discussion in Fort Worth with MHMR of Tarrant County hosting. It will be an opportunity to talk about Behavioral Health and Physical Health with the Department of State Health Services' Commissioner David Lakey, and key staff. We have developed a partnership with the Community Healthcare Center and have had a similar discussion with Wilbarger General Hospital. Integration is ongoing. 120210-10 ANNOUNCEMENTS A)Next Meeting Ken Andrews announced the next meeting is scheduled for 11 A.M., Thursday, January 6, 2011, Child and Adolescent Services, 516 Denver, Wichita Falls 120210-11 OTHER BUSINESS Texas Council Board of Directors Ken Andrews announced his interest in stepping down from the Texas Council Board of Directors and asked if there were any members that would be interested in representing our facility. Sara Rugeley stated she would be willing to be our representative. Ken Andrews thanked Ms. Rugeley for volunteering and asked Mr. Atkins to notify the Texas Council Board of Directors of the change in representation. 120210-12 ADJOURN The Board of Trustees' meeting adjourned at 1:49 PM. Approved as presented: Approved as corrected: January 06, 2010 Board of Trustee Meeting Minutes 6 December 2,2010 ;14 Wichita Falls Administrative Office ( H E L E N FA RA B E E P. O. Box 8266, Wichita Falls, TX 76307-8266 Regional MHMR Centers 1000 Brook Street, Wichita Falls, TX 76301 ' g Phone (940) 397-3100 Fax (940) 397-3150 January 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 Regional MHMR Centers is enclosed for the regularly scheduled meeting held on December 02, 2010. These minutes were approved by the Board at its meeting held on January 06, 2011. Sinc , an Admi strative Assistant/Board Liaison /jw enclosure �_ �o - 11