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Helen Farabee Centers Board of Trustees Minutes - 03/05/2009 HELEN FARABEE REGIONAL MHMR CENTERS BOARD OF TRUSTEES • March 5,2009 $\V 11:00 AM Child and Adolescent Services 516 Denver Street Wichita Falls,Texas Board of Trustee Ken Andrews, Chair; Bill Coombs, Vice-Chair; Sue Nunn, Secretary/Treasurer; Members Present: Kay Ainsworth; Linda Ammons Robert Clement; Shelley Owen; Bobby Smith; Billie Ruth White Board of Trustee None Members Absent: Senior Roddy Atkins, Executive Director; Rod Brennan, Chief Financial Officer; Management Staff Lynn Hartje, Mental Health Services Director; Rose Wilson, Mental Present: Retardation Services Director Other Staff and Charles Elmore, District 5 City Councilman; Jim Ginnings,District 4 City Guests Present: Councilman; Ray Gonzalez, Precinct 1 County Commissioner; Rick Hatcher, District 3 City Councilman; Jana Simpson, Chief Accountant; Jan West, Administrative Assistant/Board Liaison, Recorder AGENDA TOPICS 030509-1 CALL TO ORDER Ken Andrews, Chair called the meeting to order in open session at 11:05 AM with a quorum of nine jresent. A)Introduction of Guests Rick Hatcher,District 3 City Councilman was introduced as a guest. Charles Elmore, District 5 City Councilman; Jim Ginnings, District 4 City Councilman; and Ray Gonzalez, Precinct 1 County Commissioner arrived later and were welcomed upon their arrival. 030509-2 PRESENTATIONS A) Open Citizen Comment to the Board No citizen comment was offered. 030509-3 APPROVAL OF MINUTES The Board of Trustees approves the minutes of the February 05, 2009 Board of Trustees meeting. Motion: Ms. Nunn Affirmative: 8 Second: Ms. Ammons Negative: 0 Citizen Comment: None 030509-4 TRAINING A)Financial Indicators from the Balance Sheet Rod Brennan, Chief Financial Officer and Jana Simpson, Chief Accountant presented the training on Financial Indicators from the Balance Sheet (on file). THE BOARD OF TRUSTEES RECESSED FOR LUNCH AT 11:25 PM. THE MEETING WAS RECONVENED BY JUDGE ANDREWS AT 12:05 PM WITH NINE BOARD OF TRUSTEE MEMBERS IN ATTENDANCE. Board of Trustee Meeting Minutes 1 March 5,2009 030509-5 RECOMMENDATIONS A. BOARD OF TRUSTEES No Agenda Items B. BUDGET AND FINANCE 12:25 PM Robert Clement left the meeting_ 1)Financial Statements RECOMMENDED ACTION: That the Board of Trustees approve the financial statements for January 2009. Rod Brennan, Chief Financial Officer presented the financial statements for January 2009 (on file). The Board of Trustees approved the financial statements for January 2009. Motion: Ms. Ammons Affirmative: 7 Second: Mr. Coombs Negative: 0 Citizen Comment: None C. CONTRACTS AND PLANS No Agenda Items D. FACILITIES AND EQUIPMENT 1)Brook Street Facility Heating, Ventilation and Air Conditioning(HVAC) System RECOMMENDED ACTION: That the Board of Trustees approve the replacement of the Heating, Ventilation and Air Conditioning(HVAC)system at the West End of the Brook Street facility at a cost not to exceed $19,937. Rod Brennan, Chief Financial Officer presented the information on the Heating,Ventilation, and Air Conditioning(HVAC) system at the Brook Street facility(on file). We received three bids and are recommending approval of the Ferguson Veresh bid of$19,937 which includes all electrical wiring, gas lines and gas meter. The Board of Trustees approve the replacement of the Heating, Ventilation and Air Conditioning(HVAC) system at the West End of the Brook Street facility from Ferguson Veresh at a cost not to exceed $19,937. Motion: Ms. Nunn Affirmative: 7 Second: Mr. Smith Negative: 0 Citizen Comment: None E. POLICIES AND PROCEDURES No Agenda Items F. PROGRAM AND PERSONNEL No Agenda Items Board of Trustee Meeting Minutes 2 March 5,2009 030509-6 QUARTERLY REPORTS A. PLANNING AND NETWORK ADVISORY COMMITTEE No Agenda Items B.ESSENTIAL SERVICES AND CLINICAL ACCOUNTABILITY No Agenda Items • C. EXTERNAL AUDITS 1)First Quarter Report RECOMMENDED ACTION: Information item only. Rose Wilson,Mental Retardation Services Director reported on the annual recertification audit of the Intermediate Care Facilities for Persons with Mental Retardation (ICF/MR)Program conducted at Chanute Circle on September 15 - 17,2008. There were no programmatic or safety deficiencies noted. No action required, for information only. Citizen Comment: None 030509-7 EXECUTIVE DIRECTOR'S REPORT 12:36 PM Robert Clement returned to the meeting Wichita County Legislative Day As you know we are preparing for Wichita County Legislative Day in Austin on March 23"1 and 24t. Representative Farabee requested that I serve on the Wichita County Legislative Committee. Those in attendance will be presented in the House of Representatives and the Senate. Jim Smith, Superintendant at North Texas State Hospital, and I will be hosting a luncheon on Tuesday March 24th to address mental health issues. Key staff from the Department of State Health Services, including Commissioner David Lakey, have accepted the invitation to be there. Aids from Senator Estes', Representative Farabee's, and Representative Hardcastle's offices will be there. These leaders know both Jim and I very well,they hear our needs regularly. We feel like they need to hear from other key stakeholders, to let them know how vital our organizations are to the community and help express the tremendous need there is for public mental health service, and in particular, public substance abuse resources. Jim and I will be putting together some talking points. We want the event to be informal; it will be less threatening. The agenda will be sent out. It will be a neat event, and I would encourage you if you can to plan to attend. Child and Adolescent Psychiatrists We have appointments scheduled to interview three Child and Adolescent Psychiatrists in the next three weeks. I hope we will be able to hire one of them. One would be available within thirty to as soon as sixty days. Board of Trustee Meeting Minutes 3 March 5,2009 • Substance Abuse Services Rod and Marcy(Thomas, Director of Substance Abuse Services)have a conference call tomorrow with the Criminal Justice Department to talk about the SAF-P program for Wichita, Wise, and Jack Counties. The Probation Office in Wise County has asked us to step up to the plate after they lost their provider. We can do it if they are willing to cover the costs. The STAR Council out of Stephenville received the Grant to provide outpatient Substance Abuse services in our region. They have not been able to provide the services and we are negotiating with them to turn the money over to us. Our waiting list is growing primarily due to our relationship with the Truancy Court. Lynn Hartje, Star Council has requested that $40,000.00 of their grant come to us. Roddy Atkins, there are a couple of positives. Legislative Session Update Mental Health Issues There has been good positive testimony with regards to Mental Health and Substance Abuse Services. They are considering ways to increase funding. They will address crisis funds and the expansion of ongoing crisis services. Substance Abuse Services is a big request, with 66 million dollars requested to expand treatment services. There is a lot of sympathy. The hot, hot topic now in Mental Retardation Services is the State School issue. The Federal Crimnal Justice Department has been involved with the investigation of State Schools. Senator Ogden, Chair of the Finance Committee has developed a rider. As the MRLA (Mental Retardation Local Authority) we woulde become the Case Managers and plan and develop all services. The Private Providers are against that. Chairman Ogden says you have two choices, figure out or develop a new waiver program or blend the Mental Retardation Medicaid Waiver Services and delete services. The Private Providers changed their tunes. Targeted Case Management Waivers include 10,000 consumers; HCS (Home and Community— Based Services) program will add an additional 15,000 consumers. That will double the Case Management. Senator Ogden's committee wants somebody else guarding the hen house. They want the Community Centers to serve in an MRA (Mental Retardation Authority) role. They want to expand the HCS (Home and Community—Based Services)program by 6,000 slots over the next biennium. One suggestion is that State Schools suspend admission for one year. HCS (Home and Community—Based Services) is a large Medicaid Waiver Program that allows consumers not to live in a large facility. It promotes foster care, small group homes, and consumers to live at home with support. There is a big effort to double the size of the Case Management function. If it occurs the next 12 to 15 months after the session ends will be wild. The Texas Council and the Private Providers Association are drafting a modification to Senator Ogden's bill. The other question is the HCS (Home and Community—Based Services) program administration rate. When the HCS (Home and Community—Based Services) program was built and they determind the rate for services they did not bundle into the rate the administrative costs. They loaded the administrative rates on top of the rate. It has been that way since the HCS (Home and Community—Based Services) program was established in the mid 1980s. The Federal government decided they did not like that. They want the administration costs loaded in the rates. They put the bulk of the administrative costs into residential services. In the past the goal has been to minimize residential services and encourage foster care. We only have one HCS (Home and Community—Based Services) residential home; we are basically a foster care facility. We developed a spreadsheet about the financial impact and we would have a$286,000.00 income loss. There is a lot of work to be done at the state level. It is a scary scenario. We are a small provider and we are capped at the number we can serve. We will have to analyze the rate hearing progress and see how it plays out. If a new rate is adopted, it will not go into effect until September. We will see if they are listening to the testimony. The Texas Council has a rate analyst looking at it. It will be an interesting session for IDDS (Intellectual and Developmental Disability Services). Board of Trustee Meeting Minutes 4 March 5,2009 Autism Program and Services Lynn Hartje chaired the first meeting of the Autism Workgroup. Attendees represented the Independent School System; Sheppard Air Force Base; Region 9; ECI (Early Childhood Intervention) and the Autism Support Group. We are looking at developing an Autism Program similar to the one at Texana MHMR Center. We have to figure out how we can pay for it. The demand is incredible. Our focus will be an intensive behavioral program designed for children between the ages of three and eight years of age. The Texana Program is experiencing a 50 to 60% full recovery rate with that age group. We need to look at what services currently exit in Wichita Falls. Sheppard Air Force Base is looking for an effective intervention and treatment program. We are gathering data. We want to start small and go forward. It will require a blending of funds. The Texana program is private pay and charges $4,000.00 per month for individuals in their program, and they have a waiting list. Families are desperate to get good care for their children. We will be looking for grants to help offset the cost to the families. MSU (Midwestern State University)has a new Autism and Aspergers Home program. Autism and Aspergers is not Mental Retardaton. The Episcopal School has had an Autism Program but their specialist just left. We feel there is a large enough demand to move forward. We want to take it in small bites to ensure success. 030509-8 ANNOUNCEMENTS A)Next Meeting Ken Andrews announced the next meeting is scheduled for 11 A.M., Thursday, April 02, 2009, Wise County Mental Health Center, 407 Park West Court, in Decatur. Robert Clement requested that the meeting be available via televideo. 030509-9 OTHER BUSINESS A) Texas Council Risk Management Fund Meeting Bill Coombs distributed and went over three documents (on file) from the Texas Council Risk Management Fund meeting. The Texas Council Risk Management Fund is under the umbrella of the Texas Council of Community Mental Health and Mental Retardation Centers,but is autonamous. We are in a good situation and have been looking good since 2003. Workers' Compensation is the most expensive because it is a life long liability. The Liability Program had a surplus from the beginning. We took a hit from the hurricanes. We anticipate a slight increase in the rates next fiscal year, it could be as much as $3,000.00. The third page is a flow chart to demonstrate the complexity of the funds. There have been a few Centers that opted out of the Risk Management Fund and then get back in. The flow chart shows the various strategies. The important thing we did is approve a new logo after two years of deliberation. I am impressed with the value the Centers get for their money. There are centers that will get strapped for cash and believe they can get the services cheaper, and they maybe can for a year,but four, five or six years down the road is when they will be hurt. The Texas Council Risk Management Fund provides an incredible amount of training to the Centers as well as a Web Based Curriculum. We also have access to Brian Crews and Pam Beach, two very personable, knowledgable attorneys. Pam Beach usually entertains us with news of the weird. Alliance for Workers' Compensation issues is rolling out in Texas and should be rolled out to us by July. Thirty—two of the 39 Community Centers are members of the Texas Council Risk Management Fund. Roddy Atkins, I concur with Bill on the value of the Texas Council Risk Management Fund. I talk to the attorneys routinely and that keeps us from having to pay alocal attorney,there are no billable minutes. Board of Trustee Meeting Minutes 5 March 5,2009 030509-10 ADJOURN The Board of Trustees' meeting adjourned at 1:25 PM. Approved as presented: Approved as corrected: April 2, 2009 Board of Trustee Meeting Minutes March 5,2009 014 HELEN FARABEE bar• REGIONAL MHMR CENTERS Wichita Falls Administrative Office 'A P P. O.Box 8266 1000 Brook Street Wichita Falls,Texas 76307-8266 Phone (940) 397-3100 Fax (940) 397-3150 March 11, 2009 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 March 05, 2009. These minutes were approved by the Board at its meeting held on April 02, 2009. Sincerely, Jan We Admi ' trative Assistant/Board Liaison /jw enclosure RECEIVED IN CITY Ci"CRK'S OFFICE Date By _ Time