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Helen Farabee Centers Board of Trustees Minutes - 04/02/2009 1 r f f' 5 HELEN FARABEE REGIONAL MHMR CENTERS � l BOARD OF TRUSTEES •�v April 2,2009 411:00 AM Wise County Mental Health Center 407 Park West Court Decatur,Texas Via Televideo Sue Nunn Conference Room 1000 Brook Wichita Falls,Texas Board of Trustee Ken Andrews, Chair; Bill Coombs, Vice-Chair; Sue Nunn, Secretary/Treasurer; Members Present: Linda Ammons (via Videoconference); Billye Ruth White (via Videoconference) Board of Trustee Kay Ainsworth; Robert Clement; Shelley Owen; Bobby Smith Members Absent: Senior Roddy Atkins, Executive Director; Lynn Hartje, Mental Health Services Management Staff Director Present: _ Other Staff and Kaci Bosley, Child and Adolescent Caseworker, Wise County Mental Health Guests Present: Center; Dr. Kent Floerke, Center Manager, Wise County Mental Health Center; Andrew Martin, LPC, Utilization Manager; Anya Miramontes, Secretary, Wise County Mental Health Center; Darice Montgomery, Intake, Wise County Mental Health Center; Debbie Moore, Day Hab, Mental Retardation Services; Stacy Strassmann, Service Package 3 and 4 Caseworker, Wise County Mental Health Center; Julie Torres, Medication Clerk, Wise County Mental Health Center; Jan West, Administrative Assistant/Board Liaison, Recorder; Tamie Winters, Secretary, Wise County Mental Health Center AGENDA TOPICS At 11:00 a.m. a quorum was not present, Ken Andrews, Chair announced while we are awaiting the arrival of another member we will proceed with Agenda Items 040209-2 PRESENTATIONS, B) WISE COUNTY MENTAL HEALTH CENTER and C) MENTAL RETARDATION SERVICES IN WISE COUNTY; and 040209-4 TRAINING. 040209-2 PRESENTATIONS B) Wise County Mental Health Center Dr. Kent Floerke, Center Manager, Wise County Mental Health Center, introduced his staff, Tamie Winters, Secretary; Julie Torres, Medication Clerk; Anya Miramontes, Secretary; Darice Montgomery, Intake; Kaci Bosley, Child and Adolescent Caseworker; Stacy Strassmann, Service Package 3 and 4 Caseworker; presented a handout (on file) and went over the information about the services they provide. Board of Trustee Meeting Minutes 1 April 2,2009 4 I C)Mental Retardation Services in Wise County Debbie Moore, Day Habilitation, reported we serve 22 General Revenue and nine HCS (Home and Community—Based Services) clients in the Decatur area. At this time we have one client working, three clients looking for jobs, and one client going through the enrollment process at DARS (Department of Assistive and Rehabilitative Services). All of these clients are General Revenue. We have five Trainers in Decatur: two Day Habilitation Trainers, one for HCS (Home and Community—Based Services) and one for General Revenue; one Supported Employment Trainer; and two new Trainers. The two new Trainers just completed the first half of their training to allow them to also do Supported Employment. The Trainers are doing an exceptional job. I have received many good reports on their attitudes, their ethics, and their ability to get the job done. We have four HCS (Home and Community—Based Services) clients; one Angle Community HCS (Home and Community—Based Services)client; and nine General Revenue clients attending the Day Habilitation Center. We have one HCS (Home and Community—Based Services) and one General Revenue client attending the Mobile Day Habilitation in the Decatur area. We are providing more services in this area due to the new clients coming in. We are very excited about our growth over the past year. 11:20 AM Billye Ruth White arrived at the meeting via Videoconference from Wichita Falls 040209-4 TRAINING A) Behavioral Health Services Lynn Hartje, Behavioral Health Director provided annual training (on file). 040209-1 CALL TO ORDER Ken Andrews, Chair called the meeting to order in open session at 11:50 AM with a quorum of five present. (Three physically present in Decatur and two via Videoconference from Wichita Falls). A) Introduction of Guests Mike Peak, Decatur Police Department was introduced as a guest. 040209-2 PRESENTATIONS (Continued) A) Open Citizen Comment to the Board Mike Peak, Decatur Police Department asked what the preferred procedure for contacting Helen Farabee Regional MHMR Centers for screening? Roddy Atkins, Executive Director stated we can see the patient wherever it is the most convenient for the Police Officer. If the situation requires they be transported to the emergency room,then we can see them there or we can see them where they are being detained. Call the Crisis Hot Line and that will activate the on-call clinician who will be there typically within an hour. Mike Peak stated one concern of his Police Chief is who is responsible for the emergency room bill? Evidently he has been receiving bills from the hospital. Roddy Atkins stated the patient is responsible for the emergency room bill; neither the Police Department nor Helen Farabee Regional MHMR Centers is responsible for the emergency room bill. Mike Peak asked if Helen Farabee Regional MHMR Centers would be able to assist the Police Department with providing training for their SWAT Team. Roddy Atkins stated yes, we can help. If you need more specific training and consultation for your officers in dealing with critical mental health related incidents, we would be happy to assist or find the expertise. We are going to start a Wise County Focus Group which will include Law Enforcement and Hospital staff. That will give us an opportunity to get together on a regular basis and talk through these types of issues. THE BOARD OF TRUSTEES RECESSED FOR LUNCH AT 12:05 PM AND ANNOUNCED THAT THEY WOULD RECONVENE AT 12:30 PM. Board of Trustee Meeting Minutes 2 April 2,2009 THE MEETING WAS RECONVENED BY JUDGE ANDREWS AT 12:45 PM WITH FIVE BOARD OF TRUSTEE MEMBERS IN ATTENDANCE (THREE PHYSICALLY PRESENT IN DECATUR AND TWO VIA VIDEOCONFERENCE FROM WICHITA FALLS). 040209-3 APPROVAL OF MINUTES The Board of Trustees approves the minutes of the March 05, 2009 Board of Trustees meeting. Motion: Ms. Nunn Affirmative: 4 Second: Mr. Coombs Negative: 0 Citizen Comment: None 040209-5 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 February 2009. Roddy Atkins, Executive Director distributed and presented the Financial Statement Report (on file). The Board of Trustees approved the financial statements for February 2009. Motion: Ms. Nunn Affirmative: 4 Second: Mr. Coombs Negative: 0 Citizen Comment: None C. CONTRACTS AND PLANS No Agenda Items D. FACILITIES AND EQUIPMENT No Agenda Items E. POLICIES AND PROCEDURES 1) — 6)Administrative Policy And Procedures RECOMMENDED ACTION: That the Board of Trustees approve Administrative Services Policy 101.1 and Procedures 101.1.1 through 101.1.5. Roddy Atkins, Executive Director presented the proposed revisions to the Administrative Services Policy and Procedures (on file). Bill Coombs questioned the meaning of Administrative Services Procedures 101.1.4, section 7.1.4"The notice of the telephone conference call meeting must specify as the location of the meeting the location where meetings of the Board of Trustees are usually held." For clarity it was recommended it be revised to read "The Announcement of Meeting for a telephone conference call must specify the location of the meeting as Child and Adolescent Services, 516 Denver Street, Wichita Falls, Texas, which is the location where meetings of the Board of Trustees are usually held." Board of Trustee Meeting Minutes 3 April 2,2009 The Board of Trustees approved Administrative Services Policy 101.1 and Procedures 101.1.1 through 101.1.5 with the correction as stated to Administrative Services Procedures 101.1.4, section 7.1.4. Motion: Ms. Nunn Affirmative: 4 Second: Mr. Coombs Negative: 0 Citizen Comment: None F. PROGRAM AND PERSONNEL No Agenda Items 040209-6 QUARTERLY REPORTS A. PLANNING AND NETWORK ADVISORY COMMITTEE No Agenda Items B.ESSENTIAL SERVICES AND CLINICAL ACCOUNTABILITY 1) Second Quarter Report RECOMMENDED ACTION: Information item only. Andrew Martin, LPC,Utilization Manager presented the First Quarter report on the Essential Services and Clinical Accountability(on file). The Target for Criteria# 4.2 State MH Facility Readmissions should be <_ 10% which makes us in compliance at 10%. Bill Coombs stated as someone who works with parents, it is a job well done by the Child and Adolescent services in being above target on Criteria# 2.3 Ohio Scales Completion. No action required, for information only. Citizen Comment: None C. EXTERNAL AUDITS No Agenda Items [ O4O2O97 EXECUTIVE DIRECTOR'S REPORT Wichita County Legislative Day Five of our Board of Trustee members were able to attend the Wichita Falls Legislative Day in Austin. I also stayed over for the Vernon Legislative Day. It was a very good trip. We had an opportunity to visit with key staff from the Department of State Health Services, including Dr. David Lakey, Commissioner; Mike Maples, Associate Commissioner for Mental Health and Substance Abuse Services; Ross Robinson, Director of Community Mental Health and Substance Abuse Services; Tom Best, Director of the Mental Health and Substance Abuse Contracts Division; and Rod Swan, Community Mental Health Contacts Division Manager; as well as Karen Polvado from Midwestern State University and Rhonda Poirot from Senator Estes' office. At the luncheon we were able to highlight the collaboration we have in the community. Bill Coombs Tell us about the special recognition you received. Roddy Atkins Representative David Farabee surprised me with a Resolution on the Floor of the House thanking me for my work in North Texas over the past 30 years. The Vernon Legislative Day I was able to visit with the Vernon delegation including the Texas Youth Council Executive Director. While in Austin, I was also able to visit all three of our legislator's offices and brief them on the current issues. Board of Trustee Meeting Minutes 4 April 2,2009 Legislative Session Update Mental Health Issues At this point there is a hugh debate over how to use the Stimulus money. There is some question as to whether they will get the Appropriations Bill done in time. There is an 88 million dollar ask to expand Emergency Psychiatric Services. They want to de-emphasize the focus on Crisis Services and place it more on what to do with the patient after the crisis. They are looking at expanding the length of time for follow up after the crisis. They are considering money around the cost of doing business since there has been no increase since Fiscal Year 2000. All expenses have gone up including salaries and utilities. Substance Abuse is getting mixed support as there are those that think individuals choose to be addicted so they have no sympathy for the need for treatment. They have pushed through the Medicaid portion of Substance Abuse treatment. They took that out 15 or 20 years ago. Mental Retardation (Intellectual and Developmental Disabilities) Issues The State Schools are the big political issue. There is a lot of legislation to limit State School censuses by declining the census over time or putting a moratorium on admissions for a year. There is a huge push for clearing the HCS (Home and Community—Based Services) program waiting list. They are looking at expanding the HCS (Home and Community—Based Services)program to accommodate discharges from the State Schools. Senator Ogden, Chair of the Finance Committee, wants the Case Management function to go to the MRLA (Mental Retardation Local Authority), pulling it from the provider. This goes back to several years ago when there was talk of the MRLA(Mental Retardation Local Authority). We were on the verge of executing it when they pulled it back. The Private Providers Association killed it. The Finance Committee revisited it, and said the Private Providers could either agree with it or they would push for a consolidated waiver. The Texas Council and Private Providers Association crafted the language to modify Senator Ogden's bill. This will expand our Case Management component significantly. We will have local oversite of all HCS (Home and Community—Based Services) sites. The other piece is the HCS (Home and Community—Based Services)program administration rate. When the HCS (Home and Community—Based Services) program was built and they determined the rate for services they did not bundle into the rate the administrative costs. They loaded the administrative rates on top of the rate. When we provide Foster Care services we get the Case Management Rate and Administrative Overhead all in one. The Federal Government does not like that and they are forcing us to redo it. The Administrative Fee models so far has placed a bulk of the Administrative overhead into residential care. The bulk of our services are in Foster Care or caring for individuals in the community. If they load the rate towards residential services, we will have a tremendous loss. We are predicting a loss of $200,000.00 annually. We may be able to make enough with Case Management to cover the losses in HCS (Home and Community—Based Services). Substance Abuse Services The STAR Council out of Stephenville received the Grant to provide outpatient Substance Abuse services in our region,they have de-obligated $40,000.00. We are waiting on the Department of State Health Services (DSHS) to give us the money. United Way has decided to grant us and Communities in Schools a combined grant of$49,000.00. I am not sure that is doable. We are still haggling with the Criminal Justice Department over the reimbursement rate for Wise and Wichita County SAF-P programs. We will see what happens there. Local Network Development Plan A meeting of the Planning and Network Advisory Committee (PNAC) is being scheduled to review the Local Network Development Plan. According to the plan we will put out Request For Proposal (RFP) for Cognitive Behavioral Therapy (CBT) Services from the private sector and for Psychiatric care. We do not anticipate getting any bites, but we have to do it. We will talk to you later about the Request For Proposal (RFP) once we have the Planning and Network Advisory Committee (PNAC) recommendations. The North Texas Community Centers have combined to write the Request For Proposal (RFP) draft. Board of Trustee Meeting Minutes 5 April 2,2009 Bill Coombs It seems to me there is a less adversarial relationship between the Community MHMR Centers and the state than there was five, six, or seven years ago, and I appreciate that. Roddy Atkins It is less adversarial. The Texas Council of Community MHMR Centers is being more assertive. There is a lot of work up front with our recommendations. They see the value of what we do. 040209-8 ANNOUNCEMENTS A)Next Meeting Ken Andrews announced the next meeting is scheduled for 11 A.M., Thursday, May 07, 2009, Child and Adolescent Services, 516 Denver, Wichita Falls 040209-9 OTHER BUSINESS None 040209-10 ADJOURN The Board of Trustees' meeting adjourned at 1:25 PM. Approved as presented: Approved as corrected: May 7, 2009 Board of Trustee Meeting Minutes /� , 6 D Agri I ot, a00Ci ( qF✓`— 11164111 HELEN FARABEE 4000, REGIONAL MHMR CENTERS Wichita Falls Administrative Office P.O.Box 8266 1000 Brook Street Wichita Falls,Texas 76307-8266 Phone (940) 397-3100 Fax (940) 397-3150 May 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 April 02, 2009. These minutes were approved by the Board at its meeting held on May 07, 2009. Sincerely, Jan West Admini rative Assistant/Board Liaison /jw enclosure IRECEIVED IN CITY CLERK'S OFFICE Date By Time 157�