MINUTES

REGULAR MEETING OF THE ALLEGHANY HIGHLANDS COMMUNITY SERVICES BOARD
Thursday, November 17, 2016

The Alleghany Highlands Community Services Board held the November board meeting on November 17, 2016 at 5:00 p.m. at the Clifton Forge Public Library in Clifton Forge, Virginia. The Board Member Appreciation Dinner was held at the Friendship Residence, 433 Alleghany Street in Clifton Forge, at 4:00 P.M.

PRESENT: Robert McCallister, Anne Dean, Teresa Johnson, Lisa Hicks, Nolan Nicely, Jr., Connie Back and Robin Mieras.

ABSENT: Terrie Wright and Robert Johnson, Jr.

Also present: Ingrid W. Barber, Executive Director; Angie Goodbar, Director of Intellectual Disabilities Services; Adam Kenny, IT Manager, Jock Wedlowe, Controller; Nancy Curry, QI Manager, Crystal Homer, Human Resources Manager, and Felicia Prescott, Director of Outpatient and Support Services.

Anne Dean called the meeting to order.

Welcome: Deanna Cox, with Robinson, Farmer & Cox, presented the FY2016 Financial Audit

APPROVAL OF MINUTES OF September 15, 2016 REGULAR MEETING
MOTION: That the Board approve the minutes of the September 15, 2016 regular meeting.
MOTION: Robin Mieras
SECOND: Lisa Hicks
VOTE: Unanimous

PROGRAM REPORTS
Mental Health & Substance Abuse
Felicia Prescott submitted the following report:

Case Management Services: The recruitment for case managers continues. New Hire, Kenny Harman, joined the team. Tiffany Reynolds moved into the Case Management Team Lead position, as an on the job training point to transition into the case manager supervisor role by February 2016. Congratulations Tiffany!

Outpatient Psychiatric Services: Recruitment for a “permanent” part time psychiatrist is still ongoing. The good news is that tele psychiatry has begun. As with any effort to modernize services, startup requires lots of people working together. Tele psychiatry is a best practice, especially in rural areas. It gives the agency options that it has never had before. Recruitment for top quality psychiatrist throughout the state is possible via telemedicine. Thanks to Adam Kenny for setting up the equipment and testing it with Dr. Rosse, as well as the billing set up. Thanks to Edie Fix and Dr. Pandit for working with me to establish his schedule. Thanks to Nancy for assuming the credentialing role. Special thanks to Cheryl Davis for scheduling clients and cancelling and scheduling! I am grateful for the practice of patience that I am learning. I have spent hours of talk time maneuvering, negotiating, and coordinating this effort with so many moving parts. This is still a work in progress.
VACSB Updates: This Director attended VACSB public policy conference in October.

The Substance Use Disorder (SUD) services will be revamped effective April 1, 2016. This will include service delivery redefinition of hours, and reimbursement. Addiction and Recovery Treatment Services (ARTS) is the project name. I attended the introductory training on A.R.T.S as well as ASAM training at VACSB. The Outpatient Supervisor, Andrea Dilley-Frame, also attended ASAM training. All case management and outpatient staff will be scheduled for a two day ASAM training provided by DBHDS in January 2017.

AHCS will continue Intensive Outpatient services, but need to expand the hours of delivery to 9 per week. The provision of services will require increased education and certification of staff. Case managers with a Bachelor’s degree (including 10 core components), a combination of 620 clock hours and hours of supervision, can apply to become Certified Substance Abuse Counselors (CSAC). CSAC or LMHP are among the minimum requirements to provide the new SUD services. Medication Assisted Treatment (MAT) is a new service delivery option that AHCS will pursue. The use of Suboxone for OPIOD treatment is one primary element of MAT. It involves quite an extensive startup, and more details will follow.

Managed Long Term Care and Supports has been renamed Common Wealth Coordination of Care Plus (CCC P). It involves contracting with managed care companies for enhanced care coordination and case management services. AHCS staff will have to become well versed in the service and additional staff will be needed for case management/care coordination. Individuals meeting unique criteria including disabled persons will be placed into a managed care plan through CCC Plus.

Prevention Services: The agency is excited to announce that we have hired a Prevention Coordinator. Jeffrey Robison started employment on 9/12/16 and the agency sent him to the National Prevention Network Conference (NPN) in Buffalo, New York on the same day. The conference was held from 9/13/16 thru 9/15/16 and the title was “Advancing a Prevention Agenda in an era of Health System Reform”.

Prevention Services participated in the annual Suicide Prevention week at Dabney S. Lancaster Community College on 9/26/16, 9/29/16 and 9/30/16. Staff members provided students with four different presentations about suicide signs and symptoms and substance use signs and symptoms. In addition, we completed the community readiness surveys with the groups at the end of the presentations. We had a total of four groups and served the following numbers: 9/26/16 1st group – 10 students; 2nd group – 17 students; 9/30/16 – 28 students; 9/30/16 – 7 students.

Local schools throughout Alleghany County celebrated Red Ribbon Week (RRW) from October 23-31. Although schools had their own activities, several activities were spearheaded by AHCS. All stood unified in the goal of bringing awareness of substance abuse to their community and to express the need to be drug-free.

Adult Outpatient Services: Federal Probation/Parole services conducted their semi-annual audit. AHCS received a satisfactory score. Federal Probation and Parole is a referral source with whom the agency has a one year renewable contract. FPP pays at 100% plus for service delivery.

Trainings: Adult CM staff, Linda Southall and Evan Nicely, attended one day training regarding suicide awareness hosted by Region 1. Andrea Dilley-Frame, Debbie Burns, Natasha Caravati, Jada Callender and I attended the HPR 3 training series on emotional regulation and the Hero’s Journey.
Developmental Services
Angie Goodbar provided the following report:

• Waiver Redesign Updates: The Support Coordinators and waiver providers are working diligently to learn the new Waiver Authorization Management System (WAMS) as DBHDS works out all the bugs in the system. DBHDS has scheduled additional online trainings to provide guidance to the users of WAMS.

• Developmental Services developed a project plan to implement the new competencies required for all employees serving individuals with intellectual and developmental disabilities. Jennifer Jarvis, Residential In-Home Supervisor, has taken the lead to conduct several four hour trainings for direct support professionals on the new Orientation Workbook developed by the state. All existing employees must have the revised training by February 1st. New employees will receive the training upon hire. There are three other competency documents that the supervisors must review with each employee 1:1. The employee verifies the training in a specific area and demonstrates competency in ability to provide the service as trained.

• AHCS published a Request for Proposals (RFP) for Developmental Services Case Management. Mom’s in Motion responded to the RFP and agreed to the terms of the RFP. A contract and Business Associates Agreement was signed with an effective date of November 1st. Marcie Adkins is the support coordinator with Mom’s in Motion that serves this catchment area. The contract with Mom’s in Motion will allow families and individuals in the community choice of providers and will offer additional firewalls for conflict free case management services.

• Employee Appreciation: October 9-15 was National Case Management Appreciation Week. AHCS hosted a paint party at the Historic Masonic Theater Ballroom for the MH Case Managers and DS Support Coordinators. Lunch was provided. Everyone seemed to enjoy the event.

• Grants: Remodeling of the flooring on the second and third floors of the Moody Building has begun. All of the tile has been removed on the third floor. Removal of the tile on the second floor will begin November 16th. All of the programs housed in the Moody Building will be moved to the Life House on 600 Granville Avenue in Clifton Forge from November 16-December 12. Letters of notification were sent out to the participants, families and guardians. A notice of modification was also submitted to Pam Debose, DBHDS Licensure Specialist, for approval.

• Partnerships/Community Events: The participants of Life Skills Day Support program made tie dyed t-shirts, table coasters and scarves to sell at the Fall Foliage Festival on October 14th. Employees of the CSB also donated baked goods to sell. The individuals made over $300 to put back into their budget for community engagement opportunities. The event was successful in that the individuals made the products and gained self confidence in being able to sell their items. They were proud of their accomplishments and received a great deal of positive feedback during the event.

• The DS Director attended the State DS Council meeting in Henrico, the Regional ID Council and REACH Advisory meetings in Charlottesville and the Support Coordination Roundtable meeting in Charlottesville. The DS Director attended the Public Guardianship Board Meeting and participated in the multidisciplinary team meetings for the guardianship program. The Director attended the HPRIII Conference on Autism in Roanoke and the VACSB Conference in Charlottesville.

• Upcoming Events: Christmas Dinner for individuals served on December 9th at 6:00 PM at First Christian Church Fellowship Hall in Covington; Open House – Friendship Group Home November 17th.

Quality Improvement
Nancy Curry provided the following report:

UR, Compliance and EHR:
• There were 21 Incident Reports processed during the month of September. There was one safety inspection in September.
• There were 13 Incident Reports processed during the month of October. There was one safety inspection in October.
• Surveys in process or completed: ARTS InTotal Health Survey

Staff Development: This report is completed around the 10th of each month.
• September 2016: 143 staff with 82% compliance for annual training (7 courses).
• October 2016: 142 staff with 85% compliance for annual training (7 courses).
• No 32-Hour Medications Classes were administered in September or October. One 32-Hour Medications Class was administered in November.
• One 4 Hour Med Overview Course was administered in September. No 4 Hour Med Overview Courses were administered in October or November.
• New Hire Orientations were conducted in September, October and November.
• TOVA classes were administered in September, October and November.
• No Mental Health First Aid class were administered in September, October or November.

Projects completed or currently in process:
DD Training Modules and CCC Plus

Other:
Attended Safety meeting in November.
Attended LHRC meeting in November.
Attended VACSB QL meeting in October.
Attended VA Credible Users meeting in November.
Attended Regional Nursing meetings in October and November.

IT Manager Report:
Adam Kenny provided the following report:
Duties performed or in progress since September 2016:

Help Desk:
• Completed 152 help desk requests.
• Completed 108 Credible change requests.

EHR:
• Assisted with form changes in DD and MH.
• Set up new TDT program for Turning Point.
• Set up billing for telepsychiatry.

Hardware and Networking:
• Set up telepsychiatry at the jail and clinic with Dr. Rosse.
• Met with Charles Hammond from Ricoh to discuss printer needs.
• Set up new chromebooks for DD-Community Based staff.
• Started research on new provisioning platform.
• Started to plan move of J drive from old server to new server.
• Upgraded backup applications for our servers.

Other:
• Attended monthly DMC meeting
• Attended all supervisors meeting
• Attended ID picnic
• Attended Rural Health Funding Summit
• Held 3rd Annual Recovery Run
• Had lunch with Greenbrier Technology
• Assisted with CSB promo video
• Met with Terri Tuck about Billing priorities
• Attended CCC+ training
• Attended Open Mind Technology conference
• Attended weekly meetings with Nancy
• Participated in new hire orientation
• Submitted monthly CCS data
• Attended Credible User Group Meeting

Human Resources
Crystal Homer reported the following:

Turnover:
• For FY16, there were 41 terminations. For FY17, there have been 22 terminations.
• Overall agency turnover rate for FY17 is 15%. Mental Health turnover rate 18%. Intellectual Disabilities turnover rate 14%. Administrative turnover rate 20%.

Loss Report:
• There were 2 Worker’s Comp Claims, 1 auto claim and no property claims.

Filled Positions:
• Intellectual Disabilities – DSP-In Home (1), C.N.A. (2), Recreation Specialist, Community Day Support Coordinator, Day Support Professional (2) and Van Driver.
• Mental Health – Case Manager, New Beginnings Technician, R.N., Child and Family Therapist and Child Case Manager.

Open Positions as of 10/31/16:
• Intellectual Disabilities –Community Based Day Support- Direct Support Professional; Friendship Residence Supervisor; Support Coordinator; Friendship Residence – Direct Support Professional; Merryfield Residence – CNA/Direct Support Professional; Behavioral Navigator- Licensed Eligible/Licensed; On-Call Navigator – Licensed Eligible/Licensed.
• Mental Health – Therapeutic Day Treatment Site Supervisor; Assessment Administrative Assistant; Outpatient Clinician; Psychiatrist; New Beginnings Residential Technician; Community Supports and Emergency Services Supervisor – Licensed; Case Manager; Psychiatric Nurse; Mental Health Intensive Services Clinician – LMHP-E.

General Updates:
• Revised the Hourly Employee Evaluation to be more skills based and focused on job duties
• Monitoring FLSA Exempt status changes
• Creating stronger social media and services awareness
• Created a presentation for Education about the CSB
• Visiting other CSB’s for bench marking
• Working on the establishment of position classification/compensation

Financial Reports
• Financial reports were submitted by Jock Wedlowe.
EXECUTIVE DIRECTOR’S REPORT AND RECOMMENDATIONS
Ingrid Barber provided the following report:
OLD BUSINESS:
1. Alleghany Foundation Grant Update – included in ID report
2. CIT Grant Update – The CIT Coordinator is planning a meeting of the leaders of the local law enforcement entities on November 15, 2016 at 12:00 noon to discuss the memorandums of understanding, potential location of assessment site, security, and transportation of individuals. Plans are still underway to provide training locally to officers. An initiative has been started to make training sustainable locally.
3. Jail Services Update – Felicia Prescott and Ingrid Barber quickly applied for a grant with Dominion Foundation in the amount of $48,750.22 for behavioral health services for our local jail.
4. DBHDS Update on the Extraordinary Barriers List, DAP plans, State Hospital Census, and Waiting List for Waiver Services – As of November 8, 2016, there are no one-time DAP plans (totaling $0) and one on-going DAP plan totaling $78,000.00. There are 2 on extraordinary barriers list at Catawba (working on placement) and 2 on extraordinary barriers list at Western State (working on placement). There are 5 individuals at Catawba State Hospital, 8 individuals at Western State, and 1 individual at Hiram Davis Medical Facility (discharged from Central State). Currently, 18 individuals are priority 3, 5 individuals are priority 2 and 1 individual has an unknown priority.

NEW BUSINESS:
1. Acceptance of FY 2016 Audit – 990 still needs to be completed and sent to DBHDS
MOTION: That the Board accept the FY 2016 Audit.
MOTION: Teresa Johnson
SECOND: Nolan Nicely, Jr.
VOTE: Unanimous

2. FY 2016 FIPS report –report was provided to the board

3. Calendar of Board Meeting dates for 2017 – list of 2017 board meetings, committee meetings and executive director’s breakfast meetings was provided to the board.

4. By-laws of Alleghany Highlands Community Services Board – By-laws are to be reviewed and any changes or recommendations will be approved at the March 2017 board meeting.

5. Nominating/Personnel Committee Report on Appointment of 2017 Officers – Lisa Hicks stated that the Nominating Committee will be comprised of Nolan Nicely, Jr., Robin Mieras and Lisa Hicks. She emailed the selected 2017 slate of officers to the board. The officers for FY 2017 include Anne Dean as Chairwoman, Lisa Hicks as Vice-Chair and Connie Back as Secretary.
MOTION: That the Board approve the slate of officers for 2017 as recommended by the Nominating Committee.
MOTION: Nolan Nicely, Jr.
SECOND: Bob McCallister
VOTE: Unanimous

6. Reappointment of Robin Mieras/Anne Dean for 1st term and reappointment of Nolan Nicely for 3rd term.

7. Appointment of Reverend Bill Gilliland to AHCS Board FY 2017 – He will fill the vacancy of Bob McCallister.

8. Next VACSB Conference January 17 & 18, 2017 @ Richmond Hilton Downtown Hotel, Richmond, VA

CLOSED SESSION
CODE OF VIRGINIA: PERSONNEL 2.2-3711.A.1

MOTION: That the Board enter closed session to discuss Personnel Matters, as authorized by the Code of Virginia Sections 2.2-3711A.1.
MOTION: Robin Mieras
SECOND: Connie Back
VOTE: Unanimous
TIME: 5:52 p.m.

CERTIFICATION OF EXECUTIVE SESSION
A signed roll call was taken for each member present who certified that to the best of the member’s knowledge that:
-Only public business matters lawfully exempted from opening meeting requirements by Virginia law were discussed in the closed meeting to which this certification applies; and only such public business matters as were identified in the motion convening the closed meeting were heard, discussed or considered by the Alleghany Highlands Community Services Board.

Reconvene Regular Session:
MOTION: Lisa Hicks
SECOND: Bob McCallister
VOTE: Unanimous
TIME: 7:34 p.m.

MOTION: That the Board approve the Executive Director’s evaluation
MOTION: Robin Mieras
SECOND: Nolan Nicely, Jr.
VOTE: Unanimous

MOTION: That the Board approve recommended changes to the Executive Director’s contract
MOTION: Teresa Johnson
SECOND: Robin Mieras
VOTE: Unanimous

MOTION: That the Board authorize the chairman to sign the Executive Director’s contract
MOTION: Nolan Nicely, Jr.
SECOND: Lisa Hicks
VOTE: Unanimous

ADJOURNMENT
MOTION: That the November 17, 2016 regular meeting of the Alleghany Highlands Community Services Board be adjourned.
MOTION: Lisa Hicks
SECOND: Robin Mieras
VOTE: UNANIMOUS
TIME: 7:44 p.m.

NEXT MEETING: The next scheduled Board Meeting (Board Member Training Work Session) will be on Thursday, January 19, 2017 at 4:00 PM at the Administration Office located at 205 E. Hawthorne Street in Covington, Virginia.