Thursday, February 19, 2015

The Alleghany Highlands Community Services Board held its regular meeting on February 19, 2015 at 5:30 p.m. at the Administration Office located at 205 E. Hawthorne Street in Covington, Virginia.

PRESENT: Teresa Johnson, Anne Dean, Connie Back, Robert Johnson, Jr. and Nolan Nicely, Jr. (by telephone).

ABSENT: Robert McCallister, Carla Dobbs, Lisa Hicks and Charli Laws.

Also present: Ingrid W. Barber, Executive Director; Angie Goodbar, Director of Intellectual Disabilities Services; Cara Major, HR Manager; QuoVadis Washington-Brown, Director of Outpatient and Support Services; Nancy Curry, QI Manager; Adam Kenny, IT Manager, and Amanda Webb, Public Guardianship Director.

Teresa Johnson, Chairwoman, called the meeting to order at 5:35 p.m.

APPROVAL OF MINUTES OF November 20, 2014 REGULAR MEETING
MOTION: That the Board approve the minutes of the November 20, 2014 regular meeting.
MOTION: Anne Dean
SECOND: Connie Back
VOTE: Unanimous
TIME: 5:55 p.m.

Communication: A retirement commendation was made to Linda Mack, Day Support Supervisor, after 27 years of service.

Public Guardianship Partnership Update was given by Amanda Webb, Public Guardianship Director.

PROGRAM REPORTS

Mental Health & Substance Abuse
QuoVadis Washington-Brown provided the following report:
• Outpatient Services participated in multiple audits, surveys, and trainings in the months of December 2014 and January 2015. Additional reviews of programs and treatment processes continue.
• In December 2014, Outpatient Services worked on building a waitlist for individuals seeking services and a comprehensive place to store waitlist, clinician caseloads, and caseloads for orientation groups for MH and SA.
• In January 2015, Quovadis attended VACSB, reviewed bills for legislative process, and attended the ES Council meeting. There continues to be ongoing monitoring of SB1410 which may affect the credentialing of ES Clinicians.
• Beginning January 12, 2015, Outpatient clinicians prepared for the GAP screening process to aid individuals with severe mental illness, without insurance coverage, and whose income is below $11,670. All licensed clinicians are assisting in the process of determining eligibility and contacting Cover VA to begin the insurance application process.
• January 29-30, 2015, Outpatient Staff attended Treatment Planning Training sponsored by the DBHDS in Richmond.
• January 30, 2015, Director attended the statewide Recovery Oriented Systems of Care Committee Meeting. The Committee has chosen a new name: RAFT, Recovery Action Facilitation Team. Becky Sterling, Department of Behavioral Health and Developmental Services, Office on Recovery, will lead this team. Discussion regarding peer services, peer specialist certification, developing future leaders of the recovery-oriented systems movement in Virginia.

Intellectual Disabilities
Angie Goodbar provided the following report:
• Update on Waiver Redesign – The Support Coordinators are working closely with Ascend (Support Intensity Scale Independent Interviewers) to get all SIS assessments updated. According to DBHDS, all DD Waiver individuals must have a SIS by March 2016 in order to merge the ID and DD Waivers. The three new waivers will be the independence waiver, community living waiver and the individual and family supports waiver. The independence waiver will be available for individuals that can live in their own home or have shared housing with the assistance of housing vouchers/rental subsidies. Those with DD Waiver will automatically qualify for the individual and family supports waiver. Individuals with more complex behavioral and medical needs will receive the community living waiver. Emergency regulations will be introduced throughout the year to implement the new waivers.
• Person Centered Planning – The new person centered planning forms were distributed by DBHDS in February with an April 1st implementation date. Sue Childs, Support Coordination Supervisor, and Angie Goodbar, ID Director, have been working closely with Adam Kenny, IT Director, to develop the new forms in the electronic health record. The AHCS ID providers have been oriented to the new forms. Regional training sessions will be offered in March to share information on the new person centered planning process.
• Merryfield VDH and Fire Marshall Audit (January 13-15) – The Virginia Department of Health (VDH) Survey was conducted at Merryfield Residence. The survey consisted of a review of records, observation of a medication pass, interviews with the employees and residents, and off-site observation of service delivery at two day support programs including JRE and Life Skills. The audit resulted in two minor findings that had already been identified within the program and reported to quality assurance through the internal incident reporting process. The Fire Marshall also completed an inspection of Merryfield and found no issues with physical layout or deficiencies within the sprinkler system. As a result of the fire inspection, AHCS secured an addendum to the contract with FLSA to provide all fire safety inspections and monitoring services instead of using two different companies for this service.
• Department of Medicaid Services (DMAS) Audit (January 21-29) – DMAS conducted a quality management review of five programs within the ID Department. The audit consisted of a review of records and interviews of individuals receiving services. Technical assistance was provided by the auditor.
• Health Department and Fire Marshall Audit of LSC and ADC (December and January) – The Health Department auditors visited the Adult Day Care Center of the Highlands and found everything to be in compliance with the health department regulations. The fire marshal inspected and noted compliance with fire safety regulations.
• Virginia Department of Social Services (VDSS) Audit of ADC (February 10th) – Debra Jackson, VDSS, showed up for an unannounced visit to the Adult Day Care Center of the Highlands. There were minimal findings and the issues were corrected during the on-site visit. The corrective action plan was signed and implemented prior to Debra’s departure from the program.
• CCT (Commonwealth Community Trust) Applications – The ID Support Coordinators are in the process of completing applications for funding on behalf of the individuals served. Individuals can obtain up to $1,000 in funding for such items as adaptive equipment, medical and dental services, respite services, therapeutic activities, summer camps or other needed services.
• Community Integration – The individuals served attended the AHCS Annual Christmas Party, CF, Moose Lodge Christmas Party, Shrine Circus and the Illusionary Magic Show in Roanoke. The individuals at Life Skills have a walking club, volunteer at the local SPCA, exercise at the YMCA and participate in activities at the Clifton Forge Art School.
• The ID Director attended several meetings and conferences this reporting period, including the WDAC (Waiver Redesign Advisory Committee), ID Regional Council Meeting, VACSB Conference, Safety Committee Meetings, Leadership Meetings, Coordination of Care Meetings, ID Supervisors Meetings, CMS Webinars, Guardianship Board Meeting and the Guardianship Multidisciplinary Team Meeting.
• Upcoming Event – March is ID Awareness Month and the ID Department will be promoting the Employment First Initiative. Letters are being sent out to local businesses asking them to give individuals with intellectual disabilities the opportunity to volunteer, job shadow or have paid employment opportunities throughout the month. The DSP’s in the residential program will assist the individuals with transportation to the businesses as well as helping them to perform the duties requested by each business. AHCS will publicly recognize each business that is willing to participate in this initiative.

Quality Improvement
Nancy Curry provided the following report:

UR, Compliance and EHR:
• 2014 YTD totals include 55 QI Communications processed (6 months); 298 Incident Reports processed; 13 New Hire Orientations; and 8 Safety Inspections.
• 2015 YTD totals include 10 QI Communications processed for January; 13 Incident Reports processed for January; and 0 Safety Inspections for January.
• Audits and/or surveys since the last meeting:
1/12/15 Merryfield annual Financial Audit site visit
1/14/15 Merryfield annual VA Department of Health site visit
1/21-1/29/15 DMAS qualitative audit site visit (ID CM, In-Home, Rehab, Friendship)
1/23/15 Merryfield Fire Marshall site visit
1/31/15 DBHDS, I/DD Waiver Provider Home and Community Based Setting
Self-Assessment Survey
2/10/15 DSS Annual Audit of Adult Day Care

Credentialing:
• 2015 YTD figures include (for January): 9 AHCS licensed staff; 12 Insurance Panels; and 83% of Staff Credentialed.
• Currently credentialing two new staff members. The remaining seven staff are credentialed on all available panels.

Staff Development:
• 2014 YTD average: 150 staff per month; 89% compliance for annual training per month
• 2015 YTD (for January): 151 staff; 95% compliance for annual training
• 1 8-hour Medications class was given; 1 TOVA class was given; and 1 New Hire Orientation was given

Other:
Several projects are in process, including QI Plan-Performance Contract, Annual P&P Review, Client Satisfaction Survey, Core Services/PC/Budget Alignment.

Attended Safety Meetings, LHRC meeting, and VACSB QM Meeting in January.

IT Manager Report:
Adam Kenny provided the following report:

Help Desk:
• Completed 98 help desk requests.
• Completed 180 Credible change requests.

EHR:
• Completed form changes for MH Case Management.
• Updated CCS data elements form.
• Completed portion of ID form updates.
• Created proposed list of team changes.
• Set up insurance and billing matrix for GP.

Hardware and Networking:
• Set up new laptop for Friendship Residence.
• Set up Windows 2012 server for timetrak.
• Set up Chromebooks for In-Home and Merryfield.
• Re-provisioned 7 laptops.
• Added memory to computer in Friendship.
• Worked on wiring for Life Skills downstairs room.

Other:
• Completed FIPS data.
• Updated mileage forms.
• Completed ES phone line changes.
• Attended VA Credible User Group Meeting.
• Attended DMC meetings.
• Completed fax service provider change at Merryfield and Friendship.
• Met with Lumos about fiber opportunities.
• Set up and configured J drive folders for ES.
• Attended beginner, intermediate, and advanced Excel classes.
• Met with Nancy to discuss J drive folder organization.
• Assisted with audits.

Human Resources
Cara Major reported the following:

Turnover:
• For Fiscal Year 2015, there were 22 New Hires and 27 Terminations with a turnover rate of 18%.

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

Advertising/Recruitment:
• Advertising was done through websites: VEC, Shentel, Monster, Indeed, Careerbuilder, Chamber of Commerce; and through newspapers: Virginian Review, Staunton, Lexington, Lewisburg and Roanoke.

Filled Positions:
• Intellectual Disabilities – DSP (In Home – 3, Friendship – 1, Merryfield- 3)
Office Cleaner
Life Skills Day Support Supervisor
Life Skills Day Support Team Leader
• Mental Health – Clubhouse Supervisor
Intake/Emergency Services Clinician
Emergency Services Clinician
In School Prevention Specialist
MH/SA Therapist – 2
Psychiatric Services Case Manager
• Administration – Reimbursement Manager
Office Cleaner

Open Positions:
• Intellectual Disabilities – Direct Support Professional (In-Home, 2, Friendship, 1)
• Mental Health – Emergency Services Clinician (Part-Time)
Outpatient Services Supervisor
Clubhouse Program Psychosocial Technician
Intensive Case Manager (Full Time)
MH/SA Therapist
Director of Outpatient Services

General Updates:
• Updated Benefits Booklet being printed by BB&T
• Timetrak
• Centralized Supply Ordering
• 2014 Benefits Statements in progress
• Met with DSLCC regarding need for Human Services degree
• Audits – ICF and Medicaid
• Annual Report almost ready for print
• AHCS Relay for Life Team
• Employee Appreciation – March 5

Participation:
• Attended Dec. 1 & Jan. 26 – VACSB Innovation and Best Practices Workgroup Conference Call
• Jan. 20-21 VACSB Conference including HR Committee Meeting
Upcoming:
• March 8-11 VA SHRM Conference

Financial Reports
• Ingrid gave a report on the Financial Statement Summary YTD December 31, 2014 submitted by Ann C. Bostic, CFO.

EXECUTIVE DIRECTOR’S REPORT AND RECOMMENDATIONS
• Alleghany Highlands Chamber Annual Dinner Meeting is scheduled for March 7, 2015, at The Greenbrier. The list of AHCS attendees and their guests needs to be finalized.

Ingrid Barber provided the following report:
Old Business:
• DBHDS Audit Final Update – information provided to board members by Ingrid Barber.
• ICF Financial Audit Update and Clinical Audit Update – information provided to board members by Ingrid Barber.

MOTION: That the Board approve the Amendments and Updates to By-Laws.
MOTION: Robert Johnson, Jr.
SECOND: Anne Dean
VOTE: Unanimous
TIME: 6:35 p.m.

New Business:
• Governor’s Proposed Budget Amendments FY 2014-2016 Bienniel Budget – Ingrid provided board members with a snapshot summarizing the provisions. She emphasized that although there is no new funding for CSBs, there are no plans to cut any of the CSBs.
• Discharge Assistance Plans, Extraordinary Barriers List, State Hospitals Census Update, and Waiting List for Waiver Services – Ingrid provided board members with a snapshot and summary.
• Local Funding Request 2014 – Ingrid is planning to meet with John Strutner (Alleghany County) and J.B. Broughman (City of Covington) regarding a request for additional funding.
• VACSB Budget Update-Public Hearing/Legislative Priorities – Ingrid provided information for 2015 and 2016 regarding what AHCS is advocating for.

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: Anne Dean
SECOND: Connie Back
VOTE: Unanimous
TIME: 6:45 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.

ADJOURNMENT
MOTION: That the February 19, 2015 regular meeting of the Alleghany Highlands Community Services Board be adjourned.
MOTION: Robert Johnson, Jr.
SECOND: Connie Black
VOTE: UNANIMOUS
TIME: 7:25 p.m.

NEXT MEETING
The next scheduled Board Meeting will be on Thursday, March 19, 2015 at 5:30 p.m. at the Administration Office located at 205 E. Hawthorne Street, Covington, VA.