MINUTES

REGULAR MEETING OF THE ALLEGHANY HIGHLANDS COMMUNITY SERVICES BOARD
Thursday, July 21, 2016

The Alleghany Highlands Community Services Board held the May board meeting on July 21, 2016 at 4:00 p.m. at the Administration Building, located at 205 E. Hawthorne Street in Covington, Virginia.

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

ABSENT: Robin Mieras

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, and Felicia Prescott, Director of Outpatient and Support Services.

Anne Dean called the meeting to order at 4:11 p.m.

APPROVAL OF MINUTES OF June 16, 2016 REGULAR MEETING
MOTION: That the Board approve the minutes of the June 16, 2016 regular meeting.
MOTION: Bob McCallister
SECOND: Lisa Hicks
VOTE: Unanimous
TIME: 4:16 p.m.

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

Prevention Services: Gail Taylor, Director of Prevention Services, and Colleen Hughes of the Department of Behavioral Health, did a site visit on May 16, 2016. The Department representatives shared the new direction Prevention Services will be taking for FY17. This visit led to a review of the current AHCS service delivery model and planning between the Children’s Services/Prevention Supervisor (Debbie Burns) and Department Director (Felicia Prescott) for FY17 changes. In order to meet the state requirements, AHCS will be hiring a full-time prevention coordinator. The Department awarded AHCS additional prevention funding to accommodate this need.

On June 13-15, both Debbie and I attended the Prevention Summit 2016 in Staunton and received technical training on the Needs Assessment, Community Readiness Survey, Environmental Strategies, and the Virginia Retailer Assessment Module. The Children’s Services/Prevention Supervisor also took 3 students to Richmond on June 27 and 28 for Lead and Seed training. The three youth: Chase Woodard from AHS, Aliyah Hairston from CHS and Olivia Portillo from CHS were selected in preparation for becoming a part of a developing community coalition to address a local public health problem. They will also serve as youth community leaders to help facilitate community-level change primarily at the student level. We also hope that the Lead and Seed training will positively influence the students who attended with growth in social, emotional, educational and civic development areas. Five other youth from both Covington and Alleghany middle school will participate as a part of the youth coalition.
Jail Services Pilot Project: Three four week group therapy sessions were completed in June 2016. The pilot project will be suspended until funding is sought to continue it in FY17. Exploration of a Virginia Department of Criminal Justice Services grant is underway.

Cross System Collaboration: Addressing Maternal Substance Use workshop was an opportunity to participate with community stakeholders to learn more about maternal substance use and how to address the needs of substance exposed infants. AHCS was asked by the Department of Behavioral Health Substance Use Disorders department to gather partners for attendance on June 22 in Charlottesville. Our group included Sally Putnam representing Lewis Gale Hospital Alleghany, Suzanne Adcock representing Department of Social Services (DSS), Staci Craft and Teresa Byer representing the Covington Health Department, Ingrid Barber and myself. The group was given an assignment to determine how to get reports to DSS from the multiple out of county birthing hospitals, and in turn have those individuals referred to AHCS for treatment services. A marketing campaign was discussed among the group, and first step is the development of a draft flyer for circulation in the community. DSS is the lead agency on this project. I will share more as things develop.

Crisis Intervention Team: The end of year report was submitted to the Department of Behavioral Health reflecting the status of this project utilizing the grant awarded funds. The AHCS Board of Directors is invited to attend presentations related to CIT and the potential assessment center to the Alleghany County Board of Supervisors on August 2 and the Covington City Council on August 9.

New Beginnings Transitional Housing was awarded $186,828 to operate New Beginnings in FY17 for the provision of a residential setting to assist in the discharge of state hospital inpatients from region 1. The home is staffed and has been most recently serving those on 48 hour passes from Western State Hospital. The New Beginnings Supervisor for Community Supports and New Beginnings, Christina O’Keefe, and the MH/SUD Department Director, Felicia Prescott, presented the New Beginnings program to Catawba Hospital on June 27 for potential utilization by any region 1 individuals they are serving.

Trainings: Nurse Manager, Edie Fix, attended the Virginia Association of Community Psychiatric Nurses conference (VACPN) on May 5-6.

Save the Date: July 22, 2016 the agency will host Kevin Hines, a nationally known speaker regarding his failed suicide attempt when he jumped from the Golden Gate Bridge. Location: Clifton Middle School auditorium at 10:00 a.m.

Intellectual Disabilities
Angie Goodbar provided the following report:
• Waiver Redesign Updates: Intellectual Disability Services is now referred to as Developmental Services. In the past, AHCS served only individuals with intellectual disabilities (ID). Starting July 1st, AHCS became a provider for individuals with developmental disabilities (DD). Two of the private providers serving individuals with DD in the area have opted out of providing case management services. AHCS has received referrals from these two entities while also managing the DD waitlist consisting of twelve individuals. The case managers are reaching out to others in the community that are in need of case management services. All other aspects of waiver redesign was put on hold and will potentially go into effect starting 8/1/16 if approved by Centers for Medicaid/Medicare.

AHCS established a planning committee consisting of the DS Director, Quality Assurance, Billing and Information Technology to implement all the needed changes to prepare for waiver redesign. The billing office adjusted all billing codes and rates to reflect the new services being provided and the new billing rates. Information Technology developed new forms in the electronic health record including priority checklist, VIDES and program teams and forms for DD case management and the new community based day support program.

The DS Director wrote policies, procedures and position descriptions for the new community based day support service. This service will promote opportunities for individuals with I/DD to integrate into the community with non-disabled individuals and build natural supports. Pam DeBose, Licensure Specialist, met with the DS Director and Quality Assurance Manager on June 22nd to review all policies and position descriptions. Pam issued the license for the new program effective July 1st. The positions were advertised and Jenny Blythe was hired as the Community Based Day Support Coordinator.

• The support coordinators attended numerous trainings to stay abreast of upcoming changes. All three support coordinators have been trained and are considered waiver experts for our community. A new electronic authorization process called WaMS will be implemented in the next couple months. Sue Childs, Support Coordination Supervisor, attended WaMS training and will be responsible for training all support coordinators and agency providers.
• Delmarva conducted a case management audit on one individual receiving services. The audit consisted of an interview with the individual and family receiving services as well as a chart review. The auditor was complimentary of services delivered.
• The DS Director coordinated an Autism Training with Dr. Jill Hamlin, Occupational Therapist. The training was held at Dabney S. Lancaster Community College on May 26th. There were 35 employees from the agency in attendance.
• AHCS Developmental Services has moved out of Region III and into Region I per the department’s request to realign the regions in the state. The Executive Director and DS Director met with Region I Adult and Children’s REACH Program representatives in order to discuss procedures for supporting individuals in crisis situations and build partnerships with regional members.
• Grants: AHCS received notice from KOVAR that the grant application for $20,000 was approved for the remodel of the kitchen at Friendship Residence. The construction will be completed by December 2016.
• Partnerships: The DS Director and Residential In-Home Supervisor met with Angela Rice, CPMT Coordinator at the Department of Social Services (DSS) to discuss waiver redesign and the availability of services for individuals with I/DD. Angela discussed concern for individuals that will be aging out of residential programs and will be in need of services in the community. Discharge planning will be a joint effort between DSS and AHCS.
• The DS Director, ICF Manager and Financial Department met with all entities that contract services for the ICF to conduct performance evaluations and renew agreements/contracts. The ICF established one new contract with Lexington Prescription Care as the new pharmacist due to Owen’s pharmacy closing.
• The Employment First Committee hosted an “Employer Appreciation Breakfast” on June 8th at the Alleghany County School Board Office. The goal of the breakfast was to recognize local businesses that have supported TEACH and Career Support with their mission to help individuals with developmental disabilities to acquire employment. AHCS facilitates the Employment First Committee and works in collaboration with other entities in the community with the same mission to employ individuals with intellectual and developmental disabilities. The businesses recognized during the event include Walmart, Magnuson Hotel, Food Lion, Taco Bell, Fudge Street Café, Dabney S. Lancaster Community College, YMCA Early Learning Center, LewisGale Hospital Alleghany, CVS, and Clifton Forge Public Library.
• The DS Director attended the State DS Council Meeting in Henrico, chaired the Regional DS Council Meeting in Radford, attended the Support Coordination Roundtable Meeting in Radford and participated in the monthly regional REACH conference calls. The DS Director attended the Public Guardianship Board Meeting and participated in the multidisciplinary team meetings for the guardianship program.

Quality Improvement
Nancy Curry provided the following report:

UR, Compliance and EHR:
• There were 24 Incident Reports processed during the month of May. There was one safety inspection in May.
• There were 16 Incident Reports processed during the month of June. There was one safety inspection in June.
• Surveys in process or completed: Disaster Behavioral Health Survey, Request for Information Regarding Suboxone, and Collect data for Genoa.

Staff Development: This report is completed around the 10th of each month.
• May 2016: 143 staff with 90% compliance for annual training (7 courses).
• June 2016: 140 staff with 91% compliance for annual training (7 courses).
• No 32-Hour Medications Classes were administered in May. One 32-Hour Medications Class was administered in June.
• One 4 Hour Med Overview Course was administered in May.
• New Hire Orientations were conducted in May and June.
• TOVA classes were administered in May and June (2 per month).
• A Mental Health First Aid class was administered in June.

Projects completed or currently in process:
Incident Reporting, HIM, Annual P&P Review, New Beginnings Startup, HR Evaluation in Relias, DD Changes, Active Shooter Training.

• QI and IT provided training on new incident reporting process. Thanks to Merryfield staff who piloted the process.

Other:
Attended VACSB QL Meeting in June.

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

Help Desk:
• Completed 99 help desk requests.
• Completed 110 Credible change requests.

EHR:
• Assisted with form changes in DD and MH.
• Completed infant and child VIDES.
• Completed the DD/ID/DS form and team structure changes in Credible.
• Implemented new CCS changes.

Hardware and Networking:
• Set up meeting for rural health telecom with Jock.
• Completed setup of new server infrastructure for GP.
• Wired new offices at MH for phones.
• Worked with BB&T telecommunications to configure new MH offices.
• Met with Charles Hammond from Ricoh to discuss printer needs.

Other:
• Attended monthly DMC meeting
• Attended reimbursement meetings
• Attended meetings regarding DD changes
• Attended weekly meetings with Nancy
• Participated in new hire orientation
• Submitted monthly CCS data
• Set Recovery Run date of October 9th at 3 PM
• Had a great vacation off the grid!

Human Resources
Cara Major reported the following:

Turnover:
• For Fiscal Year 2016, there have been 45 New Hires and 41 Terminations.
• For FY17 (to date), there have been 6 New Hires.
Loss Report:
• There were 4 Worker’s Comp Claims, no auto claims and one property claim.
Advertising/Recruitment:
• Advertising was done through websites: VEC, Indeed, Craigslist, Facebook, and Shentel, and through newspapers: Virginian Review, Lewisburg, The Recorder, Roanoke Times, Lynchburg.
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:
• Admin – Human Resources Manager, Office Cleaner
• Intellectual Disabilities –Infant Toddler Coordinator, Direct Support Professional (In Home, Friendship), C.N.A., and Community Based Day Support Professional.
• Mental Health – Outpatient Clinician, Case Manager, Case Manager Supervisor and New Beginnings Technician.

General Updates:
• Employee Breakfast June 2
• Monitoring FLSA Exempt status changes
• Open Enrollment Meetings July/August
• Recruiting and Hiring Training for Supervisors
• Completed Salaried Evaluations
• Aflac Open Enrollment completed
• Interviews
• DSLCC Meeting exploring possibilities to work together

Participation:
• Attended BB&T Webinars
• DOL Overtime Webinar
• Employment First Breakfast
• May 26-VRS Roundtable
• VRS Service Buyback Meeting

Financial Reports
• A financial report was provided by Jock Wedlowe. He explained the revenues and expenses for the month of May.

EXECUTIVE DIRECTOR’S REPORT AND RECOMMENDATIONS

Ingrid Barber provided the following report:
OLD BUSINESS:
1. Alleghany Foundation Grant/Moody Building Update – Ingrid submitted a request to the Foundation to allow us to use the remaining funds left in the grant for the asbestos abatement and for additional flooring. They responded by stating they do not have the additional funds as of now but they repurposed the grant for us to do the asbestos abatement with the condition that we abate the entire building (second and third floors). Ingrid spoke to Dina McDeel, owner of Prime, and told her about our situation. She agreed to work with us and do the abatement for the whole building for $25,000 which is mostly the remaining amount in the grant. The difference would be viewed as a donation to AHCS and Ingrid said we would put her name on the Recovery Run shirts as a donor. The abatement is being planned for the last week of September. AHCS would still need to pay for the flooring and possibly preserve the carpet if possible. Angie has also reached out to another source for grant funding to pay for some of the flooring.
2. Presentation of FY 17 Performance Contract/CIT Update – Jock and Ingrid will attend the Alleghany County Board of Supervisors meeting on August 2 and the Covington City Council meeting on August 9 to present the Performance Contract for approval by the local governing bodies. At those meetings they will also provide a CIT presentation. We are also looking at the possibility of getting an assessment site here locally. Felicia has been working with Doug and Jonathon to make sure they have an updated power point presentation for those meetings in August. Today Ingrid and Felicia met with jail personnel to talk about jail services. Probation and Parole was also here from Roanoke and stated that they are serving 150 people in our community under their program with 50%-60% percent of those people having an S/A problem. They are very supportive of us trying to expand services within the jail and are willing to come to a Board of Supervisors or City Council meeting with Ingrid to discuss funding and jail services. Jail personnel are also willing to attend a meeting.

NEW BUSINESS:

1. New grant opportunity – Angie, Adam, Jock, and Jennifer Jarvis have been working on a grant application in hopes of obtaining some additional items, including mi-fi’s, computer equipment, 35 chromebooks, mini-laptops, storage cases, 8 window air conditioner units for the Moody building, and laptops for Mental Health clinicians. $13,750 would come from the grant and our responsibility would be $11,250. As part of the application process, a resolution needs to be signed by Anne and the secretary of the board.
MOTION: That the Board approve the resolution for the new grant.
MOTION: Lisa Hicks
SECOND: Robert McCallister
VOTE: Unanimous

2. Community Foundation of Rockbridge, Alleghany and Bath grant – Angie researched and applied for this grant whereby we can apply for up to $2,500. The Board needs to state whether or not they approve of this grant opportunity. The grant is due August 1st.
MOTION: That the Board approve the grant application.
MOTION: Teresa Johnson
SECOND: Lisa Hicks
VOTE: Unanimous

3. Audit with Robinson, Farmer and Cox Associates – An audit is scheduled for September 8 and 9, 2016. An engagement letter needs to be signed by Ingrid and Anne Dean. The letter explains the audit process, what they will be looking at, what kind of reports will be produced, internal controls, management responsibilities, fees, etc. Their fee will be $12,300.

Mary Earhart, CPA, will be helping us with the year- end closure of our financial books to make sure we are in compliance. Her fee is roughly around $7,000. She will be here prior to the audit which is due to be completed in November.

4. Pharmacy update – Genoa Full-Service, on-site pharmacies – Nancy and Adam have completed their report as to how many medications are being used on Mental Health and ID sides in order to make a determination to see if we have enough of a census to part a pharmacy in the clinic or in the Burke building. AHCS would like to get a pharmacy in the clinic. Genoa would do all of the infrastructure and hire the staff.

5. Health Insurance Update – There was an overall increase of 15.9% (14.06 % for the top two plans and 25.1% for the H.S.A. plan). The increases were due to changes in the Affordable Healthcare Act and a high number of sick employees/family members. Ingrid stated that Local Choice was an option but was too expensive and not cost effective. It would also require at least 75% participation which was not guaranteed. It was decided to offer a Keycare plan, Lumenos and a new Elements Choice plan.

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: Robert Johnson, Jr.
SECOND: Nolan Nicely, Jr.
VOTE: Unanimous
TIME: 5:15 p.m.

Reconvene Regular Session:
MOTION: Nolan Nicely, Jr.
SECOND: Bob McCallister
VOTE: Unanimous
TIME: 5:45 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 July 21, 2016 regular meeting of the Alleghany Highlands Community Services Board be adjourned.
MOTION: Bob McCallister
SECOND: Lisa Hicks
VOTE: UNANIMOUS
TIME: 5:48 p.m.

NEXT MEETING: The next scheduled Board Meeting will be on Thursday, September 15, 2016 at 4:00 PM at the Family Life Center of First Christian Church in Covington, Virginia.