MINUTES

 

REGULAR MEETING OF THE ALLEGHANY HIGHLANDS COMMUNITY SERVICES BOARD

Thursday, July 20, 2017

 

The Alleghany Highlands Community Services Board held the May Board meeting on July 20, 2017 at 4:00 p.m. at the Administration Office located at 205 E. Hawthorne Street in Covington.

 

PRESENT:   Anne Dean, Robin Mieras, Terri Wright, Bill Gilliland, Teresa Johnson, Robert Johnson, Jr., Connie Back, Lisa Hicks, and Nolan Nicely, Jr.

 

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

 

Anne Dean called the meeting to order at 4:00 p.m.

 

APPROVAL OF MINUTES OF May 18, 2017 REGULAR MEETING

MOTION:  That the Board approve the minutes of the May 18, 2017 regular meeting.

MOTION:  Robin Mieras

SECOND:   Bill Gilliland

VOTE:  Unanimous

 

PROGRAM REPORTS

Mental Health & Substance Abuse

Ingrid Barber presented the following report which was submitted by Felicia Prescott:

Note: Felicia’s last day with AHCS was July 13, 2017 but will stay on as a consultant for a period of time.

Children’s Mental Health Awareness was recognized in May with a program at the YMCA from 5:30 pm to 7 pm. Rise Against Stigma campaign videos were shown. There was a question and answer period after the videos and light refreshments were served.

 

The Healthy Youth Coalition meeting was held on June 8, 2017 at the Alleghany Regional Library. The Healthy Youth Coalition now has a Facebook page, so please like the page and receive information about the work of the coalition and tips for reducing underage marijuana use. This is a community coalition and we need your support.

 

AHCS is partnering with DBHDS to apply for the Zero Suicide grant sponsored by SAMHSA. The state level grant application was a group effort. If awarded the grant AHCS will be among five CSBs to work with the DBHDS and SAMHSA on suicide reduction. The deadline for application is July 18, and the award will be announced early fall.

 

The end of May recognized the first complete month of Medication Assisted Treatment (MAT Suboxone Clinic). Dana Hiner, RN and MAT Coordinator, attended a conference in Richmond focusing on the Addiction Recovery Treatment Services program and MAT. The expansion of ART services has made a dramatically positive impact on the Intensive Outpatient Program budget in May and June. The Suboxone clinic is still in the developmental stages and is currently serving three individuals with opioid addiction. The good news is that opioid addiction is not an overwhelming issue in the Alleghany community at this time. The AHCS prevention program is a part of a regional opioid treatment coalition to assist in keeping the issue minimal in the area.

 

July 2017 indicates the beginning of fiscal year 2018. As always, several initiatives go into effect as of July 1. A new prescreening form will be used by Emergency Services, and the Columbia Suicide Severity Scale will be added as an assessment tool for individuals with major depressive disorder.

 

July 15 was my last day as the Director of Mental Health and Substance Use Disorders. I have appreciated this opportunity and learned a tremendous amount about the challenges of rural areas in meeting “urban performance standards”.

 

AHCS provides very important services to the community. Without the behavioral health services that the CSB offers, many individuals would not have any behavioral health and substance use disorder resources. Ingrid Barber is making significant efforts to transform the agency into its most productive representation of a 21^st century behavioral health organization. With that comes continued culture changes.  Accountability and quality are key. AHCS provides quality care and is now preparing for the future transition from fee for service to total health outcomes.

 

In the last 26 months Ingrid has supported my efforts in program expansion, stakeholder engagement, and staff accountability. She has also supported my self-growth and development as a leader. Thank you Ingrid!

 

I have met wonderful professionals and made relationships that I value greatly. My direct reports made things happen and I appreciate their contributions greatly. Continued success to Rhonda Adams, Andrea Dilley-Frame, Susan Chittum, Debbie Burns, Tiffany Bowser, Edie Fix, and Stephanie Hepler and everyone on their teams.

 

I look forward to working in a special projects capacity for AHCS whenever there is a need. I will stay in touch! Thank you for your support.

 

Developmental Services

Angie Goodbar provided the following report:

• As of July 1^st, Licensure will be updating AHCS licenses to replace the term “Intellectual Disability” with “Developmental Disability”. Supervisors are in the process of updating all brochures, policies and procedures and job descriptions to reflect this change.
• Jill Hamlin provided Behavior and Autism Competency Training on May 23^rd and 24^th at Dabney S. Lancaster Community College. Supervisors made accommodations in programs to ensure that all Direct Support Professionals received the training.
• Virginia Department of Health conducted an unannounced annual audit at Merryfield ICF on June 26^th and 27^th. They reviewed charts, interviewed employees, visited the day programs, monitored a meal, and medication pass. They were complimentary about the service delivery provided during the visit. There were no findings during the audit which resulted in another perfect survey!
• AHCS met with contract employees for the ICF and agency. Yearly evaluations were completed on vendors and the contracts were revised and renewed.
• Exciting things are happening at Friendship Residence! We recently welcomed two new house mates to the home on July 1^st. That weekend they enjoyed a Friends and Family Dinner where guests gathered for fun, food and fellowship. Merryfield hosted a Friends and Family Dinner on May 5^th with over forty guests in attendance.
• AHCS will be expanding transportation services to individuals with Virginia Premier. A training by Virginia Premier was conducted on June 30^th.

 

Grants:

• Developmental Services will submit a grant application to the Foundation of Rockbridge, Bath and Alleghany for living room furniture for Friendship Residence. If approved, the furniture will be purchased from Butler Woodcrafters at the cost of $5,575 and will have a ten year warranty.
• AHCS received notification from the Department of Rail and Public Transportation that the grant request for a 15 passenger bus and two 5 passenger minivans was approved. DRPT will provide funding for 80% of the cost of the vehicles. With board approval, AHCS will submit a grant application for 20% from KOVAR for the purchase of the vehicles.
• The Infant/Toddler Program will submit a grant application for a vehicle from USDA.
• The DS Director attended the State DS Council Meeting in Richmond, the Regional ID Council and REACH Advisory Meetings in Charlottesville. The DS Director attended the Public Guardianship Board Meeting and participated in the multidisciplinary team meetings for the guardianship program. The Director joined agency CCC Plus planning committee meetings.

 

 

Quality Improvement

Nancy Curry provided the following report:

(No report submitted)

 

IT Manager Report:

Adam Kenny provided the following report:

Duties performed or in progress since May 2017:

 

Help Desk:

• Completed 148 help desk requests.
• Completed 98 Credible change requests.

 

EHR:

• Assisted with form changes in DD and MH.
• Set up and pushed out new CCS changes.
• Implemented new ES Prescreen form and exports.

 

Hardware and Networking:

• Ordered computers for Admin and MH CM.
• Ordered 35 chromebooks for In-Home.
• Ordered iPads and iPhones for Infant Toddler employees.
• Implemented Ricoh streamline NX at Admin.
• Migrated file servers to Server 2012.
• Created imaging system for Windows 10 Enterprise.
• Printed and tested new proximity cards for Streamline NX.
• Met with Sonicwall reps to review new firewall devices.
• Ordered Polycom device for telepsych.

Other:

• Attended monthly DMC meeting
• Attended Relay for Life at AHS
• Attended quarterly Credible User Group Meeting
• Attended reimbursement meeting
• Assisted with zero suicide grant
• Created training material for using new Streamline NX software on the Ricoh printers
• Listened to MTM demo on DLA
• Met with Greenbriar Tech to discuss IT infrastructure changes
• Attended bi-weekly leadership meetings
• Attended CCS Plus meetings
• Submitted monthly CCS report
• Set up new Group Policies for agencies
• Submitted EOY CCS

 

Human Resources

Crystal Homer reported the following:

Loss Report:

• Worker’s Comp Claims – Fiscal Year Totals
• YTD Loss Summary 16/17: $12,767.35 paid, $15,146.64 placed in reserve
• YTD Loss Summary 15/16: $17,477.45 paid
• Type of injury 16/17: 2 punctures, 1 fracture, 1 strain, 2 contusions
• Type of injury 15/16: 3 punctures, 2 strains, 1 contusion
• Auto Claims – Fiscal Year Totals
• Auto Physical Damage 16/17 – $2,370.35 incurred
• Auto Physical Damage 15/16 – $11,002.71 incurred
• Auto Liability 16/17: $16,994.90 incurred
• Property Claims – 0

Separations:

FY 16 – 41 separations

FY 17 – 49 separations

 

Recruitment:

Open Positions as of 6/30/17:

Intellectual Disabilities –

• Support Coordinator
• Friendship Residence, In-Home and Life Skills – Direct Support Professional
• Merryfield Residence – CNA/Direct Support Professional
• Behavioral Navigator – Licensed Eligible/Licensed
• On-Call Navigator – Licensed Eligible/Licensed
• Case Manager Supervisor

 

Mental Health –

• Therapeutic Day Treatment Specialist
• Psychiatrist – ongoing recruitment
• New Beginnings Residential Technician
• Child and Family Therapist
• Mental Health – Intensive Services Clinician – LMHP-E
• Prevention Specialist
• Mental Health Director

 

General Updates:

• Continuing to create stronger social media and services awareness
• Continuing to work on performance review process, implemented new format, schedule and policy for part of the process
• Focused on benefit renewals
• Attended Employee Handbook training with Woods Rogers

 

Financial Reports

• Financial reports were submitted by Patty Flanagan

EXECUTIVE DIRECTOR’S REPORT AND RECOMMENDATIONS

Ingrid Barber provided the following report:

AGENCY ISSUES:

1. Guinan Center/Mental Health Clinic Roofing update – The roofing bid was awarded to Dan Largent Roofing Company headquartered in Harrisonburg, Virginia. The bid for replacement of a new roof was $106,889. Patty Flanagan and Ingrid Barber met with Chad Snoddy, Service Manager, on June 19, 2017 to discuss the detail of the RFP and a timeframe to begin the project. Based on their schedule, it is projected that the roof replacement will take place around the end of August to the first part of September. Materials will be scheduled to be ordered. Once the end of the year is closed, we will determine how much we plan to finance with Highlands Community Bank. It was recommended by the roofing company and the City of Covington Building Inspector that we test the roof for asbestos before beginning construction of the project. The testing was completed by James Daugherty of Roofing Consulting Services and no asbestos was present.
2. Myers and Stauffer sent a letter on May 26, 2017 regarding the finalization of the ICF Cost Settlement FY 2016. Based on their analysis of our cost report, we have received an adjustment in our favor in the amount of $26.404. (see attached letter)
3. In your packet is an update as of June 2017 regarding the Commonwealth Coordinated Care Plus Program. Also attached is a Health Plan Comparison Chart of the six participating health plans.
4. Felicia Prescott’s official last day in her position will be July 14, 2017. We have received a few applications, but I am going to wait a few months before filling the position. My plan is to contract with Felicia a few days per month in the interim especially during transition of changes in the psychiatric department and with those individuals who are currently pursuing licensure. I spent the entire day with Felicia and her supervisors on June 15, 2017 to get program updates and concerns.
5. Fiscal 2018 Budget Development/Local Funding – Letter of Notification from the Department of Behavioral Health and Developmental Services was sent on May 12, 2017. The proposed FY18 Budget Summary will be provided in your packet.
6. Locality budgets have been approved. For the FY2018 fiscal year, AHCS will receive $141,275 from Alleghany County Board of Supervisors and $54,940 from City of Covington. The increase is due to funding of psych and therapy services for the jail.
7. In your packet, you will find a copy of the State Holiday for calendar year 2017. It has come to my attention that some days were added to the State Holiday Calendar. Although by policy, AHCS does not follow State Holiday Schedule, I am proposing to adopt two ½ days as holidays on November 22 and December 22 for FY 2017 for employees.
8. Audit with Robinson, Farmer and Cox Associates – An audit is scheduled for August 28 and 29, 2017. An engagement letter will 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. We will let you know the fee as soon as we receive the engagement letter. 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 $5,000 to $8,000. She will be here July 31 and August 1, 2017.
9. Health Insurance Update – Crystal Homer and I have been working diligently on our health insurance renewal and evaluating options. This year we received a 19% increase from Anthem for the current plans we offer and other carriers declined to provide a quote to us. We have elected to offer The Local Choice. We will discuss plan options at our Board Meeting.

 

COMMUNITY ISSUES:

1. On June 23, 2017, Felicia and I met with Major Terry Cronk and Lieutenant Dan Larnerd from the Alleghany Regional Jail to renew the 2017-2018 contract for jail services. Due to the fact that the Alleghany County Board of Supervisors and Covington City Council both have supplied additional local funds in the FY 2018 budget, the jail will not have to pay for psychiatric or therapy services during the FY 2018 fiscal year.

 

STATE/REGIONAL/FEDERAL ISSUES

1. AHCSB is one of five (5) community services boards in Virginia that will work with the Department of Behavioral Health and Developmental Services on Zero Suicide Grant application. (see grant letter attached)
2. Governor Terry McAuliffe announced that Virginia has received a $9.76 million federal grant to help fight the opioid epidemic. The one-year grant comes from the Substance Abuse and Mental Health Services Administration, an agency of the U.S. Department of Health and Human Services. It will support prevention, treatment and recovery efforts in 14 Virginia communities where data indicates an emerging need. The grant will be administered by the Department of Behavioral Health and Developmental Services (DBHDS). AHCS was chosen as one of the CSB’s to receive funding from this grant. AHCS will receive $10,000 for Prevention in addition to the $103,000 which is the FY 18 Federal Block Grant Prevention funding. There are treatment and recovery dollars available also for AHCS through this grant, but the Department has not made known the allocations.

 

PUBLIC POLICY:

1. The public policy committee with the Virginia Association of Community Services Board (VACSB) is still advocating for continued support and funding with Same Day Access for the remaining CSBs and primary care screenings which was approved by the General Assembly but not funded. They also continue to advocate to increase the reimbursement rate for Medicaid Early Intervention Targeted Case Management to its data-determined adequacy.

 

OLD BUSINESS:

 

1. WestRock Grant- Angie Goodbar and Ingrid Barber applied for a grant asking for $28,000 for assistance for air conditioning for Life Skills. WestRock presented Ingrid with a check for $5,000.  Ingrid has asked Steve Bowers to do an assessment of the facility to see what he could do to replace the wall units.  It may be wise to do at least one installation and see what the total cost would be and then possibly do one or two installations per year over the next three years.
2. Guinan Center/Mental Health Clinic Roofing Updates – Patty and Ingrid met with Don Largent Roofing regarding the contract. They also met with the service manager, Chad Snoddy, regarding a plan to order supplies and materials. The Board gave Ingrid authority to apply for a loan at Highlands Community Bank up to $125,000 if needed. Before the roofing project can begin, the building inspector suggested that it be tested for asbestos.  No asbestos was found but we did have to pay for the cost of the testing.
3. Alleghany Highlands CSB 2016 Annual Report – Ingrid thanked Crystal Homer, HR Manager, for her hard work and modifications to the annual report. The annual report has already gone out to the businesses and individuals on our mailing list. A copy of the annual report was included in the board packet.
4. Finalized ICF Cost Settlement FY 2017 and update – Myers and Stauffers sent a letter on May 26, 2017 regarding finalization of the ICF cost settlement. After the financials were reviewed again and adjustments were made, it appears that AHCS will receive a portion of that cost back. This letter was included in the board packet.
5. CCC Plus Update – Commonwealth Coordinated Care Plus – Our slated time period to go through this will be November 2017 but VACSB and DMAS are still giving out a lot of information. The Leadership team has been meeting in addition to the regular leadership meetings in order to get better educated on the update. Adam is working on a letter which will go out to our consumers regarding programs, etc. to make it less confusing to the clients we serve.

NEW BUSINESS:

1. VACSB Meeting Calendar for FY 2017-2018 –The conference is coming up in October in Williamsburg. Any board members are welcome to attend; they just need to let Ingrid know in advance.  The next conferences are January 2018 in Richmond and May 2018 at the Norfolk Waterfront hotel. The October 2018 conference will be moving to Hotel Roanoke and Conference Center which will be more convenient for everyone.
2. Modification to Holiday Leave Policy/Holiday Leave Schedule – After looking at the state website and their holidays, Ingrid has suggested that AHCS offer employees two additional paid holidays that AHCS does not currently provide. She suggests added a half day on November 22^nd and a half day on December 22^nd.

MOTION:  That the Board approve modification to the Holiday Leave Policy/Holiday Leave Schedule with the addition of half days on November 22 and December 22.

MOTION: Teresa Johnson

SECOND:  Lisa Hicks

VOTE: Unanimous

3. USDA Grant Approval for the Infant/Toddler car – The Infant Toddler program is applying for a grant for a vehicle. This is a matching grant based upon our population so it will pay 55% of the grant. Per Angie Goodbar, the agency has brought in a lot of Medicaid revenue this year so we can afford to match it and fund the remaining balance of $8,800.

MOTION: That the Board approve the USDA grant for the Infant/Toddler car

MOTION: Robert Johnson, Jr.

SECOND: Robin Mieras

VOTE: Unanimous

4. Grant Approval – Community Foundation of Rockbridge, Alleghany and Bath for Furniture for Friendship Residence – We have had the furniture for 5-6 years so Angie applied for a grant in the amount of $5,575.00 to purchase new furniture which the agency will then match. The furniture will be purchased from Butler Woodcrafters which specializes in furniture designed specifically for group homes, etc. and it also comes with a 10 year warranty.

MOTION: That the Board approve the grant in the amount of $5,575.00 from the Community Foundation of Rockbridge, Alleghany, and Bath for Furniture for Friendship Residence

MOTION: Bill Gilliland

SECOND: Connie Back

VOTE:  Unanimous

5. Grant Approval – KOVAR for September 2017 submission – AHCS received a grant from the Department of Rail and Public Transportation for a bus and 2 minivans. They only pay 80% so Angie applied for a grant from KOVAR for the remaining 20%.

MOTION: That the Board approve the KOVAR grant for the September 2017 submission for vehicle purchases.

MOTION:  Robin Mieras

SECOND:  Lisa Hicks

VOTE:  Unanimous

6. Audit with Robinson, Farmer and Cox Associates scheduled for August 28 and 29/Mary Earhart, PLLC Consulting – Mary Earhart will help us get everything in order prior to this audit. The audit cost should not exceed $13,000.
7. Health Insurance Update – Crystal provided this information to the board. The Local Choice plan provides better coverage to employees but comes with a higher cost to families.
8. DBHDS Accomplishments 2014-2017 – Ingrid was in Richmond for the Executive Director’s meeting and the VACSB Board of Director’s meeting and was given the DBHDS accomplishments since the new commissioner took over. This is going to be supplied to the governor and put on the website as well.
9. Ingrid discussed a policy change to give holiday pay for full time hourly employees. On closed holidays, they would get those holidays as paid but would take them as a floating holiday. She would like to roll this out by September 1 so that it would be effective for Labor Day.
10. Dates have been finalized for Ingrid to meet with the Board of Supervisors and City Council regarding approval of the Performance Contract. She will present the contract to City Council for approval on August 8^th and to the Board of Supervisors on September 5^th.

 

 

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:   Nolan Nicely, Jr.

VOTE:  Unanimous

TIME:  4:53 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:   Bill Gilliland

VOTE:  Unanimous

TIME:  5:20 p.m.

 

ADJOURNMENT

MOTION:  That the July 20, 2017 regular meeting of the Alleghany Highlands Community Services Board be adjourned.

MOTION:  Robert Johnson, Jr.

SECOND:  Nolan Nicely, Jr.

VOTE: Unanimous

TIME:  5:25 p.m.

 

NEXT MEETING:   The next scheduled Board Meeting will be on Thursday, September 21, 2017 at 4:00 PM at the Family Life Center at First Christian Church located at 231 E. Fudge Street in Covington, Virginia.

 

REMINDERS: 

• Thursday, September 21, 2017 – Annual Meeting – Family Life Center at First Christian Church 3:00 pm – 4:00 pm (mandatory for all employees)
• Recovery 5K Run/Walk- tentative date TBA; tentative location AET
• October 4-6, 2017: Public Policy Conference – Williamsburg Lodge