MINUTES

REGULAR MEETING OF THE ALLEGHANY HIGHLANDS COMMUNITY SERVICES BOARD
Thursday, June 16, 2016

The Alleghany Highlands Community Services Board held the May board meeting on June 16, 2016 (rescheduled from May 19)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, Robin Mieras and Terrie Wright
ABSENT: Nolan Nicely, Jr. and Connie Back

Also present: Ingrid W. Barber, Executive Director; Angie Goodbar, Director of Intellectual Disabilities Services; Cara Major, HR Manager; 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 4:15 p.m.

APPROVAL OF MINUTES OF March 17, 2016 REGULAR MEETING
MOTION: That the Board approve the minutes of the March 17, 2016 regular meeting.
MOTION: Robin Mieras
SECOND: Bob McCallister
VOTE: Unanimous
TIME: 4:16 p.m.
APPROVAL OF THE CORRECTION OF THE NOVEMBER 2015 BOARD MEETING MINUTES
MOTION: That the Board approve the correction of the November 2015 board meeting minutes.
MOTION: Robin Mieras
SECOND: Lisa Hicks
VOTE: Unanimous
TIME: 4:18 p.m.

CIT (Crisis Intervention Teams) – Doug Albrecht, CIT Community Liaison, gave a presentation to the Board.

Communications – A copy of the Letter to the Editor regarding “May is Mental Health Month” was distributed to board members.

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

Case Management:
The interim supervisor has worked successfully to implement the new training orientation checklist developed for use by the entire department. She has expanded it to include program specific training topics. Filling vacancies has resulted in a reduction of caseloads, and as of May 16, all positions will be filled. Critical indicators for the month of March highlight the number of admissions to case management (25) and the number of discharges (52), which equals 48%.
Emergency Services:
The Department of Behavioral Health and Developmental Services (DBHDS) has implemented a new standard for the positions of Emergency Services prescreeners. The enhanced qualifications for Certified Preadmission Screening Clinicians will begin July 1, 2016. There is a process for Retaining Experienced Staff who do not meet the Enhanced Qualifications as of July 1, 2016. AHCS Emergency Supervisor and Director completed the necessary paperwork to apply for variances.
DBHDS hosted a statewide ES conference in Alexandria, Virginia in April. It was attended by three AHCS staff.
Critical indicators for the month of March highlight the number of hearing attended. The state expectation is 100%. This standard was not met due to staff being on crisis calls during the time of the hearings.

Psychiatric Services:
The telepsychiatry program is fully operational. Four veterans were served in March and April. The strategy to maximize appointments revolves around utilization of the Virginia Veterans and Family Services Resource Specialist.

Prevention Services:
A “Smoking Stinks” Tobacco Prevention Fair was provided at Sharon Elementary School to 73 fourth and fifth grade students. The students were able to learn about the dangers of tobacco, both smoking and smokeless, as well as the impact it has on the community as a whole. Each student was provided a “Smoking Stinks” t-shirt and other giveaways.

Trainings:
On April 1st, Dr. Michael Gillette provided the agency with a two hour ethics in-service focused on avoiding dual relationships. The training was attended by 35 staff and held at Dabney S. Lancaster Community College.
Rhonda Thissen and Susan Pauley with the Department of Behavioral Health provided a training to the department on May 11th titled “Got Recovery? Recovery-Oriented Thinking in Behavioral Health Services”. AHCS invited Rockbridge Area CSB to send up to 4 staff, and Valley CSB to send up to 4 staff. The training was held at DSLCC.

Community Engagement:
Mental Health First Aid: AHCS partnered with Covington City Schools and provided two Youth Mental Health First Aid trainings to staff and community members. The first training was held on April 6, 2016 and April 7, 2016 with 4 completing the training. The second training was held on April 20, 2016 and April 21, 2016 and 8 completed the training.
Crisis Intervention Team (CIT): Four Alleghany Regional Jail corporals completed the 40 hour CIT training in April, along with one AHCS emergency services prescreener. One prescreener attended the training the week of May 9-13. One additional prescreener is scheduled to attend in June. On May 16, Crisis Intervention will be the focus of a community awareness walk and luncheon. The end of year report for the grant is due in June.
Addressing Health Disparities: April 20 AHCS hosted a community dialogue focused on addressing health disparities, in conjunction with Rockbridge Area Health Center. RAHC is the closest federally qualified health center (FQHC). Thirteen community stakeholders attended. The group acknowledged the need to explore primary care and dental options for the uninsured and underinsured in Alleghany County. RAHC proceeded to get approval from their Board members to apply for an upcoming Health Resources and Services Administration grant for the expansion into Alleghany County. This project has the potential to improve the overall health of the community and especially those served by AHCS.

Save the Date:
Prevention Services has begun planning for a suicide prevention community event to be held on July 22, 2016. The agency has contracted with Kevin Hines, a nationally known speaker, about his failed suicide attempt when he jumped from the Golden Gate Bridge. More details to follow regarding the location and time of the event.

Intellectual Disabilities
Angie Goodbar provided the following report:
Waiver Redesign Updates:
AHCS will start serving individuals with developmental disabilities beginning July 1st. AHCS will contract with Blue Ridge Independent Living Center (BRILC) and Mom’s in Motion to assure that individuals with developmental disabilities are offered choice of providers. AHCS has secured Memorandum of Agreements with Rockbridge Area CSB and Blue Ridge CSB in the event that an individual residing in the local catchment area would prefer to seek services at one of the neighboring CSB’s.
The support coordinators and providers attended the “My Life, My Community Training” in order to stay abreast of all changes with waiver redesign. The support coordinators mailed letters to the twelve individuals on the developmental disabilities wait list in order to schedule appointments to orient them to CSB services. The ID/DD waitlist will be managed by the CSB starting July 1st. The support coordinators have encouraged individuals and families to attend the information workshops about waiver redesign offered by DBHDS.
AHCS established internal project planning committees to implement changes needed for waiver redesign. Starting July 1st, new community engagement services will be offered by Licensure and DMAS. AHCS will request a licensure modification to acquire a community based day support license. Job descriptions, policies and procedures have been established and sent to Licensure and Human Rights for approval.
Planning meetings are in place to identify each individuals tier/level and establish new projected budgets for group home and day support services. Meetings are also in place to develop new forms in the electronic health record and billing procedures.

Early Intervention Updates:
In April, Early Intervention (EI) providers met with Jackson River Pediatrics, a primary referral source for their quarterly meeting. Angelina facilitated a Local Interagency Coordinating Council Meeting that included representatives of agencies serving children birth to five years of age. The Early Intervention program is experiencing a state-wide record review. The results of that review will be made available in June. The Early Intervention program will receive an additional $2,704 of one-time state general funds from the Caboose Funds for FY16.

Partnerships:
The Employment First Committee is spearheading an “Employer Appreciation Breakfast” for June 8th. The goal of this breakfast is to recognize local businesses that have supported TEACH and Career Support with their mission to help individuals with intellectual disabilities to acquire employment. AHCS facilitates the Employment First Committee and will work in partnership to recognize businesses in the community that employ individuals with intellectual disabilities.
The ID Director attended the 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 ID Director attended the VACSB Conference in Portsmouth and participated on a panel discussion to present information about Region III’s involvement in implementing waiver redesign.

Quality Improvement
Nancy Curry provided the following report:
UR, Compliance and EHR:
• There were 16 Incident Reports processed during the month of March. There was one safety inspection in March.
• There were 14 Incident Reports processed during the month of April. There was one safety inspection in April.
• Surveys in process or completed: Maternal SU and SUB Exposed Infant Survey, Adult MHSIP survey, 2016 National Survey of SA Treatment Services (N-SSATS), and 2016 National Mental Health Services Survey (N-MHSS).

Staff Development: This report is completed around the 10th of each month.
• March 2016: 142 staff with 87% compliance for annual training (7 courses).
• April 2016: 143 staff with 87% compliance for annual training (7 courses).
• 32-Hour Medications Classes were administered in March and April.
• New Hire Orientations were conducted in March and April.
• TOVA classes were administered in March and April.
• A Mental Health First Aid class was administered in March.

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

Other:
Attended Safety Meeting in April.
Attended VACSB QL Meeting in April.
Attended the National Credible Users Convention with Adam and Jeannie in March.
Attended VACSB conference in May.

IT Manager Report:
Adam Kenny provided the following report:
Duties performed or in progress since September 2015:

Help Desk:
• Completed 67 help desk requests.
• Completed 120 Credible change requests.

EHR:
• Assisted with form changes in DD and MH.
• Made service changes to several SA teams.
• Resolved issues with VA and Televideo services.
• Finalized configuration for New Beginnings teams.
• Completed Meaningful Use submissions for all doctors.
• Preparing to pilot Incident Reporting in Credible.

Hardware and Networking:
• Purchased new computers for Merryfield.
• Ordered hardware for GP Server Upgrade.

Other:
• Attended monthly DMC meeting
• Attended reimbursement meetings
• Attended the Credible Partner Conference
• Attended VACSB Conference
• Attended meetings regarding DD changes
• Attended Relay for Life meetings
• Attended weekly meetings with Nancy
• Assisted with the billing staff move to Admin
• Participated in New Hire Orientation
• Participated in ID Fashion Show
• Submitted monthly CCS data

Human Resources
Cara Major reported the following:

Turnover:
• For Fiscal Year 2016, there have been 39 New Hires and 35 Terminations.
Loss Report:
• There were no Worker’s Comp Claims, one auto claim (windshield replacement), and no property claims.
Advertising/Recruitment:
• Advertising was done through websites: VEC, Indeed, Craigslist, Facebook, Shentel, and through newspapers: Virginian Review, Lewisburg, and The Recorder.
Filled Positions:
• Intellectual Disabilities – DSP (In Home); C.N.A. (2); RN; In Home Residential Supervisor.
• Mental Health – Case Manager; New Beginnings Technician
Open Positions:
• Intellectual Disabilities –Direct Support Professional (In Home, Friendship); Day Support Professional; Recreation Specialist; Substitute Van/Bus Driver; C.N.A.
• Mental Health – Outpatient Clinician; Case Manager, Child Case Manager; Case Manager Supervisor, Child/Family Therapist and New Beginnings Technician

General Updates:
• Employee Breakfast March 10, next one June 2
• Employee Assistance Program implementation April 1
• ACA Reporting
• Monitoring FLSA Exempt status changes
• DSLCC Job Fairs – March 15&16
• Salaried performance evaluations due June 10
• Working to convert evaluations to electronic format
• Change Management Training for Supervisors

Participation:
• Attended BB&T Webinars
• Attended April 17-20 SHRM Conference
• Attended May 4-6 VACSB HR Committee
Upcoming:
• BB&T Webinars
• May 26 – VRS Roundtable

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

EXECUTIVE DIRECTOR’S REPORT AND RECOMMENDATIONS
Ingrid Barber provided the following report:
OLD BUSINESS:
1. Life Skills Moody Building/Alleghany Foundation Update – Ingrid wrote a letter to Mary Fant Donnan, Alleghany Foundation Executive Director, in which she provided an update on the work completed at the Moody Building. Mary advised Ingrid to check on the cost of having the tiles removed, and she also advised getting quotes on a local vendor replacing the flooring. Ingrid has obtained an estimate from Town and Country for this project but still needs to decide the best course of action. Since the grant period is set to expire at the end of the month, Ingrid requested an extension. The Foundation agreed to extend the grant period through the end of December.

2. ICF Update – Loan Repayment Plan – AHCS has entered into a repayment plan to repay the ICF cost settlement. Ingrid provided the Board with copies of the letter requesting a repayment plan and the letter with their response and terms of the agreement. The payments will be taken out of our DMAS revenues and will be applied to the debt. AHCS would still have to pay back all the interest even if we pay it off early.

3. Town of Clifton Forge update – Ingrid provided an update regarding the Town of Clifton Forge land transfer.

NEW BUSINESS:
1. Updates and Approval of Proposed FY 16/17 Performance Contract/Budget – MOTION: That the Board approve the FY 16/17 Performance Contract
MOTION: Bob McCallister
SECOND: Robin Mieras
VOTE: Unanimous
TIME: 5:10 p.m.
MOTION: That the Board approve the FY 16/17 Budget
MOTION: Lisa Hicks
SECOND: Robin Mieras
VOTE: Unanimous
TIME: 5:11 p.m.

2. Certified Community Behavioral Health Center Update – The state has recognized that our behavioral health system needs to have reform around services, accountability, quality, and the individuals we serve. The former commissioner had transformation teams. The interim commissioner would like to transition into looking at a Virginia certified behavioral health clinical type model. Ingrid provided a handout from the Commissioner for board members.

3. Resolution of Affordable Care Act Eligibility Policy/Required by Anthem – MOTION: That the Board approve the resolution of Affordable Care Act Eligibility Policy
MOTION: Teresa Johnson
SECOND: Lisa Hicks
VOTE: Unanimous
TIME: 5:15 p.m.

4. AHCSB Foundation Resolution for Land Transfer – MOTION: That the Board approve the AHCSB Foundation Resolution for Land Transfer
MOTION: Teresa Johnson
SECOND: Bob McCallister
VOTE: Unanimous
TIME: 5:25 p.m.

5. Jail Services Update – Ingrid provided an update on the jail services being offered by AHCS.

6. DD Private Providers Contracts – Ingrid provided a sample copy of contract.

7. Contracts for Neighboring CSB’s to provide ID/DD Case Management – Ingrid provided the Board with copies of the executed contracts between AHCS and Rockbridge Area CSB and Blue Ridge Behavioral Healthcare.

8. Next VACSB conference – October 5-7, 2016 – Public Policy Conference at Charlottesville Doubletree Hotel

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: Bob McCallister
VOTE: Unanimous
TIME: 5:35 p.m.

Reconvene Regular Session:
MOTION: Bob McCallister
SECOND: Lisa Hicks
VOTE: Unanimous
TIME: 5:55 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 June 16, 2016 (rescheduled from May 19) regular meeting of the Alleghany Highlands Community Services Board be adjourned.
MOTION: Bob McCallister
SECOND: Lisa Hicks
VOTE: UNANIMOUS
TIME: 5:56 p.m.

NEXT MEETING: The next scheduled Board Meeting will be on Thursday, July 21, 2016 at 4:00 PM at the Administration Office located at 205 E. Hawthorne Street in Covington, Virginia.