REGULAR MEETING OF THE ALLEGHANY HIGHLANDS COMMUNITY SERVICES BOARD
Thursday, March 27, 2014

The Alleghany Highlands Community Services Board held its regular meeting on March 27, 2014 at 5:30 p.m. at the Lifeskills/Moody Building located at 550 Pine Street, Clifton Forge, VA.

PRESENT: Connie Back, Carla Dobbs, Lisa Hicks, Robert H. Johnson, Jr., Teresa Johnson, Charlie Laws, Robert McCallister, Nolan R. Nicely, Jr. and Anne Dean.

Also present: Ingrid W. Barber, Executive Director; QuoVadis Washington-Brown, Director of Outpatient and Support Services; Angie Goodbar, Director of Intellectual Disabilities Services, Cara Major, HR Manager; Adam Kenny, IT Manager; Donna Conner, Chief Financial Officer; Nancy Curry, Quality Improvement Manager and Mary Ellen Plitt, Infant Toddler Program Supervisor.

Teresa Johnson, Chairman called the meeting to order at 5:30 p.m.

APPROVAL OF MINUTES OF January 16, 2014 REGULAR MEETING
MOTION: That the Board approve the minutes of the January 16, 2014 regular meeting.
MOTION: Bob McCallister
SECOND: Lisa Hicks
VOTE: Unanimous

Employee Recognition: Teresa Johnson welcomed Mary Ellen Plitt, Infant Toddler Supervisor.
Mary Ellen was recognized for her commitment and dedication to the “Coaches Program” associated with the Early Intervention Program.

Communications: Copies of letters to the Editor for March (Intellectual/Developmental Disabilities Awareness Month) were provided in the packets.

PROGRAM REPORTS

Mental Health & Substance Abuse
QuoVadis Washington-Brown provided the following report:

• QuoVadis attended Applied Suicide Intervention Training (ASIST) on March 10-14, 2014 to become an ASIST Trainer. AHCS will have three trainers that can provide suicide first aid training. Training will be offered to all AHCS staff and any community members who would like to receive this training.

• QuoVadis attended a meeting with Nancy, Ingrid, Donna and Andrea Gerhard, Magellan Clinical Liaison. Impending audits for Targeted Case Management and review of additional services utilizing the Treatment Records Review Tool and Clinical Practice Guidelines were discussed.

• QuoVadis reported that outpatient services has seen an increase in the number of persons seeking services via Emergency Services and Open Access. Access has steadily increased in the months of January and February 2014. The front office staff have been working on a new protocol for collecting the demographic information to assist in getting a new client to a provider in a timely manner in order for the assessment to begin promptly.

• QuoVadis reported that she along with Ingrid and Andrea Dilley, participated in meetings in February reviewing and developing of Region 7 protocols for admission. QuoVadis provided a copy of the current Region 7 protocols.

• QuoVadis reported that outpatient staff have participated in Daily Living Assessment (DLA) Training. This tool will assist providers with determining level of functioning to best determine which services are appropriate for care; along with helping to determine what type of progress individuals receiving services have made and can be noted in 30 or 90 day increments.

• QuoVadis reported that Outpatient Staff and Intellectual Disability staff participated in a two-day “Person Centered Thinking-Planning” training held at DSLCC on March 12-13, 2014. This training was provided by Phillip Caldwell, Director of Intellectual Disability Services for Alexandria Community Services.

• QuoVadis reported that Outpatient Services will be celebrating Alcohol Awareness Month in April 2014 with activities at local high schools to include a texting and drunk/drugged driving simulators. Events will also be held to bring light to STD Awareness.

Intellectual Disabilities
Angie Goodbar provided the following report:

• Angie reported that DBHDS has contracted with a national consulting group, Human Services Research Institute (HSRI) and their subcontractor, Burns and Associates, to conduct a study of our system of supports for people with intellectual and developmental disabilities (ID/DD) in Virginia. DBHDS intends to transform the current system so that people with ID/DD have supports they need to live full lives in the community. The work being undertaken to achieve this goal is entitled “My Life, My Community”. There are two phases to this research. The first phase has been completed in that 1,000 stakeholders attended public forums across the state to share their thoughts and ideas about the current ID/DD system. The second phase will establish proposed changes to accomplish the following: address the increasing demand for services in the state; establish and implement uniform infrastructure for screening and determining eligibility; offer a flexible array of services that allow for choice, control and creativity to meet individuals needs and preferences; assure that waiver rates are commensurate with the costs of providing services.

• Angie reported that in order for DBHDS to implement the second phase of this process they have established three subcommittees and a Waiver Redesign Advisory Committee. The three subcommittees are 1. Case Management-focus on how to combine ID/DD waiver case management and eliminate conflicts of interest. 2. Wait list- come up with a better way to manage wait lists for ID/DD. 3. Eligibility- will propose eligibility criteria for both ID/DD population. The subcommittees will submit all proposals to the Waiver Redesign Advisory Committee. Angie Goodbar, AHCS ID Director serves on the Waiver Redesign Advisory Committee.

• Angie reported that the regional crisis stabilization program for individuals with ID/DD has changed the program name from START to REACH which stands for Regional Educational Assessment Crisis Response and Habilitation. The regional program has been beneficial in the Alleghany Highlands in regards to response time and willingness to provide services promptly to individuals in our area. The therapeutic facility in Radford has been available to individuals needing out of home placement to resolve the crisis. The REACH program has been challenged to provide crisis stabilization services to children and adolescents in the region. A regional proposal and budget has been submitted to DBHDS in order to provide crisis stabilization services to children and adolescents.

• Angie reported that in February, the Early Intervention Program employees visited area referral sources including Alleghany-Covington Health Department, Department of Social Services, schools and pediatricians to give out information about early intervention services. At the end of February, Early Intervention participated in the “Child Find” in collaborations with the YMCA and local school divisions. Developmental screenings were completed during the event which resulted in identifying infants and toddlers in need of AHCS early intervention services. AHCS received a letter from Catherine Hancock, Early Intervention Administrator with DBHDS recognizing Mary Ellen Plitt, EI Supervisor for her commitment to the coaching model initiative and participation in 100% of the technical assistance opportunities. AHCS commends Mary Ellen on her work towards this initiative.

• Angie reported that The Public Guardianship Program Inc. and Amanda Webb, Public Guardian underwent the annual monitoring process on March 12-13th. Janet James, esq from the Department of Aging and Rehabilitative Services visited AHCS and reviewed five charts. She visited the group homes and nursing homes where individuals live and interviewed staff about Amanda’s quality of care and response to needs of the individuals. During the exit interview Janet was complimentary of Amanda’s charting and the quality care that is being provided. Janet received many positive comments about Amanda from other stakeholders in the community. Janet James also requested that Amanda Webb and Angie Goodbar, ID Director present a one hour workshop at the Guardianship Conference in April 2015 on successful collaboration between CSB’s and Guardianship Programs.

• Angie reported that AHCS submitted a grant application to the Department of Rail and Public Transportation (DRPT) for two new handicap accessible mini-vans and one handicap accessible bus. Part of the application process included submitting the application for intergovernmental review by the Roanoke Valley-Alleghany Regional Commission. The board unanimously supported the AHCS grant request for FTA funding. The letter of support has been sent to DRPT for final approval of the grant application.

• Angie reported that January and February brought about new training needs and opportunities. The ID program area revised their new employee orientation packet. Defensive driving classes were offered to new employees with driving responsibilities. Teresa Byers, RN provided training on lifting, transferring and repositioning individuals. Ann Gilbert, RN educated direct support professionals on feeding and medication administration via percutaneous gastrostomy tube. Ann also provided three on-site visits to each direct support professional within 30 days in order to determine their competency on the material and delegate staff to administer medications via g-tube under the nurse delegation act. This service allows families in our area caring for a loved one with a g-tube to be able to live in the community and successfully remain out of a nursing home or other institution.

• Angie stated that March is Intellectual and Developmental Disability Awareness Month. Two families in the community wrote letters to the editor to bring about public awareness that individuals with intellectual and developmental disabilities have hopes, dreams and abilities. Display boards about AHCS services were set up at Charles P. Jones Memorial Library and Clifton Forge Library. An event called JAM (Just About Me) is scheduled to take place at Gleason Hall Auditorium at Clifton Forge Middle School on March 29th. This event will showcase three stories about the individuals that AHCS supports and how they have accomplished many goals. Individuals with ID/DD will also be performing at the event through hand bells, singing and dance.

Quality Improvement
Nancy Curry provided the following report:

UR, Compliance and EHR

• Nancy attended the quarterly Local Human Rights Committee Meeting in Roanoke to present AHCS report.
• Nancy reported that the annual agency wide P&P workgroup continues to review and update the manual.
• Nancy will begin facilitation of COOP (Continuity of Operations Plan) Workgroup in April. This workgroup will develop a COOP plan for our agency and particularly our residential facilities. This will expand and enhance policies AHCS currently has in place.
• Nancy facilitated a Medical workgroup. Jill Upchurch is updating AHCS medication management training curriculum. Nancy and Jill will revise the Medication Administration refresher course that AHCS offers.

Credentialing
• Nancy reported that AHCS currently has 4 staff in various stages of the credentialing process.

Staff Development
• Nancy reported that as of March 11, 2014 AHCS had 150 staff enrolled in Relias.

• Nancy conducted two Mental Health First Aid Classes. Susan Chittum and Nancy co-facilitated the training. Fifteen staff with Alleghany County Schools completed and received their certification. Participants were school nurses and school counselors.

• Nancy reported that AHCS will be conducting a MHFA class for the community on Saturday, April 5, 2014. This will be free of charge and lunch provided. Currently there are 16 out of 20 seats filled.

• Nancy reported that Jill Upchurch attended ASIST Training (Applied Suicide Intervention Skills Training) in Roanoke the week of March 10, 2014 and became a certified instructor.

• Nancy participated in three New Hire Orientation trainings.

Other
• Nancy will be attending the Credible National Users Group conference on April19-21, 2014 with Adam Kenny and Donna Conner.

IT Manager Report
Adam Kenny provided the following report:

Help Desk
• Adam completed 27 help desk requests.
• Adam completed 120 credible change requests.

EHR
• Adam completed a pregnancy report project for the DBHDS audit.
• Adam completed EHR data changes required for new version of CCS reporting.
• Adam installed credible mobile for several employees in ID department.
• Adam implemented Physician Orders within Credible.
• Adam made necessary form changes within Outpatient Psych. Program to comply with Core Objective 1 of Meaningful Use.
• Adam trained AHCS doctors and nurses on how to use the new forms and physicians orders.

Hardware and Networking
• Adam reprogrammed mental health phones to work with the time change.
• Adam configured VPN connections to utilize AES-256 encryption.
• Adam installed 2 new computer at the Mental Health Clinic.
• Adam installed 3 new computers at Clubhouse.
• Adam updated software to comply with Internet Explorer 8 End of Life.
• Adam completed warranty repairs on two laptops.
• Adam purchased chrome book management licensing for new chrome books.
• Adam implemented new group policy rules regarding Windows Updates and Internet Explorer rights.
• Adam implemented group policy to allow Internet Explorer version 10 automatic update.
• Adam installed time clocks at all locations.
• Adam completed server side software installation and configuration of Time Trak software.
• Adam installed and configured texting hardware for Time Trak.

Other
• Adam attended monthly DMC meetings in Richmond.
• Adam completed a new salary review document.
• Adam participated in the agency wide Policy and Procedure review.
• Adam met with Josh Craft at Clifton Middle School to discuss technology requirements for JAM.
• Adam attended the Credible Partner Conference.

Human Resources
Cara Major reported the following:
Turnover
• Cara reported 9 new hires and 11 terminations for the months of Jan-March.
• Cara reported the turnover rate of 27.0% for FY14 %.

Loss Report
• Cara reported 2 accident Worker’s Comp Claims with no medical attention needed.
• Cara reported 3 auto claims.
• Cara reported 1 property claim at the Mental Health Clinic.
• Cara reported that AHCS has received payment from VACO for the MH roof claim from July 2013.

Advertising/Recruitment
• Reported that advertising for open positions are published through VEC, Job.Roanoke.com, Indeed, Monster, VA Review, Roanoke, Lewisburg, Southwest Virginia Journal, Lexington.
• Cara reported the following filled positions
Intellectual Disabilities
o In-Home DSP (3), Merryfield (2)
o Janitor
Mental Health
o Mental Health Supports-QMHP-E (1)

• Reported the following Open positions:
Intellectual Disabilities
o Direct Support Professional (In-Home, Merryfield and Friendship House)
o Van Driver (Part-Time)
o RN (Lifeskills Part-Time)

Mental Health
o Support Provider (Full-Time)
o New Beginnings Support Provider (Full-Time)
o Case Manager (Full-Time)
o Licensed Clinical Services Supervisor (Full-Time)
o Emergency Services Clinician (Part-Time)
o Substance Abuse Therapist (Full-Time)

General Updates
• Cara reported that the AHCS FY 2013 Annual Report has been completed
• Cara reported that the Agency Brochure is being updated.
• Cara reported that employee appreciation day was held March 7, 2014 and all employees received a polo shirt with the agency logo.
• Cara attended 2 job fairs hosted by DSLCC.
• Cara has been coordinating Wheelchair Transportation Training with VACO.
• Cara reported that she has been updating employee information for personnel files.

Participation
• Cara attended the VACSB HR Meeting in Richmond on March 27, 2014.
• Cara attended the Kaufman and Canoles Employment Lay Update Seminar in Richmond on April 3, 3014.
• Cara attended the SHRM State Conference in Hot Springs on April 27, 2014.
• Cara will attend the VACSB Conference in Norfolk on April 30-May 2, 2014.

Financial Reports
Donna Conner provided the following report:

Balance Sheet:
▪Total Cash at the end of February 2014 is $996,750, an increase of approximately $61,379 since January. (Total cash includes $58,072 from the Foundation)
▪Total Assets increased by $45,836 since January 2014.
▪Total Liabilities increased by $57,100 since January 2014.
▪Total Stockholders’ Equity is $1,754,387 at the end of February 2014 which includes current Fiscal Year-to-Date Surplus of $124,353.

Income Statement:
Total Agency for the month of February 2014 closed with a Net Deficit of $11,264 but YTD Net Surplus of $124,353 due to repairs in the mental health clinic. We were also closed/delayed for several inclement weather days.

EXECUTIVE DIRECTOR’S REPORT AND RECOMMENDATIONS
Ingrid Barber provided the following report:

Old Business
• Ingrid talked about the Logisticare Transportation rate request update.
• Ingrid provided an update on the Department of Rail and Transportation Grant.
• Ingrid provided a building update for the Guinan Center-Mental Health Clinic.
• Ingrid provided an update on the Catawba Regional Partnership and the JourneyHouse Dap Plans.

New Business
• Ingrid stated that the next VACSB conference is April 30, 2014-May 2, 2014 at the Sheraton Norfolk Waterside Hotel.
• Ingrid spoke about the regional admission protocols for Emergency Services.
• Ingrid provided a copy of the Alleghany Highlands Community Services Fiscal Year 2013 Annual Report.
• Ingrid provided a copy of the VACSB 2013 Annual Report.
• Ingrid provided a VACSB General Assembly and Budget update.

CLOSED SESSION
CODE OF VIRGINIA: PERSONNEL 2.2-3711.A.1
MOTION: That the Board enter closed session to discuss Personnel Matters and Real Estate, as authorized by the Code of Virginia Sections 2.2-3711A.1.
MOTION: Anne Dean
SECOND: Bob McCallister
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 March 27, 2014 regular meeting of the Alleghany Highlands Community Services Board be adjourned.
MOTION: Robert Johnson
SECOND: Lisa Hicks
VOTE: Unanimous
TIME: 7:08 p.m.

NEXT MEETING
The next scheduled Board Meeting will be on Thursday, May 15, 2014 at 5:00 pm. at Administration Office – 205 E. Hawthorne Street, Covington, VA.