MINUTES

REGULAR MEETING OF THE ALLEGHANY HIGHLANDS COMMUNITY SERVICES BOARD

Thursday, March 15, 2018

The Alleghany Highlands Community Services Board held the March Board meeting on March 15, 2018 at 4:00 p.m. at Life Skills located at 550 Pine Street in Clifton Forge.

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

ABSENT:   Robert Johnson, Jr. and Robin Mieras

Also present:  Ingrid W. Barber, Executive Director; Adam Kenny, IT Manager; Crystal Homer, Human Resources Manager, Patty Flanagan, Finance Manager, Lynn Brackenridge, QI Manager, Angie Goodbar, Director of Developmental Services, and Cathy Schiffer, Director of Mental Health and Substance Use Services.

Angie Goodbar presented a Power Point of “Night to Shine” which had over 30 attendees from our catchment area.

Lisa Hicks, Chairman, called the meeting to order at 4:29 p.m.

Welcome:  The Board welcomed Lynn Brackenridge, new QI Manager, and Cathy Schiffer, new Director of Mental Health and Substance Use Services.

Communications:  Letters to the Editor (March is Intellectual/Developmental Disabilities Awareness Month)

Thank You card from Ingrid Barber

Donations from Anne Dean and Jill Moersh (Client Assistance Fund)

APPROVAL OF MINUTES OF November 16, 2017 REGULAR MEETING

MOTION:  That the Board approve the minutes of the November 16, 2017 regular meeting.

MOTION:         Nolan Nicely, Jr.

SECOND:         Bill Gilliland

VOTE:              Unanimous

PROGRAM REPORTS

Mental Health & Substance Abuse

Cathy Schiffer presented the following report:

Edie Fix, RN, and Dana Hiner, RN, attended the VACPN (Virginia Association for Community Psychiatric Nurses) Conference on November 2-3, 2017. They attended seminars on addiction and the effects it has on family units. One of the speakers was a therapist certified in alcohol and drug addiction who helped lead a MAT Program. Dana shared information from this conference with the MAT team.

Susan Chittum and Robbie Lawson from Clubhouse attended the VAPRA (Virginia Psychiatric Rehab Association) Conference in November along with two Clubhouse members.

The Clubhouse program sold Christmas pins repurposed from Christmas ornaments. All proceeds went to the Psychosocial Rehab Services Consumer Account which is used for special events and activities for their members throughout the year.

Soapy Club Car Wash held their last car wash on November 9, 2017. Their services were much appreciated and will begin again in the spring. Soapy Club Car Wash also hosted a Thanksgiving luncheon with Mountain House through Blue Ridge Behavioral Healthcare.

Prevention Services hosted the Drug Free All Stars at both Covington High School and Alleghany High School on November 10, 2017. This program provided fun and education in a new way of educating youth about the importance of making good choices and staying away from alcohol, tobacco and other drugs.

Prevention Services held their “Smoking Stinks” fairs at Callaghan and Sharon Elementary on November 30, 2017. Students in 4^th and 5^th grade were able to see six different booths that ranged from smokeless tobacco, health and unhealthy lungs and the dangers of tobacco. Approximately 130 students attended.

Prevention also hosted an Alleghany Highlands Healthy Youth Coalition meeting on December 14, 2017. There were approximately 30 participants with a wide variety of community members.

The agency’s annual Case Management client Christmas party was held on December 7, 2017 at the First Christian Family Life Center. Adult Case Management clients as well as Child Case Management clients were invited. Goody bags were given to all clients and a special appearance was made by Santa Claus.

The Coping Skills Group, along with MH/SA staff, won first place in the Iron Gate Christmas parade with their float “Wiley Coyote & Road Runner”. The theme of the parade was “Looney Tunes Merry Melodies”. Participants on the float gave out information to spectators about the services we offer at MH/SA and Open Access.  In addition, a list of coping skills was also distributed at the parade.

New Beginnings recently completed a crisis and de-escalation training that was presented by Sarah Deffinbaugh from our Emergency Services Department. It was a 5 session training that incorporated techniques, scenarios and materials to support staff in intervention of client crisis.

Developmental Services

Angie Goodbar provided the following report:

• Developmental Disability Awareness Month – AHCS is celebrating National Developmental Disability Awareness Month by hosting the movie “Wonder” at the Historic Masonic Theater in Clifton Forge on March 16^th. “Wonder” tells the inspiring and heartwarming story of August Pullman. He was born with facial differences that prevented him from going to mainstream school. The movie shows how a larger community came together with compassion and acceptance to support August on his extraordinary journey of success. The theme for National Developmental Disability Awareness Month is “See me, for me”. On March 17^th, AHCS will be hosting a Paint Nite at the Life Skills Center in Clifton Forge, conducted by a local artist, David Hayslett. Attendees will paint a picture of ladybugs in honor of the artist’s daughter that lived with a developmental disability.
• Brain Injury Awareness Month – March is also Brain Injury Awareness Month. AHCS will bring about awareness by encouraging employees to wear blue on March 20^th. AHCS will also share information about brain injury awareness through social media publications. The theme for Brain Injury Awareness Month is “Change your mind about brain injury”.
• Waiver Slots – AHCS has two waiver slots to allocate. There are twenty individuals on the waiting list for waiver services from the Alleghany Highlands catchment area. DBHDS is actively coordinating the slot committee who will allocate the waiver slots.
• Child Find Assessments: The Infant/Toddler program conducted Child Find Assessments at Mountain View Elementary School on February 21^st and Edgemont Primary School on March 15^th.
• Independent Review Committee: In order to be in compliance with new human rights regulations, AHCS developed an internal independent review committee to review all behavioral plans that are restrictive in nature. These plans will then be passed on for approval by the Behavioral Advisory Committee in Staunton on Region 1 Local Human Rights Committee. The independent review committee will meet quarterly and track the frequency in which behavioral interventions were utilized as well as continued need for the plans.
• Residential Services: Merryfield Residence is at capacity with all nine beds occupied. On February 23^rd, Merryfield hosted a Friends and Family Dinner with “Breakfast for Dinner”. The individuals opened up their home to friends and family for an exciting evening of feasting on breakfast food followed with games. Six out of eight beds are occupied at Friendship Residence. There in one referral actively seeking admission.
• Board Approval for Grant Applications:

Department of Rail and Public Transportation – AHCS is requesting funding for one bus and two minivans. The bus will replace an existing bus utilized by the Life Skills Day Support Program. The two minivans will be utilized by Community Engagement and Residential In-Home Services. The total amount of the request is $145,000. DRPT will fund 80% which is $116,000.

USDA – The Public Guardian Partnership, Inc. is requesting approval to submit a grant application to USDA for a vehicle. The cost of a vehicle is $26,000 and USDA will fund $14,300. The remainder of the cost of the vehicle will be covered by the PGP budget. This has been approved by the PGP Board.

Home Depot – AHCS is requesting grant funds to remodel a room at the Life Skills Day Support Program and to purchase exercise equipment from Home Depot in the amount of $4,999.94.

Westrock – AHCS is requesting funding in the amount of $4,020 to replace the security cameras at the Life Skills Day Support program. The current system is not operable and the parts are obsolete.

• Audits – The Infant/Toddler Program underwent a Quality Measurement Review (QMR) with the Department of Medicaid Services. The audit went well and there were no significant findings. The auditors conducted interviews with families receiving services.
• More audits – DMAS Quality Review of Waiver Services occurred from January 22-26. The audit consisted of a review of sixty charts throughout case management, residential in-home, day support and skilled nursing services. They also reviewed personnel records of all employees that interacted with those consumers and interviewed three of the individuals receiving services. During the exit conference, the auditors made recommendations for best practices but did not note any significant findings that would warrant a financial audit.
• Marketing/Educating the Community – Alyson King, Case Manager, attended the Special Education Advisory Committee and gave an update on waiver services. Amanda Webb attended the CAPP Meeting and shared information about events occurring during Developmental Disability Awareness Month.
• The DS Director attended the Regional DS 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 continues to attend agency CCC Plus planning committee meetings.

Upcoming Events:

• April is Autism Awareness Month – AHCS will be “lighting it up blue” to celebrate Autism Awareness Month by putting blue light bulbs in all of our CSB locations. We have purchased “Light it up Blue, Autism Awareness” signs that will be placed at each location to educate the community. The individuals at the day support program will be making ribbons for employees to wear on April 2^nd. AHCS will also encourage employees to wear blue to bring about awareness.

Quality Improvement

Lynn Brackenridge provided the following report:

UR, Compliance and EHR:

• Incident Reports Processed – 26 in November, 29 in December, 32 in January and 27 in February.
• # CHRIS Reportable – 11 in November, 9 in December, 13 in January and 17 in December.
• Safety Inspections – 2 in February

CAPS:

12/18/17 – Life Skills – DBHDS Licensure CAP: Provider failed to adhere to evacuation drills and maintenance of fully charged fire extinguisher.

02/05/18 – MH CM – DBHDS Licensure CAP: Provider did not report serious injury within 24 hours as required by regulation.

• Licensure visit by Kevin Lassiter, Licensing Specialist, from DBHDS on 12/18/17. The unannounced visit reviewed In-Home Respite for licensure renewal due 1/11/18. Mr. Lassiter visited Merryfield, Friendship and Life Skills.
• Licensure review of CHRIS reports resulted in a CAP on 2/5/18 for not reporting illness/serious injury within 24 hours.
• Licensure visit by Kevin Lassiter, Licensing Specialist, from DBHDS on 2/27/18. The unannounced visit reviewed the following areas for compliance – Clubhouse, New Beginnings, and chart reviews. Findings were noted during site visit and awaiting response from Mr. Lassiter. Findings are being addressed and corrected prior to Licensure response.
• DMAS audit conducted January 22-26, 2018. The timeframe for the audit review was July-September 2017. Awaiting results of DMAS audit.

Other:

Participation in Meetings/Trainings/Committees by QI staff:

• Safety Meetings, LHRC Meeting, VACSB QL Meeting, VA Credible Users Meeting and Regional Nursing Meeting
• Attended VACSB Legislative Conference January 16-17, 2018
• VACSB Conference scheduled May 2-4, 2018
• Human Rights Train the Trainer Event scheduled April 4, 2018
• Credible Conference March 27-29, 2018
• DBHDS case management quality improvement review scheduled 6/20/18

AUDIT schedule:

• 2018 Audit schedule has been revised. New templates have been implemented to calculate a score demonstrating either compliance or areas of opportunity. The audits are weighted and scored which evaluate DMAS, Licensure, Agency Workflow Compliance and Best Practice.

SAFETY schedule:

• Monthly safety/maintenance inspections are scheduled for Merryfield, Friendship and New Beginnings and annual inspections are scheduled for Life Skills, Clubhouse, Administration office, Mental Health Clinic, and ID office.
• Service Modification Merryfield on January 5^th – remove linoleum from office 2 and replace with floating vinyl laminate tile.
• Service Modification Merryfield on January 8-9 – remove laminate flooring and carpeted area from bedroom 2 and replace with a floating vinyl tile.

QI Projects:

• Updating the COOP plan, Emergency preparedness policy, and risk management policy
• Unapproved visits
• Active shooter drill at all locations
• Merryfield bathroom modification scheduled for May 2, 2018
• Credible Super User Committee
• New Human Rights Advocate – Artea Ambrose. Scheduled site visit on March 22^nd at 10:30 a.m.
• Review and update all agency policies and procedures by Policy Committee

IT Manager Report:

Adam Kenny provided the following report:

Duties performed or in progress since November 2017:

Help Desk:

• Completed 431 help desk requests.
• Completed 315 Credible change requests.

EHR:

• Assisted with form changes in DD and MH.
• Added forms to Infant Toddler with the capability to map on to state forms.
• Helped train new QA staff
• Configured login changes to accompany Infant Toddler therapist access.
• Assisted with DMAS audit
• Created several reports for QA
• Started research for E-fax opportunities.

Hardware and Networking:

• Re-wired offices to accompany new staff at Admin.
• Set up iPads and Chromebooks for credible mobile use.
• Replaced failing router at DD Admin office.
• Purchased polycom conference phones.
• Re-wired DD Admin for printer moves.
• Met with Shentel to discuss fiber opportunities in Covington area.
• Installed new wireless access point at Admin.

Other:

• Implemented Skype for use with TDT.
• Attended Open Minds Conference.
• Attended and helped set up for Jingle Mingle.
• Attended training for Credible Mobile.
• Implemented Office 365 Exchange and email encryption.
• Attended monthly DMC meeting.
• Attended quarterly Credible User Group meeting.
• Attended reimbursement meeting.
• Attended bi-weekly leadership meetings.
• Attended CCC Plus meetings.
• Presented in New Hire Orientation.
• Submitted monthly CCS report.

Human Resources

Crystal Homer reported the following:

Loss Report:

• Worker’s Comp Claims – No new claims for new fiscal year at this time. Mod Factor received showed an increase from .78 to 1.13, expected premium increase for 2018/2019.
• Auto Claims – $1,379.65 YTD
• Auto Physical Damage – Merryfield $576.75 paid for bus damage
• Auto Liability Claims – Clubhouse: $355.81 and $410.00 paid for damage to other vehicles.
• Property Claims – 0

Separation Reasons – new reports coming soon from Bamboo with this information

Separations July-February 2018 – 21 Total

4 retirement (Prescott, Burns, Childs, Curry)

3 job abandonment

6 other employment

1 medical reasons

4 personal reasons

1 relocation

2 termination

Recruitment: Please visit our website to link to the new BambooHR careers site

Open Positions as of 02/18/2018:

Intellectual Disabilities –

• In-Home and Life Skills – Direct Support Professional
• Merryfield Residence – CNA/Direct Support Professional and Registered Nurse
• Behavioral Navigator – Licensed Eligible/Licensed and On-Call Navigator – Licensed Eligible/Licensed (Regional Positions)

Mental Health –

• New Beginnings Residential Technician
• Child and Family Therapist
• Mental Health – Intensive Services Clinician – LMHP-E
• Clinical Services Supervisor
• Case Manager
• Prevention Coordinator

General Updates:

• Focus has been on selection and implementation of new HRIS system, BambooHR. Bamboo will integrate with Trax Payroll and timekeeping to give us full electronic capabilities and create efficiency in recruiting, hiring, onboarding, and timekeeping. Eliminating paper processes and strengthening the organization.
• VACSB HR Subcommittee has been reactivated as an opportunity to share information and best practices among peers as well as address ongoing issues all CSB’s struggle with. I was selected as Vice-Chair of the committee and have been participating in the overall VACSB May Training Conference planning committee.
• We received our first renewal form from The Local Choice and it is 5%. AHCS has not had an increase this low in the past without having to change plans.
• We have been scheduling employee benefit education events including meetings for our VRS Hybrid staff, Liberty University visiting for those interested in furthering their education and will be scheduling time for VRS Plan 1 & 2 staff as well as Virginia Credit Union to visit.
• Jacob, the HR Specialist, has been participating in internship, graduate and recruitment fairs.
• Supporting programs and the Agency through design/creation of marketing materials and promotional items. New brochures and letter for New Beginnings and Open Access. Created the logo for the Healthy Youth Coalition and a community awareness postcard. Annual Report is in draft and almost finalized. Please like our Facebook page and share events and information.
• Working on QMHP registration process, understanding and setting up.
• Implemented a Professional Licenses and Certifications policy.

Financial Reports

• Financial reports were submitted by Patty Flanagan.

EXECUTIVE DIRECTOR’S REPORT AND RECOMMENDATIONS

Ingrid Barber provided the following report:

Agency Update:

1. Alleghany Highlands Community Services (AHCS) is pleased to report progress made during 2017 regarding a start-up grant in the amount of $74,940 which was awarded in August 2015 for crisis intervention training of local law enforcement officers. The grant provided funding for a half-time CIT Coordinator and a part-time CIT Community Liaison to further develop the already-established working relationships within the community among local stakeholders. The primary goal of this start-up grant was to train police, deputies, jailers, dispatchers, probation and parole, and clinicians to recognize the signs of a behavioral health crisis and to focus on obtaining a clinical confirmation, and if confirmed to divert the individual into mental health care rather than incarceration. To date as of November 6, 2017, 36 Alleghany County Sheriff Patrol and Jail Deputies, 20 police officers from City of Covington and Town of Clifton Forge, and 3 emergency services clinicians have been trained. The CIT Coordinator and the CIT Community Liaison have completed both the Virginia CIT Train the Trainer training and the 40 hour training, as well as one District 40 Probation and Parole Officer. This effort brings our total having received CIT 40 hour core training to over 60 individuals to date.
2. The commercial loan for roofing and HVAC for the Guinan Center (Mental Health Clinic) was closed on February 5, 2018. Details of the loan include a loan amount of $175,000 minus settlement charges of $3,357.33 with a remaining balance of $171,642.67. The loan will be paid in 60 consecutive payments of principal and interest in the amount of $3,267.17 beginning March 5, 2018. The interest rate is fixed at 4.500%.
3. Alleghany Highlands Community Services (AHCS) requested one time funds from the Department of Behavioral Health and Developmental Services (DBHDS) to support funding for New Beginnings Transitional Housing Program. In addition, AHCS also requested Substance Abuse Residential Purchase of Services (SARPOS) funding for individuals in need of detox services. AHCS exceeded the funding granted by the DBHDS this fiscal year.
4. Funding requests for Alleghany County and City of Covington are included in your packets. Please plan to attend the joint meeting held at the Alleghany Highlands Regional Library on March 22, 2018 at 6:20 pm.
5. Alleghany Highlands Community Services was one of four CSBs selected by DBHDS to receive funding for a Zero Suicide Initiative grant. The other CSBs that received the grant funding were Eastern Shore CSB, Northwestern CSB, and Rappahannock CSB. Each board will receive $37,967 each year over a five year period to provide staff training, obtain materials to conduct assessments and treatment with clients and support persons, and engage community stakeholders/health systems in training and collaboration for external services.

Community Update:

1. I attended the regular meeting of the WestRock/Ingevity-Alleghany Highlands Community Advisory Panel (CAP) on November 14, 2017. I was updated about expansions in the WestRock Covington Mill and Ingevity (Carbon Operations). There was concern about workforce development with the expansions. Both companies are working with DSLCC. Richard Douglas, Covington City Manager, reported the city is purposing zoning changes to enable industry to expand in the future along Riverside Street. Darlene Burcham, Town Manager of Clifton Forge, reported there will be a ribbon cutting to open 13 acres for a business park in Clifton Forge. Marketing will begin soon for the property near I-64. Utilities are already on this site. A large building is going up near the railyard and is nearing completion. Dabney is starting a food pantry and clothing closet for students. Clothing will be available to students to help them prepare for job interviews.
2. I attended the Alleghany Chamber of Commerce Board Meeting on January 30, 2018.

Regional Update:

1. I set up an SFUR (State Facility Utilization Review) training for our Emergency Services staff with regional staff, Dennis Vaughan, Elizabeth Signorelli Moore, and Susan Pauley with DBHDS on February 5, 2018. The purpose and use of this regional funds initiative is to divert TDOs whenever possible and appropriate, while also allowing these funds to help reduce bed utilization at the state facilities in other ways (including expedited step-down transfers to residential programs).
2. I set up a Child REACH training for staff on February 15, 2018 with Amanda Cunningham, Region One Reach and Mental Health Child Crisis Director. She updated the staff on regional requirements for children in need of REACH and Mental Health Services.

Public Policy:

1. A summary of relevant budget amendments for FY 2018 is attached to this report. The summary was prepared and distributed by Dr. Jack Barber, Interim DBHDS Commissioner.
2. Interim Commissioner Dr. Jack Barber has issued new expectations for CSBs in relation to state hospital discharge planning and for case management services. These changes are increasing CSB responsibility in both areas.

OLD BUSINESS:

1. Update on the Crisis Intervention Services Grant (CIT) – The CIT grant is coming to an end. Meetings will continue to be held on a monthly basis while we await word on possible funding for an assessment site.
2. Update/Approval of Board By-Laws for 2018 – By-laws for 2018 have been reviewed by the Board.

MOTION:  That the Board approve the By-Laws for 2018.

MOTION:   Anne Dean

SECOND:    Teresa Johnson
VOTE:  Unanimous

3. Update on Loan with Highlands Community Bank – Roof/HVAC – Ingrid and Patty met with Bryan Thompson of Highlands Community Bank regarding the reauthorization for the loan. Ingrid explained the conditions of the loan.
4. Approval of FY 2017 Form 990-Tax Return for Alleghany Foundation – Form 990 has been reviewed by the Board.

MOTION:  That the Board approve FY 2017 Form 990- Tax Return for Alleghany Foundation.

MOTION: Teresa Johnson

SECOND:  Connie Back

VOTE:    Unanimous

NEW BUSINESS:

1. VACSB Development and Training Conference: May 2-4, 2018 Renaissance Portsmouth Norfolk Hotel – Eight CSB employees will be attending the conference in May. The next conference will be held in October.
2. Funding Requests for Alleghany County/City of Covington – Included in board packet. The meeting will be held March 22^nd and board members are encouraged to attend.
3. Award of Zero Suicide Initiative Grant – AHCS is one of four CSBs awarded this grant which will award approximately $37,000 per year for five years to each CSB to educate the public about suicide and prevention.
4. Approval of 2018 Community Impacts Grant (Home Depot) – A grant was presented to the Board for approval for $4,999.94 for exercise equipment from Home Depot. This equipment will be used by individuals at Life Skills as well as employees.

MOTION:  That the Board approve the 2018 Community Impacts (Home Depot) grant:

MOTION:  Bill Gilliland

SECOND:   Anne Dean

VOTE:        Unanimous

5. Approval of 2018 Department of Rail and Public Transportation Grant – This grant was presented to the Board for approval to replace one Life Skills bus and two minivans.

MOTION:  That the Board approve the 2018 Department of Rail and Public Transportation Grant:

MOTION:   Nolan Nicely, Jr.

SECOND:    Connie Back

VOTE:         Unanimous

6. Approval of USDA Public Guardian Partnership, Inc. Grant – This grant was presented to the Board for approval to provide a new vehicle for Amanda Webb/PGP Program.

MOTION: That the Board approve the USDA Public Guardian Partnership, Inc. grant:

MOTION:   Teresa Johnson

SECOND:    Bill Gilliland

VOTE:          Unanimous

7. Approval of WestRock Grant- AHCS applied for a WestRock grant for new security system/cameras for Life Skills.  This grant was presented to the Board for approval.

MOTION:  That the Board approve the WestRock grant for new security system/cameras for Life Skills:

MOTION:    Bill Gilliland

SECOND:     Nolan Nicely, Jr.

VOTE:           Unanimous

8. Approval of 2018 USDA Grant for two new vehicles for AHCS – This grant was presented to the Board for approval.

MOTION:  That the Board approve a 2018 USDA Grant for two new vehicles for AHCS:

MOTION:   Anne Dean

SECOND:    Teresa Johnson

VOTE:          Unanimous

9. Alleghany Highlands Community Services Fiscal Year 2017 Annual Report – The Board reviewed a draft of the Annual Report.
10. VACSB General Assembly/Budget Update – Included in packet. The budget has not yet been approved and will have to go into special session. Budget items include Open Access, Bed Census, DOJ Settlement Agreement, Data Management Group, Inc.
11. Ingrid provided an update on Performance Contract changes that were submitted to the Performance Contract committee. Some of the topics were controversial due to staff performance and surplus of funding. Once the contract is approved, Ingrid will update the Board.

 ADJOURNMENT

MOTION:  That the March 15, 2018 regular meeting of the Alleghany Highlands Community Services Board be adjourned:

MOTION:  Nolan Nicely, Jr.

SECOND:   Bill Gilliland

VOTE: Unanimous

TIME:  5:25 p.m.

NEXT MEETING:   The next scheduled meeting will be on Thursday, May 17, 2018 at 4:00 PM at the Administration Office located at 205 E. Hawthorne Street in Covington, Virginia.