May 20, 2013

The Alleghany Highlands Community Services Board held its regular meeting on May 20, 2013 at 5:30 p.m. at the Lifeskills location on 550 Pine Street, Clifton Forge, VA.

PRESENT: Robert McCallister, Lisa Hicks, Connie Redman Back, Charli Laws, Nolan Nicely,Karen Burns.

Also present: Ingrid W. Barber, Executive Director; QuoVadis Washington-Brown, Director of Outpatient and Support Services; Angie Goodbar, Director of Intellectual Disabilities Services, Patty Flanagan, Fiscal & Reimbursement Supervisor; Nancy Curry, Quality Improvement Manager; Cara Major, Human Resources Manager; Adam Kenny, IT Manager and Gloria Humphries, Administrative Assistant and Clerk to the Board.

Absent: Teresa Johnson, Robert Johnson Jr. and Eleanor Payne

Bob McCallister called the meeting to order at 5:29 p.m.

MOTION: That the Board approve the minutes of the April 8, 2013 regular meeting.
MOTION: Karen Burns
SECOND: Lisa Hicks
VOTE: Unanimous

Board Education

Tiffany Reynolds, Residential In-Home Supervisor, provided a brief presentation of information about the In-home residential services program that AHCS provides.


Ingrid provided a copy of the Letter to the Editor for May is Mental Health Month.


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

• QuoVadis reported that Outpatient and Support Services have been preparing for a number of regulatory changes that will affect behavioral healthcare within the next few months. These changes will allow for opportunities to improve services while also improving efficiency and effectiveness of services. While these are sure to be improvements to service delivery, these changes will impact the financial stability of programs in the following areas: Case Management, Mental Health Support Services, Therapy, Psychiatric Services and Emergency Services.

• QuoVadis reported some of the changes:
1. Changes to the amount of time it will take to execute a Temporary Detention order from 48 to 72 hours;
2. Changes to regulations regarding Mental Health Support Services to include criteria for eligibility, diagnosis, rate changes.
3. Impending changes to behavioral health as a result of the selection of a Managed Care Organization delivering behavioral health services.
4. Integrated Behavioral and Physical Health.
5. Enhanced Care Coordination for Dual Eligible (individuals with Medicaid and Medicare coverage that have serious mental health, SA, or ID and serious medical conditions.
6. Training on health education, positive behavioral support, DSM 5, ICD-10—Upcoming Summer of 2013 for implementation of fall 2014.

• QuoVadis reported that Outpatient and Support Services are glad to have 2 new therapists and 1 Master’s level intern from Liberty University to join our team in April and May.
• QuoVadis participated in the following meetings:
1. QuoVadis met with Blue Ridge Behavioral Healthcare Regional Stabilization Unit on 3/15/2013 to discuss referrals from Alleghany Community Services.
2. QuoVadis attended the VACSB Mental Health and Substance Abuse Council Meeting on 3/22/2013.
3. QuoVadis met with Major T. Cronk and Captain Craighead, Alleghany Regional Jail, on 4/11/13 to discuss providing psychiatric services for inmates beginning June 2013.
4. QuoVadis participated in the Medical Records Training on 4/18/2013.
5. Met with ID Director, Angie Goodbar, to discuss applying for a grant through the Virginia Department of Rail and Public Transportation for 2 wheel chair accessible vehicles to assist our clients and community on 4/22/2013.
6. QuoVadis met with ID Director, Angie Goodbar, Day Support Supervisor, Linda Mack, Angie Deem, Case Management Supervisor and ID Case Management Supervisor, Sue Childs, and Brooklyn Cooke, MH Case Manager on 4/23/2013 re: Supportive Employment Initiative. Plans for luncheon to discuss next steps will be held on May 16, 2013 at 12 noon at MH clinic.
7. QuoVadis met with ID Director, Angie Goodbar, Angie Deem, MH Supports and Case Management Supervisor, ID Case Management Supervisor, Sue Childs, ID Case Manager, Amy Haymaker, ES Supervisor, Andrea Dilley, Alleghany Group Home Supervisor, Billy Harrison, and Crisis Stabilization Supervisor, Susan Chittum to discuss ways of improving services for an individual diagnosed with MH/ID.
8. QuoVadis met with MTM Services, Scott Lloyd, Consultant, regarding the progress on Same Day Access on 4/24/13. MH has seen a 25 % increase in access to services which means an additional 20 persons per month actually being seen for services from their initial call. Post session documentation has decreased.
9. QuoVadis met with Mental Health Support Providers on 4/25/13 to discuss assignments for clinical supervision to assist in treatment planning, review of quarterly review documentation, weekly notes, and set up schedule for clinical supervision to occur.
10. QuoVadis participated in Relay for Life with Alleghany Highlands Community Services on 4/27/2013.
11. QuoVadis attended the VACSB Conference-VA Beach, VA 4/29-5/3/2013.

Intellectual Disabilities

Angie Goodbar provided the following report:

• Angie stated that spring brings about many exciting opportunities for Intellectual Disability Services. A newsletter will be published every other month to inform individuals, families, and members of the community about services offered, delivered and upcoming events. Individuals involved in services will help develop and distribute the newsletter. ID Services are focusing on offering individuals opportunities for increased community inclusion such as involvement in community activities and volunteer work.

• Angie reported that as a follow up to the Employment First Initiative Workshop in March, AHCS held a Supported Employment Stakeholder meeting May 16th. The purpose of the stakeholder meeting was to discuss possible partnerships among organizations in the community to offer individuals with MH/ID/ SA disabilities opportunities for supported and integrated employment. The DOJ Settlement mandates that individuals with ID should be offered integrated and community based employment due to employment giving individuals a greater sense of accomplishment and increasing their feelings of competence and self- worth.

• Angie reported that ID Services has been audited by external entities with favorable results. ID Services participated in a DBHDS Audit which resulted in feedback to improve service delivery and suggestions in regards to best practices. ID Services is also pleased to announce that the Environmental Modification and Assistive Technology Services were audited by DMAS and there were no findings or deficiencies.

• Angie reported that the Support Coordinators have worked diligently to enroll 5 individuals into waiver services. There are 4 individuals on the urgent waiver wait list. There are 5 individuals at Central Virginia Training Center that will need support in transitioning back into the community.

• Angie reported that the Support Coordinators started providing “enhanced case management” services on March 1st. The Support Coordinators attended a meeting in Radford conducted by Kathy Drumright and Dee Kennan from DBHDS to monitor the progress CSB’s are making in implementing the DOJ Settlement agreement and any barriers.

• Angie reported that as of April 1st all ID services require pre-authorization. The providers request authorization in IDOLS web based system and receive approval in order to bill for services. Program Supervisors will attend the quarterly Provider Roundtable Meetings to stay abreast of changes and receive updates from the Community Resources Consultants and DBHDS.

• Angie reported that with the conversion of Merryfield ICF, the staff are now classified as hourly full-time. Since Merryfield ICF is a skilled care facility, the staff are required to have a CNA license. AHCS is offering educational assistance for staff to enroll in the CNA classes at DSLCC.

• Angie reported that Merryfield ICF continues to provide active treatment to residents. Sheena Jackson, Administrator visited an ICF in Danville to compare service delivery. Angie Goodbar, ID Director and Ingrid Barber, Executive Director visited an ICF in Virginia Beach.

• Angie reported that in order to offer services on a regular basis and offer opportunities for community involvement, the agency must have reliable transportation. A used handicapped accessible van was purchased for Merryfield ICF. The ID Director and MH Director are working collaboratively to write a grant proposal to the Department of Rail and Public Transportation for handicap accessible vans. The deadline for the grant submission is Feb. 2014.

• Angie reported that Sheena Jackson, ICF Administrator and Tiffany Reynolds, Residential In-Home Supervisor attended Person Centered Training in New Market, VA.

• Angie attended the VACSB Conference in Virginia Beach in May. Angie brought back information to staff in regards to housing and Case Management Operational Guidelines. Angie also attended the Developmental Services Council Meeting.

Quality Improvement

Nancy Curry provided the following report:

UR and HER
• Nancy reported that AHCS has received reports from two of the DMAS Audits. The reports are listed as follows:
- 2/4/2013 Desk Audit for ID Assistive Technology and Environmental Modification. No deficiencies were found.
- 2/26/2013 Desk Audit of VICAP. Nancy stated that the agency received a request for additional information and it has been sent. AHCS is still waiting for the final report.

• Nancy stated that monthly UR reports were distributed.
• Nancy stated that quarterly reports were distributed.
• Nancy completed a Mental Health Support Services Study to project the financial impact on the agency regarding the rate changes. Nancy also provided detailed data regarding staff caseloads to QuoVadis for reviewing individual cases.
• Nancy facilitated the quarterly safety meeting.

• Nancy reported that AHCS has been assigned a new Licensure Specialist, Pam DuBose.

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

Staff Development
• Nancy reported that AHCS has 151 staff enrolled in Elevate.

• Nancy completed the Mental Health First Aid Class.
• Nancy attended the Voter Registration training in Roanoke.

IT Manager Report

Adam Kenny reported the following:

Help Desk
• Adam reported that he has configured help desk software and has started creating tutorials for the employees.

• Adam reported that he received approximately 55 help desk request.

• Adam reported that he has completed approximately 180 visit change requests.

• Adam reported that he has made several changes to intake forms.

Hardware and Networking
• Adam reported that he has installed and configured 6 computers for Merryfield.

• Adam reported that he has planned out cabling changes and a new phone system for Merryfield.

• Adam discussed that he has researched Team Viewer which will allow for remote administration of agency computers.

• Adam reported that he has corrected phone issues at Admin and ID.

• Adam attended monthly DMC meetings in Richmond.

• Adam completed the ROSI and Waiting List surveys.

• Adam installed Great Plains updates for all Fiscal/HR computers.

• Adam attended the Relay for Life event.

• Adam attended the VACSB Conference.

Human Resources

Cara Major provided the following report:

• Cara reported the 2013 fiscal year turnover rate for 7/1 through 5/10 was 28%.

• Cara reported the 2012 fiscal year turnover rate from 7/1, 2012 through 5/10, 2013 was 26.8%.

• Cara reported that the 2012 fiscal year turnover rate for the entire year was 30%.

Loss Report
• Cara reported that there was 1 Worker’s Comp Claim.

• Cara reported that advertising is being done with local papers (Roanoke, Lynchburg, Lexington, and Stanton), Shentel Cable, Lumos Internet and the Roanoke paper.

• Cara provided an update on the filled and open positions.

General Updates
• Cara stated that the employee breakfast was held on 4/29/2013. The next breakfast will be 6/4/2013 at 9:00am.

• Cara stated that she is working with the agencies broker BB&T to ensure that the agency is in compliance with the Health Care Reform.

• Cara stated that she is working with a law firm in regards to the H1B Visa for the Psychiatrist position.

• Cara reported that salaried performances evaluations are currently being conducted and completed evaluations are due to HR 5/31/2013.

• Cara completed the SHRM PHR Course

• Cara attended the Mental Health First Aid Training 4/10-11/2013.

• Cara attended the SHRM conference 4/22-24/2013.

• Cara attended the VACSB Conference 5/1-3/2013.

• Cara will be attending the VRS Hybrid Retirement Plan Information Session on 5/22/2013.

• Cara will be shadowing Cumberland CSB HR Office on 5/29/2013.

Budget Reports

Patty Flanagan provided the budget report.
• Patty provided the balance in the regular checking and foundation account and the consolidated year to date totals for the agency for the month of April 2013.

• Patty provided the MH/SA and ID fund balance reports.

• Patty provided a copy of the Comparison of FY13 & FY13 Letter of Notification.


Ingrid Barber provided the following report:

Old Business
• Ingrid stated that the Board Financial Committee Meeting is scheduled for Monday, June 3, 2013 at 4:00pm.

• Ingrid provided an update on the Catawba Regional Partnership.

• Ingrid provided an update on the New Lease on Life Grant.

New Business
• Ingrid reviewed the FY Proposed 2013 Performance Contract. Ingrid stated that a motion is needed to approve the FY Proposed 2013 Performance Contract.

MOTION: That the Board approve the FY Proposed 2013 Performance Contract.
MOTION: Nolan Nicely
SECOND: Charli Laws
VOTE: Unanimous
TIME: 6:43 p.m.

• Ingrid provided an update on the VACSB initiatives.

• Ingrid provided the 2012 ID Family Survey results.

• Ingrid provided brief information regarding Dual Eligible Criteria.

• Ingrid stated that the next VACSB conference (Public Policy Conference) is 10/2-3/2013.


MOTION: That the Board enter closed session to discuss Personnel Matters, as authorized by the Code of Virginia Sections 2.2-3711A.1.
MOTION: Eleanor Payne
SECOND: Teresa Johnson
VOTE: Unanimous
TIME: 6:30 p.m.


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.


The next scheduled Board Meeting will be on Monday, July 22, 2013 at 5:30 pm. at the
Administration Building; 205 E. Hawthorne Street, Covington, Virginia.


MOTION: That the January 28, 2013 regular meeting of the Alleghany Highlands Community Services Board be adjourned.
MOTION: Robert Johnson
SECOND: Charli Laws
VOTE: Unanimous
TIME: 7:30