REGULAR MEETING OF THE ALLEGHANY HIGHLANDS COMMUNITY SERVICES BOARD
Thursday, May 21, 2015

The Alleghany Highlands Community Services Board held its regular meeting on April 16, 2015 at 4:30 p.m. at the Administration Office located at 205 E. Hawthorne Street in Covington, Virginia.

PRESENT: Teresa Johnson, Robert McCallister, Connie Back, Carla Dobbs, Robert Johnson, Jr., and Anne Dean

ABSENT: Nolan Nicely, Jr. and Lisa Hicks.

Also present: Ingrid W. Barber, Executive Director; Angie Goodbar, Director of Intellectual Disabilities Services; Cara Major, HR Manager; Nancy Curry, QI Manager; Adam Kenny, IT Manager, and Felicia Prescott, Director of Outpatient and Support Services.

Teresa Johnson, Chairwoman, called the meeting to order at 4:45 p.m.

APPROVAL OF MINUTES OF April 16, 2015 REGULAR MEETING
MOTION: That the Board approve the minutes of the April 16, 2015 regular meeting.
MOTION: Carla Dobbs
SECOND: Bob McCallister
VOTE: Unanimous
TIME: 5:00 p.m.

Communication: Ingrid read a Letter to the Editor which discussed May being Mental Health Month.

Program Update on Children’s Services by Debbie Burns, Children and Prevention Services Supervisor.

PROGRAM REPORTS

Mental Health & Substance Abuse
Felicia Prescott provided the following report:
• In addition to learning and meeting the staff as the new Director of Outpatient and Support Services, she completed new hire orientation and Relias online trainings. She interviewed candidates to fill important supervisory and direct care vacancies in the department, was introduced to the electronic health record and the agency budget, attended the Family Assessment and Planning Team (FAPT) and CMPT meetings, visited Covington Manor I and attended the VACSB conference. She is working on an internal committee facilitated by Nancy Curry to prepare the agency for a major transition from the International Statistical Classification of Diseases and Related Health Problems, ICD9 to ICD10 in October 2015. The ICD codes drive billing and code selections must be supported by documentation in the record. This project has significant implications and will require across the board staff training.
• Facility Improvements – The reception area in the Guinan Center is being renovated to accommodate the relocation of the reimbursement team. The reimbursement team will be added value to the center by assisting with health information management, financial intakes, and other reimbursement functions on site. The administrator responsible for securing service authorizations has attended a recent Virginia Premier meeting to gain current training.
• Prevention Services – This area has been busy with end of school year activities. The Covington High School After Prom event was held on April 25-26 at the YMCA. The After Prom contest was judged and prizes awarded to one Covington High School student and one Alleghany High School student. The winners won a Kindle Fire and case. Their art submissions were printed on the After Prom posters as well as the T-shirts which were distributed to the students at the After Prom events, and provided by AHCSB.
• Billboards – Three billboards promoting a Smoke Free life for the residents of our community are displayed and will be up until October 13, 2015.
• The Alleghany Clubhouse (PSR-psychiatric rehabilitation program) Program- this program is incorporating member feedback into programming. Per members’ request, a suggestion box was created as a new avenue for them to voice their wishes, for their program. PSR staff assisted members in implementing these suggestions to include education group topics, lunch menu items, and program outings.
• Case Management – The Case Management supervisor and three case managers attended an Advance Directive Facilitator training in Roanoke April 20-21. Advanced directives help anyone make their wishes known when they are unable to express them for themselves. It is similar to a power of attorney. The case management team has also been challenged to complete 30 short form Governors Access Plan (GAP) enrollments for our existing clients by May 15. This will give those clients the best possibility to qualify for insurance at 100% of federal poverty as opposed to the 60% level being enforced on May 16. This is important because it adds another payer source for the agency and reduces self-pay.
• Emergency Services – ES submitted the quarterly Exhibit B report to the Department of Behavioral and Developmental Services (DBHDS) showing 91.67% of individuals involved in civil admission access following up with AHCS for services within required timeframe. This was a significant improvement over the DBHDS required 73%. An ES supervisor also attended ICD 10 Transition training in Henrico and is part of a group of staff working to implement the DSM 5 and ICD 10 changes prior to the October 1, 2015 deadline. ASIST training (Applied Suicide Intervention Skills Training) was held May 18-19 at Family Life Center, First Christian Church and was open to the public.

Intellectual Disabilities
Angie Goodbar provided the following report:
• Update on waiver redesign: The findings of the Burns and Associates Survey has been published on the DBHDS website. As a result of the survey, new rates of reimbursement will go into effect as of July 1st. The projected date for the implementation of the three new waivers is July 2016.
• Intellectual Disability Services is in the process of creating safeguards to address conflict free case management. The case management program will continue to operate out of the ID Administrative building but residential in-home services has been moved to the Moody Building in Clifton Forge. This will create a firewall to allow families and individuals to make informed choices of service providers. A letter has been mailed out to families and individuals to inform them of the change and new contact phone numbers.
• Support coordinators requested funding for individuals needing items through Commonwealth Community Trust’s Charitable Fund Award.
• Remodeling has occurred at Friendship Residence Group Home in that two new bathroom shower units have been installed. Merryfield recently had raised garden beds built in the yard.
We have found that gardening is therapeutic for all residents and the fresh vegetables improves their diet and health. On May 26th, Merryfield will be admitting a new individual, putting the program at full capacity with nine beds filled.
• In April, satisfaction surveys were mailed out to individuals receiving services that have guardians and authorized representatives. The support coordinators assisted individuals with completing surveys the week of April 13-17. Please see the attached results of the survey in the board packet.
• During the month of April, employees worked on corrections needed for the Patient Fund Account (PFA) Audit for Merryfield. All corrections were accepted by the auditors. The ID Director and QI Manager worked on completing the Department of Rail and Public Transportation (DRPT) Title IV Agreement required in order to receive the grant funding for the fifteen passenger bus. The bus should arrive in July of 2015.
• A “Community Breakfast” was held May 14th in order to educate the community about the Intellectual Disability services provided by AHCS.
• Angie Goodbar, Ingrid Barber and Amanda Webb attended the 2015 Public Guardian and Conservator Annual Conference in Richmond, Virginia. Angie Goodbar and Amanda Webb gave a presentation on “Community Collaboration between Guardian Programs and CSB’s”.

Quality Improvement
Nancy Curry provided the following report:

UR, Compliance and EHR:
• There were 22 Incident Reports processed during the month of April. There were no safety inspections.
• Client satisfaction surveys were completed 4/30/15 and a summary of responses is attached.
• DBHDS Data Dashboard data for AHCS – updated copy attached.
• An updated copy of Exhibit B of the Performance Contract for AHCS is attached.

Credentialing:
• May 2015 figures include: 9 AHCS licensed staff; 12 Insurance Panels; and 86% of Staff Credentialed.
• Currently credentialing three new staff members. The remaining six staff are credentialed on all available panels.

Staff Development:
• April 2015: 134 staff with 94% compliance for annual training (7 courses)
• May 2015: 137 staff with 96% compliance for annual training (7 courses)
• One 32-hour Medications Class was administered; no 8-hour Medications Class were administered; no TOVA classes were administered; and one New Hire Orientation was conducted.

Projects:
The Client Satisfaction Survey was concluded in April; the Annual P&P Review and Core Services/PC/Budget alignment projects are concluded, and the ICD-10 project is in process. The QI Plan-Performance Contract is in process. Documentation/Credible Training and Incident Reporting in Credible are in process.

Other:
Attended Safety Meetings in May.
Attended training on changes to the CMHRC DMAS manual on May 11th.
Attended Boys’ Home Residential Education Day on May 6th.
Will be offering Mental Health First Aid course at Admin building on May 18th.

IT Manager Report:
Adam Kenny provided the following report:
Help Desk:
• Completed 26 help desk requests.
• Completed 76 Credible change requests.

EHR:
• Assisted with form changes in ID and MH.
• Worked with Fiscal on Revenue matrix changes.
• Received MU payments for Dr. Bates and Dr. Ladenika.
• Set up liability for automated write off of sliding fee visits.

Hardware and Networking:
• Assisted with office move between ID and Life Skills.
• Worked with advanced telephone for phone changes at MH.

Other:
• Attended monthly DMC meeting.
• Attended ICD 10 workgroup meetings.
• Visited Western State Hospital.
• Assisted with Relay for Life fundraisers.
• Re-wired MH Front Office and Intake Room.

Human Resources
Cara Major reported the following:

Turnover:
• For Fiscal Year 2015, there have been 32 New Hires and 46 Terminations with a turnover rate of 30%.
• FY15 Reasons for Separation:
Other Employment – 20; Moved – 2; School -2; Personal Reasons – 11; More Money -1; Retired-4; Terminated – 4; Did not return from FMLA – 2.

Loss Report:
• There were 2 minor Worker’s Comp Claim, no auto claims and no property claims.

Advertising/Recruitment:
• Advertising was done through websites: VEC, Indeed, Careerbuilder, and Jobs.roanoke.com, Craigslist and Facebook and through newspapers: Virginian Review, Staunton, Lexington, Lewisburg and Roanoke.

Filled Positions:
• Intellectual Disabilities – In Home Residential Supervisor; Support Coordinator/Case Manager
• Mental Health – Skill Building Provider; Case Manager
• Administration – Quality Improvement Specialist

Open Positions:

• Intellectual Disabilities – Food Services Specialist; Direct Support Professional (In Home, Friendship); C.N.A.; Infant Toddler Systems Manager/Early Intervention Professional; Van Driver
• Mental Health – Emergency Services Clinician (Part-Time); Outpatient Services Supervisor; MH/SA Therapist; and Skill Building Provider.

General Updates:
• Visited Western State
• Cleaned out MH Pit area
• Attended agency P&P meeting
• Transitioned New Beginnings Employees to Friendship Residence
• Conducted interviews

Participation:
• Attended VACO Short Term Disability Insurance Training on April 28
• Attended VACSB Conference May 5-7
Upcoming:
• VACSB HR Meeting – June

Financial Reports
• Ann Bostic, CFO submitted financial reports for AHCS.

EXECUTIVE DIRECTOR’S REPORT AND RECOMMENDATIONS

Ingrid Barber provided the following report:

Old Business:
• Catawba Regional Partnership Update – Ingrid has one more meeting to attend and then, effective July 1, 2015, AHCS will be part of PPR 1 and the catchment area will be Western State Hospital. A DAP meeting will be next Tuesday and Felicia, Ann and Ashley Smith (GAP case manager) will attend. Funding for July 1, 2015 going forward is $112,000 in LIPOS which is significant. In addition, we will continue to receive $50,000 in Recovery funds. Ingrid took GAP staff, ES staff, and Leadership staff over to visit Western State. Western State also came over and visited the Mental Health Clinic, Clubhouse and the New Beginnings building.
• Ingrid and Felicia met with the Community Services Director for DBHDS, Stacy Gill. They took her around to the different facilities and explained our services. It was a very good visit and she seemed impressed with the various services we were able to offer with us being a rural board.
• Life Skills Moody Building Update – The Foundation requested a local contractor to perform the work so Mary Fant Donnan worked with Sams and Co. to submit a proposal. His proposal exceeded the grant amount. The last day the Autism School will be in the building is June 30th. They are taking the playground equipment that they purchased. Ingrid said that Lionberger Construction is still very interested in the project but we have to wait to see if the Foundation is going to allow someone from outside the area to perform the work.
• ICF Update – We do not owe anything on the Patient Fund Audit. We received the final report on the year-long audit and they still say that we may have to refund some money. Ingrid wants to continue contesting the findings.

New Business:
• Updates and Approval of Proposed FY 2016 Performance Contract – DBHDS has decided to go back to having six meetings per year so AHCS is going back to the old board schedule. AHCS will meet in June, September and November after which we will be back on schedule. There was also language regarding whether or not ES workers must be licensed. Most of the changes involved the DOJ settlement and Emergency Services. The Performance Contract will be voted on at the June meeting and Ingrid will take it before the County Government and Covington City Council before the end of September.
• Joint Subcommittee Studying Mental Health Services in the Commonwealth in the 21st Century – Creigh Deeds is chairing this committee and they are still meeting. The word is that he is going to continue to try to invoke change into the system. He wants to fix our Mental Health system by concentrating on qualifications, criteria and training. They are looking at requiring supervisors to have a certain amount of experience which is difficult when you have a lot of turnover. Ingrid will provide updates to the Board as they become available.
• Administrative Staff relocation to Mental Health Clinic – The transition took place on May 27th. Position descriptions are still being created. Ingrid thanked Adam and Michael Garcia for taking care of the wiring, etc.
• VACSB Update – Ingrid chaired the conference which was very successful. Updates were provided at the conference regarding ES services, conflict-free case management, etc. She already has a keynote speaker lined up for next year.
• Next VACSB Conference is October 7-9, 2015 – Public Policy Conference at Charlottesville Doubletree Hotel – any board members interested in attending the conference need to let Ingrid know.
• Letter from Ed Stein regarding Jail Services – There was no formal complaint filed but some concerns have been raised. Ingrid explained to Stein that AHCS is not required to render services in the jail per the performance contract.

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: Lisa Hicks
SECOND: Anne Dean
VOTE: Unanimous
TIME: 6:28 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 May 21, 2015 regular meeting of the Alleghany Highlands Community Services Board be adjourned.
MOTION: Anne Dean
SECOND: Connie Back
VOTE: UNANIMOUS
TIME: 5:50 p.m.

NEXT MEETING
The next scheduled Board Meeting will be on Thursday, June 18, 2015 at 5:30 p.m. at the Administration Office located at 205 E. Hawthorne Street in Covington, Virginia.