MINUTES

 

REGULAR MEETING OF THE ALLEGHANY HIGHLANDS COMMUNITY SERVICES BOARD

Thursday, November 16, 2017

 

The Alleghany Highlands Community Services Board held the November Board meeting on November 16, 2017 at 4:00 p.m. at the Administration Office located at 205 E. Hawthorne Street in Covington.

 

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

 

ABSENT:   Robert Johnson, Jr.

 

Also present:  Ingrid W. Barber, Executive Director; Adam Kenny, IT Manager; Crystal Homer, Human Resources Manager, and Patty Flanagan, Finance Manager.

 

Anne Dean, Chairman, called the meeting to order at 4:12 p.m.

 

Retirement Recognitions:  The Board recognized Debbie Burns who was present at the meeting, along with Sue Childs and Nancy Curry, who were not present.

 

Presentation of FY 2017 Financial Audit – Emily Viers from Robinson, Farmer & Cox

 

APPROVAL OF MINUTES OF SEPTEMBER 21, 2017 REGULAR MEETING

MOTION:  That the Board approve the minutes of the September 21, 2017 regular meeting.

MOTION:         Robin Mieras

SECOND:         Nolan Nicely, Jr.

VOTE:              Unanimous

 

PROGRAM REPORTS

Mental Health & Substance Abuse

Ingrid Barber presented the following report:

• Twenty-four people attended the Healthy Youth Coalition on Thursday, September 14, 2017, at the Alleghany County School Board Office. Great networking and plans are being made in our community to address issues around youth substance abuse.

 

• Prevention services presented programs at DSLCC to the orientation classes on September 18, 19, and 21 regarding Alcohol Abuse & Suicide Prevention. On September 27, 2017, Prevention and ES Staff organized and held a Live Stream event addressing opioids and other additions.

 

• Tiffany Bowser will now be the Case Management and Prevention Supervisor, and Susan Chittum will be supervising TDT and Mental Health Skills building doing assessments under the supervision of Angie Goodbar, effective October 1, 2017.

 

• The Virginian Review shared a front page article on Case Management Appreciation Week (October 9-13). Our case management staff celebrated this week and ended it with a “Pizza and Paint” party.

 

• Prevention has a new part-time Prevention Specialist, Matina Kazameas. Prevention staff constructed bulletin boards at AHS for Red Ribbon Week in which red ribbon bracelets, stickers, pencils and bookmarks were given away. On October 20 and 21, Prevention staff represented the Alleghany Highlands Healthy Youth Coalition with a table set up at the Fall Foliage Festival where they gave out information on marijuana use in our area as well as popcorn and apple cider. Prevention also represented the Healthy Youth Coalition at Hometown Halloween on October 28, 2017 in Covington.

 

• MAT (Medication Assisted Treatment) is in the very important development stage. This is a phase of learning and growth for the clinicians and clients. We are adjusting how the program operates. CSAC’s and the MAT Coordinator, Dana Hiner, will be receiving additional training related to group facilitation.

 

• We are excited to welcome a new onsite psychiatrist, Dr. Iskander, who will begin work on November 7, 2017. He will be working with us every Tuesday in the MH/SA clinic. Pandit continues to provide TeleHealth Services 3 weeks out of the month and is physically in the MH/SUD clinic one week per month.

 

Developmental Services

Angie Goodbar provided the following report:

• Case Management – AHCS recognized National Case Management Appreciation Week October 8-14. Employee profiles were shared on the agency facebook page. The employees participated in a luncheon and Paint Party at Cucci’s. Door prizes were awarded throughout the week.
• Waiver Slots – DBHDS awarded four Community Living Waiver Slots to individuals rating priority one on the CSB wait list. Currently, there are twenty individuals on the AHCS waiver wait list.
• Marketing/Educating the Community – Lisa Pritt, CM Supervisor, met with the Covington Special Education Advisory Committee to give a presentation on the waiver services.
• Emergency Preparedness – The Center for Medicaid and Medicare (CMS) issued new guidelines this year to prepare long term care facilities for compliance with emergency preparedness regulations by November 15^th. A committee was developed to revise existing policies and develop new procedures for emergency preparedness. The committee facilitated a table top exercise and short term evacuation drill at Merryfield.
• CCC Plus and Transportation – AHCS currently provides medically necessary transportation services and is in the process of securing contracts with the MCO’s in our region. The administrative support staff will be working closely with the MCO’s to learn processes for scheduling and billing these new insurance companies.
• LSC Day Support Program – The individuals attending the day support program made crafts to sell at the Fall Festival. They interacted with community members and took pride in the crafts they made and sold at the festival. The participants also enjoyed “Game Show Day” in September and the Halloween Party in October.
• Board approval for Walgreens grant application – Developmental Services is requesting board approval to submit a grant application to Walgreens for exercise equipment in the amount of $16,995. The exercise equipment will be utilized to improve health and wellness of the individuals that attend the day support program and employees.
• KOVAR Grant Application Update – DRPT awarded AHCS 80% for a 14 passenger bus and two minivans. AHCS applied with KOVAR for the remaining 20% for the cost of the vehicles. AHCS was awarded $25,000.
• Foundation of Alleghany, Rockbridge and Bath Application Update: AHCS was awarded $1,000 in funding for living room furniture for Friendship Residence.
• Audits – The Patient Fund Audit for Merryfield was conducted by Myers and Stauffers on September 20^th. The auditors looked at Merryfield financial records from 2014-2017. The audit resulted in no citations.

The Department of Aging and Rehab Services (DARS) conducted the Monitoring Visit of the Public Guardian Partnership Inc. Program the week of September 18-22. The auditors had many complimentary remarks about Amanda Webb, Guardianship Director. They stated that her documentation has now set the standard for the rest of the state. They will be using her documentation as examples of what they are requiring from other PGP programs. They also commented that Amanda’s direct care for the individuals is exemplary.

The Fiscal Audit of the Public Guardian Partnership Inc. Program (PGP) was October 23-25. Financial records for the PGP and the agency were thoroughly reviewed. This audit also resulted in no citations.

The Case Management Program received a desk audit from DMAS of two assistive technology cases. All documentation was supplied timely and met all requirements. No citations were noted.

The Infant/Toddler Program is currently undergoing a Quality Measurement Review (QMR) with the Department of Medicaid Services.

 

• The DS Director attended the State DS Council Meeting in Richmond, 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 joined agency CCC Plus planning committee meetings.

 

Quality Improvement

Nancy Curry provided the following report:

UR, Compliance and EHR:

• Incident Reports Processed – 38 in September and 35 in October.
• # CHRIS Reportable – 23 in September and 21 in October.

 

CAPS:

10/2/17 – Friendship – DBHDS Licensure CAP: Provider did not report serious injury within 24 hours as required by regulation.

10/6/17 – Friendship – DBHDS Licensure CAP: Provider failed to adhere to staffing pattern.

 

Emergency Preparedness tabletop exercise was conducted at Merryfield.

Jennifer Jarvis, DS InHome Services Supervisor, oversaw Earthquake Drill. This was part of the ShakeOut International Day of Action held annually on the third Thursday of October. This was AHCS’ first time participating.

 

Staff Development:

• Chart provided displaying training compliance by department for 2017.
• Table provided showing trainings provided by QI staff, including 32 Hr Medication Management courses, 4 Hr Medication Overview Courses, 4 Hr Medication Refreshers, TOVA, New Hire Orientations, Mental Health First Aid classes, and Skin Integrity and Lifting Class.

 

Other:

Participation in Meetings/Trainings/Committees by QI staff:

• Safety Meetings, VACSB QL Meeting, VA Credible Users Meeting and Regional Nursing Meeting

 

IT Manager Report:

 

Adam Kenny provided the following report:

Duties performed or in progress since September 2017:

Help Desk:

• Completed 119 help desk requests.
• Completed 193 Credible change requests.

EHR:

• Assisted with form changes in DD and MH.
• Created new Universal Drug Screen visit.
• Added nonpayment schedule status so we can track what clients are being rescheduled due to nonpayment.

Hardware and Networking:

• Setup and configured polycom unit for Dr. Pandit.
• Setup and configured polycom video border proxy for negotiating traffic of multiple polycom devices.
• Setup and configured new cable modem to deliver multiple IPs in the clinic. The second IP is used for all polycom traffic.
• Installed new wireless access points at Admin, Merryfield, ID Admin, Life Skills, and Friendship.
• Installed new computers at Merryfield.
• Moved networking equipment out of Rhonda’s office. Installed new cabinet and rack in closet to house networking equipment.

Other:

• Talked with company about old computer recycling.
• Started testing office 365 migrations.
• Created trainings for new doctor.
• Attended monthly DMC meeting.
• Attended quarterly Credible User Group meeting.
• Attended reimbursement meeting.
• Attended bi-weekly leadership meetings.
• Attended CCC Plus meetings.
• Submitted monthly CCS report.

 

Human Resources

Crystal Homer reported the following:

Loss Report:

• Worker’s Comp Claims – Fiscal Year Totals Updated
• No new claims for new fiscal year at this time
• Auto Claims –
• Auto Physical Damage – $576.75 paid for bus damage at Merryfield and $355.81 paid for an accident.
• Property Claims – 0

Separations:

FY 17 – 49 separations

Separations for July-October 2017 (12 total) – 3 retirements; 3 job abandonments; 3 other employment; 1 medical reason and 2 personal reasons.

 

Recruitment:

Open Positions as of 10/31/17:

Intellectual Disabilities –

• Support Coordinator
• 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 –

• Therapeutic Day Treatment Specialist
• New Beginnings Residential Technician
• Child and Family Therapist
• Mental Health – Intensive Services Clinician – LMHP-E
• Mental Health Director
• Clinical Services Supervisor

Administration –

• Quality Improvement Specialist
• Quality Improvement and Compliance Manager

 

General Updates:

• Full implementation of new performance evaluation process.
• HR Specialist getting acclimated.
• Attended Woods Rogers employment seminar and VRS Roundtable.

 

Financial Reports

• Financial reports were submitted by Patty Flanagan.

 

EXECUTIVE DIRECTOR’S REPORT AND RECOMMENDATIONS

Ingrid Barber provided the following report:

AGENCY ISSUES:

1. Guinan Center/Mental Health Clinic Roofing Update – We received first invoice on roof from Don Largent Roofing, Inc. on October 31, 2017 in the amount of $74,822.30. This included materials and labor. In working on the roof replacement, it was determined that more sheeting will be needed, and our HVAC units will also need replacement. I am currently receiving quotes on the cost of replacing three 5-ton units and one 2 or 3-ton unit. In addition, asbestos removal from the front of the roof is estimated at $24,000.
2. Loan Re-Authorization for Mental Health Roof Replacement/HVAC/Change orders – I will need reauthorization and approval from the Finance Manager and the Executive Director to exercise a loan with Highlands Community Bank to pay for roofing, HVAC, and change order related constructional needs as necessary. (Attached document)
3. CIT Grant Update – (Attached document)
4. Jail Services Update –

MALES                                  FEMALES

Total Admissions                                                              14                                           15

Transfers to other correctional facilities                 1                                              3

Releases from ARH                                                          1                                              2

Total dropouts                                                                  7                                              4

Other                                                                                    1 denied by jail staff       0

Follow up @ AHCS after release                                0                                              0

Reincarcerations                                                               0                                              0

 

Katie Lewis, our employee who is licensed eligible, is onsite one day per week, and offers gender specific MRT (Moral Reconition Training) therapy groups. Participation in the groups is voluntary, with jail administration approval. Initially the male inmates showed the greatest interest, however most recently female inmate participation has grown to surpass the males. MRT has a minimum of 16 steps and two females have achieved completion of step 9, while three males have achieved completion of step 6.

 

5. DBHDS Update on the Extraordinary Barriers List, DAP plans, State Hospital Census, and Waiting List for Waiver Services – Census = 6 currently in state hospitals with one pending transfer to Western State as soon as a bed is available. 4 at Western State, 2 at Catawba, no one currently on the EBL or ready for discharge. We currently have 13 DAP plans. Of the 13, three are ongoing plans, six are considered one-time plans and four plans for individuals residing in our catchment area that are receiving DAP funds from other CSBs/Regions for services provided by AHCS. There are 20 individuals on the waiver wait list and 2 are in priority one categories.

 

COMMUNITY ISSUES:

1. The Health Department is conducting a Community Health Needs Assessment for Alleghany County, Covington, and Clifton Forge residents. They have copies of surveys in most businesses in the community, and our CSB Mental Health Clinic. Their goal is to collect at least 1,000 surveys.

 

STATE/REGIONAL/FEDERAL ISSUES

PUBLIC POLICY:

1. Financial Realignment– Recommendations will be coming from the Department of Behavioral Health and Developmental Services to the upcoming General Assembly Session that could impact funding and expectations starting in Fiscal 2019. The system as proposed in its current draft would provide for a target bed-day utilization for each CSB in Virginia based on its historical usage patterns per 100,000 in population. That target number would then be used to provide financial incentives for CSBs by charging for bed utilization beyond that target and providing some credits for usage under the targets. New state dollars are also proposed for all CSBs during the first two years as the overall system statewide transitions to this new model. Although there remains a number of questions, the basic concept is receiving support so I think it is appropriate to anticipate some of these changes to begin in Fiscal 2019. New dollars would be used to develop programs aimed at diverting individuals from requiring State hospitalization and developing services to further facilitate discharges when individuals are clinically ready to return to the community.
2. Please be reminded of the VACSB Legislative Conference being held at the Hilton Downtown Richmond Hotel from January 16 to 17, 2017. (Attached document)

OLD BUSINESS:

1. Guinan Center Roof Update – Everything was going well with the roof replacement and repairs should be completed in the next week.
2. Loan Reauthorization for Mental Health Roof Replacement/HVAC/Change Orders –There were some issues with the old units so they will have to be replaced with new units. There were also a couple of change orders because they had to replace more sheeting. Although the estimate for the repairs was $109,000, with new A/C units, asbestos removal and additional sheeting, we are anticipating that the cost will be closer to $175,000. Ingrid and Patty met with Bryan Thompson at Highlands Community Bank to secure a loan which will be repaid in 60 payments/5 years.  Ingrid requested reauthorization from the Board in the amount of $175,000.  The bank requested a copy of our board minutes for approval; however, Ingrid will submit a resolution to the bank signed by the Board Chair since our next meeting is in March.

MOTION:  That the Board approve a loan reauthorization in the amount of $175,000 for the  Mental Health Roof Replacement change orders.

MOTION:   Teresa Johnson

SECOND:    Lisa Hicks
VOTE:  Unanimous

3. CIT Grant Update – The grant will be coming to an end. It was successful as we have far exceeded our 25% goal. Approximately 60 people were trained including 36 sheriff deputies, 9 Covington City police officers, 11 Clifton Forge police officers, 3 ES prescreeners, 11 CIT trainers and 1 Probation and Parole officer. Ingrid will submit an article to the newspaper recapping its success and explaining that it is concluding.
4. Jail Services Update – Ingrid provided an update on Jail Services. Katie Lewis, a resident at MH/SA clinic, is doing a great job. She said one of the problems is that participation in the group is voluntary. The biggest problem with a group like this is that we don’t know how long they may remain in jail and some are being released before they can complete the group.
5. DBHDS Update on the Extraordinary Barriers List, DAP plans, State Hospital Census, and Waiting List for Waiver Services – Ingrid provided an update and advised that we currently have six in state hospitals and one with a pending transfer to Western State when a bed is available.  13 have DAP plans; 3 are ongoing, 6 are one-time plans and 4 are plans for individuals who are residing out of our catchment area and receiving DAP funds. There are 20 individuals on the waiver wait list and two are Priority 1 Category.

 

NEW BUSINESS:

1. Approval of 2018 Holiday Calendar – Ingrid provided a 2018 holiday calendar for AHCS and a state holiday calendar. We are not able to add all of the additional state holidays, but Ingrid requested to add December 31 and half-day November 21 to the AHCS calendar.

MOTION that the Board approve the 2018 Holiday calendar

MOTION:  Robin Mieras

SECOND:   Bill Gilliland

VOTE: Unanimous

2. Acceptance of FY 2017 Audit – Emily Viers from Robinson, Farmer and Cox gave a presentation of the FY 2017 Financial Audit.

Motion:  That the Board approve and accept the FY 2017 Financial Audit

MOTION:  Bill Gilliland

SECOND:   Robin Mieras

VOTE:  Unanimous

3. Approval of Walgreens Grant Application for exercise equipment for the Lifeskills/Day Support Program – Angie was able to get a grant for exercise equipment which can be used by both clients and employees. Employees will have to sign a release before they can use the equipment.

Motion:  That the Board approve the Walgreens Grant Application to purchase exercise equipment for the Lifeskills/Day Support Program

MOTION:  Connie Back

SECOND:   Lisa Hicks

VOTE:  Unanimous

4. FY 2017 FIPS report – Ingrid provided a report for the board for review.
5. Calendar of Board Meeting Dates for 2018 – Included in packet.
6. By-laws of Alleghany Highlands Community Services Board – review for changes/updates – By-laws will be approved at the March meeting. If there are any changes to be made, this will be done at the March meeting.
7. Nominating/Personnel Committee Report on Appointment of 2018 Officers – The Nominating Committee presented a Slate of officers for 2018: Lisa Hicks, Chair, Anne Dean, Vice Chair and Teresa Johnson, Secretary.

MOTION:  That the Board approve the slate of officers as presented above.

MOTION:  Robin Mieras

SECOND:   Terrie Wright

VOTE:  Unanimous

8. Reappointment of Teresa Johnson/Connie Back for 3^rd terms and Reappointment of Lisa Hicks for 3^rd term – Included in the packet were letters Ingrid sent to the City of Covington and Alleghany County regarding the reappointments of Lisa Hicks, Teresa Johnson, and Connie Back.
9. DBHDS Financial Realignment Plan – CSBs are going to be responsible for the state hospital census and the money spent for hospitalizations. They want individuals released when they are ready for discharge, and also want alternatives available for them in the community. Ingrid will be attending a meeting with the Commissioner at the end of November to discuss this plan. In Region 1, 50% of our beds are being used by people who have substance use issues or need to be detoxed. We are working on a plan regionally to release those individuals and see what we can do locally as well. Ingrid said we should know more about the Financial Realignment plan at the end of the month.
10. VACSB Legislative Conference January 16-17, 2018 Richmond Hilton Downtown Richmond, VA – Five hotel rooms have been reserved. If any board member wants to attend, let Ingrid know right away.

 

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:   Teresa Johnson

SECOND:    Robin Mieras

VOTE:        Unanimous

TIME:         5:16 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.

 

Reconvene Regular Session:

MOTION:     Lisa Hicks

SECOND:      Teresa Johnson

VOTE:   Unanimous

TIME:    5:32 pm

 

MOTION:  That the Board approve the Executive Director’s Performance Evaluation

MOTION:    Robin Mieras

SECOND:     Bill Gilliland

VOTE:   Unanimous

 

MOTION:  That the Board approve recommended changes to the Executive Director’s contract.

MOTION:  Connie Back

SECOND:   Terrie Wright

VOTE:         Unanimous

 

MOTION:   That the Board authorize and sign a new annual contract for the Executive Director.

MOTION:    Robin Mieras

SECOND:     Terrie Wright

VOTE:  Unanimous

 

ADJOURNMENT

MOTION:  That the November 16, 2017 regular meeting of the Alleghany Highlands Community Services Board be adjourned.

MOTION:  Nolan Nicely, Jr.

SECOND:   Teresa Johnson

VOTE: Unanimous

TIME:  5:37 pm

 

NEXT MEETING:   The next scheduled meeting (Board Member Training/Work Session) will be on Thursday, January 18, 2018 at 4:00 PM at the Administration Office located at 205 E. Hawthorne Street in Covington, Virginia.

 

REMINDERS/NOTES:

• The agency holiday party will be on December 1, 2017 from 3:00 pm to 5:00 pm at the Masonic Theater.
• ID and Case Management will be having holiday parties in December and all board members are encouraged to attend.
• Angel Tree at ID office – as of November 15^th, there were no angels left on the tree.
• Chamber Annual Dinner is April 7^th, 2018