MINUTES

 

REGULAR MEETING OF THE ALLEGHANY HIGHLANDS COMMUNITY SERVICES BOARD

Thursday, September 21, 2017

 

The Alleghany Highlands Community Services Board held the September Board meeting on September 21, 2017 at 4:00 p.m. at First Christian Church/Family Life Center located at 231 E. Fudge Street in Covington.

 

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

 

ABSENT:  Lisa Hicks, Robert Johnson, Jr. and Terrie Wright

 

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

 

Anne Dean, Chairman, called the meeting to order at 4:00 p.m.

 

Thank you letter from Fincastle Baptist Church.

 

APPROVAL OF MINUTES OF July 20, 2017 REGULAR MEETING

MOTION:  That the Board approve the minutes of the July 20, 2017 regular meeting.

MOTION:         Teresa Johnson

SECOND:         Bill Gilliland

VOTE:              Unanimous

 

PROGRAM REPORTS

Mental Health & Substance Abuse

Ingrid Barber presented the following report:

Lydia Hall, CM Team Lead, attended the Virginia Summer Institute of Addiction Studies (VSIAS) conference in Williamsburg, Virginia July 16-19, 2017. The training focused on how to charter change within the substance abuse treatment population, how the media gives a biased representation of SA treatment, and the increasing number of corrections population and their reentry into communities.

 

Prevention Services team participated in the HPR 1 Regional Suicide Prevention retreat in Lexington. The participants reviewed the logic model and planned for the FY18 activities for Lock and Talk.

 

July marked the beginning of the third month for the Medication Assisted Treatment (MAT Suboxone Clinic) which continues to grow.

 

Virginia Veterans and Family Support will participate in a resource fair in conjunction with the re-entry council on August 29, 2017. The Veteran’s Resource Specialist continues to build partnerships with the area VFW’s and American Legion Posts which have been a source of assistance and referrals.

 

AHCS and Veterans and Family Services hosted an ASIST (Applied Suicide Intervention Skills Training) August 24 and 25, 2017 at First Christian Church, Family Life Center. There were 20 participants who came from varied backgrounds and agencies within the community. Five of the adult case managers also participated in this training.

A job fair was held on August 29, 2017 at the Family Life Center in Covington which was sponsored by the Re-entry Council. There were 16 businesses and 4 agencies represented at the fair. Twenty-two individuals participated and 5 of those were interviewed and hired “on the spot”. Another 6 applications were completed for future potential employment. Recovery and collaboration in action!! Great job.

 

Prevention Services/Healthy Youth Coalition participated in the YMCA 25^th anniversary celebration on August 19, 2017. Information was provided to 34 people and 8 medical lock boxes were distributed during the health fair.

 

Walmart Pharmacist gave exceptional praise about the AHCS Suboxone program and stated that he was impressed by how it is being handled and controlled. He said “You guys know how to do this thing right.”

 

Developmental Services

Angie Goodbar provided the following report:

• Alleghany Highlands Community Services recognized Direct Support Professionals (DSP) Week September 10-16, 2017 – Direct Support Professionals Week is celebrated annually across the country to honor the work of DSP’s who provide services to people with intellectual and developmental disabilities. Alleghany Highlands Community Services employs 55 Direct Support Professionals (DSPs) amongst four program areas including Friendship Residence, Residential In-Home, Merryfield ICF and Day Support Services. The Direct Support Professionals are hard-working and dedicated. They build close, respectful and trusted relationships with individuals. Direct Support Professionals empower people with a disability to lead a life of their choosing, including helping them build strong relationships to remain connected to friends, family and their community. They aid individuals by listening to their dreams and help them learn skills to live the lives they choose. Personal care assistance, day to day life skills, employment support, and components of health care are all a large part of the service delivery provided by the DSP’s. AHCS celebrated the DSP’s by giving them all a gift, recognizing them on the agency facebook page, proclamation signing for the local newspaper and drawings for prizes throughout the week.
• Developmental Services Annual Picnic – Individuals receiving services attended the annual picnic at AET on September 8^th. The day support dance group performed a salsa dance at the amphitheater. Everyone enjoyed eating, playing games and dancing.
• Case Management – Sue Childs retired after 28 years of dedication and hard work in the human services field. Sue was a true advocate for individuals with intellectual and developmental disabilities. She also served as a trainer and mentor to many of her coworkers and subordinates. As a result of succession planning, Lisa Pritt has accepted the position of case management supervisor. Lisa will serve as the central point of entrance for all intakes and she will complete the 90 day assessments to determine eligibility. Lisa will manage the developmental services waitlist. She will work collaboratively with community agencies and market case management and waiver services in the community.
• Marketing/Educating the Community – On September 5^th, Angie Goodbar, Director, and Lisa Pritt, CM Supervisor, met with the Alleghany County Special Education Advisory Committee to give a presentation on waiver services.
• Waiver Slot update: AHCS received two waiver slots from DBHDS. One slot for an individual meeting the Community Living Waiver and one for the Family and Individual Supports Waiver. AHCS currently has two individuals rating priority one and eligible for these slots.
• USDA Grant Application Update: The Infant/Toddler program was awarded the grant funds from USDA for a vehicle for the program. Rob Wilson, USDA, met with Angie Goodbar, Ingrid Barber, and Mary Ellen Plitt on September 13^th to review and sign the letter of condition.
• Logisticare Training – Tom Garnett, Logisticare Representative, visited AHCS on September 13^th and trained employees on how to complete online billing. He also provided training about the upcoming changes for individuals that will be enrolled in one of the six MCO’s through the CCC Plus program. AHCS currently provides medically necessary transportation services and will need to have contracts with the MCO’s in our region. The administration support staff will be working closely with the MCO’s to learn processes for scheduling and billing these new insurance companies.
• The DS Director attended the State DS Council meeting in Richmond, the Regional ID 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.
• Upcoming audits – The Patient Fund Audit for Merryfield will be conducted by Myers and Stauffers on September 20^th. The Department of Aging and Rehab Services (DARS) will conduct the Monitoring Visit of the Public Guardian Partnership Inc. Program the week of September 18-22. The Fiscal Audit of the Public Guardian Partnership Inc. Program will occur October 23-25.

 

Quality Improvement

Nancy Curry provided the following report:

UR, Compliance and EHR:

• Incident Reports Processed – 46 in July and 31 in August.
• # CHRIS Reportable – 19 in July and 11 in August
• Safety Inspections – 1 in July and none in August

Surveys/Audits in process or completed:

• NMHSS 2017 – survey submitted 7/31/17
• NSSAT 2017 – survey submitted 7/31/17

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
• Working on Emergency Preparedness and DNR Policy

 

IT Manager Report:

Adam Kenny provided the following report:

Duties performed or in progress since July 2017:

Help Desk:

• Completed 132 help desk requests.
• Completed 195 Credible change requests.

 

 

EHR:

• Assisted with form changes in DD and MH.
• Submitted complete End of Year CCS.
• Created new Universal Drug Screen visit.

Hardware and Networking:

• Ordered polycom telepsychiatry equipment for psychiatrist.
• Ordered polycom Video Border Proxy that will negotiate traffic for multiple Polycom televideo carts.
• Ordered second static IP for clinic to support second televideo station.
• Installed new Ethernet cable from phone room to switch room to support second IP Address and new polycom equipment.
• Installed new computers at Merryfield.
• Replaced 11 old computers in Mental Health Case Management program area.
• Installed 2 new wireless access points at Merryfield.

Other:

• Met with Shentel representative to discuss fiber options in Covington.
• Met with Netsmart to discuss Office 365 Migration
• Attended CCC+Town Hall meeting in Harrisonburg
• Attended monthly DMC meeting
• Attended Credible WaMS reporting meeting
• Attended quarterly Credible User Group meeting
• Attended reimbursement meeting
• Assisted with zero suicide grant
• 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
• YTD Loss Summary 16/17: $43,820 paid, $16,962 placed in reserve
• No new claims for new fiscal year at this time
• Auto Claims –
• Auto Physical Damage – $576.75 paid for bus damage at Merryfield
• Carrier in the process of settling April car claim.
• Property Claims – 0

Separations:

FY 17 – 49 separations

Separations for July/August 2017 – 2 retirement; 1 job abandonment; 1 other employment

Recruitment:

Open Positions as of 8/31/17:

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
• Psychiatrist – ongoing recruitment
• New Beginnings Residential Technician
• Child and Family Therapist
• Mental Health – Intensive Services Clinician – LMHP-E
• Prevention Specialist
• Mental Health Director
• Clinical Services Supervisor

General Updates:

• Completed open enrollment and introduction of new benefit plans

 

Financial Reports

• Financial reports were submitted by Patty Flanagan. These include FY 2017 June Closeout Update, July/August Financial Reports, and FY 2017 End of the Year Performance Contract Report.

EXECUTIVE DIRECTOR’S REPORT AND RECOMMENDATIONS

Ingrid Barber provided the following report:

AGENCY ISSUES:

1. Guinan Center/Mental Health Clinic Roofing Update – Don Largent Roofing acquired the building permit on September 5, 2017 with the City of Covington. We agreed that we would work with a contracting company to look at the drains as there was concern about them. The company would be able to use a See Snake Video/Locator to scope the drains. The company figured one 12 hour day with 2 technicians, and they would use the video/locator to inspect the lines for any clogs, broken joints or cracks. If anything is found, the company would be able to mark the location and provide pricing on making repairs as needed before roof replacement occurs. The work would be done on a time and material guideline not to exceed $2,785.00. The work is scheduled to occur September 14, 2017.
2. I extended an offer to Dr. Malak Iskander, Psychiatrist, of Roanoke, Virginia, who was recruited by BAS Healthcare. He will be providing one day of psychiatry on site beginning November 1, 2017. Dr. Iskander will be our employee.
3. Revenue cycle management collections in the clinic are going well with front office staff. Clients are making payments on co-pays or rescheduling their appointments until they are able to make payments. This has increased some cancellations and no-shows for some appointments, however, I met with the psychiatrists and discussed the possibility of double booking clients for appointments, especially those that have been habitually not showing up for scheduled appointments. Rhonda Adams will be reviewing reports to determine possible hours and days to implement double booking.
4. Felicia Prescott continues to contract with the Agency to provide various services and supervision.
5. The FY 2017-2018 Performance Contract was approved by the Covington City Council on August 8, 2017 and the Alleghany County Board of Supervisors on September 5, 2017. Special thanks to Anne Dean and Patty Flanagan for attending those meetings.
6. Audit with Robinson, Farmer and Cox Associates – complete with a few minor year end adjustments. Final audit report to be provided at the November Board Meeting.
7. The Crisis Intervention Team (CIT) group continues to meet monthly. To date, 55 individuals have been trained, and the program has 11 train the trainers. Next training is scheduled for first week in October.
8. Capital Update – Parking lots have been scheduled to be sealed and painted for Administration Office, ID Administration Office and both lots at MH.

 

COMMUNITY ISSUES:

1. I have served as Chair of the Community Management Policy Team. The Community Policy and Management Team was established to implement the mandates of the Virginia Comprehensive Services Act for At-Risk Youth and Families which the 1992 Virginia General Assembly enacted to create a coordinated system of services and funding to meet the needs of troubled youth and their families and at-risk children. Presently, all department heads for schools, CSB, social services, health department, and County Administrator and City Manager, etc. comprise the local team. This local team will meet at AHCS on September 20, 2017 to work on a long range Quality Plan for CSA. I will work closely on this project with Angela Rice, CSA Coordinator.
2. I was contacted by Elizabeth Heath of Alleghany County Public Schools regarding a tobacco issue at the middle and high school. I met with Dwayne Ross and Kelly Huff on September 11, 2017 to discuss the issues and concerns. Due to culture issues, they are finding that many students are getting into trouble using chewing tobacco on school premises. I am going to work closely with our Prevention Team to discuss some ideas to tackle this issue. We also discussed partnering with Covington High School to look at this issue.

 

STATE/REGIONAL/FEDERAL ISSUES

PUBLIC POLICY:

1. The Planning and Advocacy Committee with the Alleghany Highlands CSB Board of Directors comprising of Terrie Wright, Robert Johnson, and Bill Gilliland met with me on September 7, 2017 to discuss the VACSB 2018-2020 budget priorities. We discussed the three main priorities, funding of STEP-VA system transformation, Excellence, and Performance in Virginia. This funding is for 10 services, of which Same Day Access and Primary Care Screening are to be fully put into place for all Boards by 2019, and the remaining 8 services mandated to come on board by 2021. In addition, the increase in the reimbursement rate for Medicaid Early Intervention Case Management to its data-determined adequacy, and reducing the ID/DD Waiver Wait List. The committee determined that AHCS would support the VACSB initiatives, and that a letter would be drafted by the committee to our legislatures, Senator Deeds and Delegate Austin expressing support and requesting that they reach out to our Board to learn more about AHCS.
2. Please be reminded of the VACSB Public Policy Conference being held at the Williamsburg Lodge from October 4-6. Featured on October 4^th is a luncheon presentation by Dr. Ron Manderscheid, Executive Director of NACBHDD (National Association of County Behavioral Health and Developmental Disability Directors), along with workshops of interest.

 

OLD BUSINESS:

1. Mental Health Roof Update – Don Largent from Harrisonburg was awarded the contract. He secured the building permit from the City of Covington on September 5^th, and Mr. Largent and Ingrid are working on a timeline to start the work on the roof. The roof was checked for asbestos and a few small places were found that needed to be cut out. Ingrid discussed with Mr. Largent her concerns about the drains since there has been so much leakage. Ingrid asked them to make sure all drains were clear before they put the roof on to avoid any problems later on so they are going to work with another company to check them. This will be an additional cost but it is necessary and will be worth it. It is anticipated that work will begin before the end of September.
2. Loan Authorization for Mental Health Roof Replacement – At the last board meeting, a discussion was held regarding borrowing up to $125,000 from Highlands Community Bank, if it becomes necessary, and there was an agreement but no motion was made. Ingrid doesn’t feel that it will be necessary to borrow the entire amount and would like to get through August and September before deciding whether to exercise a loan. Ingrid has been in contact with the President and CEO of Highlands Community Bank. A motion would have to be made and approved since this loan amount would be over the limit.

MOTION:  That the Board approve a loan authorization for Mental Health Roof Replacement in the amount not to exceed $125,000.

MOTION:   Nolan Nicely, Jr.

SECOND:    Robin Mieras
VOTE:  Unanimous

3. Recruitment of Psychiatrist – Dr. Pandit is our current psychiatrist and has been working with us under a visa. She is planning to move away from the area but will continue to do telepsych with us and the equipment has already been purchased. We are also doing telepsych with Locums Tenums two days a week. In addition, since we’ve started the medication assistance program, Dr. Pandit will be here at least one week per month. A recruitment company has been contacted to assist in hiring more psychiatry time.
4. CIT Update – 55 people have been trained so far and they are planning another training the first week of October. We are getting ready to run out of grant money with approximately $10,000 remaining.  The program has been supported by all three local law enforcement entities across our jurisdiction.  At the last meeting, we discussed applying for a grant from the Alleghany Foundation to give us one more year to do training because of so much turnover with law enforcement. Ingrid talked with Mary Donnan from Alleghany Foundation about the Foundation’s ability to fund more training.  Ed Stein talked to Creigh Deeds to see if there was going to be grant funding for an assessment site but it doesn’t look like there are funds for that.  If the grant is to end, we can say that great progress has been made. Initially we aimed for 25% success but have far exceeded that and most local law enforcement have everyone trained now. The group wants to continue to meet but may meet quarterly instead of monthly now. The hospital is still a player and will be attending the meetings and have also upgraded the ER to make it more behavioral health friendly. Renovations have been made to the bathrooms where everything has been mounted and can’t be pulled off the walls, etc. Our CSB and Emergency Services staff, the hospital, local law enforcement are all willing to work together if the funding becomes available for an assessment site.

 

NEW BUSINESS:

1. Capital Improvement Update – The parking lots have been sealed and striped and vinyl has been put down in some of the facilities. Ingrid is reviewing the capital improvement list and if the money is available, we will continue to do some improvements. AHCS will be converting over to CCC+ on November 1^st but we are unsure of the funding stream because each provider will have to be billed separately. Ingrid wants to wait until January to see about cash flow. In talking with other CSBs, Ingrid learned that they have had some issues with billing and credentialing with CCC Plus. She plans to take our staff to Rappahannock CSB because they just converted last month to ensure we are ready by November 1^st.
2. Holiday Schedule – Closed December 22 (half day), December 25 and 26 – Crystal will work with the facilities to make sure there are signs posted, etc.
3. Status of Approval of Performance Contract by Alleghany Board of Supervisors and Covington City Council – Ingrid thanked Anne and Patty for attending both of those meetings which unanimously approved the performance contract.
4. Establish Nominating Committee for Officers and Executive Committee for FY 2018 – Teresa Johnson, Robin Mieras and Nolan Nicely, Jr. were nominated.  ACHS bylaws allow a member to hold an office for two consecutive years but then must wait one year before holding that office again.  A report will be provided at the November meeting.
5. 2017 Public Policy Conference October 4-6, 2017 at Williamsburg Lodge – Seven (7) staff will be attending the conference. Two board members were also interested in attending but it was too late to register. Ingrid stated that she hoped some of them could attend the next conference in January.
6. VACSB 2018-2020 Budget Priorities/Legislative Letter from Planning and Advocacy Committee –The list contains mainly the same things that are always requested, including looking for an increase in the case management rate for early intervention services, funding of waivers, and a Step Virginia program where same day access is part of the program. They decided to break it down and start with open access but there are other services they are hoping to provide. Last year, the General Assembly approved open access and some kind of primary care services within the CSB but they didn’t fund the primary care services. The Planning and Advocacy Committee met (Bill Gilliland, Robert Johnson and Terrie Wright) met and Ingrid discussed services and priorities. Ingrid included copies of letters to be sent to Senator Creigh Deeds and Delegate Terry Austin in an attempt to contact them about our priorities and extend an opportunity to visit.
7. The next board meeting is November 16^th at which time Ingrid’s review will be discussed. This will also be the Board Member Recognition Dinner.

 

ADJOURNMENT

MOTION:  That the September 21, 2017 regular meeting of the Alleghany Highlands Community Services Board be adjourned.

MOTION:  Nolan Nicely, Jr.

SECOND:  Teresa Johnson

VOTE: Unanimous

TIME:  5:04 p.m.

 

NEXT MEETING:   The next scheduled Board Meeting/Board Recognition Dinner will be on Thursday, November 16, 2017 at 4:00 PM at the Administration Office located at 205 E. Hawthorne Street in Covington, Virginia.

 

REMINDERS/NOTES:

• The Recovery Run/Walk has been postponed until Spring 2018. We hope to partner with other entities in an effort to have a better turnout.
• Agency Holiday Party will be held December 1, 2017 from 3:00-5:00 p.m. at the Historic Masonic Theatre in Clifton Forge.