Leadership Team Meeting March 19, 2014

Attendees: Joe Hubbard Sherri Diven Tina Sadler Melissa DeVault Keith Piercy Carol Webster

Joe Hubbard  Karen is out covering nursing shortages. Several LT members are in Sarasota, Florida for the CoCentrix Conference.  Received a handwritten letter from an inmate. The letter has been passed on to Jennifer for follow-up. Carol will be given the name to follow-up on specifics as well.  Attended VACSB Executive Forum yesterday. Jennifer Faison is the new Executive Director. She will be replacing Mary Ann Bergeron at the end of June. The Department came in and gave their report. The Finance Director stated there were some shortfalls in state revenue projections. They have not been requested to put together a reduction plan, but there might be a possibility if things don’t turn around. They have done this in the past, but it has not affected CSB’s.  The Association decided to continue to fund the ROI project (a platform of Community Health Systems). Melissa is probably the only person in the agency to use ROI because of CIT. There is a website that can be useful to us for strategic planning, policy analysis and program development. Joe asked Melissa contact Caitlin Feller to see if she can come to LT meeting to give an overview.  There is an upcoming study that will start in July. It was reported that the study will ask for a lot of information that will not come easily. That is all part of healthcare review in Virginia, triggered by the Deeds incident, Affordable Care Act, and Medicaid expansion. It is Senate Bill 427 if anyone cares to read it. It will be a tight timeline, two to three years in the making.  The VACSB has started discussing how care coordination is a real problem. Since the DOJ Settlement and ID case management, they are calling it conflict – free case management. Right now it is ID, but they recognize case management SPO ID and mental health. This will potentially roll over to mental health, because of the lack of barriers. Whether it is done through policy or attrition, it should happen to support those out-patient programs that do not support themselves.  Joe talked to Melissa earlier about the Dual Eligible Project. There are three MCO’s for Enhanced Care Coordination (ECC). Only Anthem has stepped up to the plate and is willing to sign an agreement with CSB’s that are already under  this $466.00. The other two are trying to do a different rate structure. One apparently wants a flat fee of $92.00 per hour on top of targeted case management, so that it is not cutting into case management. Another wants the rate to be $92.00. One apparently wants to do outcome base by paying a certain percentage up front during the course of the year, and if objectives are met, they will pay the rest of it later. This is somewhat risk based. Nothing is known yet, but letters are being sent out to our consumers to sign up. Case managers need to be aware of questions that will be asked by the consumers as to what it is about, and which plan they should choose. We cannot tell them which plan to choose, but right now Anthem seems to be the only one on board.  The Department talked about Performance Contract language they would like to agree upon. If you did not meet Exhibit D, failure to report timely, they could take up to 15 percent of state funds.  All of the Psychiatrists will be attending the next Board meeting. Dr. Byrne will present an educational topic.  The Region will have a BRSS TACS Recovery Forum on April 25, 2014, from 9:00 a.m. to 12:00 noon in the Henrico CSB Conference Room.  The Department is stating D19 does not have a sizable dual diagnosis population. Tina (Finance) should use the percentages that came from Rod and Melissa. PACT allocations are one-third (1/3) based on analysis from Mary Berrey. Tina and Lisa will meet at the end of week to see how to go retroactive. If we can’t fill positions to provide services, we may need to contract out. Carol replied to Martha regarding Substance Use group. If we do not get a reply back in 48 hours, we will reply back to the Department.  The Department is also stating we are not providing enough substance abuse services, and that we are underutilizing SA funds. The list for dual diagnosis consumers is extremely low board-wide. A list will be provided to Carol and Sherri to review again. If we cannot come up with a resolution, we will bring in the Department to do a review. This issue has to be addressed to find other ways to meet the needs of the community.  There will be no Leadership Team meeting March 26, 2014, due to Joe attending a conference.

Tina Sadler  Working on the personnel budget. Still need the operations budget for Adult Services. Responses are coming in slowly, which is causing us to fall a little behind.  Joe requested a draft to look at soon. It is critical that he receives it by the time board packets are sent out in May. He is requesting bottom line board wide numbers, which need to be compared to revenue. He also needs changes in personnel with current revenue.  The background check is being done on the candidate for Payroll Accountant. If everything goes well, she should be starting soon.  Quarterly tax information will take some time. We are waiting for MIS assistance. Monique will provide when she returns from Florida conference on Monday. Keith Piercy  Continuing to work on ideas for next All Staff meeting.  We plan to include I-work consumers on the program.  SAC will be meeting today.

Melissa DeVault  Pulling primary care provider information from Profiler. Staff should make sure they are putting this information in and listing the name of the primary care provider the consumer is seeing for care.  Waiting on IT for the list of dual eligible consumers with Medicare and Medicaid, to see what the need is and level of care.  Crisis Assessment Center (CAC) is still looking for prn staff. They must be certified prescreeners.  Children can now be referred to CAC. They must be voluntary and cannot be in need of hospitalization.  Melissa and Tory will meet with Cameron Foundation today to provide any information needed for the grant.  It is unsure when CAC at SRMC will be ready. Melissa will try to contact someone involved with the decision making. Contacted Poplar Springs, but have not heard back from them yet.

Sherri Diven  Recruiting for several positions in Children’s Services.  Will be out of the office for meetings with CMPT, Smart Beginnings, Chesterfield Social Services, Sr. Leadership Forum regarding Trauma Informed Care Systems of Care this week and next week.