Community Mental Health for Central Michigan

Provider Minutes

Date: January 16, 2007 Time: 10:03 a.m. Place: Lake Michigan Conference Room Meeting called by: Bryan Krogman Type of meeting: Regular Note taker: Amanda Dosson

Welcome/Sign-In Introductions

Agenda Topic: Announcements - All Presenter: Bryan Krogman, Provider Network Manager Discussion & Conclusions:

Agenda Topic: State and Agency Update Presenter: Linda Kaufmann, Executive Director Discussion & 1. New Administration Structure – Kathie Swan is taking over Mike Hilley’s position Conclusions: as the Deputy Director for Services after his retirement in March. John Obermesik has taken over Karen Langeland’s position as the Deputy Director for Administration and Kim Seidel is taking over for Kathie as the Program Director for Midland County. 2. 2007 – 2008 financial outlook for the state is looking down. Governor Granholm is giving her State of the State Address on February 6th, and it is expected that spending will be reduced. It is possible the cuts will be made in the Mental Health field, however we don’t believe we will have to do anything major this year. Our budget looks steady and we are looking for ways to maximize dollars as our revenue will likely not increase. 3. Mental Health parity legislation was not successful in Michigan this past legislative year; however there appears to be movement at the national level. The “Paul Wellstone Mental Health Equitable Treatment Act of 2007” is to be introduced in the next month or so. We remain in support of mental health parity legislation, believing it is a way to assist individuals in receiving necessary services to assist them in their recovery. 4. The Health Services Advisory Group (HSAG) will again be reviewing our programs in February. HSAG is under contract with the Michigan Department of Community Health to review compliance of CMHCM with the Balanced Budget Act outline on characteristics of managed care plans. This review relates primarily to the areas of Provider Network, Delegation of managed care functions, Credentialing, Access and Availability, Coordination of Care, Appeals and Advance Directives. This is not a review that contacts the providers on our network. In May the Michigan Department of Community Mental Health will do a follow-up review on standards found in our contract with MDCH and with Medicaid policy. 5. There is an emerging trend in Health Information Technology. Governor Granholm addressed it in Michigan when she charged the Michigan Department of Community Health and the Michigan Department of Information Technology with bringing together Michigan’s health care and business stakeholders to develop a vision and plan for the future of health information technology and exchange in Michigan. This was mentioned in her 2006 State of the State

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Address. The movement is basically the transformation to the electronic exchange of health information across traditional organizational boundaries to provide consolidated clinical information to health care providers to improve the health care of the citizens of Michigan. The Michigan Legislature in support of this movement established the Health Information Technology Commission and appropriated about $9.5 million to fund Regional Health Information Exchange Planning and Implementation Projects in FY 2007. MDCH recently issued a Request for Proposals with a deadline of February 12. There are no specific boundaries mentioned in this document. There are several groups across the state that are already forming, and others still under consideration. There is the potential of one in the Central Michigan area coordinated by Central Michigan University. It is also possible that CMHCM’s geographical area would be represented by more than one RHIO. This will be a process that takes several year as there are numerous issues to be addressed.

Agenda Topic: Recipient Rights Reminders Presenter: Kris Stableford – Recipient Rights Officer Discussion &  Staff is allowed to go straight to a recipient rights advisor with a complaint if Conclusions: necessary.  Don’t give out information about complaint to a suspended employee before they are questioned by the recipient rights staff. This will help us obtain more accurate information.  Need for reducing risk of sexual abuse against people who have developmental disabilities.

Agenda Topic: Risk Reduction/Healthy Relationships Presentation Presenter: Clare Blouin – Women’s Aid, Inc. Discussion & Community Mental Health for Central Michigan has provided a grant to Women’s Aid, Conclusions: Inc. to coordinate training designed to build healthy relationships while reducing the risk for exploitation and abuse in the lives of people with developmental disabilities. Ms. Blouin from Women’s Aid shared program goals for consumers and support staff and presented curriculum tools. Social Work student at CMU, working on project to train and educate individuals with developmental disabilities and who are involved with persons with DD, to understand when, how, and where it is appropriate for sexual conduct to take place.  Consumers need to learn healthy ways to express the sexual feelings and frustrations they are having to reduce incidents of abuse.  They also need to learn how to recognize sexual abuse so they know when it’s happening to them.  Need to train Support Staff so they understand and recognize the signs and symptoms of sexual abuse.  12-week program will implement training in gender specific groups, then will include everyone together.  Program will use tactics like; Journaling, Lists, Personal Poems, Emotograms, Relationship map, and Framing.  These are meant to build on the self-esteem of the individual in all aspects, physically, mentally and emotionally.  There will also be training and education about healthy relationships of all kinds, showing different kinds of relationships and how those relationships are beneficial.

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Agenda Topic: Provider Network Corporate Compliance and Ethical Standards Policy; Deficit Reduction Act Presenter: Bryan Krogman Discussion & Information on the Deficit Reduction Act was sent to all Providers. This information was Conclusions: then supposed to be communicated to employees. In our annual Site Reviews, we will be checking to assure that the employees have been given this information, which includes; the Whistleblower act, the False Claims Act (both federal and state). Information regarding the Corporate Compliance and Ethical Standards policy was provided. This will be applicable to all providers and includes the following:

1. Providers shall establish a corporate compliance plan for identification and reporting of suspected fraud, waste and abuse in health care delivery to assist in the provision of quality care to consumers. 2. Providers’ corporate compliance plans shall include the following: a. Identification of a staff person responsible for compliance efforts b. Development of written standards of conduct c. Staff training on State and Federal False Claims Acts and Whistleblowers Protection Act d. Effective means to report suspected fraud, abuse and waste e. Enforcement and disciplinary processes f. Internal monitoring and auditing g. Timely response to detected offenses with appropriate corrective action 3. Providers shall ensure compliance with state and federal regulatory agency standards and applicable laws and regulations including but not limited to: a. Federal Law and Regulations: Social Security Act (Title XIX Medicaid), Balanced Budget Act of 1997, Health Insurance Portability and Accountability Act, Federal False Claims Act b. State Law and Rules: Michigan Mental Health Code & Administrative Rules, Michigan Department of Community Health Medicaid Provider Manual (Mental Health/Substance Abuse), Michigan False Claims Act, Michigan Whistleblowers Protection Act. 4. Providers will ensure the integrity of all Medicaid transactions. Transaction will be executed in accordance with established policies and procedures and with all federal and state law and recorded in conformity with generally accepted ac- counting principles. 5. Any provider with knowledge or concern about an ethical violation or compliance issue shall report that concern to the CMHCM Provider Network Manager or Deputy Director for Administration (Corporate Compliance Officer) who shall review available information and take appropriate steps. 6. Providers will be monitored for the existence of a compliance plan and staff training during the CMHCM annual site review process.

Web sites where additional information regarding the Deficit Reduction Act can be found are at: http://www.miassistedliving.org/. www.macmhb.org

Agenda Topic: Provider Manual Addition for Grievances and Appeals Presenter: Bryan Krogman Discussion & A new section: Grievances and Appeals will be added to the Provider Network Manual. Conclusions: It is important for providers to know the process whereby a consumer can file a grievance and appeal. Providers can make an appeal on behalf of a consumer, however the consumer must indicate in writing that he/she wants the provider to make the appeal. It was also pointed out that Medicaid beneficiaries can pursue local and state appeals at

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the same time.

Agenda Topic: Provider Topics Presenter: All Discussion: NONE

Meeting adjourned at: 11:06 a.m.

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