| Board
Meeting Minutes - February 9, 2004 |
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| 800 Preston Avenue Charlottesville, Virginia Members Present Susan Garrett, Chairman Members Absent Bondy Shea Gibson
James R. Peterson, Executive Director Evelyn Cotton, Mental Retardation Residential Services I. CALL TO ORDER Ms. Garrett, chairman, called the meeting to order at 6:02 p.m.
Ms. Garrett welcomed Dr. Marcia Becker, recently appointed director of the Access and Quality Assurance Division. Ms. Garrett announced that Ms. Bondy Shea Gibson has been appointed by the Fluvanna County Board of Supervisors to fill the slot held by Ms. Irene Rebholz.
Ms. Garrett asked if there were any comments from the public. There were none.
Ms. Barrett said that she would like to discuss plans for Region Ten’s 35th anniversary, and also for the board to go into closed session to discuss personnel matters.
Ms. Garrett complimented Mr. Pezzoli on the role he played in the recent Mental Health Association meeting which involved consumers, family members, police, providers and others. Also, Mr. Peterson was on a panel addressing the issues of reinvestment and restructuring, and Mr. Reed Banks on another panel discussing who is doing what in the community. Ms. Garrett asked what the next steps might be. Mr. Pezzoli responded that the dinner and conference were sponsored by the Mental Health Association, but his role was to focus on gaps in services, with an emphasis on crisis stabilization. An advocacy and action plan will be developed over the next year. Ms. Garrett said she was excited about the talk of a mobile crisis unit.
Ms. Barrett cited two typographical errors, and Ms. Hammond another one. ON A MOTION BY DR. SHERAS, SECONDED BY MS. HAMMOND, THE MINUTES OF THE JANUARY 12, 2004, BOARD MEETING WERE UNANIMOUSLY APPROVED AS CORRECTED.
Mr. Pezzoli introduced Mr. Phillip Crosson, LPC, director of prevention and child and adolescent services. Mr. Pezzoli recalled that at the previous board meeting, Mr. Belair had asked about prevention services, and so this presentation is in response to that interest. Mr. Pezzoli credited Ms. Downing Miller with developing many of Region Ten’s prevention services. Mr. Crosson has been director of prevention services since 1992, and noted he had been a student at Virginia Commonwealth University where he got to know Ms. Miller, and later she hired him. He noted that with Ms. Miller’s impending retirement, this would be her last board meeting. He thanked her for everything she has done to build prevention services. Mr. Crosson commented upon some of the unintended consequences of the education Standards of Learning which have placed pressures on students and teachers alike. There is an absence of teaching about decision-making and how to “think on your feet.” Prevention services focus on these areas, and the specific services must be grounded in science-based practices because that is a requirement of the funding (federal substance abuse prevention block grant). Mr. Crosson said that we can identify by age 6 who is at risk. Mr. Crosson distributed copies of a brochure, “Just Say Yes,” and content information for the presentation. He defined the different levels of prevention, from universal, environmental approaches, to individual. Ms. Garrett asked about Region Ten’s prevention services contracts with the schools, and Mr. Crosson said that the amount for the Albemarle County schools is $17,500, but that Region Ten actually provides more service than that by augmenting the contract funds with federal block grant funds. Prevention services are less costly to provide because the recipients are not enrolled as clients and there is no charting, thus greatly reduced paperwork. The “client” is the school or the community. Ms. Johnston asked if the schools basically specify what services they want, and Mr. Crosson said it is a mix depending upon the identified needs. For example, a support group is offered at Henley Middle School for students whose parents or siblings have died. Ms. Hammond asked how the effectiveness of the prevention programs was assessed. Mr. Crosson said that both pre-and post-test instruments are employed to assess attitudinal and behavioral changes, and there is a system to directly report the results to the state. Mr. Belair asked if Mr. Crosson was saying that for those students who succeed it is due to the prevention programs, and Mr. Crosson responded affirmatively and gave an example of a student taken up to see Hump Back Rock who had never left the city before and cried when seeing the mountains for the first time. Mr. Belair said that he was looking at the listing of services and did not see Green or Nelson. Rev. Cameron asked about services in the Nelson Schools, and Dr. Becker responded that those services are managed in her budget and include $64,000 for three counselors. Mr. Belair felt that we’re not reaching the numbers we need to, and he wondered what he as a board member could do about that. Mr. Crosson said that he thought we are able stewards of the resources we have, but far short of what we need. Ms. White said that she supports prevention and pointed out that Charlottesville and Albemarle spend about $8 million for services through the Comprehensive Services Act for At-Risk Children, and that more prevention services could really make a difference in this. The key is to determine Region Ten’s role and what are the gaps because one agency can’t do it all. Ms. White said she applauded the work in the schools, but what kind of really early intervention--before six years of age--is offered, and what services would be provided if funding were available. Mr. Crosson pointed to the experience in Oregon and Washington State looking at the behavioral check lists for six year olds, and also the SAMHSA (the federal Substance Abuse and Mental Health Services Administration) website lists over 250 science-based programs, and so these would be implemented on an age-specific basis. He has been looking at the 0 to 3 population with Mr. Bob Taibbi, Region Ten’s director of children and family services, and where these services would fall. Ms. Hammond suggested that consultation to day care centers could be a part of the training for their licensure. Dr. Sheras said that the programs at Region Ten are quality, but only a finger in the dike because there is resistance to identifying people who are not yet sick, and also it is so difficult to document that something didn’t happen. Further, if you succeed, then funding is withdrawn. He gave the example of successful suicide prevention programs that lose funding because suicide is seen as no longer a problem. He said it is courageous of the board to put dollars into prevention because we might not be able to demonstrate the results.
Ms. Hammond referred to the minutes of the Personnel Committee meeting noting that Ms. Jane Lewis, director of human resources and training, had drafted a strategic plan component covering the responsibilities of the committee for incorporation into Region Ten’s strategic plan. The committee is recommending that the board adopt this component for the plan. Ms. Garrett commended the committee for taking this goal and specifying it out. Ms. Barrett said that the Executive Committee had questioned the use of the word “sabbatical,” and also the need to come up with time lines. Ms. Hammond said that the Personnel Committee had discussed that the word “sabbatical” was incorrectly applied, that the benefit was more like leave for time off to refresh and regroup, but not to take courses or other study such as in education. Ms. White said that a major element would be to have a feedback loop, and Mr. Belair asked who were the members of the committee. Ms. Johnston said that as former chair of the committee, she saw this plan component as very helpful because although the committee addressed many of these things in the past, it was on an ad hoc basis. Mr. Belair suggested that the committee consider establishing time lines so that the board would know when to expect what. Mr. Murphy said that the component was strong on goals but weaker on methods and how to measure successes.
Mr. Peterson called the members’ attention to the handout entitled, “Update on CARF Accreditation.” The revised recommended target date for full implementation of CARF policies would move the date from the fall of this year to March 2005, and then to fully operate under those polices until final accreditation in March 2006, to coincide with the date of the renewal of the CARF accreditation for employment services. Ms. Barrett asked why the slot for a representative from mental retardation on the Utilization Review Committee was vacant, and Ms. Maltais responded that she had been the representative, and now they were looking at what position would best fill that slot. Mr. Kelley asked why other boards had decided to become CARF accredited. Mr. Peterson responded that CARF accreditation signifies quality programs and is recognized internationally. Also, some funding sources require CARF accreditation, such as the Department of Rehabilitative Services required CARF accreditation for any organization, including Region Ten, that is a vendor of employment services. Finally, there was a movement a few years back to turn all services over to be administered by HMOs, and although the effort was defeated at that time, if this were to happen in the future, boards that were accredited would have a better chance to maintain operations and contract with the HMOs to continue to provide services.
Ms. Garrett said that the position for executive director will be listed on the Region Ten website and the VACSB website. Also, Mr. Brown is sending information to search firms to see if they have services that would be helpful to the board in conducting the search.
Ms. Maltais commended the members of the committee for their willingness to participate in the day-long orientation at Region Ten that is required of persons who will be doing volunteer work. Ms. Barrett said that the social will be held on March 27. Dr. Sheras asked Ms. Maltais to comment on the Madison House arrangement, and Ms. Maltais responded that they will begin volunteering in the fall. Dr. Sheras said that they provide good service, but there is a need to monitor. Ms. Barrett commented that the committee members were scheduled to go through the day-long orientation last Friday, but it was canceled due to the ice. She encouraged all board members to participate in the orientation (held almost every Friday from 9:00 a.m. to 2:00 p.m. in the board room at Preston Avenue).
Ms. Miller reported that Dr. Becker and she were already working together to plan for the transition, and Ms. Miller sees this as a very exciting and wonderful time. Ms. Garrett expressed her appreciation for Ms. Miller’s work at region Ten and that she will be greatly missed. Mr. Pezzoli said that all divisions are changing, and the immediate task is to see how to replace Dr. Becker as she leaves the rural services position. Mr. Pezzoli also tipped his hat to Ms. Miller for all of her fine work. Mr. Brown said that the board members have copies of the December financial reports, and although they show us trailing in Medicaid collections, this is just due to a delay in entering payments, and the good news is that the dollars are in. He anticipates that by the February report, all reports will be up-to-date and showing that the billings are on target. This is more of a cash flow issue than anything else. Mr. Murphy asked if this would cause an end-of-the-year problem, and Mr. Brown responded that it would not. Dr. Sheras asked if this was an on going problem, not just a one-time problem. Mr. Brown said that the input of payments is now much more time consuming, that Medicaid wanted the change, but are now looking at receiving and posting Medicaid payments into the system electronically. Mr. Trippel asked if this type of billing was secured, and Mr. Brown said it was. Mr. Brown said that both Ms. Miller and he started in February 19 years ago, and he was delighted to have Ms. Miller as a peer. He knew he could speak for everyone by saying how much she will be missed. Ms. Maltais reported that Ms. Barrett and she took consumers to Richmond today for the rally, and a photo was taken with one of the consumers with the Governor. Ms. Garrett said that the Coalition had a very large turnout two weeks ago. Ms. Barrett said it was important to get people to the rally, and yet it was dominated by higher education and other groups Dr. Moody commented that he worked with Ms. Miller at the Greene County office back when she was a counselor--before becoming a team leader and later a division director, and he had a great appreciation for her.
Ms. Barrett reported that the VACSB has a meeting of a Clearinghouse Committee every week to discuss pending bills in the General Assembly. The report from the House of Delegates last week was very discouraging, so efforts will be focussed on the Senate. She added that the next meeting of the VACSB board will be held on March 17, and the next conference will be May 5-6 in Virginia Beach.
Mr. Belair reported on his visit to Friendly Oaks, and how he was able to secure a refund on paint that had been purchased but improperly mixed.
Ms. Barrett noted that Region Ten’s 35 anniversary was February 2, and she thought this would be an opportunity to get Region Ten in the public eye, possibly involving all past board members, the Governor and others. Ms. Mary Miller is willing to do whatever the board would like to promote the anniversary during the year, but she said that Ms. Miller does not feel like a large dinner meeting would be a good use of resources. Ms. Barrett also commended Ms. Miller for everything she does to help Region Ten. Ms. Hammond asked what had been done to observe previous anniversaries, and Mr. Peterson said that a newspaper insert was developed for the 20th anniversary, and a major float was entered in the Dogwood Parade for the 25th anniversary which won the Grand Marshall’s prize. Mr. Belair said that the many weekly papers could be used to promote the observation. Ms. Garrett asked who could work on the planning, and it was agreed that Ms. Barrett, Ms. Garrett and Mr. Peterson would work with Ms. Miller to establish a plan. Ms. Garrett said that she would call for a recess of the meeting (7:29 p.m.) of Region Ten Community Services Board in order to convene into a meeting of the board of Region Ten Community Services Board, Inc. Ms. Garrett reconvened the meeting of Region Ten Community Services Board at 7:36 p.m.
Ms. Garrett announced that a request has been made for the Board to enter into a Closed Meeting to receive information on personnel matters. The Meeting is warranted and complies with Section 2.1 344 of the Code of Virginia, 1950, as amended. ON A MOTION BY MS. BARRETT, SECONDED BY MR. MURPHY, IT WAS UNANIMOUSLY VOTED TO ENTER INTO A CLOSED MEETING TO RECEIVE INFORMATION ON PERSONNEL MATTERS. Ms. Garrett reconvened the board in Open Meeting at 7:46 p.m. She stated that no resolution, ordinance, rule, contract, regulation or motion was adopted, passed or agreed to in Closed Meeting. The Region Ten Community Services Board hereby certifies that to the best of each Member's knowledge, (i) only public business matters lawfully exempted from Open Meeting requirements by Virginia law pursuant to Section 2.1 344 of the Code of Virginia, 1950, as amended, were discussed in the Closing Meeting to which this certification applies, and (ii) only such public business matters as were identified in the motion convening the Closed Meeting were heard, discussed, or considered by the Region Ten Community Services Board. Ms. Garrett asked for a role call from all members certifying to the foregoing. MEMBERS VOTING AYE: MR. MURPHY, REV. CAMERON, MS. BARRETT, MR. TRIPPEL, MS. WHITE, MS. GARRETT, MR. MURPHY, DR. SHERAS, MS. JOHNSTON, MR. BELAIR, AND MS. HAMMOND; NO MEMBERS VOTING NAY.
Respectfully submitted, Carol Johnston REGION TEN COMMUNITY SERVICES BOARD PERSONNEL COMMITTEE MEETING
Angela Hammond, Chair
James Peterson
The committee members reviewed the final report (May 2000) of the Classification and Compensation Study conducted by Hendricks & Associates, Inc. There was considerable discussion about why and to what extent an external study should be undertaken. Considering that four years have elapsed since the previous study, and in the interim the organization underwent the entire David Lloyd process and reorganization, and further that some lingering issues remain regarding the classification approach, it was agreed that a full classification and compensation study should be conducted. It was also agreed that a staff survey would be included in the end-of-March paycheck envelopes soliciting staff input to determine issues for which a consultant should be sure to incorporate in the classification study. Ms. Lewis will develop a draft of the survey form in consultation with Mr. Kelley. On a motion by Mr. Trippel, seconded by Mr. Kelley, it was unanimously voted to recommend to the board that a request for proposals (RFP) be issued in mid-March to conduct a classification and compensation study.
It was suggested at last month’s board meeting that the Personnel
Committee develop time lines and further tease out the elements
in the Strategic Plan Components. The committee members agreed they
would pursue this to the extent possible, but given the lateness
of the hour, this would be addressed at a future meeting. REGION TEN COMMUNITY SERVICES BOARD EXECUTIVE COMMITTEE MEETING March 1, 2004 Susan Garrett, Chairman Other Board Members Present Barbara Barrett James Peterson, Executive Director
1. Planning for the March 8 board meeting Committee members reviewed the minutes of the of the February 9 board meetings. Mr. Peterson said that no program presentations were planned for the March 8 board meeting unless and the Executive Committee had a topic they would like to see addressed. Otherwise, the time can be used for the consideration of the risk management report and the strategic plan goals section. The committee also reviewed the minutes of the Personnel Committee and Region Ten Local Human Rights Committee. 2. Annual Risk Analysis Report and Recommendations It is a CARF requirement that the board annually review and adopt a risk analysis report (see attached). The board can discuss the report and recommendations at the March meeting, but if more time is needed to consider the report, final approval can be delayed without a problem. The committee reviewed the report and decided that since this is the first time this report has been issued, it would be instructive for the board to receive the entire report, including all of the attachments. 3. Application from Barbara Elias for appointment to the Mental
Retardation Services Ms. Elias’ application was reviewed, and the committee will recommend to the board approval of her appointment to the Mental Retardation Services Advisory Committee.
Mr. Peterson distributed copies of the draft goals section of the strategic plan which is still in progress. He said that the management team had given considerable consideration as to how to conceptualize and organize the plan (i.e., by disability, by division, by age groupings, by localities, etc.), and decided to organize the goals according to the major points of Region Ten’s mission statement (assess needs, create and provide accessible services, cost-effective services, highest quality, and to achieve more independent, satisfying and productive lives). The division directors have also prepared specific service goals and these will be integrated into the appropriate sections of the plan. Also, the personnel committee’s human resource component can be a separate goal because it cuts across all of the other five goals, or subsumed under the quality goal. The management team will meet in the morning to finalize the draft, and it will be mailed out prior to the board meeting. 5. Relocation of Administrative Offices Ms. Garrett asked for an update on the move to 4th Street N.E., and Mr. Peterson reported that the move was targeted for April 1. Ms. Barrett asked if this had been included in the budget, and if not, it should have gone to the Finance Committee. Mr. Peterson described the efforts over the past two years to find additional program space for the expanding Medicaid services, and how it was finally decided that it would be a better plan to relocate administration so as not to establish another program site with all the supports that are necessary to serve consumers. Mr. Peterson said that although the rental was not in the budget, the revenues from the expanded services would cover the cost and that no programs or services would be cut. Mr. Murphy said that wasn’t quite the case because the management had needed to stretch the projected revenues in order to show a balanced budget, and that was without this rental item. He added that he did think this was a program management decision, and not a policy decision. 6. Plans for the observation of Region Ten’s 35th anniversary Ms. Barrett distributed copies of the concept paper, “Celebrating Region Ten,” which had been developed by Ms. Mary Miller as part of the planning with Ms. Barrett and Mr. Peterson for the observation of Region Ten’s 35th anniversary. Ms. Barrett recapped some of the thinking behind the recommendations. Mr. Murphy suggested that proclamations from the local governing bodies could be sought. 7. Next Meeting The next meeting of the Executive Committee will be held on Monday, April 5, 12:00 noon, at the Hardware Store Restaurant, 316 East Main Street, Charlottesville. The meeting was adjourned. ANNUAL RISK ANALYSIS REPORT March 2004 Region Ten’s Risk Management Policy (board policy 31) specifies that the executive director will annually evaluate the risk analysis report, and make recommendations to the Board at the March board meeting based on the evaluation of the risk analysis report. A permanent staff Safety Committee has been established responsible for analyzing and evaluating all incidents and complaints related to health, safety, and property protection. The Safety Committee is facilitated by the human resources director and includes a cross-section of Region Ten staff and consumer representation. The Safety Committee prepared a risk analysis report and recommendations which was subsequently reviewed and revised by the Quality Management Council. The current document represents the final report and recommendations to the board. The report includes client and staff injury data and will later include property damage and vehicle data. The following data reports are attached: Emergency incident reports involving clients Recommendations: 1. Develop a training plan and strategy for training staff on how to move safely with clients, and how to lift clients. 2. Arrange for Region Ten’s nursing staff to periodically provide training to residential staff concerning needle stick prevention and the safe use and disposal of syringes. 3. Programs will adhere to admission, discharge, and exclusionary criteria when evaluating a consumer’s behaviors and appropriateness for continued services. a. Consumers who demonstrate recurrent problem behaviors that affect safety will have those problem behaviors addressed as part of the Individual Services Plan (ISP). b. Staff will observe safe riding practices when transporting consumers. Should a consumer develop a problem behavior which becomes a safety issue while in transit, staff will find a safe location to pull off the road and call for back up assistance which may include emergency 911 personnel. Staff will follow Region Ten policies in dealing with emergency behaviors. Should a consumer have recurrent problem behaviors that affect safety while in transit, those problem behaviors should be addressed:
ii. Using the least restrictive/most appropriate interventions (which may include additional staff to assist in the transportation of consumers with recurrent problem behaviors; iii. If considering non-emergency/pre-arranged suspension of transportation privileges, this should not be arbitrary and would only be considered after all other measures have been attempted to safely transport consumers. Non-emergency suspension of transportation must be approved by a division director and the local human rights committee, with terms of the suspension clearly delineated in the ISP. iv. If emergency restraints are used, such restraints must be used in keeping with Region Ten policies. 4. Staff who are involved in emergency incidents where follow up is indicated, will be offered and encouraged by supervisory staff to pursue Employee Assistance Program (EAP). Supervisors will debrief with staff concerning antecedent events, the emergency event, and outcomes of the event. Supervisors will help staff to assess the event and determine if environmental issues, staffing issues, or other factors are increasing the risk for recurrent emergency incidents. 5. Division directors will assure that all staff are held accountable for the timely submission of required reports: a. Incident reports to Human Resources on all specified incidents listed on the reports. b. Submission of reports to Compliance Services for compilation and reporting: i. Safety Inspections ii. Fire Inspections iii. Medication Error Report Forms REGION TEN COMMUNITY SERVICES BOARD LOCAL HUMAN RIGHTS COMMITTEE
Phil Carr James Peterson, Executive Director From Department of Mental Health, Mental Retardation From DePaul Family Services: Brian Veerhoff, QMRP, ARC of the Piedmont Elizabeth Bruns
1. Review of DePaul Family Services Mental Retardation Program Human Rights Policies The meeting was convened by the chair, Mr. Carr, and everyone introduced themselves. Mr. Hall noted that 30 children are served with therapeutic foster care services through this office and licensed by the Department of Social Services, but today’s review addresses DePaul’s Waiver funded congregate care services. He provided an overview of the program stating that they have 151 consumers in congregate care statewide, and of these, three moved from Charlotte Court House, VA, to Bumpass in Louisa County. For this reason, DePauls has requested the RTLHRC to review the human rights policies. Committee members asked for clarification on a number of items and in particular addressed the issue of the consumers’ capacity to give informed consent.
Mr. Collins will provide samples of bylaws and affiliation arrangements from other Local Human Rights Committee for review by the RTLHRC. On a motion by Ms. Hymes, seconded by Ms. Milner, it was unanimously voted to schedule a special meeting for the purpose of developing bylaws and affiliation agreements.
On a motion by Ms. Hymes, seconded by Mr. Carr, it was unanimously voted to elect Silvia Milner as secretary of the Region Ten Local Human Rights Committee.
The Department of Mental Health, Mental Retardation and Substance Abuse Services Office of Human Rights will present a seminar for local human rights committee members and other interested persons on Wednesday, March 31, 8:30 a.m. (check-in will begin at 7:45 a.m.) to 4:00 p.m., at the DoubleTree Hotel in Charlottesville. A reception will be held the evening before (Tuesday, March 30, 7:00 p.m. to 9:00 p.m.). Mr. Carr and Mr. Patrick will attend and will be sponsored by Region Ten. Ms. Milner may be out of the country at the time of the seminar, and will confirm her plans as soon as she is able. Ms. Hymes and Ms. Bruns will attend and will be sponsored by the University of Virginia Local Human Rights Committee.
The special meeting referenced above of the Region Ten Local Human Rights Committee will be held on Friday, March 26, 2004, 3:30 p.m., in the board room (basement level) at Region Ten’s offices located at 800 Preston Avenue, Charlottesville. The meeting was adjourned.
· Invite one speaker from each disability to give a keynote address, different dates, and different venues. The speaker would be of interest to staff, consumers, consumer families and the general public. Suggest mental health speaker at Region Ten’s Blue Ridge House, suggest mental retardation speaker at Region Ten’s Meadowcreek Center, suggest substance use disorders or prevention speaker at Region Ten’s Fourth Street Station. Highlights disability services and highlights locations and what services are provided there. · The book: similar to the City’s Parks and Recs “Root Me On” this would be a book specific to the hopes, joys, successes and “courage to try again” comprehensive services that Region Ten has given to consumers and families for 35 years. Unlike “Root Me On” this book also will contain pertinent information about Region Ten and its services, including updated materials like those included in the newspaper insert celebrating Region Ten at 20 years. One submission from each interested individual will be accepted and a small committee of local dignitaries or celebrities will participate in choosing the 150 or so that most evoke the theme. A reception for the authors and family and staff will take place after the book comes out.
Book: with 140 double-sided pages, black and white pages with color cover, bound, 400 copies cost $2,000.00 at Kinkos. Cost will be higher/lower depending on pages and copies. Identify one sponsor to cover expenses, or several to split costs, or Region Ten budgets the cost. Advertising: when the schedule of events is ready, buy affordable display ads in the local daily and the weekly papers. Display ad costs vary…so some ads might be smaller, some larger…but all say the same thing. Identify any sponsors interested in sponsoring/partnering specific print ads. Mailers, use available lists to send out invitations to parents, groups, and consumers about specific speakers. Identify a working budget identifying maximum costs to be assumed for advertising. Time Line: Speakers – scheduled throughout the year as speakers are
available. Book – have books ready and back from printer no later than
July 15. September, Jim’s retirement roast mtm 02/28/04
Medicaid Fees: 78.8% Billings support budget targets. Continue
to experience posting backlog. Expenses: No exceptions for expenses. |
