| Board
Meeting Minutes- November 10, 2003 |
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| 2000 Michie Drive Charlottesville, Virginia Members Present Susan Garrett, Chairman Members Absent Peter L. Sheras, Ph.D. Others Present James R. Peterson, Executive Director Evelyn Cotton, Mental Retardation Residential Services I. CALL TO ORDER Ms. Garrett, chairman, called the meeting to order at 7:22 p.m.
Ms. Garrett welcomed everyone.
Ms. Garrett asked if there were any comments from the public. There were none.
Ms. Garrett asked if there were other items to add to the agenda. There were none.
Ms. Garrett said that the search committee for the executive director is underway, and that the committee is looking at how it will proceed with the process. She has been in contact with Ms. Mary Ann Bergeron, executive director of the Virginia Association of Community Services Boards, who referred her to Alexandria and Goochland-Powhatan Community Services Boards which have recently gone through the recruitment for executive directors. The search committee will report back to the board in December regarding the process. Ms. Wernstrom asked who the members of the committee were, that she did not remember that a committee had been appointed. Ms. Garrett said that he committee members are Ms. Barrett, Ms. Johnston, Mr. Murphy, Dr. Sheras, Ms. White and herself, but that the entire board will be involved in the interview and selection of the executive director. VI. APPROVAL OF THE OCTOBER 13, 2003, BOARD MEETING MINUTES Ms. Garrett asked if there were any corrections to the minutes. Ms. Barrett clarified that in Section V, the VACSB would have an evaluation of the conference, and she also noted a typographical error in Section 11. Mr. Belair pointed out that the next meeting of the VACSB is in Richmond in January. ON A MOTION BY MS. REBHOLZ, SECONDED BY MR. BELAIR, THE MINUTES OF THE OCTOBER 13, 2003, BOARD MEETING WERE UNANIMOUSLY APPROVED AS CORRECTED.
Mr. Belair commented on the administrative structure and responsibilities in mental retardation. He emphasized his support for the reestablishment of the service divisions and the appointment of division directors for mental retardation and substance use disorders. He noted that Mr. Peterson had sent out an e-mail notifying members of this, and he thought it was a good move. Although there will be an increase in cost, the substance use disorders budget showed a surplus which can cover the cost. Mr. Murphy said that he wanted to add a point that was not reflected in the minutes of the Executive Committee, that since substance use disorders does not have the scope of the other division jobs, it does not make sense to be a division director job. Ms. Wernstrom said that there are very distinct differences among the divisions, and so each area merits division status. Ms. Barrett said that she agreed with Mr. Murphy, that directors of both Access and Substance Use Disorders were not needed, and also that she would like to know the budget impact of this plan. Ms. Garrett asked about the impact, and Mr. Brown responded that it would be minimal this year and as much as $58,000 to $62,000 next year. Ms. Wernstrom asked why the plan had not come to the full board for action instead of just to the Executive Committee. Ms. Garrett said that it was an administrative decision which was already made when it was brought to the Executive Committee for information. Ms. Wernstrom said that she did not have a problem with the new structure, but she did have a problem with being asked to discuss something with no information. Ms. Johnston commented that in order to have both positions going when Ms. Miller leaves, it was necessary to start the recruiting immediately, and she agrees with the need for both the Access and Substance Use Disorders positions. Mr. Belair clarified that the administration had decided that this change was necessary, and that the executive director brought it to the Executive Committee for their information. It is the board’s job to make policy and see that it is carried out, and at the retreat, the board concluded that greater emphasis was needed in the area of substance use disorders and this change helps to further the board’s direction. Ms. Barrett countered that it was up to the board to see the impact on the budget, and that the board has decision making responsibility in that area. Mr. Murphy added that an investment had been made in the David Lloyd process to break down the silos and the operations of separate divisions, and that enough time has not been given for this to work out. Ms. Garrett said that the managers are close to the work every day and know what is needed, but that also the board does need to watch the budget. Rev. Cameron said that he knows the work in substance use disorders needs special attention, but since he was not involved in the David Lloyd process, he could not evaluate that other than Mr. Peterson had said that there would be a tendency to be drawn back into the way things were. Ms. Johnston said the Executive Committee had raised the same question--was this a return to the old system--but the division of Access and Quality Assurance is where the breakdown of silos occurs, and that will continue and will not allow each division to go in its own way. She added that Mr. Pezzoli’s responsibilities are enormous and overwhelming. Also, the David Lloyd process did not eliminate paperwork although everyone is using the same forms. This will have to wait on the electronic record before the situation improves. Ms. Hammond asked why there wasn’t already a division of substance use disorders, and Mr. Peterson explained the changes which occurred as part of the David Lloyd process. Ms. Barrett asked about the services in the counties, and Mr. Peterson responded that they have always been under mental health and that would continue. Mr. Peterson and Mr. Pezzoli both described the advantages and disadvantages of the supervision either centrally for each service or together in the county, and the balance has always come down in favor of having the county offices under the supervision of one person rather than multiple centralized supervisors. Ms. White asked for clarification as to who is over the three disabilities, and Mr. Peterson responded that the disability division directors, Access, Administration and the medical director all report to the executive director. Ms. Miller said that she would like to add to what Ms. Johnston had said, that Access is not just intake, but also case management, and that each consumer gets a plan of services at the front door, and all services are approved and assigned at that point and that is the point where the silos formerly came into play. Also, the funding for substance use disorders comes down such a different way, you need to look at the entire amount available and determine how best to utilize it. Ms. Garrett said that she feels strongly that we should trust our managers. Ms. Barrett asked about the costs, and Mr. Peterson responded that the actual amounts will vary depending upon whether the vacant positions are filled from within or externally, and even that does not necessary cut one way or the other. Ms. Garrett asked if the members thought there should be a vote. Mr. Belair said that he saw it as an administrative decision, and Ms. Garrett said that she agreed. Ms. Wernstrom said that she did not see a need to vote, but if the Executive Committee saw a need to endorse the decision, then maybe the board needs to also, that we just need to see how we’re going to work together. Ms. Garrett asked if there was any further discussion on the matter. Hearing none, she called for a report from the Personnel Committee.
Ms. Rebholz said that the committee had reviewed and approved the changes to the Code of Ethics policy, and that only major changes or new policies would be brought to the board for approval. Ms. Rebholz said that the committee had brought the proposed retiree health benefit policy to the board last month for their information, and now the committee has the information on the Medi-Gap coverage and the costs. Retirees eligible for Medicare would take out their own Medi-Gap policies, and then would be reimbursed for up to half the reimbursement of regular coverage. She referred to the charts showing the years of service and maximum subsidy amounts, and also the projections for the costs over then next decades. Ms. Rebholz said the committee had discussed the employment contract with the executive director, and were recommending to the board September 30 as the last active work day. Ms. Garrett said that the Search Committee came up with September 1, but that is negotiable and so she would defer this to the next meeting for the actual recommendation. The next item considered by the Personnel Committee was to complete the implementation of the compensation plan that has been on hold for two years, and to bring all staff into line effective February 1. She said that all of the committee members were distressed that they had been unable to continue the progress over the past two years, and were concerned that we would be back in the same situation as a few years ago if action isn’t taken. Ms. Rebholz noted that the next meeting of the committee will be held on November 1. Ms. Garrett asked for discussion on the committee recommendations. Mr. Belair asked if a vote were required on the compensation plan, and Mr. Peterson responded that the proposed budget revisions would reflect the inclusion of this. Ms. Johnston said that a vote was needed on the proposed retiree health benefit. Ms. Garrett said that since the recommendation came from a committee, a second was not required, and she asked if the members were ready to vote. IT WAS UNANIMOUSLY VOTED TO APPROVE THE RECOMMENDATION OF THE PERSONNEL COMMITTEE FOR THE ADOPTION OF THE RETIREE HEALTH BENEFIT.
Ms. White reported that the purpose of the meeting was to review the audit, and that the members felt very good about the report. The committee did discuss the schedule for the approval of the initial FY 2005 budget which they would have received last Friday to bring to the board tonight, and so instead they decided that the committee will meet tomorrow and then bring a recommendation to the board in December. Mr. Peterson noted that all members are invited to attend the committee meeting for the opportunity to discuss the budget in more detail. Mr. Brown commented that the auditors had walked the committee
through the audit reports page by page, but in the overall, there
are three main points. First, the board has received the report
in a timely manner; second, there are no material weaknesses reported
in the audit; and third, there is a requirement for a new special
management report. Ms. Garrett asked for a motion to accept the audit, and Dr. Kibler called for the question. ON A MOTION BY REV. CAMERON, SECONDED BY MS. BARRETT, THE FY 2003 AUDIT REPORTS FROM HANTZMON WIEBEL AND COMPANY WERE ACCEPTED AS PRESENTED. Ms. White said that she recommends that in the future the auditors attend the board meeting for the review of the audit reports.
ON A MOTION BY MS. REBHOLZ, SECONDED BY DR. KIBLER, THE APPLICATION FROM MS. SHIRLEY ROBERTS FOR APPOINTMENT TO THE MENTAL RETARDATION SERVICES ADVISORY COMMITTEE WAS UNANIMOUSLY APPROVED.
No updates were reported at this time.
The next meeting of the VACSB will be the annual Legislative Conference to be held at the Richmond Marriott, Tuesday, January 20 - Wednesday, January 21.
Ms. Hammond reported that she developed a PowerPoint presentation
for the Louisa County Board of Supervisors, and Mr. Belair gave
a verbal report. The entire presentation took 30 minutes, and Mr.
Belair said that he subsequently received calls from three members
of the Board of Supervisors saying how surprised they were about
how much Region Ten is doing. Mr. Belair announced that on Tuesday, November 18 at noon, he will present a special award to a member of the Friendly Oaks clubhouse.
Ms. Garrett said that she would call for a recess of the meeting (7:22 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 7:30 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 7:47 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.
Respectfully submitted, Carol Johnston REGION TEN COMMUNITY SERVICES BOARD EXECUTIVE COMMITTEE MEETING December 1, 2003
Susan Garrett, Chairman Other Board Members Present
James Peterson, Executive Director Committee members reviewed the minutes of the of the November 10 board meetings and the proposed agenda for the December 8 meeting. The report on rural services originally planned for this meeting will be postponed until the January meeting given the amount of material to be covered in December. This includes the four annual reviews of reports required by CARF: (a) Accessibility Plan; (b) Outcomes Management Report; (c) Insurance Coverage; and (d) Use of Technology in Management. These were mailed out to board members prior to the November board meeting and copies will also be included with the mailing for the December 8 meeting. Other items to come before the board include reports from the Finance Committee, Personnel Committee, and the Region Ten Local Human Rights Committee. Some discussion was given to the FY 04 budget revisions and the FY 05 proposed budget as recommended by the Finance Committee, and in particular the importance of funding adequate salary levels. The FY 04 budget revisions provide for bringing all staff fully onto the compensation plan effective February 2004, and the FY 05 budget includes a 3.2 percent scale increase and a one-step longevity increase (about 1 ½ percent). The positive balance reported by the auditors for FY 03 was also seen as a strength that resulted from employees getting behind the new philosophy and procedures. Ms. Barrett will report on the Coalition for the Mentally Disabled, and will be asked to include an update on the recent e-mail from Commissioner Reinhard regarding the actions of the Virginia Office for Protection and Advocacy (VOPA), and how this could impact Region Ten. Board members will be asked to RSVP regarding their attendance at the December 20 Staff Recognition and Holiday Party, and also for the January 20-21 VACSB Legislative Conference (information will be included in the board mailing).
Ms. Garrett said that she would draft a format for the strategic plan and pass it on to members for their review. Ms. Johnston volunteered to work on this as well. Mr. Peterson suggested that all board members, staff and others in the community should identify what they see as the most pressing issues facing Region Ten and the goals, objectives and strategies proposed to address those issues. Ms. Wernstrom suggested that the Strategic Planning Committee should be a separate committee in order to draw upon the talents of other board members, and that the plan should address the real issues such as high bed utilization at Western State Hospital.
The next meeting of the Executive Committee will be held on Monday, January 5, 12:00 noon, at the Hardware Store Restaurant, 316 East Main Street, Charlottesville. The meeting was adjourned.
FINANCE COMMITTEE MEETING Committee Members Present Roxanne White, Chair
Jim Peterson 1. FY 2004 Budget Revisions Mr. Brown distributed copies of “FY 04 Revision Highlights,” and the budget tables for FY 04 proposed revisions. Although the revised expenditures include $260,000 in order to bring all staff onto the compensation plan effective February 1, 2004, the revisions reflect a net increase in projected personnel costs of $154,000. With regard to revenues, the state provided its share of a COLA increase totaling $63,341. Medicaid fees for mental health services are projected to increase by $330,000, and federal Part C funding for infant services has increased by $172,462. Overall, the expenses are up by $173,314 (0.9%) and the revenues by $525,767 (2.7%) resulting in a projected final balance for the year of $195,592. The committee members discussed whether it was necessary to revise the budget during the year since it is a planning document and therefore changes are to be expected. It was the consensus of the committee embers that it was not necessary to approve the proposed revisions, but rather just present them to the board as information.
Mr. Brown distributed copies of the initial proposed FY 05 budget for submission to the localities in mid-December. He noted that the cost of annualizing the February 2004 compensation plan implementation is $364,000 (for 7 months more than FY 04), and the cost for a 3.2% increase in salary scales is $400,000. A projected $65,000 is anticipated in state general funds as the state’s contribution to a COLA increase. The total local increased request is $149,073 (15%) which represents the combined total of the FY 04 request and a 5% increase over the FY 04 request. Mental health Medicaid fees are projected to increase $284,000. With a projected increase over revised FY 04 of $1,017,563 (5.1%) in expenses, and an increase in fees of $621,523 (3.1%), the initial proposed budget would reflect a shortfall of revenues over expenses of $200,449. It was the consensus of the committee members that although Region Ten has submitted deficit budgets to the localities in the past, the committee members would prefer to submit a balanced budget. They asked that an additional increase in revenues be incorporated into the proposed budget in order to balance the budget. These changes have been included in the attached budget table which the board will act upon at the December 8 meeting. On a motion by Rev. Cameron, seconded by Ms. Barrett, it was unanimously voted to recommend to the board the approval of the initial proposed FY 2005 budget with the revisions noted. The meeting was adjourned.
TOTAL REGION TEN
TOTAL REGION TEN REGION TEN COMMUNITY SERVICES BOARD PERSONNEL COMMITTEE MEETING
Irene Rebholz, Chair Others Present James Peterson 1. Policy Reviews Ms. Lewis said that the Risk Management policy has been revised to incorporate the CARF policies adopted by the board last September and also to specify who is responsible for the various aspects of risk management. The policy is proactive in order to safeguard consumers, staff and the board. A Safety Committee has been established with specified responsibilities, and the Quality Management Council will annually review the risk analysis report, and the executive director will make recommendations to the board on an annual basis. The policy also pulls together workers compensation as well as the role of the consumer advocate. The proposed revisions for the Standards of Conduct policy adds the Code of Ethics to the policy. It is the intent of the policy that problems can be resolved verbally through supervision, but if not, then the policy specifies 1st, 2nd and 3rd level offenses and the associated consequences. Ms. Lewis then reviewed each of the minor revisions incorporated into the revised policy. On a motion by Mr. Trippel, seconded by Ms. Hammond, it was unanimously voted to accept the policy revisions for the Risk management and Standards of Conduct policies.
Ms. Rebholz will be relocating to Harrisonburg, and the December board meeting will be her last official meeting. Although she had thought that the move would be some time in the more distant future, she was notified that an apartment in the retirement community had unexpectedly become available and she has sold her home. Committee members commented on how much Ms. Rebholz will be missed, and that the committee will lose a wonderful chairperson, but they were also happy that she will be able to carry forward with her personal plans. The committee will be down to two members, but hopefully the board vacancy in Nelson County, and now the vacancy created by Ms. Rebholz’s relocation, can be filled expeditiously. Ms. Hammond and Ms. Rebholz both mentioned potential candidates for the Fluvanna County slot, and Ms. Rebholz will contact them. A Nelson County applicant has also been identified. The next meeting of the Personnel Committee will be held on Tuesday, December 16, 2003, 4:30 p.m. The meeting was adjourned. REGION TEN COMMUNITY SERVICES BOARD LOCAL HUMAN RIGHTS COMMITTEE Members Present Phil Carr Others Present James Peterson, Executive Director Charles Collins, Regional Advocate, Department of Mental Brian Veerhoff, QMRP, ARC of the Piedmont Elizabeth Bruns The meeting was convened by the chair, Mr. Carr. Mr.Veerhoff welcomed everyone to the ARC of the Piedmont.
Mr. Veerhoff reported that the ARC of the Piedmont is opening an intermediate care facility for persons with mentally retardation (ICFMR), and the Department of Health requires that behavioral plans be approved by a specially constituted local body, and that the Local Human Rights Committee can serve in that capacity. Copies of the behavioral plans were mailed to committee members prior to the meeting. Each of the five plans were discussed in detail: Consumer #1: the plan addresses outbursts and offensive language related to her delusions, and the plan calls for redirection to other topics and activities. It was suggested that benchmarks be established to see if the plan is effective. Counseling for the consumer was also recommendedConsumer #2: this consumer has autism but does not exhibit maladaptive behaviors except that he has trouble with change. At these times he is asked to go to his room, and because he is very compliant, he does so readily. Committee members said that this could be interpreted as a time-out situation given that the consumer is so compliant, and so all of the safeguards required for time-out situations must be incorporated into the plan. Consumer #3: this consumer’s hygiene is so poor that it restricts who she can see. She has also been sexually exploited. She also lies and has made unsubstantiated accusations of sexual assault by another consumer. The plan will prohibit known abusers from being alone with her, and also efforts will be made to support her self esteem to help with her hygiene issues. She will be reinforced when she tells the truth, and she will continue to get individual counseling. It was recommended that it should be suggested to the psychologist that specific treatment should be directed toward the issues of self-esteem and lying. Consumer #4: this consumer has depression and is very oppositional, and hygiene is also a significant issue. He will not get up in the morning to go to his day program, and at night he plays computer games and won’t go to bed. He refuses to participate in fire drills. The strategy is to be firm, and he responds better to male staff. It was recommended that volunteers or a “big brother” be sought, someone who can relate to him. The Mental Health Association is starting a “Friendship connection,” but the program is not completely operational yet. Consumer #5: Mr. Veerhoff said that this was not actually a behavioral plan. The consumer, age 23, has Huntington’s disease which is the degeneration of the nervous system causing the loss of motor control and faculties. Although the consumer is not psychotic, anti-psychotic medication has been prescribed to help with the symptoms of the Huntington’s disease. Proper informed consent has been secured, and the medication has been showing a positive effect. The committee members accepted the behavioral plans with the recommendations as noted, and authorized the committee chair, Mr. Carr, to sign the forms indicating that the plans have received committee approval.
Mr. Collins said that the committee membership, now at three members, must be comprised of at least five members. The three guests today have expressed interest in being considered for appointment to the committee. Also, the committee needs to establish expectations of the affiliated members. At a minimum, each provider should attend at least one meeting per year and report on any human rights issues. Other Local Human Rights Committees have established written affiliate agreements, and the sponsoring Community Services Boards are charging an annual affiliation fee to offset the expenses of supporting the operations of the committee (meetings, copying, mailings, etc.).
Mr. Collins said that the committee also needs to review the committee bylaws for consistency with the new human rights regulations. Finally, Mr. Collins asked that Ms. Bruns and Ms. Spencer tell the committee members about their interest in human rights and something about their backgrounds so that the committee members could complete forms for the evaluation of their candidacies for membership on the committee.
Then next regular meeting of the Region Ten Local Human Rights Committee will be held on Friday, February 13, 2004, 3:30 p.m. at a location to be determined. The meeting was adjourned. November 10, 2003, BOARD MEETING MINUTES Members Present Susan Garrett, Chairman Members Absent Peter L. Sheras, Ph.D.
James R. Peterson, Executive Director
Ms. Garrett, chairman, called the meeting to order at 7:22 p.m.
On a motion by Mr. Belair, seconded by Ms. Hammond, the minutes of the October 13, board meeting were unanimously approved as distributed.
Mr. Peterson reported that one or more representatives of Finnegan & Associates will visit here on Monday, November 17, to discuss possible grant applications and also to get input as to priority needs. They have already identified several potential grants, but Mr. Peterson said that Region Ten may not be the intended type of grantee to be eligible to apply for the grants. However, if Finnegan wishes to pursue them, that would be fine because they would be excellent grants.
Mr. Peterson said that the architects are completing the final drawings which have incorporated the last round of input from staff, and the next step will be to take the project to the Lovingston Planning Commission for site plan approval. The meeting was adjourned at 7:30 p.m. Respectfully submitted, Carol Johnston |
