Members Present

Michael Kelley, Chair
Joe Szakos, Vice Chair
Katherine Tolton, Secretary
Barbara Barrett
Roxanne White
Neal Walters
Steve Welsh
Carol Johnston
William Hale

Members Absent

Myra Anderson
Angela Hammond
Steven Stern

Others Present

Robert Johnson, Executive Director
Jessica Spears, Administrative Assistant
Reed Banks, Adult Rehabilitative Services Director
Dr. David Moody, Medical Director
Kenneth Moore, Consumer Advocate
Lynn Shoen, Access & Case Management Director
Neta Davis, Children & Family Services Director
Martha Maltais, MR/DD Services Director
Marcia Becker, Rural Services Director
Linda Hamilton, Adult Clinical Services Director
Jane Lewis, Quality and Improvement Standards Director
Buzz Barnett, Emergency Services Director

I. Call to Order
Mr. Kelley called the meeting to order at 6:00 PM.

II. Welcome
Mr. Kelley welcomed everyone to the meeting.

III. Comments from the Public
There were no comments at this time. Mr. Johnson introduced new directors, Lynn Shoen, Director of Access and Case Management and Linda Hamilton, Director of Adult Clinical Services to the board members.

IV. Specification of Other Items to be added to the Agenda
Mr. Kelley read a thank you card sent to the board by Charlie Harris. There were no other items to add to the agenda at this time.

V. Approval of the November 12, 2007 Minutes
Mr. Kelley asked for approval of the November 12, 2007 board minutes. On page two, section VII “Moral” should be “Morale”. On page three, in the section of motions, it should be amended that nine board members voted aye with one abstention with the abstainers name.

On a motion made by Mr. Szakos and seconded by Mr. Welsh, the November 12, 2007 board minutes were unanimously approved as corrected.

VI. Program Presentation/Action Committee Quarterly Reports
Buzz Barnett presented Emergency Services to the board members, providing handouts and information regarding areas of future change.

VII. Executive Director’s Report
Mr. Johnson addressed the Executive Director’s Forum with the board. Virginia’s First Lady, Anne Holton spoke at the forum along with Marilyn Tavenner, Secretary of Health and Human Services, the Commissioner, Dr. Rinehart, Deputy Commissioner Ray Ratcliff and Frank Tetrick. There are two areas that will impact key areas of our system as well as the likely outcome of some of the initiatives of the Governor’s Budget Recommendation that are coming out on the 17th and the General Assembly. First Lady Anne Holton has begun an initiative called “For Keeps” and it’s a responsibility in congregate care for children who are in the foster care system or need foster care placement. Her desire for this committee is to increase the number of placements with relatives, second is to increase the number of placements in regards to non-relatives, family foster care, and therapeutic foster care. Not desired is what she calls congregate care to group homes, which tends to be the most expensive type of care that is available. The “For Keeps” initiative is designed to keep the families providing the care for the children who are currently in the system. Reimbursement for the care for children in foster care placement for the families is not really high enough to attract a lot of families and some are not high enough to attract families who are very stable.

Another item the First Lady is keen to do is what she calls “Get a Handle on CSA”. These items have been discussed before, but it is a critical time when decisions will be made that will potentially and positively impacting our system. 60% of youth are using 75% of the CSA budget. So it is a relatively high percentage of youth, but it is a much lower percentage than you would expect it to be using. They are also finding that surveys that 2/3 show serious emotional disorders. Which means that in effect, youth should be in our system of care. They are trying to find a way to cut residential costs by assessments for children.

Marilyn Tavenner then introduced Ray Ratke as having new duties as of right then. The Secretary of Health and Human Services has three separate areas into one area, which she is now in charge of. They have abolished the Child Mental Health Director’s position, which is now under Mr. Ratcliff. They have combined that with the CSA Director’s position. So now the Children’s Mental Health Director position of the Department of Mental Health, the CSA Director position and the Child Welfare Reform position are all under Ray Ratcliff, who is the Deputy Commissioner of the Department of Mental Health. The purpose of this is to get a handle on CSA. What they are aiming to do is to prevent the unnecessary displacements of children and youth who are seriously and emotionally disturbed in residential placements. This is using up a majority of the budget. They will not be moving CSA into the Mental Health Department. They are looking at the Hampton/Newport News model to replicate around the state. Hampton/Newport News has a track record that is stellar over the last few years. They have done an exceptional job-keeping child out of placements. Their percentages are below 3% and are being treated successfully in less restrictive outpatient settings, which is saving the CSB area an incredible amount of dollars. The dollars saved are put right back into the CSA budget.

The Consulting Group, Casey Foundation, a consulting group from the DC area, has selected 12 localities to create a steering committee with. The committee’s task will be to create a replica of Hampton/Newport News’ model. The localities they have selected are ones with a higher number of youth placements in expensive residential services. Region Ten is one of these localities. The committee’s first meeting is tomorrow. While this was being discussed, it seemed to be that the CSBs were not going to be a part of the steering committee. Mr. Johnson asked if they would reconsider having CSBs a part of the committee because if they were not a part of the committee then it’s very possible those communications disconnect like we often have between the CSBs and Social Services might just continue and it might lessen the impact of what they are trying to achieve. They noted that they would consider it. Marilyn Tavenner really thought it was a great idea, as did First Lady Anne Holton. Though Mr. Johnson has not heard back yet regarding his request for the CSBs to participate, he will continue to raise the issue. The CSBs were invited as attendees, to which they could raise questions, but Mr. Johnson does not feel like this is an equal position.

Dr. Reinhard spoke next about the General Assembly session, which is upcoming. He had a chance to look at the Governor’s budget in early December. What Mr. Johnson thought was significant was that Dr. Reinhard has looked at the budget, looked at the increases for Mental Health and quote “it is not going to knock your socks off”. There will be an increase to front end services. These services will be funded, but it is hard to tell how much. And we won’t know how much the Governor is asking for until the 17th. Dr. Reinhard then went on to say that the General Assembly is extremely critical of the state’s data system. When they ask for something, they don’t get it right away. He wanted to know from the Executive Directors how important it would be to have data that shows outcomes of services. He informed the group that the dollars would be tied to performance data. If we don’t have a good system at state level, they reserve the right to limit dollars even if they say they are going to give them to us. Region Ten is moving in the right direction with our web-based data information system. There is criticism of the state data system because the lack uniform of care.

Frank Tetrick noted that the Emergency Services Standards would be incorporated in the performance contracts. Benchmark and performance standards will now be a part of our performance contract. The state is obviously listening to the General Assembly and wants us to respond.

Mr. Johnson referred to the handouts provided in reference to last board meeting’s discussion by Mr. Stern about Community-University Service, Learning, and Research Partnerships. There is no financial or legal responsibility.

On a motion made by Ms. Barrett and seconded by Ms. Johnson the board unanimously approved Mr. Johnson’s involvement with the Community-University Service, Learning, and Research Partnerships.

VIII. Executive Committee
Mr. Kelley noted that during the next board meeting approval would be requested for the revised Board Policies. Ms. Lewis summarized the revisions to the Board Policies, giving an overview of changes made to the document.

IX. Personnel Committee
There was no report at this time.

X. Finance Committee
Ms. White noted that the audit should be completed by December 20th with the auditors providing the board a report in January 2008. The audit looks very good so far. Most of the information was provided to the auditors ahead of time. Previous audit issues were resolved.

Ms. White then discussed briefly the 1st Quarter Financial Report. There were no issues found. We should be at 25% and we are in line with that percentage.

Mr. Johnson noted that Richard Maupin would begin his position with Region Ten in early January as the Fiscal Director.

Ms. White moved forward to the Debt Service Analysis. Mr. Brown is working on more parts of the analysis. Region Ten Inc. has $12 million loan balances and Region Ten has only $213,000. The majority of the debt is in Region Ten Inc. What Region Ten doesn’t have, and has discussed getting, is looking at the $12 million in relationship to the income to pay that debt as well as the undesignated fund from the Region Ten Board and Region Ten Inc. which can in the future help pay off more debt. The idea is to look at the capital needs and work out a five-year capital plan to pay off the debt. Looking at using the revenue stream to pay off the $12 million, but as the rental properties decrease due to Region Ten using them for offices, the revenue will not be there.

XI. Public Policy & Advocacy Committee
Mr. Szakos announced that the donation letters were mailed. A single donor made a $1,000 donation. The committee set a goal for $5,000, so the committee is off to a very good start. Mr. Szakos reminded the board that he had previously asked the full board for a commitment of donations. Approximately 180 letters were mailed, though the committee does have copies that can be provided for mailing.

Legislators Bell, Deeds and Landis have meetings set up with members of the board. The committee hopes to discuss funds that are currently being provided, and their use, as well as what we still need.

The suggestion was made to have presentations about Region Ten be provided in an effort to educate and better request funding.

A budget hearing is set for January 14th in Richmond. Mr. Moore will be attending.

XII. VACSB Update
Ms. Barrett reminded board members of the VACSB Legislative Conference in Richmond January 22-23.

XIII. Other Business
There was no other business at this time.

XIV. Adjournment

On a motion made at 7:45 PM by Ms. Johnston and seconded by Mr. Welsh the December 10, 2007 Region Ten Board Meeting was adjourned and the Board moved into the Region Ten, Inc. Meeting.

REGION TEN COMMUNITY SERVICES BOARD, Inc.

Meeting Minutes
December 10, 2007
7:45 PM
502 Old Lynchburg Rd
Charlottesville, VA

Members Present

Mike Kelley, Chair
Joe Szakos, Vice Chair
Kathy Tolton, Secretary
William Hale
Barbara Barrett
Roxanne White
Neal Walters
Steve Welsh
Carol Johnston

Members Absent

Myra Anderson
Angela Hammond
Steven Stern

Others Present

Robert Johnson, Executive Director
Marcia Becker, Rural Services Director
Jessica Spears, Administrative Assistant
Jane Lewis, Quality Improvement and Standards Director
David Moody, Medical Director
Neta Davis, Youth and Family Services Director
Martha Maltais, MR/DD Services Director
Reed Banks, Adult Rehabilitation Services Director
Lynn Shoen, Access and Case Management Director
Linda Hamilton, Adult Clinical Services Director

I. Call to Order
Mr. Kelley called the meeting to order at 7:45 PM.

II. Approval of November 12, 2007 Region Ten, Inc. Minutes
Mr. Kelley asked for approval of the November 12, 2007 Meeting minutes.

On a motion made by Mr. Walters and seconded by Mr. Welsh, the November 12, 2007 minutes were unanimously approved.

III. Other topics
Mr. Szakos requested that the Region Ten Inc. and Pine Ridge Inc. policies be reviewed. The following items should be included: Whistleblower policy, Conflict of interest policy, and Document destruction policy.

IV. Adjournment
A Motion was made by Mr. Hale and seconded by Ms. Johnston to adjourn the December 10, 2007 Region Ten Community Services Board, Inc Meeting at 7:49 PM and was unanimously approved.