CFAC Meeting Minutes: 4/25/11

Members Present: Nancy Baker, Bob Carey, Bill Cook, Leslie Huntley,  Tracey Turner, Rosemary Weaver, Kristie Sluder, Howard Graves, Joe Crowder

Members Excused:  Carolyn Burton,  Joe Sentelle,  Christine Smith, Debbie Hamrick,  James Lane

Members Absent:

WHN Staff: Arthur Carder, Dick Graham, Kelley Stines

3 Guests:  Sandy Patty (Synergy In Action, Henderson); Rich Munger (Buncombe); Toni Delaney (Buncombe)

Ruth Ann Bradshaw, - resigned

Team: Consumer Family Advisory Committee

Date:   4/25/11             

Time Started:  5:54 – Community
          Connections, 6:00 – Regular CFAC

Time Ended:  8:10   

TOPIC

DISCUSSION/FINDINGS/CONCLUSIONS

RECOMMENDATIONS/ACTIONS

Community Connections

(Bob) Healthy Yancey 4/26 Bob representing NAMI, CFAC, WHN with literature at table.

(Bill) Mitchell – Studying program concerning indigents

(Tracey) NAMI Walks, Asheville Tuesday 6/28/11. Come out and support.
(Rosemary) Rutherford MOE group to interview those who submitted needs requests. 5 applicants this year. Tue Dick Graham to speak at Rutherford/Cleveland NAMI. At June 28^th meeting, main speaker will present on Special Needs Trusts.

(Kristie) Madison – On planning committee for Winston Salem Recovery Conference.

(Leslie) Nami/Four Seasons’ fundraiser 6^th Avenue/Kat Williams Concert May 21^st at Blue Ridge Community College.  Oct 8^th NAMI 4 seasons meeting w/ Pete Early as keynote.

Welcome & Introductions

Nancy opened the meeting with introductions of CFAC and guests.

Approval of Agenda

Agenda approved as presented.

Approval of March Minutes

Minutes approved with one correction.

Action/ Crisis Items

Medicaid Waiver Update (Dick Graham, Director Consumer & Community Relations)

Implementation - Major accomplishment – completion of initial hiring for waiver positions is completed.  Next phase – external advertising positions with Employment Security Offices in each county, and Career Builder (online posting).

1^st week May – WHN managers and other waiver site managers have training at PBH around standardization of documents and processes. Puts some workgroups on hold until we find out more how standard things need to be.

Work Groups – Dick’s group had first meeting. Next meeting May 21^st.  The CFAC  Participation on Waiver Workgroup doc maps out different workgroups and which members are attending which meetings, with times and frequencies.

Treatment Planning (Arthur)

Recent legislature decided to support PBH model of waiver processes and standards across the state. Will learn more about ‘standardization’ during weeklong training early May.

State has extended new RFP (request for proposals) to other LMEs. After Jan 1, 2013, LME’s will not exist, only MCOs (Managed Care Organizations) would exist. They would provide in-house Treatment Case Management (TCM). Initially not part of waiver adoption.  TCM has to be in place at LME MCO by January 1^st.  Potentially require ~25-35 additional staff for the DD side of this function, with goal to have office space located outside of WHN central. Eventually need to manage TCM services for MH/SA. MH/SA TCM will be kept separate from DD TCM offices. WHN is obligated under the waiver to bring TCM in house.  Providers will be given a new function called Community Guides.  Arthur will send out material by Thursday to Board and CFAC outlining data, including new state-proposed map and clarification of roles and functions. Arthur encourages CFAC to use the information as they see fit.

Definition change in Treatment Case Management –Treatment Case Manager (TCM) will develop the plan of care and make sure plan is followed. Community Guides will pick up some of the current TCM functions, such as accompanying consumers to doc appointments. Bottom line is that if WHN doesn’t do it, another LME will. Changes recently communicated to WHN and will require restructuring implementation plan.

LME’s ready to Proceed: PBH, WHN, Sandhills and ECBH. Deadline May 20^th for other LMEs to submit application. State to award 5-6 more LMEs to start implementation by July 2012. Any LME not approved for Waiver Implementation by 2013 will be assigned to an LME/MCO.  

Community Relations (Dick): Fairly mixed response in the community to this latest news regarding TCM. Most providers at the Hendersonville stake holders group understand that it’s not WHN’s fault nor initiative to pull TCM services in house. Some family members feel it might be better under waiver because some providers make PCP plan based on services they provide. 1^st Innovations Workgroup met. They voiced same concerns about inconsistency in Treatment Case Mgmt services.  

Charge to members from CFAC Chair: If you don’t feel comfortable presenting this information back to your communities, please contact Dick/Arthur/Nancy.  These latest changes was passed by legislators, then communicated to WHN last week. Will have more answers in May. 

Arthur – send out info by Thursday to Board and CFAC outlining data, including new state-proposed map and clarification of roles and functions.

CFAC Support & Advocacy Plan (Nancy Baker)

Bill, Leslie, Rosemary, Tracey, Joe, James, and Nancy, Christine involved in workgroups.

Consumer Enrollment & Eligibility (Rosemary) – how consumers come into the system. Crafted a list of questions to ask at the PBH training next week.

 Consumer Education & Enrollee (Kristie, Dick) – Explored media print/television/radio to educate enrollees. Enrollee Education has two parts. 1) Educating enrollees about their benefit plan (handbook, website links, talking points, common language); 2) Enrollees are entitled to specific education based on their disability (Ex: Suicide Prevention). More ideas requested from CFAC. Handbook to be pre-approved by DMA.

Provider Enrollee Committee (Joe) – sent out letters last week to providers about enrollment. Concerned that the contract is so big & complex. On hold due to standardization issues.

Practice Parameters (Bill) –  estimated start date mid May, Marsha Ring (Chair).

Provider Monitoring (Leslie) – Working on methodology  to ensure that consumers receive services to which they are entitled, at whatever level is deemed appropriate. Trying to streamline monitoring process. My focus is on consumer outcomes, in how to help consumers’ lives get better.

CAP Innovation Workgroup – Big issue, family members will be limited on number of services they get paid for when providing services for family member consumers.

** Workgroups are still open to CFAC and Community Members.

CFAC Members – provide feedback on consumer (and provider) education needed in communities.

April 20 Conference Call (Bob)

Conference Call topic was CFAC’s roll in Waiver process. Discussed that CFACs have to get the letter of support. If CFAC doesn’t approve, the LME can’t go forward. Stressed the consequences of that option. Another topic – Appeals process under the waiver. Same entity that’s handling services is handling appeals. Another Issue – state CFAC were not informed before waiver was rolled out. Rosemary will ask at next state meeting why CFAC wasn’t consulted. Joe Crowder interested in accompanying Rosemary.

Next phone conference – May 18^th. Cathy Kocian to send out reminders.

WHN Board Meeting Report (Nancy)

Bob requests all members to read his draft to make sure our concerns are worded correctly.

Action Crisis Plan

Working on Waiver Initiatives.

Committee Reports

Treasury Report (Rosemary) – would like to see WHN CFAC have its own budget.

CQI (Bill)– met last on Feb 8 to review all reports on levels of incidents, complaints and concerns. Lower incidents in general. Several issues on reporting consistency as it pertains to human rights. Difficult to get review results from hospitals. Next meeting May 10. We spend lots of time trying to improve reports that are given to us.

Membership (Tracey) – still requesting members’ feedback on what they would like in training for new members training.   Upped membership for CFAC in last meeting. Bob to re-evaluate bylaws.

Peer-Employment – on hold