PAIMI Advisory Council Meeting

Thursday, March 17, 2016

Attendees: Marcia Roth, Sam Bowman, Sheila Wall-Hill, Kenya Howard, Damie Jackson-Diop, Katherine, Carol Cannon, Pat McGinnis, and Vicki Smith

Regrets: Bob Carey, Frederick

Location: Grandover Resort

Chair Carol Cannon called the meeting to order at 9:30 am and ask people to introduce themselves.

Vicki provided an overview of the agenda

Approval of the Minutes

Damie asked for approval of the minutes. Pam moved to accept the December. Sam seconded. Motion passed unanimously.

Treasurer’s Report

  • Vicki reported in Bob’s absence
  • 14, 467.11 (minus $11.00 that was not accounted for)
  • It was reported that we are 41.6% through the year. We are a little under but our spending is on track
  • We only had one charge out of 5k set aside for PAC members to attend meetings/training etc. – Pat went to alternatives conference and charged to this fiscal year. $4,169.32
  • Vicki reminded members of the protocol for applying for conferences and training funds.
  • It was encouraged to apply for these funds / request a scholarship to help mitigate charge against the PAIMI funds to attend the disability rights annual conference.
  • A suggestion was made to have a table for PAC members during the conference to recruit new members –
  • It is the consensus of members to staff the table during the conference: Marcia will take the lead in coordinating/staffing the table –Vicki will put in a request for a table.
  • The overall advisory council
  • Discussion of Direct Advocacy Line; included cost for any expert witness. Dr. Mike Hogan is working with Iris and Susan to prepare for meeting with DHHS to discuss slow progress with complex childrens related issues that was supposed to be addressed by the state. There is an anticipated charge for his expertise and possible filing. He will be an expert witness not testifying witness. As an expert witness he agreed to mediate with the department to warn the Department of the inevitable if DHHS does not move forward with their plans. He is not willing to get on the stand –however, a testifying witness is needed before filing. If it goes to trial the pot of money will go down quickly. In summary, Vicki stated that we can anticipate spending on this line due to possible filing and litigation.
  • Question: will there be a retreat?
  • A contact was signed two years in advance at Holiday Inn Wrigtsville Beach
  • Chair encouraged members to continue to donate. Including donating a part of your expense form and donate back to PAIMI

Chair Report

  • The Chair would like to see the Ambassador returned
  • The Ambassador training is for new members. It’s not required but best practice
  • A member suggested the DATE Training
  • The Chair stated report of family members and NAMI receiving calls about not enough services/acute care for those voluntarily seeking care in the East. Family members are placing their loved one in the group home but having to pull them out due to neglectful behaviors/not good monitoring and medication management. Not seeing enough services. It’s hard to get into a hospital when you need to. Stay at ER for as much as a week and still not get treatment.

There was a discussion about SAMHSA released RFI for federally-qualified health centers or other integrated care non-profit organizations that are interested in being certified as a Certified Community Behavioral Health Clinic (CCBHC). The purpose of a CCBHC is to improve the quality of behavioral and physical health services delivered to North Carolina populations served through its system. Ken Schuesselin, Jr. MPA -Consumer Policy Advisor

N.C. Division of Mental Health, Developmental Disabilities and Substance Abuse Services,

North Carolina Department of Health and Human Services919-733-7011 office919-306-2601 mobile

919-508-0951

BREAK

Discussion of Vacancies

  • Pam resigned
  • Jennifer has accepted an internship in DC and resigned as Vice Chair
  • Damie has agreed to be Vice Co-Chair. Sam motioned for Damie to be Vice Co-Chair (who is head of the nominations committee), Pat second.
  • Floor was open for Secretary. Pat recommended putting Gail forward as Secretary and Marcia said she would step forward to support the Exec Committee if this position is not filled.Carol will reach out to Gail
  • Frederick Davis – Carol has noted reaching out to him to see how we can assist/support him with increasing participation on the Council
  • We need a member from out West and we should be looking for
  • Vickie reviewed Composition of PAIMI AC Council from the bylaws. Composition Needs include:
  • By December we need a provider of services and someone knowledgeable
  • 60% of the PAIMI AC should be reflect the racial and ethnic composition of the NC (individuals who have received or are receiving mental health services) -(everyone can only be counted once)
  • We may need a lawyer
  • We can continue to identify individuals of ethnic representation/background
  • Must be in 3 members from each 4 regions of the state.

Next steps:

  • We will reach out to Mavis because it seems that there are some applications that do not appear on the protected side of the PAIMI website.
  • It was recommended that we reach out to obtain young adult participation
  • Nominations Committee will reach out to Victor and Donita to review these applications and then set up an interview – Mavis can help with a call-in number
  • We need to recruit for region 2
  • Nominations Committee consists of Damie, Pat and Katherine

PAC Goals for the Strategic Plan

The Strategic Planning process allows for the PAIMI Advisory Council allows for the interests of the PAC to be reflected in the strategic plan related to growth, development, and enhancement. She then sharedthe Board’s 2017-21 Strategic Plan. The Board has not adopted anything. Vicki says this is the beginning of the conversation that will become part of the final document in September.

Next steps:

  • Tease Out PAIMI Alumni/Fellow
  • Speakers Bureau: Outreach
  • Resource Development and Policy Briefs – systematizing rights related information and then a network system to getting the information out there
  • Review current documents to access and process information materials

LUNCHBREAK

EXECUTIVE DIRECTOR’S REPORT

PUBLIC POLICY DISCUSSION

  • Corey Dunn
  • Murphy Bill: On the Senate side no mention of the Murphy Bill.
  • The impression is that the Senate Bill strips less rights from individuals and is a much better bill.
  • We don’t want Medicaid dollars to be spend toward institutions because it would encourage more institutions rather that community-based solutions
  • The house bill has slowed down. The “new” bill is a new approach – it’s a completely different bill. It still violence, mass shootings and mental illness is still at the root cause which is still challenging, increase funding for services and more funding to SAMHSA for work and approaches MH more broadly for mental health and adolescents. It reflects a growing understanding of MH, services and how it works. Trying to educate sponsors on linking the cause of access to mental health services and linking to violence and crime.
  • New bill focuses on Treatment and funding research
  • IMD RULE (Institutes for Mental Disease). This is a really old policy that said MH is not our problem. The rule comes from the lack of recognizing critical integral aspect of health care!
  • In NC its any congregated setting with more than 16 beds
  • Medicaid has served as a barrier to present the state from using
  • Lift the band of using Medicaid funds and allow Medicaid funds to flow fromn state psychiatric hospitals the concern will be that the institutions will be used more often
  • There are 3 state hospitals ADATC’S (Alcohol
  • The intent of lifting the IMD Band are doing it because they believe it will increase the access to services. However, this can potentially reduce the incentive to invest in community based services
  • Is it good policy to improve community based care rather than in patient.
  • Not being able to discharge from an acute setting is of concern

1115 Medicaid Transformation

  • Framed as medicaid reform. We are moving from fee for service to Managed Care System (MCS)
  • On the IDD/MH/SA side we already have a Managed Care System which is administered through the LME/MCO. Up until now if you had Medicaid, you go to doctor, he is enrolled through state agency, the doctor bills the state, the state pays the doctor
  • Now the MCO chooses a doctor that is in the network –they pay the MCO a certain amount of funds for a certain amount of patients –benefits is cost predictability this is suppose to increase quality and better outcomes
  • Under fee for service the client had choice which was best practice now under MCS the MCO’s can decide how many they need and reduce options.
  • As a state we are moving our entire Medicaid system to a MCS. At the moment DHHS was told by General Assembly to submit to CMS and was submitted to General Assembly for public comment by April 18th. One of the big questions not fully answered that we me move toward integrated health care. F
  • The department has to submit to CMS by June –then another 18months before we have contacts for Managed Care Organizations
  • Concern: Adequacy of provider Networks - -the MCO is required seeing that services are provided

Marti Knisley: DOJ Advisor

  • 103 Items in the settlement agreement
  • Updates; voluntary settlement agreement due to expire June 2020
  • Requirements: Housing, IPS-SE, Robust Network of Providers, 3f-14 Residents Rights, DSS Adult Protective Services, Guardianship and the largest people referred to Adult Care home , requirements for Diversion, and crisis services.
  • Other issues: Civil Rights, things uncovered such as institutional bias within the Medicaid program
  • Methods: Random selection by MCO area, people that are participants who are in adult care home/eligible, in random selection they go out and interview the person, staff, family member, In-Reach worker and/or provider, focus group with providers
  • Looking at affordable housing
  • In last year report –DHHS was out of compliance on Supported Employment and services and housing. The DOJ requested a corrective action plan

Housing;

As it relates to HUD: On the criminal background checks there are only 3 items on who can be denied. If you are producing methamphetamines, sexual offender registry, felony drug charge.

In the law you can request a reasonable accommodation.

On the credit side –if your rent is being paid there should be no issue around credit.

Reminders:

  • Register for the conference. If you want to use PAIMI Training Funds submit a request ASAP
  • Marcia will be in charge of the table
  • Our April monthly call is on guardianship
  • The next meeting will be in June in Blowing Rock, NC

Adjournment

moved the PAIMI meeting be adjourned, and seconded.The motion passed unanimously and the meeting was ADJOURNED.