CMHSAS-SJC Board Minutes
October 30, 2012
Page 1
PROPOSED
COMMUNITY MENTAL HEALTH & SUBSTANCE ABUSE SERVICES BOARD
OF ST.JOSEPHCOUNTY
MEETING MINUTES OF NOVEMBER 27, 2012
677 E MAIN STREET, SUITE A, CENTREVILLE MI 49032
OFFICERS
PRESENT:Barbara Parker, Chair, Robin Baker, Vice Chair; Veronica Atkins, Secretary, Gaylene Adams, Member at Large
MEMBERS
PRESENT:Betty Massey, Rebecca Black, Gwen Donmyer, Allen Balog
EXCUSED:Greg Hackman, Dori Leo,David Pueschel,Larry Walton
OTHERS
PRESENT:Elizabeth O’Dell; Randy Kline;Mike Houck; Jeff Patton, KCMHSAS CEO; Cindy Lowe, KCMHSAS CFO; Michael Schlack, KCMHSAS Legal Council
- CALL TO ORDER
The meeting was called to order at 5:30 PMbyBarbara Parker, Chair.
- AGENDA
The preliminary agenda for the meeting was included in the board packet.
A MOTION WAS MADE BY BAKER, SUPPORTED BY ATKINS, TO APPROVE THE AGENDA AS PRESENTED. ALL IN FAVOR/NONE OPPOSED
MOTION CARRIED.
- VISITORS, GUESTS
No visitors or guests chose to comment.
4.APPROVAL OF PROPOSED OCTOBER MINUTES
A MOTION WAS MADE BY BAKER, SUPPORTED BY BLACK, TO APPROVE THE MINUTES OF OCTOBER 30, 2012 AS PRESENTED. ALL IN FAVOR/NONE OPPOSED.
MOTION CARRIED.
- RECIPIENT RIGHTS REPORT
Mike Houck reviewed the annual report with the board. He defined in-catchment areas as equal to in-county and discussed how he conducts site reviews based on a checklist. He explained that any deficiencies that are found on that checklist require an action plan with follow-up.
Mike reviewed the differences between incidents that require investigation and those that can be handled with an intervention. Mike noted that we did have one substantial incident this year that was substantiated and required the client to be immediately removed from the provider.
The report also included training that is required for him to receive, the training that he has done with providers and employees, and goals for the upcoming fiscal year.
A MOTION WAS MADE BY BLACK, SUPPORTED BY ADAMS, TO APPROVE THE RECIPIENT RIGHTS REPORT AS PRESENTED. ALL IN FAVOR/NONE OPPOSED.
MOTION CARRIED.
- FINANCE REPORT
Finances were presented in front of the board by Randy Kline. The month of October is down $146,204; which continues the former trend of loss. However, it was explained that we are expecting to gain the Substance Abuse loss of $36,000 back. The main driver continues to be Specialized Residential, which has a plan being worked on for changes in service plans and it is also being looked at for other potential options. Discussions have already been had with one of our major providers regarding the need for reductions. Randy also noted that the CLS services are also being looked at to make sure that services match needs.
Contracts were included in the board packet. Randy also presented the contract for Dr. Nazeer and his renewal of reappointment to the medical staff.
A MOTION WAS MADE BY DONMYER, SUPPORTED BY BLACK, TO APPROVE THE CONTRACTS AS PRESENTED. ALL IN FAVOR/NONE OPPOSED
MOTION CARRIED.
Randy also went over some of the contract changes that have taken place such as being able to access them on our website, revision of our policies in reference to ease of use of and consistency of our contracts. He also noted that contracts have been standardized to the affiliation contracts this year as of October 1, 2012.
Contract Process Review
Liz introduced Jeff Patton, CEO Kalamazoo Community Mental Health & Substance Abuse Services (KMHSAS), Cindy Lowe, CFO KCMHSAS, and Attorney Michael Schlack. These three are here to address the review that was conducted in response to a request by the board.
Jeff asked Cindy to walk through the review that was conducted with Michael’s assistance if legal opinion is requested.
Cindy noted that Kathy Curtis-Newell led this review but was on vacation and was unable to present the report this evening. She thanked GuardianTrac and Scenic St. Joe for their cooperation in this process. She also noted that this review brought forth areas of improvement for both parties involved in the review as well as areas for the PIHP to focus on.
Cindy began by reviewing the review of CMHSAS-SJC documents and highlighted findings and the corrective actions that were recommended; it was noted a letter of completion from CMHSAS-SJC has been received.
Cindy also revealed the need for the PIHP to standardized provider re-enrollment application for all four of the counties. She noted this will be looked at in January by the Provider Network Committee. It was also noted that a standard tool for developing rates and level of services offered for CLS and personal care. This will be looked at by finance and utilization management committees.
Cindy stated that GuardianTrac (GT) recommendations will be discussed but that it will be up to the board to decide what will be required to make sure that GThas a plan of correction and how those recommendations will be fulfilled. It will be up to the board to submit this to Kalamazoo to complete this process. It was noted that GT shares in this responsibility for completing this process.
With rate and budget negotiation it was noted that leases of the independent living homes need to be obtained that protect the individuals and have clarity on the responsibilities. Since we purchase CLS services from Michigan Agency With Choice (MAWC) which was formerly GT for individuals residing in those homes, CMHSAS-SJC need to review with their accounting how rent, utilities and food are provided for those residents. This information should be included in the lease. The program should not be providing these services. During the review it was unclear how this process for funding these items was handled.
Cindy also noted that the findings of this review revealed a potential conflict of interest in GT or MAWC employees being both the landlord and provider of CLS services for individual residents. Cindy asked Michael Schlack to talk more about the legal issue.
Michael noted that at this time we do not know that there is a conflict of interest but that there is that potential. He noted that the board should be asking GT/MAWC to provide information that they also have considered this issue; provide proof to the satisfaction of the board that there is no conflict; assure that recipient dispute processes are well defined and if there is a dispute, it would be handled appropriately.
Jeff noted that from Kalamazoos perspective there is an appearance of a conflict of interest. He asked Michael to address the potential risk this could pose to the agency.
Michael noted that an individual who has a dispute where the provider is also the landlord then there is no third party to assure that the individual’s rights are being protected. This causes concern for the individual being served and their rights to receive appropriate response. This causes a risk to the board for appeals, fair hearings, grievances, recipient rights issues, Michigan Protective Advocacy issues, etc. Michael noted that having these discussions before something comes up will protect the agency and the board.
Liz asked the attorney what should be done if we do determine there is a conflict of interest. Michael said before he could answer that he would need to look at what the discussion and findings are and then make a determination based on that information.
Liz gave the hypothetical example of a client living in a house where something occurs and the individual is asked by the landlord to move out of the house that day with no notice. Michael said it seems that the individual’s rights need to be considered and that in this example there was no mechanism in place for the individuals concerns to be heard.
Cindy also noted from the financial side there is risk because the landlord is also the provider and therefore the money is all commingled; without a lease there is no idea who is paying for what. The appearance is that financially it is insecure.
Michael suggested to the board that discussions with GuardianTrac need to take place; with them also seeking their own legal opinion. They have the responsibility to insure this board that they have considered this potential conflict and a plan to address these concerns. It is then up to the board to determine if the plan is satisfactory to them.
Cindy also noted that the audit process also caused some concern since they are stating they are two separate entities, yet the audit received was one. The recommendation was that they need to review with their audit firm to see if each entity should have their own audit. If their audit firm determines they do not need two audits then there should be information in the audit notating that they are separate parties.
Cindy again told the board that these are the recommendations of this review; however it is the responsibility of this agency that holds the contract to start the dialog and get appropriate responses. Kalamazoo’s expectation would be that CMHSAS-SJC report our findings back to them to complete this review process.
Barb Parker thanked Kalamazoo for all of their time and effort in this process and asked for continued help as discussions move forward toward a resolution.
MACMHB Dues
Randy addressed the board with the current invoice for the Michigan Association of Community Mental Health Boards annual dues in the amount of $9,255 that he is requesting the board approve payment for.
A MOTION WAS MADE BY DONMYER, SUPPORTED BY BLACK, TO ALLOW THE PAYMENT OF THIS MEMBERSHIP. ROLL CALL VOTE WAS TAKEN WITH 8 APPROVED/NONE OPPOSED.
MOTION CARRIED.
- BOARD POLICIES
The following board policies were presented for review with no changes recommended.
I.1Mission, Vision & Statement of Organizational Values
I.3Guidelines for Board Member Approval
II.1Governance Commitment
II.8Annual Board Planning Cycle
II.11Recipient Rights Advisory Committee
III.4Monitoring Executive Performance
A MOTION WAS MADE BY DONMYER, SUPPORTED BY ATKINS, TO APPROVE THE POLICIES TOGETHER AS A GROUP AS PRESENTED. ALL IN FAVOR/NONE OPPOSED
MOTION CARRIED.
- AFFILIATION GOVERNANCE COUNCIL UPDATE
Liz stated that the KCMHSAS Board would like our board members to attend a regional board meeting on December 5, 2012 at the KVCCMTECCenter. The executive committee recognized this invitation; however this will not take the place of our December 18 regular Board Meeting. Liz encouraged attendance. The agenda includes discussion of the Regional Entity and concerns and opportunities. Barb noted that those members who have not been involved in the monthly meetings may be interested in going to hear the pros and cons.
Robin Baker noted that the CountyCommission meeting on December 18th could conflict with our regular board meeting. It was decided that the meeting be changed to 6:00 on December 18th to avoid quorum issues.
A MOTION WAS MADE BY BLACK, SUPPORTED BY DONMYER, TO CHANGE THE MEETING TIME TO 6:00 PM ON DECEMBER 18, 2012 AS REQUESTED. ALL IN FAVOR/NONE OPPOSED
MOTION CARRIED.
- CLUBHOUSE ADVISORY BOARD
Rebecca Black reported that she is on the committee; she is very impressed with the information she has received and is very excited about being a part of this.
- EXECUTIVE COMMITTEE REPORT
Liz asked for review of the confidential recommendation for employee of the year. It was asked that votes be returned to Lisa Loker to obtain approval. (Blind vote count after meeting showed all in favor of recommendation).
Liz asked if the board had any questions regarding the EC Report. None presented.
- EXECUTIVE DIRECTORS REPORT
Liz stated that her report was presented with the board packet and there is not much she feels she needs to highlight except for the quantity of meetings that have been scheduled.
There is a movement in our Substance Abuse area that Liz wanted to share. Meetings have been held with the Prosecutor and they discussed the shocking sales of pseudo-ephedrine in our county. Data was reviewed with the board on individual de-identified store sales. It was noted that approximately 1/3 of the sales come from one store in Three Rivers and another 1/3 is being sold from one store in Sturgis. Liz discussed the meeting that was held today for pharmacists in our county. Liz commended Walgreen’s for their representation at this meeting. Several strategies have been discussed, however there is some corporate processes to look at and also some concealment of strategies are also being asked for.
Allen Balog asked if we could get MACMHB to lobby for limit of ephedrine. Liz stated that the pharmaceutical industry lobbyists are hard at work against that and they have large amounts of money to do that. Liz stated that our best mechanism right now is the store reputations. If we find stores that do not wish to participate in the efforts, negative press in a small community could do damage.
Liz thanked the CountyCommissioners for the support in these efforts.
- ENVIRONMENTAL SCAN
Liz mentioned the boards invitation to the Employee Recognition Party on December 14th from 3-5PM at the ISD.
- ADJOURNMENT
A MOTION WAS MADE BY BAKER, SUPPORTED BY DONMYER, TO ADJOURN THE MEETING AT 6:37PM. ALL IN FAVOR/NONE OPPOSED.
MOTION CARRIED.
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Veronica Atkins, SecretaryDate