Region 6 Planning Board Meeting
November 12, 2014
AGENDA ITEMS PRESENTER(S) DISCUSSION
Call to Order
The meeting was called to order on Wednesday, November 12, 2014, at 1 pm by
Irene Cheyne, Board Chair.
A moment of reflection was provided by Jim Risher.
Attendance Present:
Irene Cheyne, Chair
Fayette
Sheila Mallory
Butts
Tommy Allen
Carroll
Jim Risher, Vice Chair
Henry
Katherine McHan
Lamar
Geraldine Jackson
Spalding
Glynda King, Secy
Pike
Sharon Herbert
Fayette
Lee Hubbard
Clay
Marilyn Roberts
Spalding
Neydi Belmonte
Coweta
Conference Call:
Lavonne Harn
Houston
Angela Craig
Henry
Julia Chibbaro
Carroll
Beverly Garland
Muscogee
Absent:
Bill Sawyer
Schley
Mary Jo Page
Marion
Betty Cason
Carroll
David Kitchens
Sumter
Marilyn Roberts
Spalding
Edward Barnwell
Muscogee
Cathy McGill
Crisp
Amy Kuhns
Henry
Sher?londa Walker
Talbot
Dave Miller
Troup
Robert Andrews
Randolph
Keith Brown
Heard
Frank Dunford
Muscogee
Janet Wyche
Troup
Jackie Begg
Fayette
Joni Jones
Taylor
Sandra Smith
Coweta
DBHDD Staff:
Chris Newland
Behavioral Health-Regional Services Administrator
Valona Baldwin
Developmental Disabilities-Regional Services Administrator
Lawonna Parks
Behavioral Health Executive Secretary
Mable Semper
Intake and Evaluation Manager
Melinda Brooks
Regional Planning Board Support Services
Guests:
Danita Crawford
Field Operations Coordinator with DHS Transportation Services
Fay Parker
Guest of Neydi Belmonte (Coweta County)
NEW ITEMS
Opening Remarks
Irene Cheyne, Chair
Board members, DBHDD staff, and guests were welcomed. All attendees introduced
themselves and stated the county in which they reside. Today?s guests included
Danita Crawford from DHS Transportation Services and Fay Parker a guest of
Board member Neydi Belmonte.
Distribution of Meeting Information and Materials
Melinda Brooks
Each in attendance received a packet with the following items:
? Minutes from our September meeting
? Agenda for the November 12, 2014 meeting
? Travel Expense Statement
? Handout with information about Katie Beckett Medicaid
? Handout with information about the NOW and COMP program
? Handout with commonly asked questions about Medicaid
September Minutes
MSP to accept minutes from September 10, 2014 meeting as written.
Presentation by Danita
Crawford on Disability
Transportation
Danita Crawford
Danita is a Field Operations Coordinator with the Department of Human Services
(DHS) Transportation Services. The State of Georgia administers three
transportation programs: (1) DOT Public Service, (2) DCH Non-Emergency
Transportation (NET), and (3) DHS human services transportation. Danita shared
a PowerPoint presentation on DHS transportation services.
DHS has 12 regions. DBHDD Region 6 falls within three of these regions?Regions
4, 6, and 8. DHS contracts with a primary provider in each region. The primary
provider subcontracts with transportation providers. Transportation is then
provided to DBHDD clients at specific sites (such as day programs and
counseling centers). The services vary from region to region, as determined by
the Regional Transportation Committee in each region. DHS also transports
clients in Aging, DFCS, and GVRA programs.
DHS transportation services are funded by programs; there is no legislated
allocation for these services. DBHDD has a memorandum of understanding (MOU)
with DHS for the services it receives. In FY 2014, 1.17 million trips were
provided to DBHDD with an average cost of $10.69 per trip. In DBHDD Region 6,
46 ?human services sites? receive DHS transportation services. Eligibility and
scheduling is handled by the authorized sites. Individuals not serviced by
authorized sites are not eligible for transportation.
DHS monitors transportation contracts, manages the fleet of state vehicles
owned by DHS and DBHDD, and has overall responsibility for the planning,
programming, and execution of the transportation services. Each DHS region has
a Regional Transportation Committee that meets once or twice a year to review
needs, make recommendations, and assist with plans and policies.
A question was asked about transportation services of Personal Care Homes.
According to Valona Baldwin, Personal Care Homes are required to provide
transportation for their clients as part of their contracted services. Thus
they are not part of human services transportation. If a personal care home is
not providing transportation, this should be reported to the DBHDD Region 6
office.
Danita was thanked for her presentation.
Region 6 Transportation Needs Follow-up
Irene Cheyne
For several years, transportation (especially in rural areas) has been
identified as one of the most significant needs in Region 6. Irene distributed
a transportation proposal that was submitted last year to the Executive
Committee by her and Sharon Herbert. The proposal suggests that the board form
a transportation committee to identify transportation challenges and creative
opportunities to secure more transportation within our Region. Jim presented
the idea that a consultant may have to be hired to make this come to fruition.
A motion was made by Jim Risher to go forward with the proposal to form a board
committee to prepare a Region 6 transportation white paper. The white paper
would identify transportation alternatives, challenges, and creative
opportunities within Region 6. Tommy Allen seconded. MSP.
Irene expressed a desire to hold a telephone conference with interested
committee members between today?s meeting and our January 14, 2015, meeting. A
sign-up sheet was passed around to get names of interested Board members.
Community Survey Report
Irene Cheyne
Irene distributed a preliminary analysis of questions 2.1 and 3.1 based on 200
survey respondents.
Respondents to question 2.1 regarding 14 services for individuals with
intellectual/developmental disabilities rated 7 of the services as poor and 7
of the services as adequate. The listing below is organized from lowest average
rating to highest average rating under each descriptor.
Poor
Adequate
Access to Medicaid waiver funding
Housing/residential choices/supports
Supported employment opportunities
Crisis/emergency response services
Transportation alternatives
Educational opportunities
Respite care services
Social activities and recreation
High school transition programs
Day programs
Job training opportunities
Access to mental healthcare
Family support services
Access to physical healthcare
Respondents to question 3.1 regarding 13 services for individuals with mental
illness rated 8 of the services as poor and 5 of the services as adequate.
Poor
Adequate
Supported employment opportunities
Peer support services
Educational opportunities
Access to recovery support services
Housing/residential choices/supports
Crisis/emergency response services
Transportation alternatives
Access to mental healthcare
Family support services
Access to physical healthcare
Day programs
Job training opportunities
Early intervention programs for children and youth
The surveys were distributed by board members in their communities, at each of
the community forums, and at both the DD and Mental Health provider meetings.
Community Forum Report
Irene Cheyne
Lavonne Harn
Betty Cason
Jim Risher
All five Region 6 community forums have been completed. A brief report was
made for each forum:
The first Forum was held in Cordele, GA (Middle Flint Service Area) on Tuesday,
October 7, 2014. Nine people attended. The facilitator was Irene Cheyne. Thank
you to Cathy McGill for being the primary organizer for this forum. Board
members in attendance were Cathy McGill, Irene Cheyne, and Bill Sawyer. DBHDD
staff in attendance were Valona Baldwin, Chris Newland, and Melinda Brooks.
The second Forum was held in Warner Robins, GA (Phoenix Service Area) on
Tuesday, October 14, 2014. Fourteen people attended. The facilitator was
Lavonne Harn. Lavonne commented that the group attending was very diverse. The
discussion covered both DD and MH. One of the key concerns was confusion. There
seems to be a lack of communication and a need for clarity of roles; for
example, the role of the support coordinator. Caregivers are tired of getting
the run around. Lavonne also stated that she and Chris Newland would be
privately meeting with the prison director at his request. Board members in
attendance were Lavonne Harns and Irene Cheyne. DBHDD staff in attendance were
Melinda Brooks, Sandra Vega, and Mable Semper. Thank you to Lavonne Harn for
being the primary organizer for this forum.
The third Forum was held in Columbus, GA (New Horizons Healthcare Service Area)
on Thursday 23, 2014. Approximately 35 people attended. The facilitator was
Tiffani Stacy. Valona commented that there was a lot of frustration related to
DD services including board members needing to be better informed and lack of
autism services. The group ended up recommending further communication in three
areas: (1) waiver programs needs more clarity and transparency, (2) RPB needs
to help people understand how to talk to legislators about additional funding,
and (3) school system is not giving enough information about transitions. Board
members in attendance were Tiffani Stacy, Irene Cheyne, Beverly Garland, and
Edward Barnwell. DBHDD staff in attendance were Chris Newland, Valona Baldwin,
and Melinda Brooks.
The fourth Forum was held in Carrollton, GA (Pathways Service Area) on
Thursday, October 30, 2014. Approximately 43 people attended. The facilitator
was Betty Cason. Tommy Allen reported that there was good attendance including
a county commissioner, superintendent of schools, providers, and parents.
Concerns included waivers, transportation, transitional planning, lack of
information from schools, and difficulty in communicating with Region 6 office.
At the end of the forum, a local committee was formed to work on the issues
identified. Board members in attendance were Betty Cason, Tommy Allen, and
Irene Cheyne. DBHDD staff in attendance were Angela Tommey and Kerri Robertson.
Thank you to Betty Cason and Tommy Allen for being the primary organizers for
this forum.
The fifth Forum was held in McDonough, GA (McIntosh Trail Service Area) on
Monday, November 3, 2014. Approximately 29 people attended including providers,
CSB representatives, law enforcement, and health department. The facilitator
was Jim Risher. Jim commented that the group was complimentary of the Henry
County DD Center and the Henry County Parks and Recreation Program?special
Olympics and therapeutic recreation. In addition the law enforcement agencies
have an active crisis intervention team and there is a mental health court.
Concerns included need for more local residential choices, lack of adequate and
consistent transition of students, need for more communication from the school
district, waiver process is poorly understood, need for supported employment,
and the need for enhanced public transportation to meet the population growth.
Jim was asked by an attendee how the forum was advertised; he stated that the
newspaper had run an ad three times, and board members had made many local
contacts. Board members in attendance were Glynda King, Sharon Herbert, Amy
Kuhns, Angela Craig, Jim Risher, and Irene Cheyne. DBHDD staff in attendance
were Chris Newland, Mable Semper, and Melina Brooks. Thank you to Jim Risher,
Amy Kunhns, and Angela Craig for being the primary organizers for this forum.
Irene complimented the board on the board?s involvement in organizing and
attending the forums. Although we did not reach our goal of 50 attendees per
forum, many more people participated this year than in previous years and we
held five forums (four forums were held in previous years).
Organizational Updates
Chris Newland
Chris spoke on the three major changes:
1. CORE redesign of DBHDD will change how we are giving services. Up until now
many CSBs could manage providing a wide range of services, but many small
providers could not even though they were contracted to do so. The core
redesign will make providers much more accountable for the services they
provide. Reimbursement will be changed from a monthly payment of 1/12th of the
contract, to a performance based contract guaranteeing that services were
provided and that the services are making a substantive difference in the
individual?s life.
2. The formation of an Administrative Service Organization (ASO). DBHDD has
contracted with Value Options to provide administrative services. Value Options
will have a broad stroke of responsibilities and will be responsible for
subcontracting services as needed. One of the things that will improve
substantially is the management of data. Data systems will be integrated and
will provide easy access to relevant data. Value Options starts April 1, 2015.
3. DBHDD is undergoing a department reorganization. There will be both new
divisions and new departments. The system will be much more centrally managed.
Regional offices will be called field offices and will no longer have a
regional coordinator. Field offices will be accountable directly to central
management at Two Peachtree. The boundaries of the regions will be more porous
with greater collaboration throughout the state. It is hoped that DBHDD will
complete the reorganization by March 31, 2015.
Carriker Resignation
Irene Cheyne
George Carriker has resigned from the board for personal reasons. Irene
circulated a card thanking George for his service.
Leadership Committee Report
Irene Cheyne
Glynda King
Tommy Allen
The Leadership Council has been working hard on defining the future role of
advocacy in the reorganization of DBHDD. House Bill 100, the legislation passed
in 1993 that formed the regional boards, included the principles of empowering
consumers and families, increasing community ownership, and leveraging
resources. The Leadership Council is asking, ?How is this vision being
reflected in the new organizational structure?? Other questions include ?Are
there flow charts that identify the path families must travel to get services
and where, on this path, are the bottlenecks?? ?What are the measures of
evaluation that will clearly show what?s working and what?s not?? and ?What are
we doing to enhance communication with individuals and families when we are
taking away a person on the regional level; i.e. regional coordinator??
At the October 31 meeting of the Leadership Council, Wendy Schneider, the Chief
Clinical Officer for Behavioral Health Link, made a presentation on the DBHDD
crisis intervention service of GCAL and the mobile crisis teams. She stated
that in September 2014, GCAL had 800-1000 calls a day, totaling 25,952 for the
month. Of these 25 percent were emergent (911 situations) and 33 percent were
urgent. She also stated that with the suicide of Robin Williams, the crisis
line experienced a 20 percent increase in calls for 6 weeks. Many of these
calls may have been generated by a Channel 11 television positing of a photo or
Robin Williams and the GCAL number.
Irene Cheyne and Glynda King have a meeting with Commissioner Frank Berry on
November 24 to discuss the role of advocacy within the DBHDD reorganization.
Medicaid Waiver 101
Mable Semper
Mable stated that the Medicaid waiver NOW and COMP waiver programs for
individuals with DD are funded by the federal government. The state of Georgia,
through the Department of Community Health, determines how to execute the
waiver program.
The waiver program is closely audited and DBHDD has many guidelines that have
to be followed in determining who is eligible for NOW/COMP waivers. The NOW
waiver provides an individual with less than $25,000 in annual support. The
COMP waiver provides an individual with $25,000 or more in annual support.
The eligibility process includes the submission of an application, review of
the application and determination of eligibility by a DBHDD contracted
psychologist. Mable stated that this is one of the bottlenecks in Region 6.
Once eligibility has been determined, the individual receives an eligibility
letter and is placed either on the long term planning list (if he or she
doesn?t have immediate needs) or the short term planning list (if there are
immediate needs). If an individual does not qualify for either NOW or COMP
waiver services, there may be funding available through Family Support or State
Funded Services.
Once a year an individual on the long-term planning list receives a letter
asking if there have been any changes. This is used to determine whether the
individual should be moved to the short-term planning list.
Once a person is determined eligible, a number of assessments must be made by
the Intake Evaluation Team to determine what services the individual may
receive. Once the assessments are completed, an Individual Service Plan (ISP)
is developed that identifies what services the individual needs and who will
provide those services. Any changes to the ISP must be clinically justifiable.
Georgia is the only state where individuals can be approved for Exceptional
Rates under the Medicaid program. An Exceptional Rate allows some expenses to
exceed the Medicaid allowable rates.
Mable commented that the school system is responsible for many services, so
DBHDD has to be sure that it is not duplicating any of these services.
Mable said that in fiscal year 2014, Region 6 gave out 44 new waivers and
placed 40 individuals on state funds. She said that so far in FY 2015, Region 6
has given out 13 new waivers and placed 22 people on state funds. Valona
recommended contacting the Two Peachtree office for additional statistics.
Mable was asked about ?self direction.? This is where a family member directs
the waiver funds instead of a licensed provider. She said that very few
families chose this because it is difficult to manage. If someone is receiving
an exceptional rate, they are not eligible for self direction. Mable was also
asked whose job it is to explain the waiver system to people who don?t have
waivers yet. Mable responded that this is one of the roles of the planning list
administrator. She also stated that Region 6 is doing quite a bit of outreach
through venues such as transition fairs.
Irene commented about the lack of information available to Georgia residents
about the waiver program. Fact sheets on the Katie Beckett waiver, the NOW
waiver, and the COMP waiver were distributed to board members, but these fact
sheets are from the Department of Community Health website, not the DBHDD
website. Irene stated that it is important to provide tools to individuals and
families so that they understand they system.
Mable was thanked for her presentation.
New Board Appointment to Leadership Council
Lavonne Harn has resigned from her position as a Region 6 representative on the
Leadership Council. MSP to appoint Tommy Allen to be one of the Region 6
Planning Board representatives on the DBHDD statewide Leadership Council.
Report from the BHPAC
Jim Risher
Amy Kuhns
No report from the Behavioral Health Planning and Advisory Committee was
presented.
Developmental Disabilities Report
Valona Baldwin
Valona stated that DBHDD is working on streamlining access to DD services and
that the NOW and COMP waivers are being rewritten to include autism services.
She also stated that meeting the Dept. of Justice settlement agreement is a
major priority for DBHDD DD. The Department has hired consultants from other
states to help with a Pioneer Project in Region 2. The intent of the project is
to develop a better transition program from hospital to community. The Pioneer
Project will include early involvement from a support coordinator, early
identification of specialists needed, and development of community connections
ahead of actual transition. The goal is to use this new transition approach to
transition two patients in Region 2 in December and then replicate the approach
region by region.
According to Valona, DBHDD has contracted with Emory University and Georgia
State University for consulting services related to autism. A consultant now
sits on the Autism Advisory Group. Valona recommended looking at the autism
resource mapping information on the www.ga-autismplan.com website.
Behavioral Health Report
Chris Newland
Chris shared three points:
1. Board members are encouraged to refer people who need services to the
Georgia Crisis and Access Line (GCAL). The services through GCAL are improving.
If anyone gets negative feedback, please let him know.
2. The construction of two new stabilization units?one in Newnan and the other
in Griffin?is exciting. The facility in Griffin is nearing completion.
3. Believe recovery is possible. Believe that we are changing lives. Chris
shared the story of an individual institutionalized with depression so severe
she did not talk or eat for years. With the success of highly individualized
therapy, the individual has now been transferred to a group home in Griffin and
is talking and eating and has plans for the future. . Chris believes that
eventually she will live unassisted.
Adjournment
Irene Cheyne
Our next meeting will be on Wednesday, January 14, 2015, from 1-4 p.m. at the
Upson County Senior Center.
MSP to adjourn the meeting at 3:58 p.m.
Minutes recorded and submitted by Melinda Brooks.
Attachments
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