Intellectual Developmental and Disabilities Director's Consortium Meeting Minutes January 12 13, 2012 Officers: Chair: Carey Amthor Vice Chair: Ray Helmcamp Secretary: Janet Brunette Treasurer: Gregg Rowe Executive Director's Consortium Liaisons: Jenny Goode & Barbara Tate TX Council of Community Centers Representative: Susanne Elrod Location: DoubleTree Hotel, 6505 Interstate Hwy. 35 North, Austin, Texas ITEM Welcome/Introductions Carey Amthor/Ray Helmcamp Topics of Interest/Concern Carey Amthor Carey and Ray convened the meeting with welcoming attendees. Carey notified the group of the hotel change for the next meeting to be held at the Embassy Suites, Arboretum. The dates for the next meeting were also changed to March 29-30 th 2012. Carey Amthor gave an overview of the critical issues that will affect future service delivery for the Authority and Provider in the Center system. Carey reviewed the document for Target Case Management, Center Information that had been sent to the centers prior to the meeting. This document contained information from 22 different Local Authorities and addressed topics related to service coordination such as caseload size, supports, budgets for Type A and Type B contacts and incentive programs utilized. There was concern noted on how to review quality of the Type B notes to determine what is billable vs. not billable. This is a risk area that will require further clarification in the future. There was discussion regarding the GR targets, number of persons served and potential budget loss for GR services in the next FY. Carey asked if Centers were using PATH facilitation as a method of discovery. He requested that LAs e-mail him if you are using PATH and the impact on interview training that was required. Texas Council/E.D. Update Susanne Elrod Susanne Elrod provided the following information: Long Term Care Redesign Targeted case management to be reviewed. Next legislative session could involve another GR deficit. 1815 waivers to be discussed for consolidation of funding streams.
LBB Review of IDD Local Authority Budget and performance review prompted by refinance initiative for 5,000 people that was a shift in resources Site visits made at ATCIC, BTCS, and Alamo COG to learn about the LA background and separation of the authority/provider functions Seeking information on the impact of 26% GR reduction & refinance, DADS oversight, HCS SC transition current impact Initial phase completed with site visits, interviews with DADS stakeholders, private providers and TX Council Report to be presented to the legislature to address government effectiveness and efficiency. GR Targets Legislature looks at number served, and average monthly costs when comparing IDD programs with others. Review of IDD Local Authority Roles & Responsibilities. Need to better define authority functions that are contract obligations but not counted in the targets. How to capture recognition of work that is done? Crisis management and behavior supports as a safety net are examples of direct service vs. administrative services. TX Council is working with DADS to redefine performance targets that include additional authority functions. Send your thoughts to Carey for Susanne that can be considered through the negotiations. HCS SC Activities New stakeholder group developed to include public/private coalition to improve the processes HCS SC workgroup to begin meeting again to support the efforts Training modules for SCs is needed for LAs Two sub-groups have been formed to review the planning process and to make recommendation for changes to the Handbook. The IP and PDP format are to be revised. Focus groups to be developed to get additional input from families and consumers. More information to come regarding the location of the focus groups in the spring.
Guardianship and Power of Attorney Kathleen Anderson, Special Counsel, HHSC Kathleen Anderson provided a basic overview of the Legal Guardianship and Power of Attorney in Texas. Guardianship statutes in Texas are currently found in Chapter XIII of the Texas Probate Code (TPC). Statutory Durable Power of Attorney (property management) statutes are currently found in Chapter XII of the Texas Probate Code (TPC). Power of Attorney is not a guardianship, it does not establish a guardianship, and only a court has the authority to do so. Nursing in HCS, TxHmL, and ICF, an update Grace White, RN MHMR of Tarrant County For a copy of the presentation contact Carey Amthor. Grace White provided a Training Follow-up for SB1857 to reflect on where are we now Provider advocate committee is only required for HCS not ICF (use of IDT) Begin date for LVN pilot is 3/1/2012 Nursing Peer Review if RN is cited a peer review committee will look at the issue as most are process issues. Nursing Service Plan is the IP for HCS but is not the same as the PDP. DADS information letter will be coming soon to clarify this issue. Nursing Assessment should be included in a transfer packet for an individual. When an individual has only selected CDS a nursing assessment is still required. Contact Grace White for a copy of the PowerPoint presentation. Direct Service Workforce Realistic Job Previews Don Henderson DADS DADS Update David Rollins and staff Don Henderson presented the Direct Service Workforce Realistic Job Previews, Selection and Retention. Focus has been given to address recruitment and retention of direct service workers. Videos have been developed and are located on the DADS website that addresses a realistic job preview for working with people who have an intellectual developmental disability. These videos can be used as resources for DADS service providers. David Rollins provided the following information: Mary Skillman will be retiring at the end of February 2012. Her knowledge of the system and support to the LAs will be greatly missed. Resources available for discovery methods : Michael Smull now has a presentation on YouTube that demonstrates Person Centered Thinking. PATH training is offered through the ARC of Texas and UT Center for Disabilities. LAs are encouraged to send staff to be trained on the various methods as the training becomes available.
582 enrollments still need to be completed for TxHmL refinance effort. David commended the group for all of the hard work and efforts to complete the numbers (almost 4,300) of enrollments up to this date. Centers will be held harmless for the % of GR targets for the remainder of FY 2012. Centers will be expected to submit a plan to the contracts manager if the GR target expectations will not be met by August 2012. An e-mail will be sent to the Executive Directors by the end of February outlining the expectations. Centers are able to get credit for GR individuals refinanced into TxHmL during the month they are being enrolled. DADS is reviewing performance targets for possible changes in the future. There is some discussion around lowering the GR targets for some centers. LA GR dollars in DADS Budget is at the biggest risk to lose monies. Question asked by LBB why the system spends so much money on so few people. Robert Evans: The Quality Reviews of Local Authorities up to this date resulted in 10 centers receiving deemed status. HCS Local Authority Reviews show a pattern of centers not in compliance with SC monitoring. He offered the following: Monitor as often as you indicated was the need Monitor all of the services needed as outlined on the PDP How are you looking at SC monitoring from the families perspective? Outcomes will not specifically be addressed this year during the audit process as there needs to be additional clarification from DADS for all parties involved regarding the expectations. Donnie Wilson: 100% of the Money Follows the Person (MFP) grant was approved until FY 2016. Grant funds will be used to hire 24 transition specialists, 1 transition coordinator (Eileen Short) and 1 support staff. Staff will be housed at the SSLCs but are supervised by DADS. Position descriptions have not been finalized but the goal is to provide families/individuals with the best match to providers that can best meet individual s special needs. Prior to admission requests to SSLCs all efforts must be exhausted and documented that least restrictive settings have been explored with no results. 240 HCS diversion slots are in FY 2012-2013 budget. 10 a month are allocated and children are given a priority.
Business Meeting Carey Amthor & Ray Helmcamp Financial Report Gregg Rowe Contract committee requests Lee Brown Recognition, past officer Carey Amthor Business Meeting Day 2 Financial Report Gregg gave an updated financial status. Gregg noted changes in meeting locations and dates for the IDD Consortium: March 29 th -30 th, 2012 Embassy Suites Arboretum (free parking and internet service) September 12-13, 2012 Double Tree Hotel No meeting to be held at the Texas Council Conference scheduled on May 30-June1, 2012 in Austin,TX. Recognition of Barbara Davis for her 4 years of outstanding service as IDD Consortium Secretary. A plaque was given to her in appreciation of her commitment and continued dedication the Consortium. Lee Brown Lee gave an update from the contracts committee. There is a request to the IDD Consortium to review the requirements for updating the interest list. It is suggested that the language in the contract allow for more flexibility for e- mail and letters, etc. Carey offered to draft a proposal to send to the group for comment. Consumer Directed Services There needs to be a better reimbursement rate. DADS has been asked to consider a new code for service strategies to capture service coordination activities, possibly similar to an administrative fee i.e. flat rate. Lee asked for feedback to consider whether this should be a monthly or yearly rate. Additional clarification is needed from DADS regarding a provider reimbursement. DADS Provider Update Curtis Walters, Survey and Certification Curtis Walters presented an update on DADS Provider Initiative Issues. Curtis noted the changes that are being considered for the PDP format to possibly include the IP. Attention will be given to any barriers in the process that would interfere with the SC and provider functions. Outcome/Interview Based Review will be the focus for Survey & Certification Team Subject Matter Experts are being identified at DADS to provide a better resource for providers. Contact Curtis if providers appear to be struggling with provision of services and would benefit from additional technical assistance.
Managing Stress Through Changing Expectations Charles MacInerney, Founder, Expanding Paradigms Charles MacInerney presented the following information: Reducing Stress with Goal Setting Skills Goals of the presentation: The group gained a better understanding of stress Understanding appropriate goal setting strategies Understanding of how to reduce or even eliminate boredom and/or anxiety. Meeting Evaluation Topics for next meeting Ray Helmcamp Meeting Evaluation Additional topics are needed for IDD presentations for the TX Council Conference to be held in Austin on May 30 June 1, 2012. Meeting Evaluation was not conducted due to time constraints. Please give feedback to Cary for any suggestions for improvement needed with future agenda or things that went well at the meeting. Submitted By: Janet Brunette Secretary, IDD Director's Consortium