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HomeMy WebLinkAboutIDD Provider Meeting Minutes 05-19-23 Intellectual & Developmental Disabilities Provider Meeting Friday, May 19, 2023 Staff Present: Marion Rowe, Jane Cline, Lori Young, John Gerak, Stacey Brookens Providers Present: Tony Fisher & Jessica Coons (Family Care Services); Gabrielle Snyder & Beth Freeman (Occupational Services, Inc.); Renee Grimm & Gina Belicic (Merakey); Ashley Pool (Tender Hearted Services); Sarah Guyer-Marshall (AHEDD); Kara Taylor (Person Directed Supports); Tara Harmening (Safe in Home); Robert Reed (Focus Behavioral Health); Judy Welch (Volunteers of America): Shanna Golden (Service Access & Management); Lorrie Miller (ARC of Franklin and Fulton Counties); Mario Bienvenue (Station MD) MEETING MINUTES WELCOME & INTRODUCTIONS This meeting was held via Google Meet. Those present introduced themselves and their agency affiliations. STATION MD MARIO BIENVENUE Mario Bienvenue, Senior Account Executive presented on Station MD. Station MD is in place to help achieve superior care for vulnerable individuals. Station MD was founded by four (4) emergency room (ER) doctors in 2017 based on their experience in the physical world in an emergency room; seeing individuals with some sort of intellectual and/or developmental disability come into a waiting room and having to wait long hours for something as simple as a prescription refill. Station MD is in 22 states (including PA); carrying for 34,000 lives. Mario shared a slide that included members and sponsors and features speakers across the country. Why do individuals with IDD tend to use an ER more than the general population? Often times they are medically complex. There tends to be a lack of access to medical care members of this population. Sometimes it because of immediate availability. Station MD tries to care for individuals in the most stable environment which is their home setting. The experience of going to an ER is not pleasant for most. It is traumatic and disruptive for the general population so for those in the ER with sensory issues, it is very disruptive for routines. The ER is a frightening experience and not a good place to receive care. It is very unspecialized. Doctors are caring for many patients at a time. The ER is also very expensive. Impact of COVID- article notes that having an intellectual disability was the strongest independent risk factor IDD Provider Meeting Friday, May 19, 2023 for presenting with a COVID-19 diagnosis and the strongest independent risk factor other than age for COVID-19 mortality. Staff and individuals were being affected. Keeping individuals out of the ER played a significant role in helping save lives during COVID. If there is a silver lining to COVID, it is that telemedicine is here to stay! It is much more important for the members of IDD than those of the general population due to the challenges presented in transportation and other factors. Telemedicine removes some barriers to receiving care. How telemedicine can help Lack of access is typically a problem but with Station MD, they can be anywhere, anytime there is cell signal or Wi-Fi. Suboptimal care for special needs - all Station MD doctors, who are carefully vetted by the four (4) founding doctors, go through specialized curriculum. They learn the medical, behavioral and social needs of the population. Peer reviews occur under the chief medical doctor. Cases are reviewed to see how things were handled, etc. Since 2017, Station MD has seen thousands of individuals and has had thousands of visits which has given lots of experience and assisted in the development of clinical guidelines on how to deal with things. Primary care unavailable in off hours call Station MD! Doctors are available 24/7; 365 days. The doctor can do an assessment and tell you whether you should continue to monitor the situation or maybe an x-ray is needed but it can wait until the next day. All doctors provide full documentation so that any regulations or requirements that you are required to meet, they are able to help fulfill. Mario provided a screen shot of StationConnect platform that they use. Doctors note in this platform after every single visit. Individuals using Station MD have access to StationConnect. After a visit with a Station MD doctor, an email will go out to the staff member that contact information was provided for. The email will contain a secure link back to StationConnect. In StationConnect, you can see notes and pull data. Data can include the number of visits, calls by hours in a day, diagnosis, etc. Station MD sends reports out on a monthly basis as well. In addition, if the provider agency is using electronic health record (EHR), Station MD can (if given permission by the agency) put the note right into the EHR. Not all cases are emergent that come to Station MD; a lot of the calls are questions, medication refills or medication questions. Station MD doctors can prescribe medications. Information is gathered regarding pharmacies during implementation. Station MD will verify those pharmacies on each call. Since inception, Station MD has been able to treat 90% of individuals in their home setting and not sending them to the ER or an urgent care environment. This number is trending up. Examples of diagnosis of those contacting Station MD are cough, med issues, seizures, body aches, cellulitis, COVID, vomiting, etc. Mario provided a graph that showed the high volume of those they were able to resolve the issue in the home setting versus those that were recommended to go to ER or an urgent care. Even in the case where an ER or urgent care was recommended, the doctors will attempt to call ahead and reach someone at the IDD Provider Meeting Friday, May 19, 2023 receiving end to give them a heads up, explain what is going on and ask them not to let them languish in the ER. Station MD has been trying to survey not only individuals but their caregivers. Individuals are generally pretty happy with the care they are receiving. Direct Support Professionals (DSPs)/Caregivers are generally happy with the care the individual is receiving as well. The numbers are lower than Station MD would like to see but they continue to survey as they have learne structure for DSPs. A slide was presented to show an agency that was piloting Station MD and the statistics they gathered. After paying for the service, they achieved a cost savings of $49,000 in seven (7) months. After the pilot, the agency decided very quickly to expanded service across all their residences due to not only better care and treatment of the individuals but also saving money in terms of overtime for staff, transportation, etc. Another slide was presented for another agency that showed cost savings. Questions Q: If someone calls Station MD, how quickly are they connected to a doctor? A: The process is initiated with a phone call. Once someone calls into Station MD, they will talk to a navigator who is employed by Station MD. The navigator will gather information such as where you are calling from, who will be the individual seen, vitals (if possible). They will make sure the technology is working, such as video and audio. Station MD uses a HIPAA compliant Zoom platform. The caller is put into a Zoom waiting room. Depending on the call volume will depend on when the caller is connected to a doctor. Calls are triaged at the initial conversation so that the more serious cases can be taken first. Some callers are connected with a doctor instantaneously while others may wait five (5) to ten (10) minutes. The waiting period is monitored very closely. If it is seen that it is trending up to 30 minutes, it is easy to bring another doctor onto the Zoom call. Q: Will the triage person just tell a caller to call 9-1- A: Yes. There are things that can be done via telemedicine and there are things that cannot be done. Station MD infrequently gets a call that is really emergent and the doctor will quickly say no hang up and call 9-1-1. It has happened but for the most part, it does not. We provide staff training. The platform is simple to use. There is video and written training as well as Zoom meetings. Part of the training does and can include when to call Station MD and when not to. Q: How much does this cost? A: Station MD charges a per individual, per month fee. That fee is $30 a month/$1 a day. That gets you 24/7 access to a physician. All training and documentation is included. The agencies would be responsible to pay this. Station MD does try to bill Medicaid, Medicare or private insurance when possible for the doctor time. The $30 is more so an access fee. enough to pay the doctors. IDD Provider Meeting Friday, May 19, 2023 Q: T A: No; never! There is a state that makes Station MD send a bill for the co-pay amount; however, they will never collect that. Q: Once you get an individual you are going to support, do you get their detailed information about their medical history? A: Absolutely! Station MD does, during implementation, asks the provider agency to provide information not only about their agency (location, etc.), such as information on the ation is uploaded into the StationConnect portal and then continues to build from there. Baseline information is requested then Station MD will continue to document in the portal. Q: What are DSPs responsible for? What is the training they need to do the service correctly to support the individual? Do they need to know how to take blood pressure? A: I and work with DSPs. It is important to have the visual on the individual so a camera is needed. Vitals are important as well. Station MD does ask that the agency has a thermometer, blood pressure cuff and pulse oximeter. The doctor or navigator will walk the DSP through how to gather the information. DSPs are responsible for a phone call. The navigator will take over and stay on the call for the duration of the call. They will walk them through everything needed. Station MD does provide training in a variety of ways. Q: Can individual families use this service? A: Due to billing regulations, Station MD cannot bill a family directly and also be billing Medicaid in a state. The model is to bill a provider agency the access fee so they do not typically contract with an individual living at home (with their parents). Q: Does it matter how big the agency is? Some may only serve a couple individuals. A: N greater returns, satisfaction from individuals and better health outcomes. They have contracted with agencies with as few as ten (10) individuals and those into the thousands. Keystone Human Services in Franklin County uses Station MD. If any providers would like more information from a local agency, they could reach out to Don Hill with Keystone. Providers can also reach out to Mario for agency specific information: mario.bienvenue@stationmd.com or see attached contact information. ADMINISTRATIVE ENTITY (AE) UPDATES Lori Young There is a new transportation provider Fulton Transportation. Gerald Peck provided the service previously but retired. Linda Laufferty has opened the service now. IDD Provider Meeting Friday, May 19, 2023 There are also some home and community and companion services agencies that are based in other parts of the state that are moving into Franklin County. Those agencies are Maxim and Bloom Human Services. If anyone has any questions for Lori regarding quality management, provider qualifications or quality assessment & improvement (QA&I), please reach out to her. Jane Cline Marion and Jane will be working on the fiscal year renewals the last two (2) weeks of st June for waiver individuals. Starting July 1, please check to see if the service authorizations are correct and no one was missed. Jane and Marion are also working on their base contracts. For community participation supports (CPS), companion and in-home and community supports providers, Franklin County Historical Society is looking for volunteers to scan old newspapers at the old jail. They will train the volunteers. Shifts are Tuesday 2 pm 4 pm; Thursday 2 pm 4 pm; and Friday 12 pm 2 pm. This may be some opportunities for individuals to get out and do some volunteering. Marion Rowe Theresa Burgard at the Office of Developmental Programs (ODP) who was in charge of incident reporting has left. There is currently not an incident management (IM) lead at our central region office at this time. The position is being covered by Robin Seville and Denise Sloand. Until they hire another IM rep, questions are being sent to them. Reminder Marion forwarded information to providers. You are no longer required to report COVID positive for your staff but you still have to report for individuals who test positive for COVID within your program. One of the trends being seen with ODP follow-up for corrective action plans is when the target is a staff person and there is no mediation that has occurred between the victim and the target before the target returns to duty. If you have an incident related to a staff person and they are the target and they are returning to shift, you must also include some mediation with the victim. The victim has to be comfortable with the staff person returning. There needs to be discussion with the individual about any changes that you can make and any corrective action. Include that information within your final section of the incident report in terms of corrective action plan. ODP is pushing for details for reports. They are looking for more information on what occurred, when, where, steps involved, what lead up to that incident, etc. Please do not forget to include those pieces especially more detail pertaining to what led up to that incident (timeline). Some of those reports only include a couple sentences. A call with licensing occurred regarding incident reports where an individual will report something that happened at a day program with one of their staff; not the IDD Provider Meeting Friday, May 19, 2023 agency that the individual is reporting the incident to. The agency the individual is making the report to should call the agency to report the incident to them so they can Supports Coordinator and AE. The SCO and AE can assure that there is follow up to the incident and that it is being reported. Licensing thought this was best practice as well. Marion asked providers if there were any concerns or additional clarification needed on the serious injury/serious incident document that came out. If anyone needs clarification on any certain categories, Marion can reach out to Robin or Denise, if needed. Marion asked if anyone has any Enterprise Incident Management (EIM) related questions. Christina Yeager, our IM point person for over eight (8) years, is back. You will be getting emails back from her. Marion still gets all approvals and disapprovals. Providers are doing a great job! Christina is a great contact to reach out to directly for incident related and/or EIM questions. SUPPORTS COORDINATION ORGANIZATION (SCO) UPDATES Shanna Golden Supports Coordinators (SC) are working on fiscal year renewals. Please make sure to check authorizations when July comes to see if everything is accurate or if anything needs to be corrected. Since the last meeting, SAM has hired their twelfth SC Katelyn. If you are going to submit critical revisions, please try to get them submitted as soon as possible so they are not getting mixed up with fiscal year renewals. Marion noted that close to the end of the fiscal year, providers start noticing issues with unit utilization. She encourages providers to start looking at that now. Once SCs and AEs are deep into fiscal year renewals there are times when things may get missed. Please try to look at utilization within the next week or two (2) and reach out to the SCs immediately so they can generate critical revisions before they start fiscal year renewal plans for individuals that you support. HEALTHCARE QUALITY UNITED (HCQU) UPDATES Katie Freeman HCQU third quarter syllabus was published. If anyone wants to attend any of them, email Katie. Reminder the HCQU is back in the community a lot more. This puts a delay on how quickly we can get things scheduled as nurses are traveling more. Please be patient! IDD Provider Meeting Friday, May 19, 2023 One nurse, Lisa, has gone 100% virtual. When sending in referrals, if you know the provider and individual is okay with doing it virtually, please mention it on the referral. There have been times when referrals come in and they say virtual but the provider says they need in person. In person is okay and can be done but it will not be Lisa providing it; it will be assigned to another nurse. The HCQU in the Eastern region has hired a nurse, Maria Farley. She will help us out on a limited/part time basis. She is not a travel nurse for us. She will primarily help out with CDC and fall risk assessments; maybe one (1) or two (2) a month. REPORTS Friendly reminders of due dates for our Base funded providers (See Procedure Statement MHIDDEI-416) May 15th Quarterly Report of Expenditures (Jan-March) June 30th Audited Financial Report (for calendar year ending 12/31) July 10th Audit Engagement/Extension Letter (for FY ending 6/30) July 31st Progress Report on Outcomes in Appendix A August 15th Property Purchased/Property Leased Report and Fixed Assets Purchased with MH/IDD/EI Funds (for FY ending 6/30) 15th of each month Monthly Invoices If anyone has any fiscal related questions, please contact iddfiscal@franklincountypa.gov. PROVIDER UPDATES Family Care Services (FCS) Tony Fisher FCS just finished annual licensing. It went well! Licensing is over so now FCS is working on trying to find new homes and applicants as well as trying to get some new LifeSharing vacancy. Safe in Home Tara Harmening Safe in Home is now approved as a remote support provider. This came out in an st amendment March1. Safe in Home can now provide remote supports with assistive technology under the adult autism waiver. AHEDD Sarah Guyer-Marshall AHEDD is looking to hire a part time employment specialist. AHEDD is getting more referrals and now needs another person to take on the referrals. Focus Behavioral Health Robert Reed Focus Behavioral Health is available to provide in home, companion, CPS and supported employment services. Merakey Renee Grimm Merakey is working with SAM to look at referrals to fill some vacancies. IDD Provider Meeting Friday, May 19, 2023 The ARC of Franklin and Fulton Counties Lorrie Miller The ARC has a bowling league in full force at Nelly Fox. There were 58 participants th this year. The ARC picnic is June 15 at Norlo Park at 6:30 p.m. Person Directed Supports (PDS) Kara Taylor PDS has no new openings or admissions. They have brought on two (2) new house managers and a new assistant director. Occupational Services, Inc. (OSI) Beth Freeman OSI had their annual licensing for Industrial Drive this week. The Redwood location licensing is coming up next week. OSI is starting a summer my work program through the Office of Vocational Rehabilitation (OVR). The program will be for students who are still in school. This program will begin in June after the school year ends. There are two (2) crews that are full at this point to provide the opportunity in the Waynesboro School District and Chambersburg. OSI has hired a supported employment coordinator to help with the summer program as well as supported employment needs. UPCOMING TRAININGS HCQU Trainings See syllabus Next Provider Meeting Friday, August 18, 2023 at 10:00 a.m. Remaining 2023 Provider Meeting Schedule thth August 18 November 17 Minutes by Erin Nye