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HomeMy WebLinkAboutIDD Provider Meeting Minutes 08-17-18Intellectual & Developmental Disabilities Provider Meeting Friday, August 17, 2018 MEETING MINUTES Welcome & Introductions Everyone introduced themselves and their agency affiliation. Fiscal Updates – Ashley McCartney  Friendly Reminders to our Base Funded Providers  The following reports were all due August 15, 2018 (refer to procedure statement MHIDDEI-416):  Quarterly Report of Expenditures (April – June)  Salary Review for FY17-18  Property Purchased/Leased Report for FY17-18  Fixed Assets Purchased with IDD Funds for FY17-18  If you have not submitted these reports, please send them to Ashley McCartney.  Billing & Projection Spreadsheets An email was sent out to all providers notifying them that billing and projection spreadsheets are no longer required for MH/IDD/EI programs.  FY17-18 Interim Cost Settlement & FY16-17 Final Cost Settlement Cost settlement pertains to providers who are program base funded. Interim cost settlement for FY17-18 and final cost settlement for FY16-17 will be completed in August/September so providers should be receiving notice about them soon. Ashley Yinger  Community Services Group (CSG) Behavioral Intervention Services IDD has been working with Community Services Group (CSG) on providing behavioral intervention services to Franklin County. At this time, the service would only be available to Franklin County as there is no means to serve Fulton County. If availability and funding is available at a later date, this may be able to be explored. Behavioral Intervention Services is a Mental Health professional that copartners with a nurse. Due to CSG being under staffed with nurses at the moment, the service in Franklin County will work with the HQCU nurses. This service is a dual team under supervision of a clinician. It is designed for dually diagnosed individuals (MH and IDD). These individuals can be in group homes, Lifesharing, or living on their own but receive in home supports. Individuals may be struggling; based on their behaviors from their dual diagnosis, the individuals may be experiencing mental health behaviors. The individuals may be in and out of crisis intervention or hospital, at risk of losing their home, placement or group home, etc. The Behavioral Specialist works with direct care staff on the presenting concerns. They implement a functional behavioral assessment. They observe how staff is responding to the individuals and determine if there is a better way to respond. The nurse will work with the psychiatrist and determine if the mental health behaviors the individual is IDD Provider Meeting displaying are stemmed from physical health complications and medications. The purpose of the service is for an additional team to come in and work with the already established behavioral health team. Ashley provided examples of positive outcomes. The service is short term (six to nine months). The goal is for the team to come in, address the problem, fix the problem and get out. CSG provides services to the five (5) capital regions; typically under reinvestment dollars. Based on sustainability and CSG’s availability, we are not at the point where they are able to hire a full staff to serve Franklin and Fulton counties. The goal is to share a team with Cumberland County. We requested five (5) to seven (7) individuals be served but they only have the availability for two (2) individuals to be served for this fiscal year. This will be a trial period to see if the service is beneficial and if we can sustain it. The long term goal would be to hire a team for Franklin/Fulton. At this moment, CSG is requesting approval from their Managed Care (CBHC) to serve two (2) individuals from Franklin and to notify them that it will not impact their other services. In addition, they are checking with Cumberland County to assure they need services for the number of individuals they have requested. For the two (2) slots that have been approved, if these individuals do well and the team is done in six (6) to nine (9) months, we may be able to serve additional individuals. Referrals will come from the Supports Coordinators at Service Access & Management (SAM). The service is paid for by the County. The individuals being referred from IDD must have at least one mental health diagnosis. This diagnosis does not need to be a serious mental illness (SMI). Individuals must be receiving psychiatry services as part of their eligibility requirements. Manage Care requires that individuals must be 21 years of age. However, since Franklin is paying for the service through County dollars, CSG is willing to accept individuals 18 years of age and older. Pamphlets with CSG’s information will be distributed once the service has been approved and contracted.  Choking Hazards Ashley attended a meeting with Nancy Thaler from the Office of Developmental Programs (ODP). The meeting consisted of Administrative Entities (AEs), administrators, CEOs, CFOs of residential providers, etc. Nancy is going around across the state with the priority of discussing choking hazards in residential. A health alert was shared. Franklin/Fulton numbers do not compare to those of other counties. ODP will be working with counties. Individualized Support Plans (ISPs) need to fully document an individual’s eating concerns (such as if the food needs to be chopped up, pureed, etc.). Direct care staff receives a 50 page ISP that contains so much information that will not be used daily. Providers need to take a step further by ensuring the information is accurate and consistent in the ISP. Providers should also pull out the key information, such as eating concerns, and creating a one page document (ISP Cheat Sheet) or highlighting this information in the ISP so that the direct care staff sees it visually. Providers need to focus in on training staff working with individuals who need their food chopped up, pureed, etc. as to what that actually looks like. ODP is sharing this information with Administrators/Directors to trickle the information to other staff. IDD Provider Meeting This meeting also clarified fatal four. Constipation and dehydration are preventable. If they are occurring and an individual ends up in the hospital, it is considered neglect. HCQU staff is willing to come out to facilities to provide training. Currently, the HCQU is reaching out to speech therapists and dietitians to work with the HCQU to do hands on demonstrations on food consistency as the HCQU is unable to do hands on training. Staff can attend training to see how food should be chopped, pureed, etc. The HCQU can train staff on fatal four, aspirations, constipations, dehydration, seizures, etc. Please give them a call to schedule training for staff. If providers have had an individual who has choked or had seizures at least once, there should be a written protocol. Data from Incident Management was pulled from a two (2) year period indicating that 14 individuals have passed away from choking across the state. All of those individuals have had incidents prior to death. There is lack of training, communication and understanding of prevention. The full understanding is that it’s an issue and direct care workers play a role in preventing it. The ISPs of the individuals who have passed did not have accurate and consistent information in them. Clarification of Residential Habilitation service description was discussed. The information discussed is not part of the service description but more so expectations specific to 6400 (but also rolled into family living). Discussion was held on the transformation of the population being served. Individuals appear to be more difficult to support, have more needs, behavioral challenges, complicated medical concerns, etc. Nancy focused on the mentality of where the IDD system used to be in the 70s as well as state hospitals. The system is no longer there. Our mentality needs to change. We are not needed for individuals who are independent and can live on their own; we are needed to serve those most complicated cases with a variety of needs. In regards to the above statement about ISPs needing to fully document information, providers posed questions, such as why do they not get thinned out and why is older information left in the ISP. Providers expressed their concern of staff wasting their time reading information that is no longer relevant. Historic information appears before new information. While the history is good information, staff reviewing the ISP want to know what’s happening today, such as what are they allergic to and how their food should be prepared, etc. The Functional section of the ISP should be the most current information. Know and Do section should be a snapshot of the individual with the most current information. If there are issues with the ISP, it needs to be discussed during team meetings. This will allow for providers and SCs to summarize the historic information, remove what no longer needs to be included and to assure nothing is missing. Provider, SC and AE should be working together to assure that the ISP is accurate information. If providers are having issues, please contact the SC; if the SC is not assisting, please contact a supervisor. Lori Young  QA&I Cycle 1 Year 2 Update Quality Assurance & Improvement (QA&I), previously known as provider monitoring, is in Year 2, Cycle 1. Self-assessments are due by August 31st. If Lori is your assigned/lead AE, she needs a copy of the email thanking you for completing the QA&I. A link was IDD Provider Meeting sent out on July 1st with a link to Question Pro to enter assessments. Already generated reminder emails will be sent out next week. The spreadsheet is different with new instructions. Interview questions are not required for self-assessments. However, they will be submitted with on-site monitoring.  Autism Only Update Franklin/Fulton IDD is now welcoming individuals into the IDD waivers for Autism Only. A fact sheet of the criteria was provided. The criteria for ID services and the waivers have not changed; only Autism Only and children under 9 are different. Bureau of Autism Services (BAS) still operates the Adult Autism Waiver and Adult Community Autism program, not the County! Jane Cline  New SIS Assessment Vendor Starting October 1st, Kepro will be completing SIS Assessments. The current provider will complete assessments until September 30th. IDD is hoping to get all SIS assessments completed prior to the change due to the amount of graduates.  Request for Program Capacity and Noncontiguous Clearance ODP sent out an announcement last week: ODP Communication Number 071-18: Request for Approved Program Capacity and Noncontiguous Clearance. ODP has always had this procedure but has expanded it to include closures and have developed a form for residential providers to use when opening new residential and day program facility locations. The announcement lists the steps that providers must go through such as contacting ODP to have the site approved prior to completing the licensing application. Complete the attachments and email them to Bill Bruaw. This form is also required for site closures.  Electronic Visit Verification Electronic Visit Verification (EVV) has been updated that providers have to be in compliance as of July 2019, instead of January 2019. This pertains to providers that are providing Companion services, In Home and Community Support, Respite (unlicensed settings only), Homemaker/Chore and Agency with Choice. Marion Rowe  Incident Management: Emergency Medical Treatment, Health Alert, Issues A health alert was sent out in regards to choking. Any choking is considered a medical emergency therefore individuals should seek emergency medical treatment. Please make sure this is clear to staff. Staff may provide first aide and treatment at the facility but they still must be seen by a professional. There have been neglect incidents as a result of day service providers contacting residential providers or primary caregiver to take individuals to the doctor or emergency room for an incident that has occurred at the day program. The provider of service is responsible for ensuring the person gets emergency medical treatment. The day program must seek medical treatment first. They can call the residential provider/caregiver to meet them at the hospital/urgent care and request that they IDD Provider Meeting provide you with all the discharge and follow up information to finalize the incident report. Please communicate this information to staff. There continues to be disapproval for not completing the family notification page incident reports correctly. The SC is not family; they can be listed as an additional contact. If there is no family involvement, state “no family involvement” in the final section of the report. When an individual goes to the emergency room or is hospitalized, include information on what symptoms would require the person to return for emergency medical treatment. Make sure this is in the final section of the incident report. Please make sure to train staff on what to look for as well. Discussion was held on the due date for incident reports. A provider will submit a report that they feel they have addressed everything within 25 days; Christina might provide her feedback within 14 days. She then requests additional information which the report is already past 30 days. A response to her kick back is required within 7 days. This starts the process over and provides a new due date. Therefore, no extension is needed. The only time an extension is needed is when you exceed the due date generated by EIM.  Topics for Meeting with ODP on October 18th The Office of Developmental Programs (ODP) has been invited to the county to meet with providers for technical assistance on general topics that providers want to discuss as well as clarification on service definitions. The meeting will take place on October 18th in the afternoon for two (2) hours (either 1:00 pm – 3:00 pm or 1:30 pm to 3:30 pm). Please let Marion know the preference on time. If no preference is determined, it will be scheduled from 1:00 pm to 3:00 pm. Please send Marion topics and questions prior to October 1st. Marion will prepare a list of all topics and questions to allow ODP time to prepare and determine which staff should attend. Marion will send the overall list to providers as well so that they can notify her which staff member(s) will be attending. A total count of attendance is needed. During this conversation, a provider discussed the topic of feedback from ODP for changing investigations determinations. The provider is trying to get explanation on what has changed and what they can do better. From what Marion can tell from her review, there have been changes in terms of who is completing the regional review. Audrey used to do all medical review; Kathy handles more of the regional review; Christina completes the County review; and Theresa does most of the initial reviews and IM training. Marion has reached out to Kathy as there have been concerns with her interpretation of what’s in the report. It has been a matter of notifying Kathy of what is going on for her to have a clear understanding but there are times that she is also requesting specific information. Encourage the investigator to ensure that the summaries are very clear on the facts. IDD Provider Meeting Provider Updates  Keystone Human Services Keystone had a visit from review agency, OIG; it went okay.  Services Access & Management New SC started, Darlanna Heinbaugh. She has started to take on individuals with the focus of the Waynesboro area. Shanna will send a revised contact list. Andrea Concordia is the new Site Director for SAM. Some providers have already met with her. If anyone is interested in meeting with her, please let Matt or Shanna know and they can provide her contact information. SAM’s Franklin County office will be relocating in the fall. An exact date has not been determined. The location will be off Orchard Drive. Providers will be notified of move date and exact address once date is finalized. Shanna and Matt have been meeting with providers quarterly to see how things are going and to address any concerns. If you are interested in setting up a meeting, please contact Shanna or Matt.  PennCares PennCares has a new Executive Director, Deborah Allen, as of April. Deborah provides various trainings for agencies to obtain CEUs. If anyone is interested in Dementia Live, an experience of what having dementia is like, please contact PennCares.  HCQU HCQU has filled their final nursing position; will be fully staffed as of September 4th. HCQU is brining Pharmacogentics Testing to their office. There are two sessions to choose from (both are the same so please only choose one): Wednesday, September 5th from 10:00 am to 11:00 am and Tuesday, September 25th from 2:00 pm to 3:00 pm. Karen Willems, a Representative from Genesight, will be presenting on what pharmacogentics testing is about, what it takes to get it, costs, why it matters, why it’s important, etc. The testing is taking a look at specific DNA to check it against medications to see which ones do and do not work for individuals. Please contact the HCQU to register for a session or for more information.  Family Care Services Discussion was held on transportation rates changing. Family Care Services has Lifeshares that have used transportation and paid for it privately. This will need to be negotiated and determined between provider and transportation providers.  At this time, it is unknown what the rates will be. The rates will that were given were high. Feedback has been provided to ODP. Jane reviewed all waiver individuals that receive transportation and their zones. Ashley sent an email to the state regarding the impact the rates will have on Franklin/Fulton counties. The state responded that they are taking comments into consideration and compiling all feedback. IDD Provider Meeting  There are 19 individuals with cap exceptions. If transportation goes the way it says it is, there will be 22 additional cap exceptions. ODP provided 12 Community Living Waivers. Out of those 12 waivers, we have to look at cap exceptions first. Even with that, there are still seven (7) individuals short of cap exceptions which would be a total of 29 individuals need exceptions.  The mileage of each zone has been changed. There are a lot of individuals that were in zone 1 that will go to zone 2. Zone 1 is going up to $10 a trip. Any trip of 20 miles is $43 (one way). Chambersburg is zone 1; Shippensburg, Greencastle, and Waynesboro are zone 2. Previously, they were all zone 1. Zone 1 will have two (2) rates – one with an aide and one without. The rate is higher with an aide. If there are six (6) individuals, an aide is required. Lifesharing Conference is October 15th and 16th. During licensure visit, it was noted that personal hygiene products are considered poisonous to most individuals. An ISP stated that poisonous items are put away but because the individual had their own deodorant and it was not noted, they considered it poisonous. FCS is revising ISPs to state that the individuals have access to shampoos, lotions, deodorant, etc. but they do not have access to cleaners. Additionally, in the past, there was an incident regarding when the dryer vent had to be cleaned. If there were clothes in the dryer and there was lint in the filter, it was okay. But if there were no clothes in the dryer and lint in the filter, it was a citation. FCS noted that with fatal four, protocols will be looked at so make sure to have healthy protocols. Events & Info  Upcoming Events  9/8 ~ A Very Special Show in Fulton County  Special Show is raising money for a sensory playground in Fulton County. A fashion show of children in McConnellsburg with and without disabilities will be held. Individuals in the fashion show will be escorted by military personnel/veterans.  9/15 ~ Autism Fair at CAMS South from 11:00 a.m. to 3:00 p.m.  Upcoming HCQU Trainings  9/14 ~ Gastrointestinal Disorders (10:00 a.m. to 12:00 p.m.); Consumer Training – Grief (1:00 p.m. to 2:00 p.m.) Next Provider Meeting Friday, November 16, 2018 at 10:00 a.m. at the Human Services Building Minutes by Erin Nye