Thursday, February 05, 2015 ALLIANCE BEHAVIORAL HEALTHCARE BOARD MEETING

Transcription

1 Thursday, February 05, 2015 ALLIANCE BEHAVIORAL HEALTHCARE BOARD MEETING MEMBERS PRESENT: Ann Akland, Cynthia Binanay, Christopher Bostock, George Corvin, MD, Kenneth Edge, James Edgerton, Lodies Gloston, Phillip Golden, John Griffin, Ed.D, Curtis Massey, Rev. Michael Page, George Quick, Robert Robinson, CEO Vicki Shore, William Stanford, Jr., Chairman, Caroline Sullivan, Scott Taylor, Amelia Thorpe, Lascel Webley, Jr., and McKinley Wooten, Jr. GUEST(S) PRESENT: Marc Jacques, CFAC Chair; Wes Rider, NC DHHS DMH/DD/SAS ALLIANCE STAFF PRESENT: Hank Debnam, Cumberland Site Director; Joey Dorsett, Chief Information Officer; Doug Fuller, Director of Communications; Amanda Graham, Chief of Staff; Carol Hammett, General Counsel; Tina Howard, Quality Review Manager; Veronica Ingram, Executive Assistant; Carlyle Johnson, Director of Provider Network Strategic Initiatives; Geyer Longenecker, Director of Quality Management; Ken Marsh, Medicaid Program Director; Beth Melcher, Chief of Network Development and Evaluation; James Osborn, Crisis and Incarcerations Manager; Ann Oshel, Chief Community Relations Officer; Sara Pacholke, Controller; Monica Portugal, Chief Compliance Officer; Al Ragland, Chief HR Officer; Sean Schreiber, Chief Clinical Officer; and Doug Wright, Director of Community Relations 1. CALL TO ORDER: Chairman William Stanford called the meeting to order at 4:00 p.m. AGENDA ITEMS: DISCUSSION: 2. Announcements Today s meeting was held at Alliance s community site in Wake county. Mr. Robinson shared information about the staff at the Wake site noting the quality of their work and expressed appreciation that Board members were able to meet staff at the reception that was held before the meeting. Mr. Robinson announced that Kelly Goodfellow will be returning to Alliance as the new CFO; Mr. Robinson introduced new employee Joey Dorsett, Chief Information Officer. 3. Agenda Adjustments There were no adjustments to the agenda. 4. Public Comment There were no public comments. 5. Committee Reports A. Consumer and Family Advisory Committee (page 6): The Alliance Consumer and Family Advisory Committee (CFAC) is a self-governing committee that serves as an advisor to Alliance administration and Board. This month s report included January Wake County CFAC Subcommittee draft minutes, December Cumberland Subcommittee draft minutes, December full Committee draft minutes, the Access training presentation and a recap of the snapshot survey for the months of October through December. CFAC Chair, Marc Jacques, presented the CFAC report, expressed appreciation for being part of the agenda, noted the meeting schedule for the respective CFAC subcommittees, provided highlights from the most recent meeting and announced upcoming events. Chairman Stanford noted that the minutes from Alliance CFAC and the CFAC subcommittees were included in the Board packet. There were no questions or discussion about the CFAC report. Page 1 of 5

2 Thursday, February 05, 2015 ALLIANCE BEHAVIORAL HEALTHCARE BOARD MEETING AGENDA ITEMS: DISCUSSION: B. Finance Committee Report (page 37): The Finance Committee s function is to review financial statements and recommend policies/practices on fiscal matters to the Area Board. This month s report included the draft minutes of the December Finance Committee meeting, the budget to actual report and ratios for the period ending November 30, 2014, the statement of net position, budget to actual report, and ratios for the period ending December 31, Finance Committee Chair, Jim Edgerton, presented the Finance Committee report. Mr. Edgerton noted that revenue is greater than expenditures and that Alliance is well above the state required ratios. Additionally, he mentioned a recent payment adjustment from the State which impacted all NC MCOs. Board members discussed the topic clarifying the reason for this payment. C. Policy Committee Report (page 44): Per Alliance Behavioral Healthcare Area Board Policy Development of Policies and Procedures, the Board is to review all policies annually. This month s report included minutes from the November and January Policy Committee meetings and Business Operations and Quality Management Policies. Policy Committee Chairwoman, Cynthia Binanay, presented the Policy Committee report. She provided an update on the recommended policy changes and noted the by-laws are currently being updated according to the new Mission, Vision and Value Statements. There were no questions or discussion about the Policy Committee report. 6. Budget Retreat (page 54) BOARD ACTION A Motion was made by Mr. Scott Taylor to approve the Travel and Employee Expense Reimbursement and Management and Investigation Grievances Policies and to repeal the Contracting with New and Existing Providers Policy; seconded by Mr. Lascel Webley, Jr.. Motion passed unanimously. An annual budget retreat is held to provide information to the Area Board in preparation for setting the budget for the upcoming fiscal year. Chairman Stanford noted that this retreat will include Board members, Alliance staff and CFAC representatives. Interim CFO, Jennifer Ternay, noted potential topics for the retreat and requested agenda topics from Board members. Board members determined the date and time for the retreat. BOARD ACTION: A Motion was made by Mr. George Quick to hold the budget retreat on Tuesday, March 31, 2015, from 1:00-4:00; seconded by Dr. John Griffin. Motion passed unanimously. 7. Consent Agenda A. Draft Minutes from the December 4, 2014, Board Meeting (page 55) B. Executive Committee Report (page 61) C. Human Rights Committee Report (page 69) D. Quality Management Committee Report (page 76) Page 2 of 5

3 Thursday, February 05, 2015 ALLIANCE BEHAVIORAL HEALTHCARE BOARD MEETING AGENDA ITEMS: 8. Board Discussion with NC DHHS Deputy Secretary of Behavioral Health and Developmental Disability Services, Dave Richard (page 113) 9. Records Retention Notification (page 114) DISCUSSION: Chairman Stanford reminded Board members that the consent agenda was part of the Board packet; there were no questions or comments regarding the consent agenda. BOARD ACTION A Motion was made by Ms. Cynthia Binanay to approve the consent agenda; seconded by Commissioner Caroline Sullivan. Motion passed unanimously. Before serving as Deputy Secretary Dave Richard served as Director of the Division of Mental Health, Developmental Disabilities and Substance Abuse Services. Deputy Secretary Richard provided an overview of activities at the State level. He noted the State s continued focus to consolidate to four MCOs by January 2016 and the MCOs agreement with this plan. He mentioned upcoming statewide meetings with MCOs. Additionally, he mentioned Medicaid reform where physical health and mental health work in close alignment and expressed confidence in publicly managed behavioral health services. Board members and Deputy Secretary Richard discussed in detail the following topics: noting current relationships with community stakeholders, interlocal agreements, legislative oversight, public management of Medicaid program, and MCO mergers. BOARD ACTION The Board received the information; no further action required. Alliance Behavioral Healthcare adopted APSM 10-6 Records Retention and Disposition Manual on February 7, The manual is developed and updated by the Department of Cultural Resources (DCR). The Alliance adopted Records Retention and Disposition Manual requires a notification to the Area Board when records have been destroyed. Chairman Stanford noted that this information was part of the Board packet. Alliance s Compliance Department received verification from the Department of Cultural Resources (DCR) and destroyed records in accordance with DCR standards. Alliance Policy requires a formal notification to the Board. The Board received the notification and discussed the topic requesting clarity on the retention schedule for specific documents and noted that this action/notification was conducted according to Alliance Policy. 10. Recommendation for Reappointment to Alliance Area Board (page 116) BOARD ACTION A Motion was made by Dr. George Corvin to accept the notification of records destroyed in accordance with the Department of Cultural Resources guidelines and Alliance Policy; seconded by Mr. Phillip Golden. Motion passed unanimously. Chairman Stanford presented the Executive Committee s recommendation to reappoint the following Board members: Ann Akland, Phillip Golden, George Quick, and William Stanford, Jr. to the respective Durham and Wake County Boards of County Commissioners. Board members discussed the length of terms (3 years) and number of terms (3) allowed by statue; additionally, Board members discussed the desire of their constituents to be appointed to this Board and to consider whether or not to reappoint members for the full three terms allowed by statue. Also, Board members discussed how a merger could impact Board seats in order to have equal representation for part of the combined catchment area. Page 3 of 5

4 Thursday, February 05, 2015 ALLIANCE BEHAVIORAL HEALTHCARE BOARD MEETING AGENDA ITEMS: 11. Training: Overview of Crisis Services (page 117) DISCUSSION: BOARD ACTION A Motion was made by Dr. John Griffin to recommend to the respective Board of County Commissioners the reappointment of Ann Akland, William Stanford, Jr., Phillip Golden and George Quick; seconded by Ms. Cynthia Binanay. Motion passed unanimously. Alliance is required per its contract with NC DHHS to develop a crisis response system within our catchment area. James Osborn, Crisis and Incarceration Manager, presented information describing the crisis continuum across the four county region and crisis services. The presentation addressed the local crisis plans and the initiatives implemented. Board members discussed the topic in detail clarifying current emergency department diversion processes, crisis intervention processes and potential service gaps/needs. BOARD ACTION The Board received the training; no further action required. 12. Updates (page 131) A. Wake Forensic Evaluations The News and Observer published an article on Sunday, July 27, 2014, on the topic of Wake County forensic evaluations for capacity to proceed. Dr. Carlyle Johnson, Director of Provider Network Strategic Initiatives, addressed the concerns expressed in the article at the August 7, 2014, Board meeting. He provided a six month update noting changes in how documents are submitted which increases efficiency and how this is change has been implemented. He also noted an increase in persons trained to conduct these evaluations. B. EQRO Final Report The Alliance contract with the Division of Medical Assistance (DMA) requires an annual External Quality Review (EQR) to evaluate compliance with federal Medicaid guidelines. Alliance s EQR report was issued by the Center for Medicaid and Medicare Services (CMS) after the November 2014 visit. Amanda Graham, Chief of Staff, provided a brief overview of the findings noting recommendations and Alliance s rating is higher than that of other NC MCOs. C. Request for QM 11 Report Waiver - Rob At the December 4, 2014, Board meeting the Board approved the recommendation to request the Secretary of DHHS to approve a waiver of the QM-11 reporting requirements (10A NCAC 27G.0604 Incident Reporting Requirements) for applicable Alliance providers. The Board authorized Alliance CEO, Robert Robinson, to sign and send the letter of request. Dr. Beth Melcher, Chief of Program Development and Evaluation, provided an update on this request; she noted that the State s response which was to approve this request. Additionally, she noted the need to offer this waiver to new providers which requires Board approval. BOARD ACTION A Motion was made by Commissioner Kenneth Edge to approve future requests for QM-11 report waivers from new providers coming into the Alliance network and to authorize the CEO to request the waiver from the Secretary of DHHS as needed. Seconded by Mr. James Edgerton. Motion passed unanimously. Page 4 of 5

5 Thursday, February 05, 2015 ALLIANCE BEHAVIORAL HEALTHCARE BOARD MEETING AGENDA ITEMS: DISCUSSION: 13. Chairman s Report Chairman Stanford opted to forgo this item in lieu of the closed sessions. 14. Closed Sessions BOARD ACTION A Motion was made by Dr. George Corvin to enter closed session in accordance with NC General Statue (a) (6) to discuss and evaluate the performance of a public official; seconded by Commissioner Caroline Sullivan. Motion passed unanimously. A Motion was made by Commissioner Kenneth Edge to enter closed session pursuant to NC General Statue (a) (3) to discuss current litigation in the case of Heartfelt Alternatives v. Alliance; seconded by Ms. Cynthia Binanay. Motion passed unanimously. A Motion was made by Ms. Cynthia Binanay to return to open session; seconded by Commissioner Caroline Sullivan. Motion passed unanimously. The Board did not take action during the closed sessions. 10. Adjournment With all business being completed the meeting adjourned at 7:13 p.m. Next Board Meeting Thursday, March 05, :00 6:00 Robert Robinson, Chief Executive Officer 3/5/2015 Date Approved Page 5 of 5

6 5A Alliance Behavioral Healthcare BOARD OF DIRECTORS Agenda Action Form ITEM: Consumer and Family Advisory Committee (CFAC) Report DATE OF BOARD MEETING: February 5, 2015 BACKGROUND: The Alliance Consumer and Family Advisory Committee, or CFAC, is made up of consumers and/or family members that live in Durham, Wake, or Cumberland Counties who receive mental health, intellectual/developmental disabilities and substance use/addiction services. CFAC is a self-governing committee that serves as an advisor to Alliance administration and Board of Directors. State statutes charge CFAC with the following responsibilities: Review, comment on and monitor the implementation of the local business plan Identify service gaps and underserved populations Make recommendations regarding the service array and monitor the development of additional services Review and comment on the Alliance budget Participate in all quality improvement measures and performance indicators Submit findings and recommendations to the State Consumer and Family Advisory Committee regarding ways to improve the delivery of mental health, intellectual/other developmental disabilities and substance use/addiction services. The Alliance CFAC meets at 5:30pm on the first Monday in the months of February, April, June, August, October and December at the Alliance Corporate Office, 4600 Emperor Boulevard, Durham. Subcommittee meetings are held in individual counties, the schedules for those meetings are available on our website. The Alliance CFAC tries to meet its statutory requirements by providing you with the minutes to our meetings, letters to the board, participation on committees, outreach to our communities, providing input to policies effecting consumers, and by providing the Board of Directors and the State CFAC with an Annual Report as agreed upon in our Relational Agreement describing our activities, concerns, and accomplishments. The Alliance CFAC is currently chaired by Marc Jacques while Dr. Mike Martin serves as vice-chair. REQUEST FOR AREA BOARD ACTION: Receive the Alliance CFAC Subcommittee draft minutes from Wake County for January. The Cumberland subcommittee draft minutes from December. The draft minutes from the full committee from December as well as the training presentation on Access. We have also included a recap of the snapshot survey for the months of October through December. CEO RECOMMENDATION: Receive the draft minutes and information. RESOURCE PERSON(S): Marc Jacques, CFAC Chair; Doug Wright, Director of Consumer Affairs

7 Tuesday, January 13, 2015 WAKE CFAC SUBCOMMITTEE MEMBERS PRESENT: Dave Curro, Faye Griffin, Denise Wood, Maribel Rivera-Elias (phone), Eric Hall (phone), Cynthia Hall (phone) GUEST(S) PRESENT: Doug Wright, Roosevelt Richard, Roanna Newton 1. WELCOME AND INTRODUCTIONS 2. REVIEW OF THE MINUTES - The minutes were reviewed and approved unanimously; Eric moved and Denise seconded. AGENDA ITEMS: DISCUSSION: NEXT STEPS: TIME FRAME: Public Comment No public comment N/A N/A Consumer/Family challenges and solutions State Update Access to Services - training MCO Updates No specific challenges or solutions were mentioned. N/A N/A Roanna mentioned that the Consumer Empowerment Team informational newsletter will only be coming out on a bimonthly basis. She mentioned the Crisis Solutions Initiative and the State CFAC to local CFAC monthly call as two items coming up where members may want to participate. Doug reviewed the power point presentation on access to services; he and Roosevelt pointed out the importance of using crisis services such as Mobile Crisis Management, Crisis and Assessment centers, CIT Officers, provider crisis lines, all instead of using the emergency departments at hospitals. The Alliance Access and Information line (800) was also emphasized as a first step to receiving appropriate levels of care when needed. Doug mentioned several items: Survey around gaps and needs sent out electronically please complete, hard copies will be made available to those needing them. Community Relations is requesting help in having CFAC members available to participate in community presentations about our It s Time to Re-Think Campaign N/A Spread the word!! Spread the word and follow through. N/A Ongoing ongoing Page 1 of 3

8 Tuesday, January 13, 2015 WAKE CFAC SUBCOMMITTEE AGENDA ITEMS: DISCUSSION: NEXT STEPS: TIME FRAME: and at events where a table is set up for information purposes. EQRO A successful review, a corrective action plan was completed and turned in early. New Consumer Affairs Staff an offer was made and accepted for a new CA staff person for Wake County. The goal is for this person to start around the first of February. Meet-Up.com members were encouraged to sign up and look for the Alliance CFAC meet-up. Something we wanted to try and see if it is good way to recruit and remind members and communities about CFAC meetings. Newsletter second newsletter went out this week, please read, forward and give the Data Com subcommittee your feedback. Wake Site Roosevelt updated the group on upcoming events, Child and Family Team training, CIT conference, Community Forum Anonymous People, Resource Fair in May Membership/other Concerns/Snapshot Survey Cross Agency Training. Dave brought the idea of a Community Resource Fair possibly the third Saturday in May at either the Millbrook Exchange Park or the Center for Active Adults. He wanted to gage interest of the committee. Interest seemed to be high and Doug offered support through Alliance. Roosevelt said he would get Dave and himself on the agenda of the Wake Provider Advisory Council to ask for participation. Doug reminded everyone that the CFAC is sponsoring the showing of The Anonymous People at the Center for Active Adults on Noble Road on the 13 th of March from 1:00pm until 4:00pm. The movie will be shown, then questions and answers will follow with a panel of people in recovery and resources. Members were encouraged to fill out snapshot surveys on a Regular basis. Doug reviewed a recap of surveys completed Dave will work to put together an adhoc committee willing to work on the resource fair. Suit up and show up February 2, 2015 March 13, 2015 Forward to the Board of Directors. February, 2015 Page 2 of 3

9 Tuesday, January 13, 2015 WAKE CFAC SUBCOMMITTEE AGENDA ITEMS: DISCUSSION: NEXT STEPS: TIME FRAME: From Oct. until Dec. This information is given to the board And used as a resource for the chair s report to the board. Membership concerns are still evident, Dave encouraged People to invite friends, neighbors, etc. to check us out. Appreciation 5. ADJOURNMENT Denise was welcomed back!! Dave acknowledged the participation level and thanked Roosevelt for getting access through the go to meeting and the different meeting room. He thanked those that braved the weather and those on the call. Continue use of go to meeting. ongoing Page 3 of 3

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13 Monday, December 01, 2014 CONSUMER AND FAMILY ADVISORY COMMITTEE MEMBERS PRESENT: Anna Cunningham, Carolina Ambrose, Sharon O Brian, David Curro, Faye Griffin, Israel Pattison, Amelia Thorpe, Dan Shaw, Jim Henry, Tammy Harrington, Debra Duncan, Doug Wright, Cynthia Daniels, Maribel Rivera Elias GUEST(S) PRESENT: Rob Robinson, Ken Marsh, Suzanne Goerger, Roanna Newton, Carlyle Johnson Dial +1 (646) Access Code: WELCOME AND INTRODUCTIONS 2. REVIEW OF THE MINUTES: The minutes were approved as submitted. AGENDA ITEMS: DISCUSSION: NEXT STEPS: TIME FRAME: Public Comment No comments made 5 Minutes The CFAC took a moment to acknowledge and thank the Board of Directors Board of Directors for their time, commitment, and 5 Minutes Recognition dedication to the people Alliance serves. Consumer/Family challenges and solutions State Updates A 10 minute roundtable around challenges faced and solutions found. Roanna Newton shared copies of the Consumer Update with the group. 10 Minutes 5 Minutes MCO Updates Doug Wright Mission, Vision, and Values Carlyle Johnson Needs and Gaps Doug provided copies of the new Mission and Vision of Alliance Behavioral Healthcare (ABHC). He explained how the values are being developed and then how goals are being developed to accomplish the mission. Carlyle explained how ABHC assesses the needs and gaps in services. He explained how a geo-mapping program is used to help ABHC members to find the needed services within the 30 miles/30 minute goal. The need for services was acknowledged. CFAC members were asked to review a draft of a survey that will be sent (using Survey Monkey) to all 25 Minutes Page 1 of 3

14 Monday, December 01, 2014 CONSUMER AND FAMILY ADVISORY COMMITTEE AGENDA ITEMS: DISCUSSION: NEXT STEPS: TIME FRAME: who are currently receiving services within the Alliance Provider Network (this could also be received/completed by family members of those receiving services). Several suggestions were made including: providing definitions for services (what the services include) and when using drop down boxes also provide space for text. Anna suggested that Israel Pattison collaborate on this project and he agreed to collaborate with Carlyle. The survey will go out late January/early February. CFAC members asked: if hard copies of the survey could be provided as well for those who do not have access to a computer/internet; could the time for completion of survey be extended (a couple of weeks was the time mentioned); can callers be linked to the survey over the phone when they call in; will a link for the survey be on our website; can adult and child services/members be split or receive separate surveys; can the survey ask for the primary diagnosis; and can space for hopes, dreams & aspirations be added to the survey (where would you like to be in 6, 12, 18 months)? I/DD Care Coordination Suzanne Goerger Committee Reports Data Com Quality Management Area Board Human Rights County Subcommittee Updates Suzanne presented a power point to CFAC. This provided a great deal of information about the services provided for the I/DD community and was well received by the CFAC members. ABHC brochures were also share with the group. DataCom- The first CFAC Newsletter has gone put- CONGRATULATIONS and thanks to all who worked on this project! The next newsletter will go out in late January. Quality Management-no meeting held. The next meeting is scheduled for Thursday, December 4, Sharon O Brian and Joe Kilsheimer plan on attending. Area Board- Amelia Thorpe is now an ABHC Board member. Human Rights-There was a wonderful discussion on members rights; and an overview of cases to stop problems/issues was 30 Minutes 5 Minutes Page 2 of 3

15 Monday, December 01, 2014 CONSUMER AND FAMILY ADVISORY COMMITTEE AGENDA ITEMS: DISCUSSION: NEXT STEPS: TIME FRAME: provided. CFAC asked how much of an impact do WE havewe are not providers? County Subcommittee updates: Durham-Gina Upchurch from Pharm-Assist spoke with the Durham Subcommittee. Doug provided a training on Medicaid Fraud and the group had a discussion on the Innovations Waiver. Cumberland- No one from Cumberland was present at the meeting. The minutes from the Cumberland subcommittee meeting were provided. Wake- There was not a quorum in November to hold a formal meeting. The members present did discuss trying to increase membership. The Wake subcommittee will host a screening of the Anonymous People on March 26, Announcements Ken Marsh was introduced to the members of CFAC. Ken is the new Medicaid Manager. Colleen Kilsheimer fell and broke her leg during the Thanksgiving Holiday. She is currently at DRH and will be moved to a rehab facility as soon as she is ready. The Durham County Community Living Program will host an open house on December 10, 2014 (2:00-6:00). 5 Minutes 5. ADJOURNMENT Page 3 of 3

16 Accessing the Services of the Alliance Health Plan Serving Durham, Wake, Cumberland and Johnston Counties

17 Accessing Services Call the 24 hour toll-free Alliance Access and Information Line at (800) Relay Calls: 711 or (800) Walk into or contact an Alliance Crisis and Assessment Center If covered by Medicaid, option to seek an independent practitioner, typically a licensed therapist, to initiate care Serving Durham, Wake, Cumberland and Johnston Counties

18 Access and Information Center Call the 24 hour toll-free Alliance Access and Information Line at (800) for: o Telephone assessments o Information on community resources o Crisis intervention Access Specialists to help with routine referrals Access Clinicians trained to work with callers with urgent and emergency needs Serving Durham, Wake, Cumberland and Johnston Counties

19 Expectations of an LME/MCO 24/7 telephone contact Emergency referrals 24/7 within one hour Emergency care within two hours Urgent care within 48 hours (usually an assessment) Routine care within 10 working days Serving Durham, Wake, Cumberland and Johnston Counties

20 Expectations of an LME/MCO State-funded benefit plan or array of services Qualified staff to evaluate service requested by providers Qualified provider network with the member given a choice between at least two providers Written material explaining the benefit plan, member rights, and how to access services within 14 days of receipt of the first service Serving Durham, Wake, Cumberland and Johnston Counties

21 Expectations of an LME/MCO Better communication with access to local decision makers Adjust existing services to meet changing needs Consumer and family feedback through an annual Consumer Satisfaction Survey Serving Durham, Wake, Cumberland and Johnston Counties

22 Who is Eligible for Services? U.S. citizen or able to provide proof of eligible immigration status Resident of North Carolina Have a Social Security number or have applied for one Be approved for Medicaid at your local Department of Social Services (DSS) office Be part of a qualifying Medicaid aid category Serving Durham, Wake, Cumberland and Johnston Counties

23 Basic Benefits Brief interventions for acute (immediate but short term) needs Available through a simple referral from a provider in the Alliance Network or through the Access and Information Center May not require prior authorization Includes ongoing evaluation and medication management Serving Durham, Wake, Cumberland and Johnston Counties

24 Basic Benefits Not typically assigned to an Alliance Care Manager/Care Coordinator Serving Durham, Wake, Cumberland and Johnston Counties

25 Enhanced Benefits Accessed through the member s personcentered planning process Range of services and supports: o Appropriate for members seeking to recover from severe mental illness and substance use/addiction o Address the needs of members with intellectual/developmental disabilities. Highly coordinated to ensure proper but unduplicated services Serving Durham, Wake, Cumberland and Johnston Counties

26 Residential Provided to individuals who require treatment outside their homes Accessed through the person-centered planning process Provided in the least restrictive community setting Highly coordinated May be time limited or longer term Serving Durham, Wake, Cumberland and Johnston Counties

27 Working with Providers What to take to your appointment: o List of your current medications (prescribed and over the counter) o List of programs you have attended prior to your appointment, including dates o List of your hospitalizations, including dates o Your Medicaid ID card and other insurance card, if applicable o Proof of income to determine financial eligibility for services Serving Durham, Wake, Cumberland and Johnston Counties

28 Working with Providers Most services available within 30 miles or minutes from your home You have the right to change providers if you are not satisfied Serving Durham, Wake, Cumberland and Johnston Counties

29 In Case of Emergency If you are experiencing a medical emergency, call 911 and/or go to an emergency room Mental health emergencies can be serious but do not always require an ER visit Call your provider Call the Alliance 24 hour toll-free Access and Information Center at (800) Come to a Crisis and Assessment Center Serving Durham, Wake, Cumberland and Johnston Counties

30 Crisis and Assessment Centers You should go to a Crisis and Assessment Center if you: o Want to hurt others or yourself o Are hearing voices or talking to yourself o Are intoxicated but have someone to safely bring you to a Center o Are depressed or too sad to take care of yourself/others Serving Durham, Wake, Cumberland and Johnston Counties

31 Crisis and Assessment Centers Durham Center Access 309 Crutchfield Street, Durham (24 hours a day) Wake Crisis and Assessment Services 107 Sunnybrook Road, Raleigh (24 hours a day) Serving Durham, Wake, Cumberland and Johnston Counties

32 Crisis and Assessment Centers Community Mental Health Center at Cape Fear Valley 1724 Roxie Avenue, Fayetteville (Monday-Friday, 8:00am-10:00pm) Johnston County Health Department Mental Health Division 521 North Brightleaf Boulevard, Smithfield (Monday-Friday, 8:00am-5:00pm) Serving Durham, Wake, Cumberland and Johnston Counties

33 Mobile Crisis 24/7 assessment and triage service Helping professionals go into the community, conduct assessments, triage for service need and provide some crisis stabilization services Accessed by calling the 24 hour toll-free Alliance Access and Information Line at (800) Serving Durham, Wake, Cumberland and Johnston Counties

34 Re -Cap Access and Information Line Benefits are based on level of need. Help your provider help you appointments Medical Emergencies Call 911 or go to Emergency Department Mental Health Emergencies Call access or your provider; go to a crisis and assessment center.

35 October December 2014 Consumer and Family Advisory Committee Snap Shot Survey 1.) In thinking in this very minute - what suggestion would you make to have CFAC be a more meaningful experience? a) More participation on State CFAC to Local CFAC conference calls. b) More consumers on the committee. c) More Guardians on the committee. d) Opportunities to help get the word out about behavioral healthcare to the community. e) More time. f) CFAC members to become CIT certified. g) Peer Support Specialists in lots of areas. h) Web site or blog for people to write about their CFAC experience. i) Get older members to train new members. j) Explain up front how this works Orientation. k) Put on stipend checks which meeting payment is for. l) CFAC ID badges m) All three disabilities need equal voice. 2.) Name two goals that you would like CFAC to accomplish in the next 4 months. a) Each member bring someone new to a meeting by July 1, b) Get more information about services provided. c) Help for consumers with problems with services. d) More written materials for CFAC. e) More outreach ID badges. f) Advocate for more Innovation slots. g) Get out into the community more a good community forum. h) Awareness of the importance of Peer Support Specialists in rural areas. i) Training for members on CFAC as a whole, purpose, mission, how it functions. j) More CFAC outreach supplies, banner for booth, CFAC invited cards, etc. k) More community information about Alliance. l) I/DD staff come to answer questions. m) Talk about implementation of Peer Support Services. n) Open a direct line of communication with the Alliance Board of Directors. (both ways)

36 3.) In thinking about your community at this very moment - is there a gap in services or a service that needs addressing? a) Population group Medicare consumers with Medicaid needing Substance Use Disorder counseling. b) Substance Use Disorder services. c) How to access services. d) Veteran s services. e) More I/DD services/slots. f) Homelessness. g) Transportation. h) Encouraging people to sign up for I/DD services/slots - will give a more accurate view of needs in that community. i) Peer Support Services at the hospital. j) WRAP Facilitator/trainer in Johnston County. k) Peer Support training/trainers in Johnston County. l) Paperwork redundancy for providers has an impact on willingness to do services. m) Peer respite. n) Peer Operated Services. o) Psychiatric evaluations for the I/DD population. 4.) In thinking about CFAC's "advisory" role - make a suggestion that you think the Alliance BHC Board should take on or address. a) People with dual coverage, Medicare/Medicaid cannot receive outpatient Substance Use or mental Health services without a denial from Medicare. It is a barrier to people getting the services they need when they need them. Some sort of standard resolution is needed so providers can bill and people can be served. b) Providers and the quality of services. c) Help increase membership talk about CFAC at events attended, etc. d) Mental Health First Aid training for all CFAC members. e) Peer Support training for all CFAC members, train instructor from Alliance to minimize costs. f) Send more consumers/family members to trainings and educational opportunities. Not just CFAC members, community members as a whole. g) Help CFAC to become more transparent to communities. h) Contact with a peer operated business for peer respite. i) Address waiting lists. Members are encouraged to fill out a Snap Shot Survey at each meeting attended and whenever they have concerns or ideas they feel the need to share.

37 5B Alliance Behavioral Healthcare BOARD OF DIRECTORS Agenda Action Form ITEM: Finance Committee Report DATE OF BOARD MEETING: February 5, 2015 BACKGROUND: The Finance Committee s function is to review financial statements and recommend policies/practices on fiscal matters to the Area Board. The Finance Committee meets monthly at 3:00 p.m. prior to the regular Area Board Meeting. The draft minutes of the December Finance Committee meeting are attached. This month s report includes the budget to actual report and ratios for the period ending November 30, 2014, and the Statement of Net Position, Budget to Actual Report, and Ratios for the period ending December 31, REQUEST FOR AREA BOARD ACTION: Accept the report. CEO RECOMMENDATION: Accept the report. RESOURCE PERSON(S): James Edgerton, Committee Chair; Robert Robinson, CEO; Jennifer Ternay, Interim CFO

38 Thursday, December 04, 2014 BOARD FINANCE COMMITTEE APPOINTED MEMBERS PRESENT: James Edgerton, Chair; George Quick, MBA, John Griffin; Vicki Shore, Bill Stanford BOARD MEMBERS PRESENT: Chris Bostock GUEST(S) PRESENT: Vicki Evans, Accounting Manager at Cumberland County STAFF PRESENT: Rob Robinson, LCAS, CEO; Sara Pacholke, BS, CPA, Controller; Jennifer, Ternay, Interim CFO, Kelly Phillips, Director of Finance; Christal Kelly, Director of Finance 1. WELCOME AND INTRODUCTIONS 2. REVIEW OF THE MINUTES The minutes from the 11/6/2014 meeting were reviewed; a motion was made by George Quick and seconded by John Griffin to approve the minutes. Motion passed. AGENDA ITEMS: DISCUSSION: NEXT STEPS: 3. Monthly Financial Reports The monthly financial reports were discussed which includes Statement of Revenue Expenses Actual to Budget for the Four Months Ending October 31, 2014 and Benchmark Ratios as of October 31, Alliance is showing revenues over expenditures of $7,325,000 which is made up of the Medicaid risk reserve requirement, Medicaid service dollars and administrative dollars. Alliance Behavioral Healthcare is currently exceeding all Senate Bill 208 ratio requirements. TIME FRAME: 4. FY14 Compliance Report Sara Pacholke reviewed the FY14 Compliance Report and Findings. No material findings were present. One significant deficiency and five nonmaterial noncompliance items were reported. We discussed the findings as well as the corrective action plans. 5. CFO Search Update Rob Robinson updated the committee on the CFO search. A candidate was offered the position and declined due to another offer. 4. ADJOURNMENT Page 1 of 1

39 Alliance Behavioral Healthcare Statement of Revenue and Expenses - Actual Budget 11/30/2014 % Received/ Original Budget Current Period Year to Date Balance Expended REVENUES Service County $36,224, ($1,071,224.28) $11,104, $25,119, % State 38,939, ,537, ,128, ,811, % Federal 7,715, ,608, ,432, ,283, % Medicaid Waiver 316,520, ,850, ,963, ,556, % Miscellanous Revenue 1.00 (1.00) 0.00% Total Service Revenue 399,399, ,925, ,628, ,771, % Administrative State 4,588, , ,835, ,752, % Medicaid Waiver 41,129, ,586, ,743, ,386, % In Kind Revenue 51, (51,054.43) 0.00% Miscellanous Revenue 100, , , , % Total Administrative Revenue 45,818, ,962, ,682, ,135, % Total Revenues 445,217, ,888, ,310, ,906, % EXPENDITURES Service County 36,224, (1,071,224.28) 11,132, ,091, % State 38,939, ,311, ,951, ,987, % Federal 7,715, , ,611, ,104, % Medicaid Waiver 316,520, ,779, ,161, ,358, % Total Service Expenditures 399,399, ,381, ,856, ,542, % Administrative Operational 5,455, , ,863, ,592, % Salaries, Benefits, and Fringe 34,274, ,022, ,636, ,637, % Professional Services 6,087, , ,785, ,302, % In Kind Expenses 51, (51,054.43) 0.00% Total Administrative Expenditures 45,818, ,713, ,336, ,481, % Total Expenditures 445,217, ,094, ,193, ,024, % REVENUES OVER EXPENDITURES 3,793, ,117, (11,117,717.61) 0.00%

40 Alliance Behavioral Healthcare Benchmark Ratios As of November 30, 2014 CURRENT RATIO 2.50 Bench Mark Alliance Current Ratio = Compares current assets to current liabilities. Liquidity ratio that measures an organization's ability to pay short term oblications. The benchmark is 1.0. DEFENSIVE INTERVAL Bench Mark - 30 Days Alliance J UL-1 3 A UG-1 3 SEP-1 3 OCT-1 3 NOV-1 3 D EC-1 3 J A N-1 4 FEB -1 4 MA R -1 4 A PR-1 4 MA Y-1 4 J UN-1 4 J UL-1 4 A UG-1 4 SEP-1 4 OCT-1 4 NOV-1 4 DefensiveInterval = Current assets divided by average daily operating expenses. This rato shows how many days the organization can continue to pay expenses if no additional cash comes in. The benchmark is 30 days. PERCENT PAID Bench Mark - 90% Alliance 102% 100% 98% 96% 94% 92% 90% 88% 86% Percent Paid = Percent of clean claims paid within 30 days of receiving. The benchmark is 90%. 92% 90% MEDICAL LOSS Bench Mark - > 80% Alliance 88% 86% 84% 82% 80% 78% Medical Loss = Medicaid claims expense divided by the total capitation payment. The ratio shows the percentage the

41 Alliance Behavioral Healthcare Statement of Revenue and Expenses - Actual Budget 12/31/2014 % Received/ Original Budget Current Period Year to Date Balance Expended REVENUES Service County $36,224, $5,314, $16,419, $19,804, % State 38,939, ,900, ,029, ,910, % Federal 7,715, , ,181, ,534, % Medicaid Waiver 316,520, ,327, ,291, ,229, % Miscellanous Revenue 1.00 (1.00) 0.00% Total Service Revenue 399,399, ,293, ,921, ,477, % Administrative State 4,588, , ,200, ,388, % Medicaid Waiver 41,129, ,467, ,210, ,918, % In Kind Revenue 34, , (85,269.40) 0.00% Miscellanous Revenue 100, , , , % Total Administrative Revenue 45,818, ,878, ,560, ,257, % Total Revenues 445,217, ,171, ,482, ,735, % EXPENDITURES Service County 36,224, ,342, ,474, ,749, % State 38,939, ,077, ,029, ,910, % Federal 7,715, ,192, ,804, ,911, % Medicaid Waiver 316,520, ,583, ,745, ,775, % Total Service Expenditures 399,399, ,196, ,053, ,346, % Administrative Operational 5,455, , ,183, ,271, % Salaries, Benefits, and Fringe 34,274, ,328, ,965, ,308, % Professional Services 6,087, , ,181, ,906, % In Kind Expenses 34, , (85,269.40) 0.00% Total Administrative Expenditures 45,818, ,079, ,415, ,402, % Total Expenditures 445,217, ,276, ,469, ,748, % REVENUES OVER EXPENDITURES 1,895, ,013, (13,013,096.04) 0.00%

42 Alliance Behavioral Healthcare Benchmark Ratios As of November 30, 2014 CURRENT RATIO 2.50 Bench Mark Alliance Current Ratio = Compares current assets to current liabilities. Liquidity ratio that measures an organization's ability to pay short term oblications. The benchmark is 1.0. DEFENSIVE INTERVAL Bench Mark - 30 Days Alliance J UL-1 3 A UG-1 3 SEP-1 3 OCT-1 3 NOV-1 3 D EC-1 3 J A N-1 4 FEB -1 4 MA R -1 4 A PR-1 4 MA Y-1 4 J UN-1 4 J UL-1 4 A UG-1 4 SEP-1 4 OCT-1 4 NOV-1 4 DefensiveInterval = Current assets divided by average daily operating expenses. This rato shows how many days the organization can continue to pay expenses if no additional cash comes in. The benchmark is 30 days. PERCENT PAID Bench Mark - 90% Alliance 102% 100% 98% 96% 94% 92% 90% 88% 86% Percent Paid = Percent of clean claims paid within 30 days of receiving. The benchmark is 90%. 92% 90% MEDICAL LOSS Bench Mark - > 80% Alliance 88% 86% 84% 82% 80% 78% Medical Loss = Medicaid claims expense divided by the total capitation payment. The ratio shows the percentage the

43 Alliance Behavioral Healthcare Statement of Net Position - Full Accrual 12/31/2014 ASSETS Current Assets Cash and Cash Equivalents $49,304, Service Restricted Cash 5,671, Due from Other Governments 16,450, Accounts Receivable, Net of Allowance for Uncollectible Accounts 98, Sales Tax Refund Receivable 103, Prepaid Expenses 331, Total Current Assets 71,959, Capital Assets Furniture and Fixtures 690, Computer Equipment 105, Vehicles 67, Software 137, Less Accumulated Depreciation and Amortization (398,329.66) Property and Equipment - Net 602, Noncurrent Assets Restricted Cash 13,649, Security Deposits 95, Total Other Assets 13,745, Total Assets $86,307, LIABILITIES Current Liabilities Notes Payable - Current Portion $2,062, Accounts Payable and Other Current Liabilities 4,017, Accrued Liabilities 13,236, Accrued IBNR 18,152, Unearned Revenue 11,645, Total Current Liabilities 49,114, Noncurrent Liabilities Notes Payable 2,876, Accrued Vacation 270, Total Long-Term Liabilities 3,146, Total Liabilities 52,260, NET POSITION Invested in capital assets, net of related debt 602, Restricted for: Risk Reserve at BOY 9,960, Services Restricted at BOY 5,671, Unrestricted Related to Risk Reserve 3,688, Related to Services 3,234, Related to Administration 10,889, Total Net Position 34,046, Total Liabilities and Net Position $86,307,109.44

44 5C Alliance Behavioral Healthcare BOARD OF DIRECTORS Agenda Action Form ITEM: November and January Policy Committee Meeting Minutes and Annual Review of Board Policies DATE OF BOARD MEETING: February 5, 2015 BACKGROUND: Per Alliance Behavioral Healthcare Area Board Policy Development of Policies and Procedures, the Board is to review all policies annually. The Board Policy Committee reviews a number of Policies each quarter in order to meet this requirement. Policies reviewed at the January Policy Committee meeting with recommended revisions: Business Operations: Travel and Employee Expense Reimbursement Quality Management: Management and Investigation Grievances Policies reviewed and recommended to repeal: Business Operations: Contracting with New and Existing Providers Policy (Reason for recommended action: This Policy is redundant; no operational procedures are currently tied to this Policy. Operational procedures for contracting with providers come under the Selection and Retention of Providers Policy.) REQUEST FOR BOARD ACTION: Accept Board Policy Committee minutes from the November and January meetings as submitted. Approve the recommended changes to the above listed policies. CEO RECOMMENDATION: Approve the revised policies for continued use and accept the meeting minutes as submitted. RESOURCE PERSON(S): Cynthia Binanay, Chair, Policy Committee; Monica Portugal, Chief Compliance Officer

45 1. WELCOME AND INTRODUCTIONS Thursday, November 13, 2014 BOARD POLICY COMMITTEE MEMBERS PRESENT: Cynthia Binanay (Committee Chair, Area Board Member), Curtis Massey (Area Board Member), Lodies Gloston (Area Board Member), Bill Stanford (Area Board Chair) MEMBERS ABSENT: None STAFF PRESENT: Carol Hammett (General Counsel), Monica Portugal (Corporate Compliance Officer) 2. REVIEW OF THE MINUTES: Motion was made by Ms. Gloston and seconded by Mr. Massey to approve the minutes of the August 14, 2014 meeting. Motion carried. AGENDA ITEMS: DISCUSSION: NEXT STEPS: TIME FRAME: Announcements: None N/A N/A Documents Provided: Minutes: 8/14/2014, Business Operations, Compliance and Information Technology Policies, Area Director Compensation Policy, Evaluation of Area Director Policy, Emergency Management Plan, Business Continuity Plan, By- Laws, Travel and Employee Expense Reimbursement and Contracting with New and Existing Providers. N/A N/A Annual Review of Policies: Business Operations, Compliance, Information Technology The Committee reviewed all Business Operations, Compliance, and Information Technology Policies. Policies reviewed and considered for continued use without revisions: Business Operations: Risk Management Contracting with New and Existing Providers Travel and Employee Expense Reimbursement Cellular Communication Devices Paybacks Management of Financial Risk Fund Balance Financial Stability Accounting Manual Accounting by Funding Source Coordination of Benefits Policies and Agenda Action Form will be submitted to Board Clerk for inclusion in the December 4, 2014 Board Packet. December 4, 2014 Page 1 of 3

46 Thursday, November 13, 2014 BOARD POLICY COMMITTEE AGENDA ITEMS: DISCUSSION: NEXT STEPS: Cyclical Financial Reporting Claims Adjudication Purchasing Compliance: Corporate Compliance Plan Guarding Against Fraud and Abuse Financial Incentives Employee Conflict of Interest Employee Code of Ethics and Conduct Records Retention Legal Proceedings Involving Service Records Information Technology: Service Codes in Alpha Eligibility Load, Error Handling and Reconciliation IT System Backup TIME FRAME: Policies reviewed with suggested revisions: General Computer Use (Information Technology) Compliance with Local Government Budget and Fiscal Control Act (Business Operations) Other Policies for Review and Revision: Committee reviewed proposed revisions to the Area Board By-Laws (top of page 4) including removing language that makes the Chairperson an ex-officio member of all Area Board Committees. Revised proposed draft will be presented at the next Board meeting. December 4, 2014 Committee also discussed combining the Area Director Compensation Policy and Evaluation of Area Director Policy as well as the Emergency Management Plan and Business Continuity Plan Policies. This will be placed on the next meeting agenda. Page 2 of 3

47 Thursday, November 13, 2014 BOARD POLICY COMMITTEE AGENDA ITEMS: DISCUSSION: NEXT STEPS: Policies to Repeal: The Committee reviewed the request to repeal the Contracting with New and Existing Providers Policy and after a brief discussion decided to table the item for the next meeting. Item will be placed on the January 7, 2015 meeting agenda. TIME FRAME: January 7, 2015 Other: Committee decided to hold another Policy Committee meeting on January 7, 2015 to review outstanding agenda items. 3. ADJOURNMENT: Next meeting will be January 7, 2015 from 4:00 p.m. to 6:00 p.m. in room 237. Page 3 of 3

48 1. WELCOME AND INTRODUCTIONS Wednesday, January 07, 2015 BOARD POLICY COMMITTEE APPOINTED MEMBERS PRESENT: Cynthia Binanay (Committee Chair, Area Board Member), Lodies Gloston (Area Board Member), Curtis Massey (Area Board Member) BOARD MEMBERS PRESENT: STAFF PRESENT: Carol Hammett (General Counsel), Monica Portugal (Corporate Compliance Officer), Sandy Valdes (Compliance Administrative Assistant) 2. REVIEW OF THE MINUTES: Motion was made by Ms. Gloston and seconded by Mr. Massey to approve the minutes of the 11/13/2014 meeting. Motion carried. AGENDA ITEMS: DISCUSSION: NEXT STEPS: TIME FRAME: Announcements: None N/A N/A Documents Provided: Minutes: 11/13/14, Area Director Compensation, Evaluation of Area Director, Business Continuity Plan, Emergency Management Plan, Contracting with New and Existing Providers, Travel and Employee Expense Reimbursement and Management and Investigation of Grievances. N/A N/A Policies with Revisions Proposed by Staff: Other Policies for Review and Revision: The Committee reviewed proposed revisions to Quality Management and Business Operations Policies and made additional changes to both Policies. Policies reviewed with suggested revisions: Travel and Employee Expense Reimbursement Management and Investigation of Grievances Committee reviewed proposed revisions to the Area Board By-Laws including adding the newly adopted Mission, Vision and Values statements, along with other proposed changes. Committee discussed combining Emergency Management Plan and Business Continuity Plan Policies. Committee also discussed combining the Area Director Compensation Policy and Evaluation of Area Director Policy and decided to defer the change until the Executive Committee has decided on a course of action. Policies will be submitted to the Board Clerk for inclusion in the February 5, 2015 Board Packet. Revised proposed draft will be presented at the next meeting. Defer combining the two polices until Executive Committee reviews at February 10, 2015 Draft minutes may be submitted with the monthly Board packet. Minutes will be approved by this Committee at a later date. Page 1 of 2

49 Wednesday, January 07, 2015 BOARD POLICY COMMITTEE AGENDA ITEMS: DISCUSSION: NEXT STEPS: Policies to Repeal: The Committee reviewed a request to repeal the Contracting with New and Existing Providers Policy. No operational procedures are currently tied to this Policy. Operational procedures for contracting with providers come under the Selection and Retention of Providers Policy. Mr. Massey made a motion to repeal Policy BO-3 and keep PN-1. Motion was seconded by Ms. Gloston. Motion carried. Other: Committee rescheduled meeting from February 12, 2015 to February 10, their next meeting on January 20, Policy will be submitted to Board Clerk for inclusion in the February 5, 2015 Board Packet. TIME FRAME: 3. ADJOURNMENT: Next meeting will be February 10, 2015 from 4:00 p.m. to 6:00 p.m. in room 237. Draft minutes may be submitted with the monthly Board packet. Minutes will be approved by this Committee at a later date. Page 2 of 2

50 AREA BOARD POLICIES AND PROCEDURES SUBJECT: Travel and Employee Expense Reimbursement LINES OF BUSINESS: All RESPONSIBILITY: Area Board Area Director NUMBER: BO-4 URAC: CORE, v. 3.0, Standard 27 REFERENCE: APPROVAL DATE: 06/07/2012 LATEST REVISION DATE: LATEST REVIEW DATE: 12/05/2013 APPROVAL AUTHORITY: PAGE: 1 Chairperson, Area Board I. PURPOSE The purpose of this policy is to provide a consistent standard for employee expense reimbursement for authorized travel for the purpose of conducting business or obtaining training. It is the intent of Alliance Behavioral Healthcare that employees neither gain nor lose personal funds when engaging in Agency authorized travel and/or training. It is also the intent of Alliance Behavioral Healthcare that all employee expense reimbursements be approved, necessary and reasonable. II. POLICY Alliance Behavioral Healthcare is committed to developing an educated and skilled workforce and shall provide funding for employee training and travel whenever possible. Funding for this purpose may be established annually during the annual budget process. Available training funds may be used for training required for obtaining or maintaining professional licensure or to obtain necessary skills required for a position when approved by the Area Director. Mileage is reimbursed for travel that is a part of an employee s job responsibilities or for approved travel for training purposes. III. ALLOWABLE EXPENSES Reimbursement for the following travel and training related expenses, both within and outside the catchment area, are allowable under this policy: A. Mileage in accordance with current IRS regulations. B. Meals based on the Board s IRS per diem rates. annually established per diem rate. Hotel charges incurred, subject to the limitations imposed by the board s annually established rate C.. D. Ancillary travel costs, e.g., tips, parking, vehicle rental, etc. as set by the Area Director. E. Tuition/Registration as set by the Area Director. Any exceptions to the established rates shall require the prior approval of the Area DirectorCEO. IV. PROCEDURES The Area Director shall develop procedures to implement the provisions of this policy.

51 AREA BOARD POLICIES AND PROCEDURES SUBJECT: Management and Investigation of Grievances LINES OF BUSINESS: Network Administration, Clients Rights, Quality Management RESPONSIBILITY: Area Board Area Director NUMBER: QM-2 URAC: CORE, v. 3.0, Standard 35 REFERENCE: 10A NCAC 27G. 7002, 7003 APPROVAL DATE: 5/15/2012 LATEST REVISION DATE: LATEST REVIEW DATE: 3/6/2014 APPROVAL AUTHORITY: PAGE: 1 Chairperson, Area Board I. PURPOSE The purpose of this policy is to establish a process for receiving, investigating, resolving and managing grievances in a consistent manner. II. DEFINITIONS Category A Provider: facilities licensed pursuant to G.S. 122C, Article 2, except for hospitals. These include 24- hour residential facilities, day treatment, Psychiatric Residential Treatment Facilities and outpatient services Category B Provider: G.S. 122C, Article 2, community based providers not requiring State licensure. Complainant: person filing a grievance. Grievance: an expression of dissatisfaction by an enrollee, their legal guardian, or Provider acting on behalf of the enrollee about any matter other than decisions regarding requests for Medicaid services. any expression of concern orally or in writing that the complainant perceives as a problem. Provider: an individual, agency or organization that provides mental health, developmental disabilities and/or substance abuse services to consumers and families. III. POLICY STATEMENT It is the policy of Alliance Behavioral Healthcare to respond to grievances received concerning the provision of publicly funded services by Category A and B providers in the Alliance Behavioral Healthcare catchment area. It is also the policy of Alliance Behavioral Healthcare to use the information gleaned from grievance proceedings as part of the Authority s Alliance s quality improvement process. IV. PROCEDURES The Area Director shall develop procedures to implement this policy. The procedures shall comply with all relevant state and Federal statutes and requirements of all regulatory, funding or accrediting bodies.

52 AREA BOARD POLICIES AND PROCEDURES SUBJECT: Contracting with New and Existing Providers LINES OF BUSINESS: Public Communications, Service Access, Utilization Management, Quality Management, Provider Relations RESPONSIBILITY: Area Board Area Director NUMBER: BO-3 URAC: CORE, v. 3.0, Standard 4; N-NM, v. 7.0, Standard 3 REFERENCE: G.S. 122C APPROVAL DATE: 6/7/2012 LATEST REVISION DATE: LATEST REVIEW DATE: 12/05/2013 APPROVAL AUTHORITY: Chairperson, Area Board PAGE: 1 of 2 I. PURPOSE The purpose of this policy is to provide a uniform and consistent approach for establishing contracts with potential, new and current providers, their agents or designees and adding new services to existing provider contracts. II. DEFINITIONS Request for Proposal (RFP): used to communicate requirements to prospective contractors and to solicit proposals for products and services. The proposals are then evaluated according to various selection criteria, which may include many factors including price. Request for Information (RFI): a standard business process which purpose is to collect written information about the capabilities of various vendors. Normally it follows a format that can be used for comparative purposes. Request for Qualifications (RFQ): a procurement tool routinely used by state and local governments and the private sector to select partners in major systems acquisitions. This approach differs from the traditional request for proposals approach in that it places greater emphasis on the actual qualifications and track record of the potential contractor rather than how well the potential contractor responds to detailed project specifications and requirements. III. POLICY It is the policy of Alliance Behavioral Healthcare to contract with agencies and other organizations in a fair and consistent manner to provide needed mental health, intellectual/developmental disabilities and substance abuse services. In contracting, Alliance Behavioral Healthcare shall give primary consideration to quality of care and, as appropriate, maintenance of existing care relationships. Alliance Behavioral Healthcare shall offer state and county contracts only to providers that take part in an official RFP/RFI/RFQ process. However, by exception, other methods for selecting providers may be employed. These other methods for selecting/contracting with providers may include but are not limited to: i. Competitive procurement ii. Legal notice iii. Procurement to obtain best prices without selective contracting iv. Non-competitive solicitation and/or selection of providers An exception to this policy can be made: i. When a critical need or emergency has been identified

53 SUBJECT: Contracting with New and Existing Providers LATEST REVISION DATE: PAGE: 2 ii. iii. When adding a service(s) that is a natural extension of existing services in the provider s contract When previous attempts to secure services have not been effective. All exceptions shall be approved by the Area Director with notification to the Area Board. The Finance Committee shall have authority to initiate the process for developing new or expanded services whether through RFP, RFI, RFQ or other methods allowed by this policy. The Area board shall have final approval over the awarding of any contracts for the provision of services. IV. PROCEDURES The Area Director shall develop procedures to implement the provisions of this policy.

54 6 Alliance Behavioral Healthcare BOARD OF DIRECTORS Agenda Action Form ITEM: Budget Retreat DATE OF BOARD MEETING: February 5, 2015 BACKGROUND: An annual budget retreat is held to provide information to the Area Board regarding the upcoming fiscal year budget. The following dates are proposed for the retreat: Friday, March 27 9:00-12:00 Monday, March 30 10:00-1:00 or 1:00-4:00 Tuesday, March 31 10:00-1:00 or 1:00-4:00 REQUEST FOR AREA BOARD ACTION: Determine the date and time for the Budget Retreat. CEO RECOMMENDATION: Determine the date and time for the Budget Retreat. RESOURCE PERSON(S): James Edgerton, Committee Chair; Robert Robinson, CEO; Jennifer Ternay, Interim CFO

55 7 A. Alliance Behavioral Healthcare BOARD OF DIRECTORS Agenda Action Form ITEM: Draft Minutes from the December 4, 2014, Board Meeting DATE OF BOARD MEETING: February 5, 2015 REQUEST FOR BOARD ACTION: Approve the draft minutes from the December 4, 2014, Board meeting. CEO RECOMMENDATION: Approve the minutes. RESOURCE PERSON(S): Robert Robinson, CEO; Veronica Ingram, Executive Assistant

56 Thursday, December 04, 2014 ALLIANCE BEHAVIORAL HEALTHCARE BOARD MEETING MEMBERS PRESENT: Ann Akland, Cynthia Binanay, Christopher Bostock, Dr. George Corvin, Kenneth Edge, James Edgerton, Lodies Gloston, Phillip Golden, Dr. John Griffin, Curtis Massey, Rev. Michael Page, George Quick, Robert Robinson, CEO Vicki Shore, William Stanford, Jr., Chairman Caroline Sullivan, Scott Taylor, Amelia Thorpe, Lascel Webley, Jr. and McKinley Wooten, Jr. GUEST(S) PRESENT: Eddie Burke, Cherry Bekaert, CPA; Dennis Farley, DMH; Denise Foreman, DMH; Dr. Nicole Lawrence, Duke Center for Child and Family Policy; Sharon O Brian, CFAC; Melissa Pall, Cherry Bekaert, CPA; and Dr. Liz Snyder, Duke Center for Child and Family Policy ALLIANCE STAFF PRESENT: Dr. Erica Arrington, Associate Medical Director; David Currey, BECOMING Project Coordinator; Hank Debnam, Cumberland Site Director; Carol Hammett, General Counsel; Veronica Ingram, Executive Assistant; Carlyle Johnson, Director of Provider Network Strategic Initiatives; Christal Kelly, Director or Reimbursement; Geyer Longenecker, Director of Quality Management; Beth Melcher, Chief of Program Development and Evaluation; Ann Oshel, Chief Community Relations Officer; Sara Pacholke, Controller; Kelly Phillips, Finance Director; Monica Portugal, Corporate Compliance Officer; Al Ragland, HR Director; Garron Rogers, Youth Coordinator; Jennifer Ternay, Interim Chief Financial Officer; and Doug Wright, Director of Consumer Affairs 1. CALL TO ORDER: Vice-Chairman Christopher Bostock called the meeting to order at 4:02 p.m. AGENDA ITEMS: DISCUSSION: 2. Announcements A. Commissioners/Board Member Recognition: Rob Robinson, CEO, congratulated Board members who are also County Commissioners on recent appointments: Kenneth Edge was elected Chairman of Cumberland Board of County Commissioners, Michael Page was re-elected Chairman of Durham Board of County Commissioners, and Caroline Sullivan was elected Vice-Chairwoman of Wake Board of County Commissioners. B. NC Council Award: Mr. Robinson stated that Alliance received an award for the open access model. This award will be presented during this evening s portion of the NC Council Conference in Pinehurst, NC. C. New DMH Staff: Mr. Robinson mentioned that Yvonne French received a promotion and will no longer serve as the MCO Liaison; he introduced Dennis Farley, the new LME/MCO Liaison. D. New Alliance Staff: Mr. Robinson introduced Kelly Phillips, new Finance Director, and Christal Kelly, new Director of Reimbursement. E. Alliance FEP Award: Additionally, Mr. Robinson mentioned Alliance s award to implement a coordinated care model for First Episode Psychosis (FEP); this will be an expansion of the current UNC Center for Excellence in Community Mental Health OASIS (Outreach and Support Intervention Services) model. He expressed gratitude for Alliance staff, Ann Oshel, for submitting the application for this award. 3. Oath of Office Durham Board of County Commissioners Chairman and Alliance Board member, Michael Page, administered the oath of office to new Board member, McKinley Wooten, Jr. Page 1 of 5

57 Thursday, December 04, 2014 ALLIANCE BEHAVIORAL HEALTHCARE BOARD MEETING AGENDA ITEMS: DISCUSSION: 4. Agenda Adjustments There were no adjustments to the agenda. 5. Public Comment There were no public comments. 6. Annual Audit Report (page 6) An annual audit is a requirement of the Local Government Budget and Fiscal Control Act GS The annual audit is also a requirement of the DHHS-DMA contract with Alliance for the Medicaid Waiver. The Alliance financial report and the report of the independent auditor were presented by the firm of Cherry Bekaert, CPA. Eddie Burke and Melissa Pall presented a detailed overview and PowerPoint presentation of Alliance s recent audit including results of the audit, areas of focus, required communications and accounting measures, metrics. Mr. Burke and Mrs. Pall stated that their firm issued an unmodified opinion on the financial statements, on Federal funding, and State funding components. Additionally, Mr. Burke mentioned corrective actions Alliance staff put in place. Board members discussed topic noting implementation of IT strategic plan and clarifying the required unrestricted/unassigned fund balance. BOARD ACTION A Motion was made by Mr. James Edgerton to accept the FY14 audit report; seconded by Mr. George Quick. Motion passed unanimously. 7. Committee Reports A. Executive Committee (page 77) The Executive Committee sets the agenda for Board meetings and acts in lieu of the Area Board between meetings. Actions by the Executive Committee are reported to the full Area Board at the next scheduled meeting. This month s report includes the minutes from the September 16, 2014, meeting and information about a recently formed ad hoc committee. Vice-Chairman, Christopher Bostock, presented the Executive Committee report. He mentioned that per our by-laws at last month s Executive Committee meeting, Chairman Stanford appointed an ad hoc committee. The members of the Executive Committee will serve on this ad hoc committee and will develop a process to evaluate the CEO. The ad hoc committee will provide an update at the February 5, 2015, Area Board meeting. There were no questions or discussion about the Executive Committee report. B. Consumer and Family Advisory Committee (page 89) The Alliance Consumer and Family Advisory Committee (CFAC) is composed of consumers and/or family members that live in Durham, Wake, or Cumberland Counties who receive mental health, intellectual/developmental disabilities and substance use/addiction services. CFAC is a self-governing committee that serves as an advisor to Alliance administration and Board. This month s report included draft minutes and notes from the CFAC Subcommittee meetings and a copy of the training presentation on Rights and Responsibilities. Doug Wright, Director of Consumer Affairs, introduced Sharon O Brian, CFAC representative. Ms. O Brian provided a summary of the CFAC report and reminded Board members that additional information was submitted in the Board packet. She expressed appreciation for being able to present the CFAC report and being part of the agenda. There were no questions or discussion about the CFAC report. Page 2 of 5

58 Thursday, December 04, 2014 ALLIANCE BEHAVIORAL HEALTHCARE BOARD MEETING AGENDA ITEMS: DISCUSSION: C. Finance Committee (page 122) The Finance Committee s function is to review financial statements and recommend policies/practices on fiscal matters to the Area Board. The Finance Committee meets monthly at 3:00 p.m. prior to the regular Board Meeting. This month s report included the budget to actual report and ratios for the period ending October 31, 2014, and the draft minutes of the November Finance Committee meeting. James Edgerton, Finance Committee Chairman, presented the Finance Committee report. He noted that current revenues exceeded expenditures. There were no questions or discussion about the Finance Committee report. D. Policy Committee (page 127) Per Alliance Behavioral Healthcare Area Board Policy Development of Policies and Procedures, the Board reviews all policies annually. The Board Policy Committee reviews a number of Policies each quarter in order to meet this requirement. This month s report included minutes from the August Policy Committee meeting and a review of Business Operations and Compliance Policies. Policy Committee Chairwoman, Cynthia Binanay, presented the Policy Committee report. She noted that the majority of the Policies were reviewed without revisions and noted three Policies were reviewed with suggested revisions. Ms. Binanay reviewed the recommended revisions for the following Policies: Board By-laws, General Computer Use, and Compliance with Local Government Budget and Fiscal Control Act. There were no questions or discussion about the Policy Committee report. 8. Consent Agenda (page 165) 9. Proposal to Cancel January 1, 2015, Board Meeting (page 171) BOARD ACTION A Motion was made by Ms. Cynthia Binanay to approve the policies as recommended; seconded by Ms. Ann Akland. Motion passed unanimously. Draft Minutes from the August 7, 2014, Board Meeting Vice-Chairman Bostock noted that the consent agenda was part of the Board packet. There were no questions or discussion about the consent agenda. BOARD ACTION A Motion was made by Dr. George Corvin to approve the consent agenda; seconded by Commissioner Kenneth Edge. Motion passed unanimously. As stated in the by-laws and in accordance with provisions set forth in the Open Meetings Act, the matter placed before the Board was to vote on whether the Board would like to cancel the January 1, 2015, regularly scheduled meeting. Vice-Chairman Bostock presented the recommendation. There were no comments or discussion about the recommendation. BOARD ACTION A Motion was made by Dr. George Corvin to cancel the January 1, 2015, Board meeting; seconded by Mr. James Edgerton. Motion passed unanimously. Page 3 of 5

59 Thursday, December 04, 2014 ALLIANCE BEHAVIORAL HEALTHCARE BOARD MEETING AGENDA ITEMS: 10. Request for QM Report Waiver (page 173) DISCUSSION: In accordance with Rule 10A NCAC 27G.0805, Procedure for Waivers by Division Director, staff proposed that the Board consider submitting a request to the Department of Health and Human Services (DHHS) to waive the requirement for providers to submit Quarterly Incident Report Summaries (Form QM-11), per Subsection (e) of the Rule. This requirement would impact approximately 380 providers. Carol Hammett, General Counsel, and Beth Melcher, Chief of Program Development and Evaluation presented this request. Dr. Melcher noted that level II and III incidents are submitted electronically by providers. Level I incidents are reviewed as part of Routine Monitoring; subsequently this report requirement is currently redundant. Ms. Hammett discussed the process Alliance would pursue if the Board approves this request. Board discussed the topic, specifically, if other MCO s will make the same request. CEO, Rob Robinson, noted that this topic was discussed at an NC Council MCO Directors meeting and all MCO Directors were in agreement to request this waiver. BOARD ACTION A Motion was made by Mr. George Quick to approve the recommendation to request that the Secretary of DHHS approve a waiver of the QM-1 reporting requirements indefinitely for applicable Alliance providers and authorize the CEO to sign and send the letter of request; seconded by Commissioner Caroline Sullivan. Motion passed unanimously. 11. Board Training A. Child and Adolescent Behavioral Health Services Presentation (page 174) Dr. Erica Arrington, Associate Medical Director, presented an overview/powerpoint presentation of behavioral health services available to children in North Carolina. Dr. Arrington reviewed common diagnoses treated in the child/adolescent population, service definitions for child/adolescent enhanced behavioral health services, and best practice expectations. Board members discussed topic noting Psychiatric Residential Treatment Facilities (PRTF) and interaction with school systems. Board members noted an increased need to interact more with school systems to better equip educators and school staff. B. SAMSHA/BECOMING Grant (page 193) Alliance was awarded a SAMHSA grant to improve life outcomes for youth disconnected from critical services and supports. Ann Oshel, Alliance Chief Community Relations Officer, facilitated the presentation in coordination with Garron Rogers, Alliance Youth Coordinator, and Drs. Nicole Lawrence and Liz Snyder from Duke Center for Child and Family Policy. This PowerPoint presentation highlighted some of Alliance s successful youth engagement efforts and provided an overview of key evaluation findings. Board members discussed topic requesting prior background of consumers and noting the positive impact of this program. Additionally, Board members noted the need for greater involvement at an earlier age, specifically, helping and equipping parents and educators to help youth. BOARD ACTION The Board received the training; no additional action required. Page 4 of 5

60 Thursday, December 04, 2014 ALLIANCE BEHAVIORAL HEALTHCARE BOARD MEETING AGENDA ITEMS: DISCUSSION: 12. Updates A. EQR Site Visit Rob Robinson, CEO, provided an update to the Board on the recent External Quality Review (EQR) visit. He noted the positive informal review and stated that the final report is expected within thirty days. B. Follow up to Newspaper Article on NC Substance Abuse Treatment Centers Mr. Robinson provided an update on a recent newspaper article about substance abuse treatment centers in North Carolina. He noted that current legislators are discussing having MCOs manage ADATCs (Alcohol and Drug Abuse Treatment Center) and that this potential service speaks to legislators confidence in the MCO model. BOARD ACTION The Board received the updates; no additional action required. 13. Chairman s Report Vice-Chairman Bostock noted that the next Board meeting will be at Alliance s Wake site on February 5, Additionally, on behalf of Chairman Stanford and Alliance staff, he extended holiday greetings to everyone. 14. Adjournment With all business being completed the meeting adjourned at 6:03 p.m. Next Board Meeting Thursday, February 05, :00 6:00 Robert Robinson, Chief Executive Officer Date Approved Page 5 of 5

61 7B Alliance Behavioral Healthcare BOARD OF DIRECTORS Agenda Action Form ITEM: Executive Committee Report DATE OF BOARD MEETING: February 5, 2015 BACKGROUND: The Executive Committee sets the agenda for Area Board meetings and acts in lieu of the Area Board between meetings. Actions by the Executive Committee are reported to the full Area Board at the next scheduled meeting. This month s report includes approved minutes from the November 18, 2014, and December 16, 2014, meetings, draft minutes from January 20, 2015, meeting, and a closed session update from the ad hoc committee. REQUEST FOR AREA BOARD ACTION: Accept the report. CEO RECOMMENDATION: Accept the report. RESOURCE PERSON(S): William Stanford, Area Board Chair; Robert Robinson, CEO

62 Tuesday, November 18, 2014 EXECUTIVE COMMITTEE MEETING MEMBERS PRESENT: Cynthia Binanay, Christopher Bostock, George Corvin, MD, James Edgerton (via phone), William Stanford, Chair, Scott Taylor, Lascel Webley, Jr. GUEST(S): None STAFF PRESENT: Amanda Graham, Chief of Staff; Carol Hammett, General Counsel; Veronica Ingram, Executive Assistant; Rob Robinson, CEO 1. WELCOME AND INTRODUCTIONS 2. REVIEW OF THE MINUTES The minutes from the October 21, 2014, Executive Committee meeting were reviewed. A motion was made by Dr. Corvin and seconded by Mr. Bostock to approve the minutes. Motion passed unanimously. AGENDA ITEMS: DISCUSSION: NEXT STEPS: 3. Updates A. Board Member Terms: Mr. Robinson advised the committee that Ms. Ingram and Ms. Hammett will meet with BOCC clerk to confirm Board member terms. B. Alliance Appointment at Upcoming Wake BOCC Meeting: Mr. Robinson advised the Committee that the Wake Board of County Commissioners will review Alliance s recommendation to appoint McKinley Wooten to Alliance s Board of Directors at their December 1 meeting. 4. CFAC Chairman Stanford and Mr. Robinson requested that the Committee consider adjusting the agenda for future Board meetings to include moving CFAC to committee reports instead of consent agenda. Committee discussed topic. A. Ms. Ingram and Ms. Hammett will meet with the Durham Clerk to the Board of County Commissioners to clarify Board member terms. B. Mr. Robinson will attend the Wake BOCC meeting. Ms. Ingram will update the agenda. TIME FRAME: A. 11/20/2014 B. 12/1/ /19/2014 COMMITTEE ACTION A motion was made by Ms. Binanay to remove CFAC from consent agenda and add to committee reports; seconded by Dr. Corvin. Motion passed unanimously. Page 1 of 3

63 Tuesday, November 18, 2014 EXECUTIVE COMMITTEE MEETING AGENDA ITEMS: DISCUSSION: NEXT STEPS: A motion was made by Dr. Corvin to allow CFAC to have five minutes to report under the committee reports section of the monthly agenda; seconded by Mr. Bostock. Motion passed unanimously. 5. Policy Committee Mr. Robinson stated that Corporate Compliance Officer, Monica Portugal, requested a semi-annual review of Alliance s Compliance Program in addition to the annual review: one mid-year and one at the end of the year. Team discussed topic. Ms. Binanay suggested that the initial presentation of the Compliance Program occur at the Policy Committee meeting and then be presented to the Board as part of the Policy Committee report. Ms. Hammett will research options for expedited approval of committee minutes and provide an update at the next Executive Committee. TIME FRAME: 12/16/ Corporate Compliance 7. January Board Meeting (1/1/2015) Additionally, Ms. Binanay requested input regarding expediting approval of committee minutes. Team discussed topic noting requirements of Open Meetings Law and establishing quorums via conference calls and/or video conferences. Per Mr. Robinson this item was covered under item 5: Policy Committee. There were no additional comments or discussion about the topic. Committee discussed proposal to cancel January Board meeting which is scheduled for New Year s Day. None needed. Ms. Ingram will update the December 2015 Board agenda. N/A 11/19/ December 2014 & January 2015 Executive Committee Meetings COMMITTEE ACTION A motion was made by Mr. Bostock and seconded by Mr. Webley to recommend that the Board cancel the January 1, 2015, meeting. Committee discussed December and January meetings and agreed to keep these meetings as scheduled. Additionally, committee discussed the December Area Board meeting and NC Council conference, noting the need for additional lodging at future conferences. Mr. Robinson will request that NC Council consider holding a block of rooms for Board members for the December 2015 conference. None specified. Page 2 of 3

64 Tuesday, November 18, 2014 EXECUTIVE COMMITTEE MEETING AGENDA ITEMS: DISCUSSION: NEXT STEPS: 9. Draft Agenda for December 4, 2014, Board Meeting 10. CEO Evaluation Tool Team reviewed the draft agenda noting revisions from today s meeting. Committee discussed topic noting that the policy for CEO evaluation was broad. Mr. Robinson provided an update regarding his work plan which he defined as a detailed version of his job description. He stated that Alliance work plans are used to determine annual evaluation of employees. Ms. Hammett mentioned criteria that the Secretary of DHHS specifies. She advised the Committee that this handout and a version of the 2012 CEO evaluation were included in the packet before them. Team discussed topic in detail including potentially utilizing an ad hoc committee (with Executive Committee members serving on this committee) and future use of 360 reviews. Ms. Ingram will update agenda and forward to staff. A. Mr. Robinson will forward the work plan to Executive Committee. B. Ms. Ingram will revise the December Board agenda by removing Executive Committee from consent agenda and adding it to committee reports. TIME FRAME: 11/19/2014 A. None specified. B. 11/19/ ADJOURNMENT COMMITTEE ACTION A Motion was made by Chairman Stanford to create an ad hoc committee to develop evaluation criteria, an evaluation tool and a process for evaluation and compensation of the CEO; the ad hoc committee will report to the full Board at the February 5, 2015 meeting; seconded by Dr. Corvin. Motion passed unanimously. Page 3 of 3

65 Tuesday, December 16, 2014 EXECUTIVE COMMITTEE MEETING MEMBERS PRESENT: Cynthia Binanay, Christopher Bostock, George Corvin, MD, James Edgerton, William Stanford, Jr., Chair, Scott Taylor, Lascel Webley, Jr. GUEST(S): None STAFF PRESENT: Amanda Graham, Chief of Staff; Carol Hammett, General Counsel; Veronica Ingram, Executive Assistant; Al Ragland, Chief HR Officer; Rob Robinson, CEO 1. WELCOME AND INTRODUCTIONS 2. REVIEW OF THE MINUTES The minutes from the November 18, 2014, Executive Committee Meeting were reviewed. A motion was made by Mr. Bostock and seconded by Dr. Corvin to approve the minutes. Motion passed unanimously. AGENDA DISCUSSION: ITEMS: 3. Updates A. Board Member Terms Ms. Hammett and Ms. Ingram provided an update from their meeting with the clerk Durham County clerk to confirm Board member terms. B. Possible Reception before February 5, 2015, Board Meeting Chairman Stanford proposed hosting a reception for former Wake Mental Health and Human Services Boards before the February Board meeting which will be at the Wake site. Committee discussed topic and recommended pursuing the event. COMMITTEE ACTION A Motion was made by Mr. Bostock to pursue hosting a reception for current and former members of Wake Mental Health and Human Services Boards; the reception will include a presentation at an appropriately sized site to include Alliance Wake staff and Wake County officials and Commissioners; seconded by Dr. Corvin. Motion passed unanimously. C. Committee Minutes: To expedite submission of Board committee minutes Ms. Hammett proposed that minutes be submitted in draft form with the following statement: to be approved at a later date by this committee. She stated that she would provide training for staff who support Board committees. NEXT STEPS: A. Chairman Stanford will contact Board members who are due for reappointment to see if they are willing to be reappointed. B. Mr. Robinson and Ms. Ingram will begin coordinating the reception and will provide an update at the January committee meeting. Ms. Ingram will advise staff (who support Board committees that meet on the same day) of the potential reception. C. Ms. Hammett will provide additional training to staff who support Board Committees. TIME FRAME: A. 1/20/2015 B. 1/20/2015 C. 1/20/2015 Page 1 of 2

66 Tuesday, December 16, 2014 EXECUTIVE COMMITTEE MEETING AGENDA ITEMS: 4. Agenda Requests for Future Board Meetings: Board Discussion and Board Trainings 5. January Executive Committee Meeting 6. LME/MCO Consolidation 7. CEO Evaluation Ad Hoc Committee 8. February 5, 2015, Board Meeting Draft Agenda DISCUSSION: Mr. Robinson mentioned feedback from the most recent Area Board meeting, specifically, a request for additional time for Board members to discuss items and a review of the proposed Board trainings scheduled for the remainder of the fiscal year. Committee discussed topic in detail and recommended considering these requests in determining upcoming agendas. Additionally, Mr. Robinson mentioned upcoming meetings with Wake County Public School System president, vice-president and Wake County Sheriff. Chairman Stanford mentioned that this meeting will occur and that a portion of the January meeting will include the ad hoc committee s review of the CEO evaluation process. Mr. Robinson noted a new NC Council position statement on the LME- MCO consolidation; this new position is similar to the earlier position statement except it does not specify the number of proposed final MCOs. Chairman Stanford reviewed the previous discussion which included conducting 360 reviews with members of the CEO s leadership team, utilizing a survey of all Board members and the CEO s work plan with a potential addendum noting strategic priorities (priorities added that impacted the current work plan). Committee discussed topic in detail. Committee reviewed draft agenda. Mr. Robinson advised the committee that Dave Richard, Deputy Secretary of DHHS Behavioral Health and Developmental Disabilities Services, is planning to attend the February Area Board meeting. NEXT STEPS: A. Committee will consider these requests when setting future Board agendas. B. Ms. Ingram will inform all Board members of upcoming Board orientation and orientation agenda topics. Ms. Ingram will confirm that Board committees scheduled to meet on 1/1/2015 are cancelling or rescheduling those meetings; she will ensure that this information is updated on the website per Open Meetings Law requirements. None specified. A. Mr. Robinson will forward the CEO work plan to Executive Committee. B. Mr. Robinson or Mr. Ragland will forward any work plan revisions/addendum to the Executive Committee. Committee will finalize the agenda at the January Executive Committee meeting. TIME FRAME: A. 1/20/2015 B. Mid-January 12/17/2014 N/A A. 12/17/2014 B. 1/10/2015 1/20/ ADJOURNMENT Page 2 of 2

67 Tuesday, January 20, 2015 EXECUTIVE COMMITTEE MEETING APPOINTED MEMBERS PRESENT: Cynthia Binanay, Christopher Bostock, George Corvin, MD, James Edgerton, William Stanford, Jr., Chair, Scott Taylor, Lascel Webley, Jr. (via phone) BOARD MEMBERS: None GUEST(S): None STAFF PRESENT: Amanda Graham, Chief of Staff; Carol Hammett, General Counsel; Veronica Ingram, Executive Assistant; Monica Portugal, Chief Compliance Officer; Rob Robinson, CEO; Jennifer Ternay, Interim CFO 1. WELCOME AND INTRODUCTIONS 2. REVIEW OF THE MINUTES The minutes from the December 16, 2014, Executive Committee meeting were reviewed. A motion was made by Mr. Bostock and seconded by Mr. Edgerton to approve the minutes. Motion passed unanimously. AGENDA ITEMS: DISCUSSION: NEXT STEPS: 3. Compliance Department: Records Retention 4. Update: Possible Reception before February 5, 2015, Meeting Ms. Portugal mentioned that the Board adopted a records retention schedule and according to this schedule the Compliance Department is required to notify the Board when destroying records. She stated that the Compliance department has notified the Department of Cultural Resources and now needs to inform the Board. Committee discussed topic and requested a written report with timeframes and a motion to request that the Board accept the report. Chairman Stanford provided an update from the previous meeting. He noted that the number of potential additional attendees from past/current Wake Boards could not be accommodated at Alliance s Wake site. He noted the specific focus for this Board meeting did not lend itself to scheduling off-site (confidentiality issues with proposed closed sessions and the opportunity for Board members to meet staff at the Wake site). Based on these factors, he recommended to postpone the reception at this time. Committee decided to add this topic to the February Area Board agenda; Ms. Ingram will update the agenda and notify staff. None specified. TIME FRAME: 1/20/2015 N/A Draft minutes may be submitted with the monthly Board packet. Minutes will be approved by this Committee at a later date. Page 1 of 2

68 Tuesday, January 20, 2015 EXECUTIVE COMMITTEE MEETING AGENDA ITEMS: DISCUSSION: NEXT STEPS: 5. April 2, 2015, Board Meeting 6. February 5, 2015, Board Meeting Draft Agenda 7. Closed Session: CEO Evaluation Ad Hoc Committee Chairman Stanford noted that the April Board meeting is scheduled the day before a holiday. Committee discussed topic noting that this is the same week as Spring Break for some local school systems and is scheduled at Alliance s Johnston location. Committee discussed topic noting the following: Keeping the meeting date as scheduled Potential reception for Johnston County officials Committee reviewed the draft agenda and discussed topic in detail. Committee noted including proposed dates for the Budget retreat with the Board packet. Committee reviewed topics and estimated time for the meeting. Committee decided to remove one scheduled training. A Motion was made by Mr. Taylor to enter into closed session pursuant to per (a) (6) to consider the qualifications, competence, performance, character, fitness, conditions of appointment, or conditions of initial employment of an individual public officer or employee; seconded by Dr. Corvin. Motion passed unanimously. Mr. Robinson will provide an update at the next Executive Committee meeting regarding a potential reception at the Johnston site in April. A. Ms. Ingram will include potential dates for the Budget Retreat with the Board packet. B. Ms. Ingram will revise the February Area Board agenda as requested by the Committee and inform staff. Ms. Ingram will send an to Committee members noting the special meeting on February 26, Also, she will ensure that this meeting is advertised according to Open Meetings Law requirements. TIME FRAME: 2/17/2015 A. 1/29/2015 B. 1/20/2015 1/23/2015 The Committee returned to open session and noted that no action was taken during closed session. 8. ADJOURNMENT Draft minutes may be submitted with the monthly Board packet. Minutes will be approved by this Committee at a later date. Page 2 of 2

69 Alliance Behavioral Healthcare BOARD OF DIRECTORS Agenda Action Form 7C ITEM: Human Rights Committee Report DATE OF BOARD MEETING: February 5, 2015 BACKGROUND: The Human Rights Committee shall include consumers and family members representing mental health, developmental disabilities and substance abuse. The Human Rights Committee functions include: 1) Reviewing and evaluating the Area Authority s Client Rights policies at least annually and recommending needed revisions to the Area Board. 2) Overseeing the protection of client rights and identifying and reporting to the Area Board issues which negatively impact the rights of persons serviced. 3) Reporting to the full Area Board at least quarterly. The Human Rights Committee shall meet at least quarterly. The Human Rights Committee is required by statute and by your by-laws. The Committee meets at least quarterly and reports to you by presenting the minutes of the meetings as well as through Quality Management Reports reviewing grievances and incidents. The Human Rights Committee is a Board Committee with at least 50% of its membership being either consumers or family members that are not Board Members. All members and the chair are appointed by the Chair of the Alliance Board of Directors. The Committee is currently chaired by Mr. Scott Taylor. Draft minutes for November 25, 2014, meeting are attached with reports on grievances, incidents, and grievances against Alliance also included. REQUEST FOR AREA BOARD ACTION: Accept the report. CEO RECOMMENDATION: Accept the report. RESOURCE PERSON(S): Scott Taylor, Committee Chair; Doug Wright, Director of Consumer Affairs; May Alexander, QM Data Manager

70 Tuesday, November 25, 2014 HUMAN RIGHTS COMMITTEE MEMBERS PRESENT: Scott Taylor, Marie Dodson, Cynthia Binanay, Bill Stanford, Dan Shaw, Amelia Thorpe, Michael Teague (Telephone) GUEST(S) PRESENT: Doug Wright, Jamie Rizza 1. WELCOME AND INTRODUCTIONS 2. REVIEW OF THE MINUTES Motion to approve minutes dated Sept. 23, 2014 made by Cynthia Binanay, seconded by Marie Dodson, approved unanimously. AGENDA ITEMS: DISCUSSION: NEXT STEPS: TIME FRAME: New Member Marie Dodson Grievances and Incidents Jamie Rizza Marie was introduced and welcomed by the committee. Marie is a representative from Johnston County. Jamie Rizza was introduced as a member of our Quality Management Team filling in for May Alexander who is out on maternity leave. Jamie presented three reports, the first being on Level 3 Incidents. A request was made to look at trends compared to the previous year. A discussion was had around where reports go, whether it was DSS, DHSR or who and if and how Alliance got word of disposition. Concerns were raised about what if providers were found negligent and what happens next. A discussion was initiated about how our Compliance Department is informed and how they disseminate that information to staff. A request was made to Doug to have the Compliance department report to the committee on actions taken against provider agencies. The next report was on Complaints Against Alliance with the largest number being 5 and being related to the Relative as Provider Process. Doug explained that since this is not an appealable process that relatives are encouraged to file a grievance, then appeal that resolution if they are still not satisfied. A request was made for the percentage of RAP requests approved. Jamie reviewed specifics around the other grievances. N/A Jamie will trend Level 3 Incidents against last year and report back to the committee. Doug will request from the Compliance Department a report detailing actions against providers. Doug to get information on approval rate of Relative as Providers. Jan. 27 th, 2014 Jan. 27 th, 2014 Jan. 27 th, 2014 Page 1 of 2

71 Tuesday, November 25, 2014 HUMAN RIGHTS COMMITTEE AGENDA ITEMS: DISCUSSION: NEXT STEPS: TIME FRAME: The next report was on Rights and Confidentiality Grievances. There was 8 concerns noted for the three Committee Procedure Next Year Calendar Next Meeting Committee Training starting at slide 39 month period with Jamie giving specifics on each instance, no committee concerns were raised. The request was made that we get a sampling of provider Clients Rights Committee minutes for review and oversight. Alliance Board Policy Committee per Monica Portugal The Policy Committee discussed this issue, Doug will get with Monica to find out next steps. Meetings and Departmental Presentations The committee reviewed the potential meeting topics for the 2015 calendar year and the significance of each department in ensuring Human Rights. They agreed this would be a good schedule to use as a guide, adding to the November meeting a System Overview. January 27 th Doug training MHFA Youth in Cumberland County, day of the week concern The January meeting will be held at scheduled date, Doug will ensure the meeting is staffed appropriately. The committee decided to take a look at other potential days of the month and week for their meeting and ask Doug to send out a doodle poll. The time of day will stay the same. Doug finished the annual training for committee members. Doug will talk to May upon her return in January and see about getting a sample of provider Clients Rights Committee minutes. Doug to talk with Monica and report back to committee. Doug to get with Department heads to ensure effective reporting to the Human Rights Committee during the 2015 calendar year. Prepare for January meeting. Send out a doodle poll. Next year s annual training. Jan. 27 th, 2014 Jan.27 th, Jan. 27 th, 2014 Dec. 12 th, 2014 September, ADJOURNMENT Page 2 of 2

72 FY2015 Summary: 8 concerns regarding Clients Rights or HIPAA/Confidentiality in FY15 4 were Clients Rights, 4 were HIPAA/Confidentiality 1 of 8 was initiated by an Alliance employee All providers mentioned were different Rights & Confidentiality Concerns Month: Clients Rights HIPAA/Confidentiality July 1 2 August 3 1 September 0 1 October November December January February March April May June 5 Breakdown of Clients Rights & HIPAA/Confidentiality Concerns - FY July August September October November December Clients Rights HIPAA/Confidentiality

73 Incident Compliance for Level 3s - FY15 Yes No October Appropriately Categorized 11 0 Notified Proper Agency 11 0 Reported Within Timeline 8 3 Effective Intervention and Protection 11 0 Report Accurate and Complete 11 0 Yes No September Appropriately Categorized 10 0 Notified Proper Agency 10 0 Reported Within Timeline 8 2 Effective Intervention and Protection 10 0 Report Accurate and Complete 10 0 Yes No August Appropriately Categorized 13 1 Notified Proper Agency 14 0 Reported Within Timeline 11 3 Effective Intervention and Protection 14 0 Report Accurate and Complete 13 1 Yes No July Appropriately Categorized 12 1 Notified Proper Agency 13 0 Reported Within Timeline 13 0 Effective Intervention and Protection 13 0 Report Accurate and Complete 12 1 October September August July Report Accurate and Complete Effective Intervention and Protection Reported Within Timeline Notified Proper Agency Appropriately Categorized Report Accurate and Complete Effective Intervention and Protection Reported Within Timeline Notified Proper Agency Appropriately Categorized Report Accurate and Complete Effective Intervention and Protection Reported Within Timeline Notified Proper Agency Appropriately Categorized Report Accurate and Complete Effective Intervention and Protection Reported Within Timeline Notified Proper Agency Appropriately Categorized Level 3 Incident Compliance by Month - FY Yes No Categories Receiving "No"s by Month July August September October Appropriately Categorized Notified Proper Agency Reported Within Timeline Effective Intervention and Protection Report Accurate and Complete Non-Compliance by Category by Month - FY15 Report Accurate and Complete 1 1 Effective Intervention and Protection Reported Within Timeline Notified Proper Agency Appropriately Categorized July August September October Combined Compliance for Level 3s - FY15 Yes No % No Appropriately Categorized % Notified Proper Agency % Reported Within Timeline % Effective Intervention and Protection % Report Accurate and Complete % Combined Compliance for Level 3s - FY15 4%, 2 20%, 8 4%, Appropriately Categorized Notified Proper Agency Reported Within Timeline Effective Intervention Report Accurate and and Protection Complete Yes No

74 Summary of Concerns Against Alliance 21 complaints against Alliance in FY regarding Access to Services, 2 Authorization/Payment/Billing, 1 Clients Rights, 12 LME/MCO Functions, 2 Quality of Services, 1 Other 5 different sources (Consumer, Consumer Advocate, Parent/Guardian, Family Member, and Provider) submitted complaints. 8 of 21 were External Stakeholder concerns; 13 were Grievances Month # of Concerns July 6 August 10 September 5 October November December Number of Concerns Against Alliance by Month July August September October November December # of Concerns Nature of Issue July August September October November December Access to Svcs Authorization/ Payment/Billing Clients Rights LME/MCO Function Other Quality of Services 2 0 0

75 # of Concerns Against Alliance - Nature of Issue July August September October November December Access to Svcs Clients Rights Other Authorization/ Payment/Billing LME/MCO Function Quality of Services

76 7D Alliance Behavioral Healthcare BOARD OF DIRECTORS Agenda Action Form ITEM: Quality Management Committee Report DATE OF BOARD MEETING: February 5, 2015 BACKGROUND: The Global QMC the standing committee that is granted authority for Quality Management by the MCO. The Global QMC reports to the MCO Board of Directors which derives from General Statute 122C-117. The Quality Management Committee serves as the Board s Monitoring and Evaluation Committee charged with the review of statistical data and provider monitoring reports. The goal of the committee is to ensure quality and effectiveness of services and to identify and address opportunities to improve LME/MCO operations and local service system with input from consumers, providers, family members, and other stakeholders. The Alliance Board of Directors Chairperson appoints the committee consisting of five voting members whereof three are Board members and two are members of the Consumer and Family Advisory Committee (CFAC). Other non-voting members include at least one MCO employee and one provider representative. The MCO employees typically assigned are the Director of the Quality Management (QM) Department who has the responsibility for overall operation of the Quality Management Program; the MCO Medical Director, who has ultimate responsibility of oversight of quality management; the Quality Review Manager, who staffs the committee; the Quality Management Data Manager; and other staff as designated. In FY 15, members of the committee are: George Corvin, MD, Committee Chair (Area Board Member); Lascel Webley, Jr. (Area Board Member); Joe Kilsheimer (CFAC-Durham member), Sharon O Brian (CFAC member); Phil Golden (Area Board Member); and Ann Akland (Area Board Member). The positions of provider representatives (2) were vacant in October, but will be filled by the February 2015 meeting. The Global QMC meets at least quarterly each fiscal year and provides ongoing reporting to the Alliance Board. The Global QMC approves the MCO s annual Quality Improvement Projects, monitors progress in meeting Quality Improvement goals, and provides guidance to staff on QM priorities and projects. Further, the Committee evaluates the effectiveness of the QM Program and reviews and updates the QM Plan annually. The final minutes and materials from the October meeting are attached. At the meeting, the committee received an update on action items from the Area Board Survey. The committee also learned of the resignations of the two provider representatives, which led to a discussion about the selection process for new representatives. The committee reviewed presentations on training provided by Alliance s Training Department and technical assistance provided by the Network

77 Development unit. Both reports incorporated feedback from last year and satisfy the requirement in the DMH contract to report to the quality management committee. Finally, the committee received a presentation on the progress of the Quality Improvement Projects. In addition to the October minutes, the Board is receiving DRAFT minutes from the December meeting, which have not been approved by the committee. In December, the committees reviewed information from applications for provider representative and recommended two candidates, one from an agency focusing on MH/SA services and another focusing on I/DD services. Recommendations will be forwarded to Board Chair for consideration. Updates on action items from the 2013 Perception of Care surveys, the EQR visit, and the Mercer action plan were provided. The committee reviewed two data reports results from the Provider Survey and an update on Quality Improvement Projects. The Provider Survey indicated positive results for Alliance. Providers rated Alliance the highest in overall satisfaction. QM will focus on the need for QM training identified in the survey. The QIP presentation indicated positive progress on all projects. Baseline data has been collected and interventions identified for most of the projects. REQUEST FOR AREA BOARD ACTION: Accept the report. CEO RECOMMENDATION: Accept the report. RESOURCE PERSON(S): George Corvin, MD, Committee Chair; Geyer Longenecker, Director of Analytics and Quality Management

78 Wednesday, October 01, 2014 GLOBAL QUALITY MANAGEMENT COMMITTEE VOTING MEMBERS PRESENT: George Corvin, MD, Chair (Area Board); Lascel Webley, Jr., MBA, MHA (Area Board); Phillip Golden (Area Board); Bill Stanford, JD (Area Board); Ann Akland, BS (Area Board); Sharon O Brian (CFAC); Joe Kilsheimer, MBA (CFAC) NON-VOTING MEMBERS PRESENT: Amy Neufeld, MSW, QP (Provider); Lakisha Perry-Green, MBA, MHRM (Provider) STAFF PRESENT: Khalil Tanas, MD, Medical Director; Geyer Longenecker, JD, Quality Management Director; Tina Howard, MA, Quality Review Manager; May Alexander, MS, LMFT, Quality Management Data Manager; Doug Wright, Director of Consumer Affairs; Sandra Ellis, Administrative Assistant GUEST(S) PRESENT: Carla Alston-Daye, Alliance Training Manager WELCOME AND INTRODUCTIONS: George Corvin, Committee Chair, welcomed the committee, introduced Carla Alston-Daye, and determined that a quorum was present. REVIEW OF THE MINUTES September 4, 2014 Minutes were read and approved. AGENDA ITEMS: DISCUSSION: NEXT STEPS: TIME FRAME: OLD BUSINESS: NEW BUSINESS: (Geyer) Board Survey The committee discussed the Area Board Survey presented at the Board s September 4 meeting. The survey found that the Board wanted reporting on Alliance s operations and performance; and additional information from consumer and provider groups. Dr. Corvin recommended the following goals: (1) 100% board participation in the 2015 survey; (2) placing appropriate reports on the Board s server to allow Board member ready access; and (3) developing a Christmas tree report that also would be placed on the Board s server site. Provider Representatives to Committee Tina reported that both of the Provider Representatives have resigned due to leaving their companies for other jobs. An application for new Provider Representatives has been posted, Geyer will provide the committee with a catalog of existing Alliance reports for review and possible placement on the Board server Geyer will provide the committee with updates from CFAC, APAC and the Alliance Strategic Planning process. Tina will ask the Compliance Department to review the current applicants. December 2014 meeting December 2014 meeting Page 1 of 4

79 Wednesday, October 01, 2014 GLOBAL QUALITY MANAGEMENT COMMITTEE AGENDA ITEMS: DISCUSSION: NEXT STEPS: TIME FRAME: and six candidates have applied to date. The deadline for applications is October 15. The committee recommended that applicants be prescreened with the Compliance Department. The applicants then will be presented to this Committee for recommendations, then forwarded to the Board, and Board Chairman Bill Stanford will recommend applicants for selection. The GMC will confirm the selections at its December meeting, and the new provider representatives will join the committee at its February meeting. DATA REVIEW: The committee recommended that at least one Provider Representative be from the I/DD community. Training Report (Carla Alston-Daye) Carla submitted and reviewed a report on training conducted by Alliance from December 2013 to September Dr. Tanas noted that recently completed psychiatric training was not included in the list. Carla explained that department-based training records were collected on a quarterly basis. Technical Assistance Reports (Tina) Tina reviewed the Technical Assistance Reports, consisting of a report from MH/SA Network Development Specialists and one report from the I/DD Specialists. Of note in both reports is the increase in technical assistance provided in the early part of the year (January/February) and latter part of the fiscal year (May/June). The spike in assistance in January/February is because Specialists conduct on-site Scope of Work reviews and the increase at the end of the fiscal year is due to assistance related to finalizing the Scope of Work in the next year s contract. Page 2 of 4

80 Wednesday, October 01, 2014 GLOBAL QUALITY MANAGEMENT COMMITTEE AGENDA ITEMS: DISCUSSION: NEXT STEPS: TIME FRAME: Update on FY15 QIPs (Tina) Reduce ED Visits: Tina noted that the goal of the QIP has been modified to reduce the rate of ED visits instead of reducing the number of visits. This better accounts for uncontrollable issues such as population growth. Mystery Shopper: The committee noted that the QIP report should calculate performance measures in terms of percent of calls instead of staff. First Responder: Only 25% of agencies called in August test responded within 1 hour. Tina reported that providers called as part of the QIP are now receiving letters detailing their performance. Dr. Tanas noted that the QIP results also are being shared with the Credentialing Committee as it reviews applications for re-credentialing. Inter-Rater Reliability: Tina reported that 89% of MHSA and IDD staff were in agreement in the most recent IRR examination, surpassing the best-practice rate of 80% and Alliance s standard of 85%. Tina noted that the QIP team has improved the examination process to make it consistent with the actual clinical review process. Intensive In-Home: Tina reported that there was no progress with the QIP. Care Coordination: Committee members asked if ISPs are reviewed prior to submission. Tina reported that as part of the QIP, QM is reviewing ISPs after submission by care coordination staff. She added that the quality of ISPs is improving. Tina will update the Mystery Shopper QIP document to calculate performance measures in terms of percent of calls. Page 3 of 4

81 Wednesday, October 01, 2014 GLOBAL QUALITY MANAGEMENT COMMITTEE AGENDA ITEMS: DISCUSSION: NEXT STEPS: TIME FRAME: Access to Care: Tina reported that QM staff is currently is improving Alliance s calculation of the state report on Access to Care in order to baseline the QIP. Geyer reported that Access to Care recently has been the focus of the state, which is interviewing LME-MCOs about their data collection and reporting processes. High-Cost/High-Risk Consumers (Tina) Tina reviewed the requirements in the DMHDDSAS contract for a High-Cost/High-Risk Consumers report. She noted that QM staff currently is evaluating the use of CCNC and medical data in order to create an accurate report. Data will be presented at a future meeting. UPCOMING MEETINGS: (Dates are final; items are tentative) November 2014 Cancel due to EQR visit (November 5-7) December 4, 2014 Update of FY 15 QIPs, Q1 of FY 15 Operational Dashboard (grievances, incidents, service utilization, other items), report on crisis services January 1, 2015 Cancel due to Holiday. Happy New Year! February 5, 2015 TBD March 5, 2015 Update of FY 15 QIPs, Q1 of FY 15 Operational Dashboard (grievances, incidents, service utilization, other items) April 2015 Cancel (Spring recess) May 7, 2015 FY 16 QIP proposals June 4, 2015 QM Plan, Evaluation of Quality Management Department, final reports of FY 15 QIPs NEXT MEETING: December 4, :00-3:30 p.m. CR 252 ADJOURNMENT Page 4 of 4

82 PROVIDER NETWORK DEVELOPMENT- TA AND SUPPORT MH/SA AND I/DD-Tammy Ramirez, Sara Wilson 10/13 11/13 12/13 1/14 2/14 3/14 4/14 5/14 6/14 7/14 8/14 9/14 # of on site visits to Providers/Agencies for Technical Support/Assistance (Including scope of work reviews, assistance related to service delivery, other internal processes, etc.) # of Technical Support/Assistance provided to staff related to provider concerns (Including out of network requests, assistance of care coordinators, etc) # of provider centered meetings attended (as member, guest or chaired/co-chaired) # of trainings delivered to providers/agencies related to service delivery, or changes in provider expectations (including provider specific trainings that may been delivered by request of provider) (ex: Block grant training)

83 PROVIDER NETWORK DEVELOPMENT- TA AND SUPPORT MH/SA Kimberly Hayes & 2 former PND staff 10/13 11/13 12/13 1/14 2/14 3/14 4/14 5/14 6/14 7/14 8/14 9/14 # of on site visits to 2 7` Providers/Agencies for Technical Support/Assistance (Including scope of work reviews, assistance related to service delivery, other internal processes, etc.) # of Technical Support/Assistance provided to staff related to provider concerns (Including out of network requests, assistance of care coordinators, etc) # of provider centered meetings attended (as member, guest or chaired/co-chaired) # of trainings delivered to providers/agencies related to service delivery, or changes in provider expectations (including provider specific trainings that may been delivered by request of provider) (ex: Block grant training) in attendance 1 15 in attendance in attendance 0

84 FY 15 Quality Improvement Projects & follow up on previous projects Presentation to Global Quality Management Committee October 2014 Serving Durham, Wake, Cumberland and Johnston Counties

85 FY 15 Quality Improvement Projects Reduce Admissions to Emergency Departments (EDs) in Wake and Cumberland Counties* Goals: o o Reduce rate of behavioral health admissions to EDs by 5% and significantly reduce # of admissions of individuals with Medicaid in Cumberland & Wake Significantly reduce # of hours WakeBrook CAS in Wake County is on diversion (doors closed) *Continuation from FY QIP Serving Durham, Wake, Cumberland and Johnston Counties

86 FY 15 Quality Improvement Projects Reduce Admissions to Emergency Departments (EDs) Interventions Wake & Cumberland: o Add Transitional Living beds as step down to crisis Cumberland: o Expand hours of crisis facility to 24/7 Wake: o o Create Rapid Response beds for youth as prevention/early intervention strategy Add Alcohol, Detox unit at WakeBrook Serving Durham, Wake, Cumberland and Johnston Counties

87 FY 15 Quality Improvement Projects Reduce Admissions to Emergency Departments (EDs) Status: o o o o Transitional Living beds in Cumberland operating, two Wake County providers awarded contracts Efforts underway to expand hours of crisis facility in Cumberland County to 24/7 Rapid Response provider identified and contract being finalized WakeBrook in process of creating ADU unit Serving Durham, Wake, Cumberland and Johnston Counties

88 FY 15 Quality Improvement Projects Mystery Shopper* Mystery review of internal and external processes, ensure consumer health/safety Review of recorded calls to Access & Information Goals: o o o o 90% of staff let caller know that call may be monitored for QA 85% of staff follow greeting protocol 85% of staff fully assess callers seeking services 85% of staff are polite & helpful *Continuation from FY QIP Serving Durham, Wake, Cumberland and Johnston Counties

89 FY 15 Quality Improvement Projects Mystery Shopper Mystery review of internal and external processes, ensure consumer health/safety Review of recorded calls to Access & Information Interventions: o o o Immediate follow up with Director of Call Center, recommendations made Staff training and coaching Action plan created and tracked Serving Durham, Wake, Cumberland and Johnston Counties

90 FY 15 Quality Improvement Projects Mystery Shopper Review of UM calls Goals: o o 85% of calls follow greeting protocol 85% of staff are polite & helpful Interventions: o o Staff training and coaching Action plan created and tracked Serving Durham, Wake, Cumberland and Johnston Counties

91 FY 15 Quality Improvement Projects Mystery Shopper* Individual Plan Review (MH/SA plans) Goals: o o 75% of quality elements are met or partially met at least 55% of health and safety quality elements are met or partially met Interventions: o o Feedback letters sent to providers Training on person-centered elements of planning and crisis plan *Continuation from FY QIP Serving Durham, Wake, Cumberland and Johnston Counties

92 FY 15 Quality Improvement Projects First Responder* test crisis lines of providers Goals: 100% of calls answered within 30 seconds, 95% of providers return calls in 1 (follow up) hour, 100% of staff answering calls are QPs or who have access to QP Interventions: o o o Providers assigned to Tiers based on last FY s performance (some called more frequently, others less) Written feedback to providers after calls Refer to Compliance for providers who continue to score unsatisfactory *Continuation from FY QIP Serving Durham, Wake, Cumberland and Johnston Counties

93 FY 15 Quality Improvement Projects First Responder Results (Quarterly & Bi-Annual Tiers): August 2014 Year 2 Goals Met Goal % of Total Benchmark Benchmark Met? Calls answered within 30 seconds 37 (of 40) 93% 100% No Respond to voic within 1 hour 4 (of 16) 25% 95% No Staff identify as QPs or have access to QPs (Live answers) 19 (of 19) 100% 100% Yes Serving Durham, Wake, Cumberland and Johnston Counties

94 FY 15 Quality Improvement Projects Inter-Rater Reliability test consistency between UM Care Managers* Goal: 80% agreement Interventions: Training on procedures, group & individual supervision, beta-testing an online tool, changing how test is administered. Results: o MH/SA UM July % agreement (substantial agreement) o I/DD UM Participated in study in September 2014 *Continuation from FY QIP Serving Durham, Wake, Cumberland and Johnston Counties

95 FY 15 Quality Improvement Projects Intensive In-Home* Improve quality of IIH services Goals: Increase # of providers offering EBPs, reduce use of crisis services & law enforcement involvement, reduce suspensions/expulsions and mental health symptoms. Interventions: o o Provider meeting to gather feedback on barriers to offering EBPs RFP for high quality services *Continuation from FY QIP Serving Durham, Wake, Cumberland and Johnston Counties

96 FY 15 Quality Improvement Projects Intensive In-Home Results o o (Baseline) Provider Surveys (N=53): 85% reported using EBP, primarily CBT (72%) (Baseline) Sample of consumers (N=209)*: Avg age=12 o o o o 4% inpatient admits before, during, and after services Suspensions: 24% before, 20% after Juvenile Justice involvement: 9% (10) before, 8% (9) after including 4 consumers with new petition during services MH symptoms: 44% report no change after receiving services *NC TOPPs initial & comparable episode completion data submitted for only 55% (107) of consumers receiving services. Serving Durham, Wake, Cumberland and Johnston Counties

97 FY 15 Quality Improvement Projects Intensive In-Home o Project delayed due to RFP, continuing project in FY 15 o Re-Evaluation: Pull the same data for another sample of youth receiving services after new contracts implemented (Fall 2014), monitor fidelity of models used by providers Serving Durham, Wake, Cumberland and Johnston Counties

98 FY 15 Quality Improvement Projects Care Coordination Improve Care Coordination Services Goals: o MH/SA: Significantly increase community tenure, reduce recidivism to community hospitals, increase adherence to procedures o I/DD: Significantly reduce # of authorization requests denied/reduced, 85% of new Innovations waiver participants receive services within 45 days of ISP approval, reduce # of clinical consultations* *Continuation from FY QIP Serving Durham, Wake, Cumberland and Johnston Counties

99 FY 15 Quality Improvement Projects Care Coordination Interventions: o MH/SA: To be determined o I/DD: Training/coaching of Care Coordination staff Serving Durham, Wake, Cumberland and Johnston Counties

100 FY 15 Quality Improvement Projects Access to Care Improve initiation in services Goals: o Increase consumer initiation in services based on need: o Emergent: 97% o Urgent: 82% o Routine: 75% Serving Durham, Wake, Cumberland and Johnston Counties

101 FY 15 Quality Improvement Projects Access to Care Interventions: o Address technical issues of aggregating accurate data o Identify means to collect valid data sources for Emergent & Urgent appointments o Training of Call Center staff to address inconsistencies in data entry o Identify and create action plan to address gaps in services Serving Durham, Wake, Cumberland and Johnston Counties

102 Projects Closing Out Inter-Rater Reliability Test consistency of Call Center staff Status: Administer test in January 2015, goal is to maintain agreement (about 85%) Discharge Planning at Durham Center Access Improve discharge planning Status: Conducted chart review in Summer, finalizing results Substance Abuse Engagement (Durham) Improve engagement in SA services in Durham Status: Pulling another random sample after implementation of new SAIOP services, analyzing results Serving Durham, Wake, Cumberland and Johnston Counties

103 Training Report November September 2014 SR-AHEC Collaborative Trainings SR-AHEC offers continuing education to health care professionals in our region, keeping them up to date on new treatments and technology. Alliance Behavioral Healthcare has a contract with SR-AHEC Mental Health to offer continuing education credits for staff and providers. SR-AHEC conducts programs and activities which further enhance its response to local changes in the health workforce and its educational needs. Programs are directed toward mental health professionals including psychologists, social workers, case managers, therapists, substance abuse professionals, counselors, and other interested human services and health care professionals. Mental Health continuing education offers credit for the following types of mental health disciplines: NBCC, Category A and B psychology credit, contact hours for social work, and credit as approved by the NC Substance Abuse Professional Practices Board. Alliance Behavioral Healthcare held 14 training that offered CEU s for staff and providers with 593 attendees as of September Trainings Date Location Who # Attended Training Type ASAM Training 1/8/2014 Corporate AHEC 70 Clinical Disruptive Conduct Disorders 5/21/2014 Corporate AHEC 44 Clinical Ethic Training 4/29/2014 Corporate AHEC 57 Clinical Ethic Training 6/10/2014 Corporate AHEC 22 Clinical HIV Training 5/27/2014 Corporate AHEC 42 Clinical Teaching Case Conference 9/10/2014 Durham AHEC 16 Clinical DSM V 8/25/2014 Corporate AHEC 95 Clinical DSM V 10/2/2014 Corporate AHEC 71 Clinical MI Training-Refresher 9/18/2014 Corporate AHEC 19 Clinical MI Training-Refresher 9/17/2014 Corporate AHEC 15 Clinical MI Training -1 day 9/3/2014 Corporate AHEC 35 Clinical MI Training -1 day 9/4/2014 Corporate AHEC 35 Clinical Being and Becoming Trauma Informed 9/17/2014 Corporate AHEC 23 Clinical Cultural Competency Training 9/18/2014 Corporate AHEC 49 Clinical Internal Trainings The purpose of internal training is to create a motivated, skilled and effective workforce through which Alliance Behavioral Healthcare goals are achieved. We offer training to improve effectiveness and productivity. Everyone needs training to do their jobs well. Internal training begins with New Employee Orientation which includes several required trainings as follows Organizational Structure, Corporate Compliance, Confidentiality, Disaster Planning, Consumer Affairs, Drug Free Workplace, Non Harassment and Workplace Violence, and URAC Core) These induction training which are offered every other Monday with newly hired staff, enables them to learn more about Alliance Behavioral Healthcare and

104 how the work they do fits into the agencies strategies. Alliance Behavioral Healthcare conducted 28 staff trainings along with two reoccurring trainings New Employee Orientation and Paychex. Trainings Date Location Who # Attended Training Type CIT De-Escalation Training 9/23/2014 Corporate internal 15 Suggested CIT De-Escalation Training 9/23/2014 Corporate internal 15 Suggested CIT De-Escalation Training 9/26/2014 Corporate internal 14 Suggested CPR 6/24/2014 Corporate internal 7 Suggested CPR 6/27/2014 Corporate internal 10 Suggested CPR 7/11/2014 Corporate internal 7 Suggested CPR 7/9/2014 Corporate internal 8 Suggested CPR 7/16/2014 Cumberland internal 8 Suggested CPR 7/16/2014 Cumberland internal 11 Suggested Cultural Competency 12/4/2013 Wake internal 38 Suggested Cultural Competency 1/27/2014 Corporate internal 67 Suggested Cultural Competency Training 12/2/2013 Corporate internal 79 Suggested Due Process Training (UM) 4/24/2014 Corporate internal 1 Required Due Process Training (UM) 8/29/2014 Corporate internal 2 Required Due Process Training (UM) 1/10/2014 Corporate internal 3 Required IT Work Flow 6/1-30/2014 Corporate internal 5 Suggested Leadership Development 8/26/2014 Corporate internal 23 Suggested Leadership Development 8/27/2014 Corporate internal 25 Suggested Mental Health Disorders (UM) 8/25/2014 Corporate internal 23 Suggested NEO - Reoccurring Every Other 11/18/2013 to Corporate internal 90 Required Monday 9/29/2014 Paychex Training -Reoccurring Every 11/21/2013 to Corporate internal 90 Suggested Other Week 9/ Performance Management Paychex 9/25/2014 Corporate internal 15 Suggested Tool-All Staff Performance Management Paychex 9/29/2014 Cumberland internal 27 Suggested Tool-All Staff Pharmacology Update (UM) 7/23/2014 Corporate internal 37 Suggested Psychosocial Rehabilitation (PSR) (UM) 2/26/2014 Corporate internal 5 Suggested SharePoint Site Administrator's 3/28/2014 Corporate internal 7 Suggested Training SharePoint Site Administrator's 4/3/2014 Corporate internal 7 Suggested Training SharePoint Site Administrator's 4/8/2014 Corporate internal 2 Suggested Training SharePoint Training 6/17/2014 Corporate internal 2 Suggested UB04 Training-Claims 1/28/2014 Corporate internal Suggested

105 Provider Trainings Alliance Behavioral Healthcare is committed to continuously improving service quality to ensure that individual health and safety is protected and needs are met by offering trainings to our provider community. We offer reoccurring, quarterly, and best practice trainings to providers at little to no cost to the providers. Trainings Date Location Who # Attended Training Type How to get your Claims Paid - 12-Nov-13 to Corporate provider 50 Suggested Reoccurring Tuesday 9/9/2014 ICF Training (Lisa Sullivan) 11/13/2013 Corporate provider 11 Suggested ICF Training (Lisa Sullivan) 11/19/2013 Corporate provider 5 Suggested ICF Training (Lisa Sullivan) 11/26/2013 Corporate provider 8 Suggested ICF Training (Lisa Sullivan) 12/3/2013 Corporate provider 1 Suggested ICF Training (Lisa Sullivan) 12/10/2013 Corporate provider 1 Suggested Incident Reporting 8/19/2014 Corporate provider 20 Suggested Incident Reporting 11/21/2013 Corporate provider 45 Suggested Incident Reporting 2/6/2014 Corporate provider 25 Suggested Incident Reporting 8/21/2014 Corporate provider 54 Suggested IRIS Training 8/19/2014 Corporate provider 11 Suggested LOCUS/CALOCUS 4/17/2014 Corporate provider 26 Required PCP Training 4/1/2014 Corporate provider 58 Suggested PCP Training 6/19/2014 Cumberland provider 55 Suggested PCP Training 6/25/2014 Johnston provider 42 Suggested Target Population Training 7/21/2014 Corporate 4 provider 5 Suggested

106 Thursday, December 04, 2014 GLOBAL QUALITY MANAGEMENT COMMITTEE VOTING MEMBERS PRESENT: George Corvin, MD, Chair (Area Board); Lascel Webley, Jr., MBA, MHA (Area Board); Phillip Golden (Area Board); Ann Akland, BS (Area Board); Sharon O Brian (CFAC); Joe Kilsheimer, MBA (CFAC) NON-VOTING MEMBERS PRESENT: STAFF PRESENT: Khalil Tanas, MD, Medical Director; Geyer Longenecker, JD, Quality Management Director; Tina Howard, MA, Quality Review Manager; May Alexander, MS, LMFT, Quality Management Data Manager; Doug Wright, Director of Consumer Affairs; Sandra Ellis, Administrative Assistant/Scribe GUEST(S) PRESENT: WELCOME AND INTRODUCTIONS: George Corvin, Committee Chair, welcomed the committee and determined that a quorum was present. REVIEW OF THE MINUTES October 1, 2014 Minutes were approved. AGENDA ITEMS: DISCUSSION: NEXT STEPS: TIME FRAME: OLD BUSINESS: Update on Perception of Care Services Action Plan EQR Update (Tina) Tina reviewed the Perception of Care Update presentation from was the survey and action plan completed in December 2013 and also shared with this committee on December 19, Tina provided an overview of the findings and presented an update on items in the action plan, all of which are in progress or finished. Doug Wright told the committee that a one page brochure along with a welcome letter detailing how to obtain a handbook is sent to all new enrollees. A revised handbook is available on the Alliance website. It includes location of crisis facilities and client rights/responsibilities. EQRO Site Visit Summary Alliance Global QM Committee Update (Geyer) The EQRO Site Visit Summary listed highlights of findings from during the EQRO audit. Although the final report has not been received, it clearly indicated that, overall, Alliance is where we need to be. There were no red flags and some of the corrective Page 1 of 7

107 Thursday, December 04, 2014 GLOBAL QUALITY MANAGEMENT COMMITTEE AGENDA ITEMS: DISCUSSION: NEXT STEPS: TIME FRAME: action plans were expected. There was an emphasis on complete and consistent documentation. Nothing huge, just a few recommendations thus far. Moving forward to be certain we have overall consistency. Quality Management: There will be a plan of correction for two of the performance measures (due to changes by the state), compilation of one master plan with project owners created, expand upon URAC s QIP form, create a CQI Committee charter and add signature lines to QM Program Evaluation. Grievances: EQR recommended streamlining the process as the current grievances/complaints/concerns process is very confusing. Provider Networks: Prior to credentialing providers, EQR recommended an initial on-site review. Credentialing Committee is to create a Committee Charter. Clinical Management: A program description is needed for the UM Program. Appeals: Current peer-to-peer review process is not allowed under federal regulations, even though it is a URAC standard. Enrollee Rights/Customer Call Center: Need a comprehensive Community Education Plan, combining many of the elements we currently have in place into one document. Mercer Action Plan Update (Geyer) QM has completed all tasks recommended by Mercer. Page 2 of 7

108 Thursday, December 04, 2014 GLOBAL QUALITY MANAGEMENT COMMITTEE AGENDA ITEMS: DISCUSSION: NEXT STEPS: TIME FRAME: NEW BUSINESS: DATA REVIEW: Provider Representatives to Committee (Dr. Corvin) Possibly bring two new board members on now; if others are needed, the option is open to add more. If possible, would like two representatives from Provider agencies. Provider representatives would remain as non-voting members. Each voting member was asked to vote on the two choices put forth today. The committee agreed with Dr. Corvin. In turn, Dr. Corvin will share this information with Bill Stanford but make recommendations of the two targeted DHHS Provider Survey (Geyer) The annual survey of providers is now entirely administered by the State; however, Alliance did provide data input. Out of 1,632 responding providers, 171 were Alliance providers. In areas of activity, Alliance had a good showing. Scored ok in areas of Access and felt staff is accessible. The numbers reflected in green indicate Alliance has the top rating; well above state averages. Stakeholder areas scored right below the state average pinpointing this as an area for possible improvement. Training outscored state averages; compliance was low. Overall Alliance scored very well. Alliance received the highest positive percent on overall satisfaction. Additional education and training were identified as a need by a substantial percent of respondents in Alliance s catchment area. QM plans to conduct a short survey to better understand specific QM training needs. Update on FY 15 Quality Improvement Projects (Tina) Tina to send resumes and applications of two recommended to Voting members for review. If voting members have concerns about the two recommended, they should share concerns with Dr. Corvin by week s end. 12/4/14 Page 3 of 7

109 Thursday, December 04, 2014 GLOBAL QUALITY MANAGEMENT COMMITTEE AGENDA ITEMS: DISCUSSION: NEXT STEPS: TIME FRAME: Reduce Admissions to Emergency Departments (EDs) in Wake and Cumberland Counties: Indicators: Admissions in Cumberland County increased 9% but decreased 6% in Wake County, closures of Crisis & Assessment continue to increase. Update on interventions: Transitional beds in Cumberland operating, delay in Wake; contract for Rapid Response beds in Wake also delayed; Roxie Center (crisis facility in Cumberland) operating 24/7 for CIT drop off (as of 12/1); ADU unit at Wake facility opened in September to expand capacity for detox, thus opening chairs at Crisis & Assessment. Committee asked about exact numbers and locations of ED Liaisons. Tina was unable to answer question, but would follow up. Mystery Shopper: Project involves several initiatives review recorded calls to the Access & Information Center and review recorded calls to UM staff. Initial review of Access calls and interventions (training, supervision) completed. Postintervention review expected in January. Initial review of UM calls underway. Review tool includes URAC standards about greeting, polite customer service, and due process requirements. Interventions expected to take place early next year. First Responder: Project involves tests of crisis lines of providers Frequency of provider calls based on last year s performance. Initial results indicate that those that performed better (called less frequently) continue to do better than those called more frequently. Second quarter calls were made and are being analyzed. Tina updated presentation and answers to committee questions 12/5/14 Page 4 of 7

110 Thursday, December 04, 2014 GLOBAL QUALITY MANAGEMENT COMMITTEE AGENDA ITEMS: DISCUSSION: NEXT STEPS: TIME FRAME: Inter-Rater Reliability: First study for MH/SA and I/DD Care year indicated 89% agreement, above 85% goal. Next study planned for December/January. Intensive In-home: No new data to report due to lag time in pulling post-intervention claims data. Care Coordination: MH/SA Goals are to increase community tenure, reduce recidivism to community hospitals and increase adherence to procedures. Initially, baseline data analyzed for consumers in hi-level intensity team decided to focus on consumers in mid-level intensity because they consist of larger population and interventions may have more impact. I/DD Focusing on umber of authorization requests denied/reduced and consumers receiving services within 45 days of ISP approval. Goal almost met (63%) for timeliness of care without intervention, conducting root cause analysis of those cases outside standard; analysis of baseline data on denials/reductions showed lack of justification as primary reason-interventions being discussed. Access to Care: Goal is to increase consumer initiation in services. Initial interventions needed to focus on internal data integrity issues, first. Addressed technical issues of aggregating accurate data, identified more accurate methods of collection valid data sources for Emergent & Urgent appointments, training call center staff to address inconsistencies in data entry. Once data integrity issues are addressed, next steps include identify and create action plan to address provider issues that may be causing delays. The State may be changing how the data is captured, which would impact this QIP. Operational Dashboard (Geyer) Page 5 of 7

111 Thursday, December 04, 2014 GLOBAL QUALITY MANAGEMENT COMMITTEE AGENDA ITEMS: DISCUSSION: NEXT STEPS: TIME FRAME: The Performance measure Dashboard Q1 FY 2015 includes our performance on standardized measures and are submitted on a routine basis to the State. This data will be brought to the Global QMC on a quarterly basis. Quarterly DMH Report: This report, like the DMA report, includes standard measures used by all MCOs across the state. The state has changed the parameters of these indicators. Alliance will be sending out reports under new standards this month. We continue to develop dashboards/capabilities. Geyer to send updates to the board; identify elements for this report As updated UPCOMING MEETINGS: NEXT MEETING: ADJOURNMENT QI Activity: Quarterly Newsletter: This is new; will begin generating over the next few month. This internal document will help the organization understand what we are doing to improve quality. This will be published on a routine basis and used as a marketing tool to solicit requests from other departments. (Dates are final; items are tentative) January 1, 2015 Cancel due to holiday. HAPPY NEW YEAR! February 5, 2015 Report on Crisis/ED Services (Location Wake Site) March 5, 2015 Update on FY 15 QIPs, Operational Dashboard (Location: Corporate) April 2015 Cancel (Spring recess) May 7, 2015 FY 16 QIP proposals (Location: Corporate) June 4, 2015 Quality Management Plan, Evaluation of Quality Management Department, final reports of FY 15 QIPs (Location: Corporate) April 2015 Cancel (Spring recess) May 7, 2015 FY 16 QIP proposals June 4, 2015 QM Plan, Evaluation of Quality Management Department, final reports of FY 15 QIPs February 5, 2015 Wake Site at 3:30pm Page 6 of 7

112 Thursday, December 04, 2014 GLOBAL QUALITY MANAGEMENT COMMITTEE AGENDA ITEMS: DISCUSSION: NEXT STEPS: TIME FRAME: Page 7 of 7

113 Alliance Behavioral Healthcare BOARD OF DIRECTORS Agenda Action Form 8 ITEM: Board Discussion with Dave Richard, DHHS Deputy Secretary of Behavioral Health and Developmental Disabilities Services DATE OF BOARD MEETING: February 5, 2015 BACKGROUND: Dave Richard, Deputy Secretary for the NC Department of Health Human Services, will be in attendance to provide an overview of mental health, intellectual/developmental disability and substance abuse services activities at the State level and answer any questions the Board may have. REQUEST FOR AREA BOARD ACTION: Receive the report. CEO RECOMMENDATION: Receive the report. RESOURCE PERSON(S): Robert Robinson, CEO

114 Alliance Behavioral Healthcare BOARD OF DIRECTORS Agenda Action Form 9 ITEM: Records Retention Notification DATE OF BOARD MEETING: February 5, 2015 BACKGROUND: Alliance Behavioral Healthcare adopted APSM 10-6 Records Retention and Disposition Manual on February 7, The manual is developed and updated by the Department of Cultural Resources (DCR). The manual provides the proper and legal foundation for the disposal of public records through destruction. This is also Cultural Resources way of giving Alliance permission to destroy the records that have met retention. Recently, as approved by DCR, Alliance has destroyed provider records, contracts, fiscal, volunteer records, and medical records (non-public) that have met retention and/or that have not met retention but that have been electronically scanned and audited for quality assurance purposes. The Alliance adopted Records Retention and Disposition Manual requires a notification to the Area Board when records have been destroyed. REQUEST FOR AREA BOARD ACTION: Accept the report. CEO RECOMMENDATION: Accept the report. RESOURCE PERSON(S): Monica Portugal, Chief Compliance Officer

115 Records Retention and Destruction Alliance Behavioral Healthcare adopted APSM 10-6 Records Retention and Disposition Manual on February 7, The manual is developed and updated by the Department of Cultural Resources (DCR). The approved manual provides the proper and legal foundation for the disposition of public records through destruction. This is also Cultural Resources way of giving Alliance permission to destroy the records that have met retention. All records, paper and electronic, that are created by Alliance Behavioral Healthcare are subject to the manual. There are other retention schedules that must be followed and Alliance follows the most stringent rule. For paper records that have been scanned, Alliance is required to develop a procedure that includes various factors about the electronic system. This procedure was approved by DCR. This same process must occur for any records that are scanned and stored in different electronic systems. Records that have met the scheduled retention can be destroyed using one of four approved methods, including: Shredded or torn as to destroy the record content Burning Placing in acid vats to reduce to pulp Sell as waste paper with an agreement that the documents will not be resold without pulverizing or shredding the documents. Records That Have Not Been Scanned Records are reviewed on a periodic basis to determine the destruction date. Records can be paper, electronic or on microfilm. If the record has met the retention period, each record or series of records are logged and then destroyed. Scanned Records For records that have been scanned, a random quality assurance review is performed. This process includes comparing the scanned version against the original. Once a determination has been made that the scanned version is the same as the original, the Request for Disposal of Original Records Duplicated by Electronic Means form is completed and mailed to DCR. Once approval is received from DCR, the records can be destroyed. If the records have already met their retention period, approval is not required from DCR. Number of Paper Records Destroyed Cumberland: Number of records destroyed - 23,452. Number of boxes of information destroyed 326. Dates range from 1979 through Types of records destroyed- medical records, provider records, contracts. The Durham Center- Number of records destroyed 1,461. Number of boxes of information destroyed 41. Dates range from 1991 through Types of records destroyed - contracts, fiscal (account receivable, payable), medical records, volunteer records. Other- Number of Boxes Destroyed that have been scanned but have not met the retention period 113. Types of records scanned - contracts, account payable, accounts receivable, and contract agency records. Method of Destruction Records were destroyed by shredding, performed by the contracted shredding company. The contracted shredding company provides Certificates of Destruction.

116 Alliance Behavioral Healthcare BOARD OF DIRECTORS Agenda Action Form 10 ITEM: Recommendation for Reappointment to Alliance Area Board DATE OF BOARD MEETING: February 5, 2015 BACKGROUND: In accordance with NC General Statute 122C d and the By-Laws of the Alliance Board the initial terms of Alliance original Board members were staggered with each initial term being considered a full term. Accordingly the terms of some original members were designated to end after one year, others after two, and others after three. NC Senate Bill 191 revised G.S. 122C d to allow members to be reappointed for two additional three-year terms. The terms of Board members Ann Akland, Phillip Golden, George Quick, and William Stanford, Jr., are set to expire on March 31, REQUEST FOR AREA BOARD ACTION: The Board is requested to recommend to the Wake Board of County Commissioners the reappointment of Ann Akland and William Stanford, Jr., and to the Durham Board of County Commissioners the reappointment of Phillip Golden and George Quick, each for an additional three-year term. CEO RECOMMENDATION: Recommend to the Wake Board of County Commissioners the reappointment of Ann Akland and William Stanford, Jr., and to the Durham Board of County Commissioners the reappointment of Phillip Golden and George Quick. RESOURCE PERSON(S): William Stanford, Area Board Chairman; Robert Robinson, CEO

117 Alliance Behavioral Healthcare BOARD OF DIRECTORS Agenda Action Form 11 ITEM: Overview of Crisis Services DATE OF BOARD MEETING: February 5, 2015 BACKGROUND: Alliance is required per its contract with North Carolina DHHS to develop a crisis response system within our catchment area. Being able to offer a comprehensive continuum of crisis services is critical to our success as a MCO. Within our four county region, crisis services are available however the completeness of the system varies. Several initiatives to expand services have been recently completed or are underway. A crisis plan has been developed for all four communities and is routinely reviewed and updated as needed. James Osborn will provide a fifteen minute presentation. The presentation will describe the crisis continuum across the four county region. Crisis services data will be provided describing numbers served, admissions, readmissions, emergency department admissions, and program performance outcome measures. The presentation will address the local crisis plans, and address the initiatives implemented. REQUEST FOR AREA BOARD ACTION: Accept the training. CEO RECOMMENDATION: Accept the training. RESOURCE PERSON(S): James Osborn, LPA, LCAS, Crisis and Incarceration Manager

118 Overview of Crisis Services Presentation to Alliance Board February 5, 2015

119 National Core Crisis Services 23 hour crisis stabilization/observation chairs Short term crisis residential services and crisis stabilization Mobile crisis services 24/7 crisis lines

120 National Core Crisis Services Warm lines Psychiatric advance directives Peer crisis services SAMHSA, 2014

121 Strengths in the Crisis Continuum Crisis Intervention Teams in each community Crisis Collaboratives in Durham, Wake and Cumberland addressing system improvements Nationally certified Mental Health First Aid trainers for Children and Adults Greater emphasis on an integrated primary care approach Veterans Treatment Court (Cumberland)

122 Strengths in the Crisis Continuum Care Coordination Discharge planner (Durham) Increased emergency housing options Implement EMS Community Paramedicine Program (Durham and Wake) Low rate of admissions to Emergency Dept. (Wake and Durham)

123 ED Admission Rates FY13 Q4* FY14 Q1 FY14 Q2 FY14 Q3 Cumberland Durham* Johnston Wake *Durham has one of the lowest rates of any county in the state for the last four quarters. * Data Source: NCDETECT, 10/29/14 (from NC DHHS, NCDMHDDSAS, ED Admissions Report)

124 Crisis and Assessment Centers Number of Chairs/Beds Provider 23 Hour Chair Facility Based Crisis Alcohol and Drug Detox Unit Inpatient Community Mental Health Center at Cape Fear Valley (Roxie Avenue Center) Durham Center Access (DCA) Mental Health Division Johnston Co. Health Dept UNC Health Care at WakeBrook (CAS)

125 Psychiatric Inpatient Beds 3-Way Contract Hospitals FY15 Contracted Beds Cape Fear Valley Hospital 10 Duke University Health 4 Johnston Health 5 UNC-Wakebrook 5 Total 24

126 Crisis and Assessment Centers Care Navigators to assist consumers and families in accessing crisis services (Durham) Alcohol and Addiction Detox Unit (ADU), Integrated Community Health Clinic, Improving CAS space for Juveniles, Inpatient unit expansion (Wake) CIT Officer and Mobile Crisis Team 24/7 drop-off (Cumberland)

127 400 CAS - Number Served (Self Report) May 2014 June 2014 July 2014 Aug 2014 Sept 2014 Oct 2014 Nov 2014 WakeBrook-presenting* DCA-presenting Roxie - presenting** WakeBrook-admit to chair* DCA-admit to chair Roxie - admit to chair** * Data from May-Oct does not include individuals with private insurance every month (about 20%-25% of admissions to chairs and 1/3 of individuals presenting) ** Data on number presenting at Roxie not submitted, data on number admitted for August, October, and November from paid claims

128 Data source: Self-report by provider