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MINUTES OF THE BOARD April 17, 2014 North Country Community Mental Health Board Room 1420 Plaza Drive Petoskey, Michigan BOARD MEMBERS PRESENT: Ed Ginop, George Anthony, Christian Marcus, Sr. Augusta Stratz, Paul Liss, Sue Allor, Dan Plasencia, Robert Boyd, Louis Scholl, Gary Averill, Debra Kimball BOARD MEMBERS ABSENT: STAFF: GUESTS: Dennis Priess, Karla Sherman, Joel Evans Alexis Kaczynski, Christine Gebhard, Donna Wheeler Joan Booth David Schneider, NMRE Mr. Ginop called the meeting to order at 4:30 p.m. ROLL CALL Mr. Ginop welcomed the Board members and staff to the meeting. PUBLIC COMMENT Ms. Kimball announced that she has resigned from the Kalkaska County Board of Commissioners. She cited personal reasons for this decision and the need to be closer to home and more accessible to her family. She has taken a position as Assistant Director with the Commission on Aging in Kalkaska. Mr. Al Hart has been selected as the new Chair of the Kalkaska County Board of Commissioners and there will be applications for a reappointment to her position. CONSENT AGENDA Financial Statement Provider Operations - North Country CMH: Balance on Hand, Feb. 29, 2014 $6,539,069.88 Receipts, Adjustments & Transfers, March $3,467,622.80 Total Disbursements & Adjustments, March$3,418,684.54 Increase in Cash Balance $ 48,938.26 Balance, March 31, 2014 $6,588,008.14 *Approximately $3,886,055 has been advanced from the State of Michigan and has been encumbered for outstanding bills.

Financial Statement Managed Care Operations - North Country CMH: Balance on Hand, Feb. 29, 2014 $3,819,253.02 Receipts, Adjustments & Transfers, March $ 60,714.36 Total Disbursements& Transfers, March $ 101,180.06 Decrease in Cash Balance 40,465.70 Balance, March 31, 2014 $3,778,787.32 *Included in the balance is the Medicaid Internal Service Fund balance of $2,809,640. MOTION BY DEBRA KIMBALL, SECOND BY LOUIS SCHOLL, TO APPROVE THE CONSENT AGENDA. MOTION CARRIED. Information (I) Items from Committee Reports Information items were included in the committee minutes. Privileging Recommendations There were no privileging items to be approved by the Board. COMMITTEE RECOMMENDATIONS BOARD ACTION Nominating Committee Mr. Ginop reported that the Nominating Committee recommended Ed Ginop, Chair; Sue Allor, Vice-Chair and Sr. Augusta Stratz, Secretary. MOTION BY LOUIS SCHOLL, SECOND BY ROBERT BOYD, TO APPROVE THE SLATE OF OFFICERS, ED GINOP, CHAIR; SUE ALLOR, VICE-CHAIR; SR. AUGUSTA STRATZ, SECRETARY. MOTION CARRIED Finance Committee Mr. Plasencia discussed the deficit elimination plan for the Affiliation fund that is required by the Department of Treasury. MOTION BY DAN PLASENCIA TO APPROVE THE DEFICIT ELIMINATION PLAN TO BE FILED WITH THE DEPARTMENT OF TREASURY BY APRIL 24, 2014. MOTION CARRIED. Mr. Plasencia reviewed the repairs needed to the roof at the Springridge home. MOTION BY DAN PLASENCIA TO APPROVE THE ROOF REPAIR AT THE SPRINGRIDGE HOME. MOTION CARRIED. Mr. Plasencia reviewed the nine-month Medicaid Subcontracting Agreement between NCCMH and the Northern Michigan Regional Entity.

MOTION BY DAN PLASENCIA TO APPROVE THE NINE-MONTH MEDICAID SUBCONTRACTING AGREEMENT BETWEEN NCCMH AND THE NORTHERN MICHIGAN REGIONAL ENTITY. MOTION CARRIED. Mr. Scholl asked what it means to contract with them. Ms. Kaczynski explained the necessity for this contract and the change that occurred when North Country CMH ceased operating as the PIHP and the Northern Michigan Regional Entity became the PIHP. ACTION ITEMS WITHOUT COMMITTEE REVIEW MOTION BY DAN PLASENCIA, SECOND BY SR. AUGUSTA STRATZ, TO AMEND THE AGENDA TO ADD THE ACCESS TO SERVICES POLICY. MOTION CARRIED. Ms. Kaczynski reviewed the Breach Notification Policy and the Access to Services Policy and asked the Board members to take a few minutes to review these policies. MOTION BY LOUIS SCHOLL, SECOND BY ROBERT BOYD, TO APPROVE THE BREACH NOTIFICATION POLICY. MOTION CARRIED. MOTION BY SR. AUGUSTA STRATZ, SECOND BY GARY AVERILL, TO APPROVE THE ACCESS TO SERVICES POLICY. MOTION CARRIED. PRESENTATION Northern Michigan Regional Entity David Schneider reported that he has been visiting all the CMH Boards in the new region and this is the last Board to visit. He reviewed the progress and the challenges. The NMRE Board is in place and has been together for a year. They are going to be selecting new officers next week. There are some ad hoc committees. Some of the boards use a Carver Model of governance and have been very vocal and other boards use a different method. They had their first planning retreat last weekend and developed a mission statement for the agency and also a vision statement. NMRE is the accountable organization for Medicaid and he explained this. Contracts have been a real challenge for them and he explained the development of this. He reviewed the various committees of the NMRE and mentioned responsibilities such as the integration of SUD services management with mental health managed care, which is required by October 1 st. The Coordinating Agencies do more than manage dollars; they are in the communities. He is interviewing for a Substance Use Disorder Services Coordinator. Funding is a challenge because when it was rebased there was a decrease compounding the five Boards coming together with various geographical factors which resulted in different rates. The risk exposure on previous funding is less than before but it is adequate. The NMRE is taking on responsibility for Healthy Michigan and he explained the problems and challenges with this funding. Another challenge is that the HAB waiver slots are not spread evenly around the region. There are different perspectives about what the NMRE is and what it is supposed to do. Contract negotiations with the state for 2015 are in process and he reviewed how this was being put together. Future survival of the NMRE and its partner agencies depends on its ability to stand up against other health plans.

NORTHERN MICHIGAN REGIONAL ENTITY Ms. Kaczynski indicated that the minutes were in the Board packet and she reported on the weekend planning meeting. Mr. Ginop indicated there was a lot of discussion. OLD BUSINESS Ms. Kaczynski referred to the Regional Board Member Educational Forums in Gaylord. She also referred to the Association Conference in Dearborn. Mr. Ginop indicated that voting members need to be appointed. Sr. Augusta Stratz was appointed. NEW BUSINESS There was no new business this month. DIRECTOR S REPORT/COMMUNICATIONS Ms. Kaczynski referred to the letter she sent to Lynda Zeller and the state senators. Last month she discussed the loss of GF and what would have to be done as a result. Over 425 letters were sent to clients regarding the potential termination or reduction of services. Some clients applied for Healthy Michigan and she explained the criteria for applying for this program and the eligibility requirements. She continues advocacy efforts, including a regional press release, which appeared in the Traverse City Record Eagle and the Petoskey News Review. She also referred to the Healthy Michigan Plan Progress Report that was included in the Board packet. She attended a meeting convened by the state in which they said they would push out more GF in April and May to help with cash flow problems. There were many state staff and executives there from several departments. She also attended a meeting of the Leadership and Visioning Committee (MACMHB) and discussed what occurred in this meeting. While in Lansing, she met again with Senator Moolenaar s office because he is the Chair of the Mental Health Appropriations Subcommittee and is most knowledgeable about the problem. There was mention of another supplemental this year, which would be positive. She referred to the article in the Petoskey News Review today. She also feels that in this region the communities are well launched in knowing what is happening. Letters were sent to the commissioners, community stakeholders and referral sources and presentations to the Human Services Coordinating Bodies are occurring. LONG RANGE PLAN/QUALITY IMPROVEMENT UPDATES Ms. Gebhard reported that 15 secretaries have been trained to help clients enroll in Healthy Michigan. Some of the outreach to clients who wish to apply has changed. She is attending HSCB meetings to offer a presentation on the reduction of GF funds and what it means. This has resulted in some interesting feedback and real concerns.

Ms. Gebhard discussed the Quality Improvement Action Team on incident reports. The tasks involved a description of the process, analysis of the system, assessment of need, streamlining of process and recommendations to leadership team. At least 200 client incident forms come in each year. The process for getting this information where it needs to go is being improved. The Electronic Health Record system has started and the next step is to eliminate paper charts. Crisis Residential needs to become more electronic and staff need to be trained on computers. The agency is partnering with Munson and McLaren Hospitals to have immediate access of lab results at the hospitals. She explained information technology, Right Facts, which helps in the whole efficiency effort. This software allows the faxing of information. Sr. Augusta reported that Sandy Pines Apartments in Kalkaska had a fire today and wondered if the agency had any clients there. MOTION BY LOUIS SCHOLL, SECOND BY GARY AVERILL, TO ADJOURN THE MEETING AT 5:40 P.M. MOTION CARRIED. Ed Ginop, Board Chair