Community Service Board Association

Developmental Disabilities Section Meeting

July 7, 2006 Minutes

Members Present:

Bonnie Standard, McIntosh Trail

Jennifer Freeman, Middle Georgia CSB

Carol Giles, South Georgia CSB

Wanda Yarbrough, Pathways CSB

Ty Kruk, Ogeechee BHS

Gloria Kenure, Pineland CSB

Kirby Gregory, Albany Area CSB

Peggy Coney, Middle Georgia CSB

Gary Maddix, DeKalb CSB

Trip Finney, Highland Rivers

David Burry, Lookout Mountain

Jennie Swirski, Lookout Mountain

Wanda Standridge, Cobb- Douglas CSB

Rob Hill, Georgia Mountains CSB

Joyce Jackson, New Horizons CSB

Acelia Solana-Prosser, Oconee Center

Bryant Wiggins, Satilla CSB

Estelle Mulherin Duncan, Serenity Behavioral Health

Bryant Wiggins, Chairperson, called the DD Section Meeting to order at approximately 10:15 a.m.

Minutes from the June 2, 2006 meeting were circulated and approved.

OLD BUSINESS:

MICP Implementation Process: There has been no official feedback on the data that has been inputted so far. The information will show up in the system as a “draft” if something is incorrect; the information will be “accepted” if it is approved. Satilla has 1100 clients still to be entered into MICP; Profiler is able to generate this number for Behavioral Health (MH/AD). Some Support Coordinators are telling staff that they cannot give us a report/verification that the required information on DD individuals has been entered. We need to ask for verification in writing in order to monitor the status. It was recommended that we provide a list of our clients to the Support Coordination agency and ask them to verify the data entry. One program reported that a Support Coordinator was in her center yesterday and did not know what MICP was! Even though we have been told that MICP is not tied to funding, some of the CFO’s are beginning to take an interest in the status of the DD client data entry.

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Prior Authorizations: Prior Authorizations (PA’s) for FY ’07 are being worked on by the Regions. Some of the CSB’s still do not have all of their FY ’06 PA’s! Region 2 and Region 3 have sent most of their PA’s out; other programs have received nothing from their Regional office. It was stressed again that we must not start services without a Prior Authorization in hand. Are programs getting the assessment reports in a timely fashion? NO.

Liability Insurance Requirements for Sub-Contracted Providers: There was much discussion on the status of the liability insurance requirement. In the Satilla area, the home providers have been notified of the requirements; however, there has not been an implementation date set yet. Bryant distributed a letter from an insurance company in his area that is trying to identify potential carriers for the coverage. It was reported that the Conner Agency can provide the coverage for $5000.00 to $6000.00 per year, depending on the number of beds. Wanda Standbridge reported that Cobb-Douglas has required home providers to provide the coverage for the last several years. She will get the name of the carrier and send it to Bryant for distribution to all members. The Athens area is planning to have the board attorney draft a letter to home providers about needed coverage, without putting in any dollar amounts. In addition, there must be a provision/statement that the home providers would not hold the agency liable in the event of a claim. Serenity Behavioral Health Systems (Augusta) has sent out a letter to home providers stating that they must have comprehensive general liability or commercial general liability insurance in the amounts of $1 million per person, $3 million per occurrence no later than July 31, 2006.

It was recommended by the DD Section that we advocate with our CFO’s to not move so fast with the implementation of this requirement until information from the various carriers can be reviewed. The possibility of finding a carrier that could offer a group policy for home providers through the CSB association was suggested. There are many sides to this issue – fiscal (for agency and home providers), policy and the human side (many of the clients have been with their providers for 10 plus years).

Division Policy on Subcontractors: What is the Division’s policy on subcontractors? There has not been any information that we are aware of since the discussion at the February SPADD meeting. The FY’07 Provider Manual refers to subcontractors. Medicaid requires that anyone they pay must be a Medicaid provider. This requirement has been loosely interpreted previously to include subcontractors. We must give the subcontractor a copy of the Provider Manual and it is expected that they comply with it.

NEW BUSINESS:

New Waiver Rate Structure: Gary Maddix had sent out to all members a copy of Annex J to the new Comprehensive and NOW waivers, requesting feedback in preparation for a SPADD meeting on the proposed rates. That meeting was held on

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Thursday, July 6. Gary provided members with three handouts from that meeting for our review. Gary added two columns (Columns 6 and 7) to the original Annex J to help clarify the numbers. It is felt that the number of users for Years 2 and 3 is incorrect and that there is an underestimation of the true costs of services for Year 1 by $23 million and for Years 2 and 3 by $30 million. This is very concerning!

Current Day Services will become Community Access services in the two new waivers. After initial review, the figures look high. Dr. Steve Hall has said that he will build in disincentives for congregate care, but will reward individual participation in the community. The average number of units of service for the new waiver is 1440 units, which equals approximately 30 hours per month. There is an incentive to provide services for 5 days per month. Is this correct?? What will happen on the other days of the month? If this is the case, we need to educate our families on the changes!

All members are encouraged to carefully review Gary’s spreadsheets and to provide him with any additional feedback.

Are these rates going to direct the implementation of the service delivery model?

The figures do not take into consideration the impact of the Supports Intensity Scale.

There is no new money in the new waivers; however, there are new services that will be available. If day services are reduced, families and/or residential programs will have to pick up the slack. The staff to client ratio will go to 10:1 for day services. We will have difficulty providing some of the services due to the new rates.

Gary will be meeting again with the SPADD group within the next 10 – 14 days. It is expected that the workgroup will send a letter to Dr. Hall regarding the concerns. Does Mark Trail recognize that the projected rates will not work?

It was recommended that the DD Section join forces with SPADD on this issue.

SPADD Conference Update: The members who had attended the conference gave summaries from the different presenters, with particular attention being given to the topic of the False Claims Act. It was recommended that this be a topic for the CSB Association Annual Conference in the fall. Overall, the conference was very good.

FY’07 Contracts: The new contracts have just come out. It was recommended that we review them very carefully. Some members reported that their numbers have increased and/or the money decreased. Others reported that services they do not provide have been added to the contract.

OTHER BUSINESS:

How will the statewide Access for Crisis impact DD Services? It is not known at this time what impact it will have on us.

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Supports Intensity Scale: There are still issues surrounding the level of knowledge about administration being demonstrated by some of the Support Coordinators. So far there has

been no correlation between the score and rate of reimbursement. DeKalb CSB has done some training sessions for the parents so that they understand the process.

Next Meeting: August 4, 2006 at 10:00 a.m. at River Edge.

The meeting was adjourned at approximately 12:35 p.m.

Respectfully submitted,

Estelle Mulherin Duncan