Fall CBHS Provider Meeting Minutes 11-1; 11-2; 11-3-2016

Children’s Behavioral Health Services (CBHS) Community Providers’ Fall Meeting

Notes can also be found at: http://www.maine.gov/dhhs/ocfs/cbhs/provider/meetings/index.shtml

Presenting CBHS Staff:
Resource Coordinators: Cheryl Hathaway (Region 3), Kellie Pelletier (Region 2), Cathy Register (Region 1); Teresa Barrows, Behavioral Health Director; Paul Maheux, Behavioral Health Policy Coordinator; Rachel Posner, Resource Coordination Team Leader; Robin Whitney, OCFS Program Administrator-District 6; Judy Demerchant, Family Information Specialist; Jeanne Tondreau, EIS Specialist

CBHS Discussions: Teresa Barrows (Bangor and Augusta) Rachel Posner in Portland
Welcome and Introduction of CBHS staff
Layoffs:

RC Team Leader position and Quality Services Unit

 Any recently conducted quality assessments will be completed and distributed to providers. RC’s will meet with any agencies that require or request technical assistance with a program. Several providers stated they are valued the service and are sorry to see it go away.

RCs will provide technical assistance when new CANS is rolled out.
Judy Demerchant, Jeanne Tondreau, and Program Coordinators/Care Specialist will also continue to support families with Transition support.

NITT (Now is the Time) grant will no longer be implemented. We will continue to provide several of the grant initiatives by using non-federal funds. CBHS has reached out to providers to ask if they want to continue the process and possibly expand statewide. Alice Preble has moved into the position of statewide CPPC (Community Partnerships for Protecting Children) Director. Youth Peer programs will continue and hopefully will be statewide.

Rate Update

Teresa Barrows attended the most recent Burns and Associates meeting and reported they are taking all Provider comments and suggestions under consideration.
Considering potential for minimum wage increase
Provider stated the rate process is thorough and positive based on her experience with her healthcare division
Concern about regulations making it harder to serve enough families – cited BCBA rates
Provider stated there have been no increases in children’s services to offset the federal wage increase.
Need to wait for rates changes to be implemented before rule changes can be made. We will be working with OMS to get a promulgation date.
Rachel stated that the rewrite of Section 28 rules is in process.

Staffing Challenges

CBHS staff joined the recent meeting of MACSP (Maine Association of Community Services Providers) to discuss staffing challenges in underserved areas. At fall provider meetings, providers expressed challenges and successes regarding BHP staffing.

One agency reported success in hiring college students as BHP’s
Provider stated it costs $3k to hire and train a BHP (cost of background checks, training, etc.) The inability to match staff with clients has created a morale problem with staff.
BHP’s love what they do, but they need to have full-time work.
Provider stated they cannot keep BHP’s due to the length of time it can take to open a new case. Delays in receiving the referral packet and coordinating meetings with family can take 3 weeks.
HCT: Policy work underway regarding changing BHP requirements to having 90 credit hours or an Associate’s Degree.

CANS and TCM Updates

TCM and BHH CANS rollout scheduled for March of 2017
New CANS will not require new training or new certification: current CANS certification will be sufficient.
The YOQ will no longer be required when new CANS is rolled out for HCT.
CBHS Planning process
Standard format for Crisis, Transition, and Service plan
Training will be available – In person and by webinar
Expected implementation date: July 1, 2017
For a draft of the plan, contact Paul Maheux at
TCM Practice guidelines will be revised

Robin Whitney, Program Administrator in District 6 (Bangor meeting only)

MEPP – Maine Enhanced Parenting Program was created to address increasing number of families impacted by substance abuse. MEPP is currently offered in District 6 (Bangor) and District 1(York). Eligible families must be involved with child protective services, have a child five years old or younger, and have at least one parent affected by substance abuse. MEPP participants attend a 16 week Intensive Outpatient substance abuse program along with an 8 week parenting education class.

OCFS is looking into the possibility of offering MEPP in Region 2.

Bangor OCFS staff is available to provide in-person mandated reporter training. Contact Robin directly at for more information.

KEPRO – Kelly Parnell (Bangor); Keara Anctil-Dupont in Augusta and Portland

KEPRO is encouraging providers to move away from faxing documents and upload forms directly to CareConnection. Training modules are available on their website: or providers may contact KEPRO staff for assistance.
During client outreach by KEPRO, families are reporting they don’t know why they were referred to a particular service. Providers should assist families in better understanding which services they are being referred to.

KEPRO does regular, scheduled telephone and written outreach to families and referents
Around 350 days, KEPRO will be contact families who need to be reassessed for MaineCare eligibility.
If a member’s case has been closed out with the referring provider, and they still want service KEPRO will provide client information packet
Provider stated that the referral source is often not reachable when agency pulls new client off the RM list
When a new TCM takes over a case, notify KEPRO who will update their contact information
Concern from provider that TCM said “He/she doesn’t have time to supply the referral information.” TCM supervisors want to be contacted if there are concerns about TCM
Provider stated it often takes a week before KEPRO lets them know if their agency was matched with a child.
From KEPRO: It is TCM’s responsibility to get referral information to picking up agency on a timely basis
System change recommendation: Parents sign authorization to have information released to agency picking up – KEPRO should be able to release the referral information

Concern from providers: It is not “ethical” to pick up a child without knowing if their available staff is a good match – as opposed to the expectation that they pick up the child and “make it work.”
A parent in attendance stated her child has had dozens of BHP’s and each staff loss takes an emotional toll on her child and family. She supports giving agencies the information they need before the case is opened to ensure a strong match can be made.
KEPRO replied that HIPAA issues prevent them from releasing more information.
Some providers weren’t aware that KEPRO recently added age and gender to the RCS 28 referral management list
Often the entire assessment time is needed, only to determine that the child and available staff is not an appropriate match
HCT provider told they must try Outpatient services first. If client does need a higher level of service, client goes back on the RM list and it’s an interruption of services. KEPRO said exceptions can be approved in certain cases. Contact Kelly Parnell to discuss
More assessment time is necessary in order to ensure that there is the right staff and right treatment in place
Concern from provider that TCM can’t open information from Case Number that is provided in email.
Keara is working on this, and if more information/assistance is needed, please call her
Concern from several providers about not being able to see if member waiting in a rural area has indicated them as a family choice
Up to TCM to educate families about the Referral Management Process
KEPRO and RCs can provide assistance in regard to explaining Referral Management Process
Any way children who are available during day time hours can be indicated? – Not competing for same time frame – OCFS can work with KEPRO to develop
If child needs to go back to Central Enrollment prior to services being able to commence, can contact Brandy, Denise, Keara to make sure priority status and not back to bottom of list
Acute, priority cases: Children coming out of higher levels of care including residential, hospitalization, and crisis
Children who are only being partially served will be listed as a priority on the RM list until authorized hours are met. Contact Kelly or Keara at KEPRO directly about partially serving members
Providers expressed concern that the letters from KEPRO to families are often filled with “jargon” that families cannot understand.

Please contact Josh Birdwell if have any questions about New Enrollment Process and HealthPas Portal
RC Updates on Recruitment efforts; underserved area needs;
Send any ideas to the Resource Coordinators ideas regarding workforce development
Transition:
Judy Demerchant Family Information Specialist
Important to enter into EIS starting at age 16: OADS needs to be aware early on for budgeting adult service needs
Judy calls the TCM or family of all youth who are 16 years old on transition list RE: updated assessments and guardianship status
Contact Judy at for any questions/support
EIS
Contact Jeanne, Information Technology Specialist at for any questions/support
New system will be called Phoenix; will be compatible with multiple browsers, more user-friendly, and up and running by spring 2017.
Updates/ Happenings from Providers:
Back to Basics approved to be a special purpose preschool.
UCP is taking referrals for their Nurturing Parent groups. It is a 12 week program and they can assist with transportation and child care. They are also offering children’s groups.
Acadia offering therapy groups for adolescents. Topics include Healthy Living and LGBTQ issues.
Catholic Charities has FFT openings
Penquis used a grant to create 20 video models for clients and families. Go to You-Tube and google Penquis.
Community Care has partnered with MSHA to offer a statewide grant funded housing assistance program for youth transitioning out of foster care system after the age of 16.
Advocates for Children will provide Mandated Reporter Training in your agency.
Woodfords is offering a BHP DSP training program at their local vocational high school. Students will leave the program with certifications in BHP, DSP, safety care, and first aid.

Closing
Condolences expressed by providers about Rachel’s departure from OCFS
Networking after meeting

Questions/Comments:

Concern from provider: Seems like CBHS have been stepping backward over the past 5 years and it took about 15 years to get a solid CBHS support.
Provider asked about the 30 day overlap between services. Agencies who want to pick up a child coming out of residential cannot start the assessment process until the child returns home. Please find more information regarding duplication of services clarification at: https://content.govdelivery.com/accounts/MEHHS/bulletins/175a2d9
Information regarding the moratorium process can be found at: https://legislature.maine.gov/legis/bills/bills_127th/billtexts/HP116201.asp
Providers concerned about implementation of standardized TCM service planning form
Standard TCM form compatible with KEPRO’s need for information. Will implementation of this wait until it is able to be uploaded into KEPRO’s system
There used to be a Community Collaborative in Lewiston. Is this now the CPPC?

There is still a community collaborative held on the 3rd Tuesday of each month from 9-11 at Community Concepts.

Additional Resources/Information:

OCFS/Mandated Reporter Training page: http://www.maine.gov/dhhs/ocfs/mandated-reporters.shtml
Maine Care Revalidation process http://www.maine.gov/dhhs/oms/revalidate.shtml
RIGHTS OF RECIPIENTS OF MENTAL HEALTH SERVICES WHO ARE CHILDREN IN NEED OF SERVICE: http://www.maine.gov/dhhs/ocfs/cbhs/policy/rights.shtml
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