Mayview Service Area Planning Steering Committee
January 20, 2006
I. Introductions: The Steering Committee members made introductions.
Members Present: Kelly Burda, Kim Campbell, Timothy Casey, Mary Jo Dickson, Mary Fleming, Bob Harms, Emily Heberlein, Carol Horowitz, Nancy Jaquette, John Klenotic, Rich Kuppelweiser, Pam Loaskie, Carol Loy, Kevin McElligott, Gerard Mike, Brandi Mauck Phillips, Steve Plyler, Laura Steiner, Janice Taper, Rick Tully, Dean Virgili, Deb Wasilchak, and Linda Zelch
Others Present: Tom Caringola and Heather Durante (VBH) and Tawnya Lewis
Members Absent: Laverne Cichon, Shirlee Hopper, Kim Patterson, Rich Rach, Patricia Valentine, and Valerie Vicari
II. Review of Meeting Summary from December 16, 2005
The minutes were reviewed from the December 16, 2005 meeting. There was a question about why Dave McAdoo and Meg Park’s names were not included as members of the Steering Committee. Brandi Mauck Phillips explained that Kim Campbell replaced Dave McAdoo and Shirlee Hopper replaced Meg Park.
There were no other questions or comments regarding the minutes.
III. Update on
Linda Zelch explained that the
Some of the challenges that lie ahead as a result of the Harrisburg State Hospital Closure include:
The remaining 62 people in the
· Those with dual diagnoses have been the hardest population to place due to high incidences of readmissions. Some of these individuals require extended acute care; however these beds are not readily available and have a maximum stay of 180 days.
There has been some struggle with the providers
in the area because they have not changed their culture and developed ways to
better meet the needs of consumers exiting the
Linda Zelch mentioned that Andrea Keppler
from the CRT (Community Residential Team) would be a good resource for the
Steering Committee to discuss ways that providers can become better prepared to
offer services to
Linda Zelch recommended that a representative from the CRT be invited to a future Steering Committee meeting.
IV. Assessment & Discharge Committee Update
Emily Heberlein explained that the 38 total Clinical, Consumer and Family Assessments are all scheduled and on target for the February 3rd (Clinical) and January 28th for the (Consumer/Family) Assessment deadlines.
During the third meeting of the Assessment & Discharge
Committee, the focus included updates to and distribution of the final
assessment tools, updates of the process to date, and discussion around the
discharge planning process, including distribution of a draft of the process
Nominations for facilitators and recorders were submitted to Kim Patterson. Kim will conduct the interviews, and those selected will attend a training session that will be scheduled within the next three weeks. The discharge planning process will begin in February and conclude by the end of March.
Other issues discussed included the following:
· Linda Zelch mentioned that CSTAP is interested in standardizing the assessments statewide so that core questions are the same. Some of the questions on the survey may need to be changed in the future.
Facilitators/Recorders should represent both
· Assessment data reports will be available and shared on a County-specific basis. AHCI developed a database to capture and analyze the information gathered by the assessments.
Information about the results of the assessment
and discharge process should be included in the SAP and
· The steps for aftercare need to be detailed in the planning process.
· Reimbursement will be offered to facilitators/recorders who are not otherwise employed. No reimbursement rate has been yet established.
· During the next Assessment and Discharge Committee meeting, the role of an arbitrator should be discussed.
V. Finance & Data Committee Update
Rick Tully and Rich Kuppelweiser
walked through the Mayview State Hospital Cost Apportionment Spreadsheet, and
explained the methodology about how costs could be transferred from
For the next meeting, the data will be converted to a transferable per diem.
Rick Tully presented a set of scenarios that delineated the
potential services and the frequency with which a consumer would utilize these
services after discharge from
A few follow-up items are needed, including:
· Each County should review the list and identify supplemental services that are not included on the diagram.
· Each County should submit Base and HealthChoices rates for each of the services listed on the diagram to AHCI. The rates will be reviewed, and unless a high degree of variability exists between the Counties, one projected rate will be developed for each service.
· Administrative Case Management rate should be added to the diagram.
· Resolution to the question about Crisis Intervention. It is a supplemental service, but how should this service be paid?
· Since Housing Supports represent housing specialist staff, but could case management staff provide the same support?
· AHCI agreed to review statistics related to expedited enrollment to determine whether or not there was a positive effect on Medicaid eligibility.
· Mobile Medical Services are targeted for clients with complicated medical issues and some people are referred to these services as they come out of the hospital. A request was made to have someone give an overview of these services for the Steering Committee.
VI. Discussion of SAP Goals Two and Three and
The Steering Committee discussed the following statistics related to the waiting list:
There are currently 61 individuals on the
waiting list for
On average, a suburban resident on the waiting
list is admitted within 18-30 days, and within 90 days for
· Many individuals on the waiting list are diverted to other services, such as LTSRs and CRRs. It was suggested that further research be done to find out how many people put on the waiting list are actually admitted to Mayview.
Mary Fleming asked each County to provide an update on Goals
Two and Three, as well as the
Goal #2 – The County has high incidences of
Goal #3 – The County has a large forensic program. The night court program matches to the e-CAPs system to track involuntary admissions. The forensic diversion program works with people waiting for their preliminary hearing. Mental health and drug and alcohol court that provide recidivism data, but not forensic data for 700 individuals. There are 90 people waiting for service.
Goal #2 – The County has a very low incidence of involuntary readmissions. Out of 50 HealthChoices admissions, 9 – 12 are involuntary admissions. Voluntary admissions continue to be a problem. While these admissions have consistently decreased each year, the number is still high.
Goal #3 – The “re-entry” liaison works with
the jail and consumers to create a treatment plan, including treatment in jail,
a re-entry initiative, upfront evaluations, as well as fostering positive
relationships with parole officers and the courts/judges.
Goal #2 – The County has very low incidences of involuntary admissions. Voluntary admissions data is tracked through Value Behavioral Health reporting.
Goal #3 – The County works closely with the social worker in the jail, but has a low number of placements in the forensic unit. In the last five years, there have been only five individuals placed there, mostly for assessments.
Goal #2 – The County has very low incidences of involuntary readmissions. In a three year period there were one or two people readmitted.
Goal #3 – Their forensic liaison position produces significant results, works with the courts and makes diversions when possible. The County has data on this. Their goal for 2006 is to develop a mental health/drug & alcohol treatment court program.
Goal #2 – The County has traditionally a low incidence of involuntary readmissions. The County office tracks voluntary admissions internally.
Goal #3 – They have a co-occurring disorders pilot, drug and alcohol/mental health treatment court for alternative sentencing, and direct services at the jail.
As part of the coordinated Service Area Plan, one item to be covered is how reductions at Mayview are driving service development. Mary Fleming requested that each County should forward a draft of their top five Service Development Priorities to Tawnya Lewis. The draft could be a plan from the prior year’s priorities.
Tim Casey will coordinate a meeting to determine the measure to be used across all counties for Goal 2 and report back to the Committee in February.
VII. Communication Strategy
Mary Fleming explained that AHCI was in the planning process of developing a website to provide information related to the Mayview project. Mary asked if there was any information posted that the Committee did not want to have posted on the website, including minutes. The Committee did not have any objections to any information posted to the website and encouraged AHCI to move forward with the planning/implementation of the website.
A few additional requests for the website included:
· The minutes from the Steering Committee should be reviewed again by the Committee members to ensure that the language is correct in the minutes. Tawnya Lewis will re-send copies of all of the minutes to the Committee.
· The website should include a way to obtain feedback from consumers.
AHCI will update the Steering Committee on the progress of the website. The expected web address is Mayview-SAP.org.
VIII. Timeframe for the Project
The Steering Committee discussed the timeframe for the
Mayview project. The Committee
agreed that beyond July 1, 2006, a two-year plan needs to be developed to
reduce/limit the number of individuals on the waiting list for
One potential goal is to, at a minimum, reduce the waiting
list by half, and apply the Assessment Tools on people on the waiting
list. This will help identify what
services are desired and needed to divert admissions to Mayview. Within
IX. Other Items
The Steering Committee scheduled March 17, 2006 for the next Stakeholders’ meeting. Linda Zelch agreed to try to coordinate this date with Joan Erney.
The Steering Committee will meet from 9:00-11:00 am.; the
Stakeholders’ meeting will follow.
Both meetings will be held at the Holiday Inn Select in