Mayview Service Area Planning Steering Committee

Meeting Summary

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 Harrisburg State Hospital Closure

 

Linda Zelch explained that the Harrisburg State Hospital is slated to close on January 27, 2006. The Governor is expected to speak positively about the closure during his budget address.

 

Some of the challenges that lie ahead as a result of the Harrisburg State Hospital Closure include:

·         The remaining 62 people in the Harrisburg State Hospital will move into a temporary Long Term Structured Facility until permanent housing is available.

·         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 State Hospital.

 

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 State Hospital individuals.  The CRT is a group of former state hospital employees that serve as an emergency team somewhat similar to a CTT.

 

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 following the Harrisburg State Hospital model.

 

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 Allegheny County and the suburban counties but form a small core group to ensure that there is a high degree of consistency across the discharge planning meetings.  It was also discussed that people from Counties other than where the patient’s home is may serve as facilitator/recorder to offer an unbiased view.

·         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 County Plans.

·         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 Mayview State Hospital into the community when beds are closed. 

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 Mayview State Hospital. 

 

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 County Plan Activities

 

The Steering Committee discussed the following statistics related to the waiting list:

 

·         There are currently 61 individuals on the waiting list for Mayview State Hospital. Five individuals represent Suburban Counties.

·         On average, a suburban resident on the waiting list is admitted within 18-30 days, and within 90 days for Allegheny County.

·         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 County Plan.  The Counties provided the following updates:

 

Allegheny County – Mary Jo Dickson mentioned that their Stakeholders’ meeting is planned for January 25, 2006.  The CSP meetings are monthly and include a planning representative.  The public hearing meeting has not been scheduled.

Goal #2 The County has high incidences of involuntary admissions.  Allegheny County can track involuntary admissions, but they have not identified what they will measure.  Community Care tracks all HealthChoices admissions.

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.

 

Beaver County – Gerard Mike noted that for the County Plan, the mission/vision statement has been widely circulated.  A providers’ meeting is planned for February, and the public hearing has not yet been scheduled.

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.  Beaver County received a grant (MISA pilot) that tracks those individuals returning to the community.  The grant includes a wide range of data, which will be shared.

 

Greene CountyKevin McEligott explained that the CSP planning meeting kicks off on March 14, 2006.  April 3, 2006 is the public hearing.

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. 

 

Lawrence County John Klenotic mentioned that they are currently in the planning stages for the County Plan, but have no dates scheduled.

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.

 

Washington County – Bob Harms noted that a planning committee is scheduled for February 9, 2006.  The CSP meeting is scheduled for the second Tuesday of each month.  Their public hearing is scheduled for April 19, 2006.  

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 Mayview State Hospital.

 

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 Allegheny County, results of the Systems Transformation Project may also be utilized to help move the system to a becoming more recovery-based.

 

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 South Hills Village (across from the South Hills Village Mall).