Mayview Service Area Planning Steering Committee

Meeting Summary

August 26, 2005


I. Introductions


Members Present: Tim Casey, Laverne Cichon, 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, Meg Park, Kim Patterson, Brandi Mauck Phillips, Patricia Valentine, Valerie Vicari, Deb Wasilchak, and Linda Zelch


Others Present: Terry Carik (for Rick Rach) and Tawnya Lewis


Members Absent: Dave McAdoo, Rick Rach, Steve Plyler, and Janice Taper                      

II. Review of Meeting Summary from July 22, 2005


The minutes were reviewed from the July 22, 2005 meeting and some corrections were requested. The following corrections are noted for the Assessment/ Discharge Committee representatives:


      Eva Bednar is representing family members.

      Marge Kearns is representing advocates.

      Cecilia Reinheimer is representing behavioral health professionals.

      Carol Horowitz is recommending someone for the Committee from the PP&A not PMHCA organization.


III. Finance and Data Needs Committee


New Consultant - Due to personal reasons, Patrick Lanahan will not be able to fulfill his obligations as a financial consultant to the Committee. Rick Tully has been identified as his replacement. He will begin working with AHCI staff immediately and will be available to attend the Steering Committee meetings beginning November 1, 2005. Mr. Tully has vast experience in Medicaid financing and offers a wide range of expertise that will be useful to this project.


Contracts - All contracts and the Business Associate Agreements have been sent out to the counties for execution. No problems or delays are expected.


PCIS - All PCIS permissions were received from the counties. OMHSAS expects it will take approximately three to four weeks to have the data available to AHCI.


Service Utilization - Service utilization specifications are ready for distribution but Tim Casey is going to review them with the new consultant prior to releasing them to the counties. Once this occurs, the specifications will be distributed and discussed either at the next meeting or through a conference call.


Summary of the State Hospital Meeting - The purpose of the meeting with Rich Kupplewieser and Linda Zelch was to gain a better understanding of what data will be needed to develop a financial model. The assessment tool will be important to determine the MA costs associated with discharge planning and will impact each Countys planning process. Another meeting will be needed with the State Hospital and Rick Tully to further develop what will be needed to finalize the financial model.


OMHSAS Update Linda Zelch explained that a meeting is planned on September 1, 2005 to discuss the State Plan amended targeted for January 2006 to include mobile outpatient, peer support services, and LTSR/RTFA services. This means that it will be requested that these services become an in-plan service. Counties are to consider how to project adding LTSRs in a cost-neutral way. One of the main issues is that LTSR savings are from SMH, not from community costs, resulting in a systems cost-saving but not necessarily savings within the HealthChoices program. Counties will need to look at LTSR funding, most of which is CHIPP money, and use those funds for federal match. This will free up some dollars to help fund the service area plan. For non HealthChoices members, counties will continue to pay with base funds.


IV. Assessment/Discharge Planning Committee


Participant List Update

The Steering Committee discussed the Assessment/Discharge Committee participant list and recommended additional names be added to the Committee. Once the names have been finalized, the names will be forwarded to the Steering Committee.


Discussion on Assessment Tool

Kim Patterson received feedback from each county regarding the three parts of the Harrisburg Assessment Tool. The Steering Committee discussed the individual tools at length, and their comments include the following:


Clinical Assessment

      Be clear with those completing the Clinical Assessment that whether community resources and supports are available or not, it is critical for planning and discharge purposes that information be accurate and based on individual client desire and need.

      Add more structure to questions that force narrative answers in order to have more measurable information. Make sure that Yes/No questions obtain enough information.

      Consumers must have input on questions and invite who they wish to participate in the assessment process or attend meetings.

      Considering the primary purpose of the Family and Consumer Assessments, review all questions for relevancy. It was suggested that Paul Freund, and other C/FST Directors review the tool and provide feedback specific to this area, since they have extensive experience in utilizing a variety of tools, instruments, and surveys.

      Contact Sherry Snyder, OMHSAS, to review local feedback on the tool and compare the feedback against the HSH experience in using the tool. In addition, ask Sherry to elaborate on the HSH assessment process and the lessons learned.

      Who is required to participate on the Mayview clinical team and Does the client have a say in who participates on the Mayview clinical team are questions of concern and delegated to the Assessment and Discharge Committee for follow-up. Members of the Steering Committee articulated that the client should have a say in who is part of their clinical team. Also, questions designated to a particular member of the Team should be addressed by that person and not by a representative of the Clinical Team.


Consumer Needs Assessment Survey

      The Assessment should focus on consumer needs, including active treatment.

      Criteria will need to be developed to determine who will be assessed and discharged first from Mayview. Initially, the Steering Committee will identify a Suburban/Allegheny pool of consumers to be discharged. It was suggested that those in Mayview the longest should have first priority.

      Related to availability of community resources and support, it was suggested that careful consideration must be exercised so that false hope is not created when consumers are being interviewed for discharge. As with all recipients of any part of the Assessment Tool, be clear with those completing the tool that whether community resources and supports are available or not, it is critical for planning and discharge purposes that information is accurate and based on individual client desire and need.

      Funding should be addressed to provide community services for those being discharged.


Family Assessment Survey

      Consumer/Family input is essential. Identify who in the family will be involved.

      Consumer/Family should be ready to answer whether or not they are ready to live in the community.

      Feedback from NAMI on the administration of the tool and the quality of responses would be helpful. It was suggested that SW NAMI representative Harriet Baum contact and solicit information from the NAMI representatives involved in the development of the HSH Family Tool.


Next Steps Regarding the Assessment Tools

The Steering Committee will provide Kim Patterson with any additional feedback on the tool by September 9, 2005. Kim will summarize all additional feedback from the Steering Committee, Harrisburg State Hospital representatives, and C/FSTs and will distribute the summary prior to the next Steering Committee Meeting.


General Process of the Committee

Kim Patterson discussed the role of the Assessment/Discharge Committee and steps the Committee will take moving forward:


      Review mission and guiding principles

      Review the Harrisburg State Hospital Assessment Tools and provide feedback

      Incorporate changes and complete final assessment tools

      Define role, competencies, and tasks of the assessment teams

      Identify composition and number of teams

      Develop training and identify trainers

      Train teams

      Begin assessments

      Create database and enter data as completed

      Summarize data by individual, county, and in aggregate

oo      Consumer, Clinical, and Family preferences

oo      System service gaps and needs

      (Addition by Steering Committee) Identify a Facilitator for each client who would have a variety of responsibilities that include helping to run meetings, helping to prepare discharge plans, and helping the discharge team to stay on track. (Note: the roles and responsibilities of this person will be developed based on the HSH experience and input from the Assessment and Discharge Committee and others)

      Disseminate data

      Based on data, develop individual discharge plans

      Monitor discharge process Each county is responsible for follow up.


The first Assessment/Discharge Committee is scheduled for the week of September 12, 2005.


V. Review of Announcement/Talking Points


Mary Fleming reviewed the draft announcement and talking points with the Committee. The Committee had a few revisions to both documents. Mary will make revisions to both documents and redistribute to the committee on Monday.


Mary requested that once the announcement is distributed, County representatives inform AHCI where the announcements were sent.


VI. Mayview SAP Meeting


Joan Erney Stakeholder Letter - The Committee discussed the letter from Joan Erney, which detailed the Mayview County-Service Area Plan Meeting scheduled for October 27, 2005. Each county will disseminate the information to potential attendees of the meeting and will manage RSVPs to get an estimate of attendees.


Service Area Plan Agenda (Draft) - Valerie Vicari distributed an outline of what each county is expected to present at the Service Area Plan Meeting and the time allotted for each presentation. It was suggested by Linda Zelch that the counties coordinate a meeting with Joan to discuss the Mayview planning process. Gerard Mike will contact Joan to see if she is available for a breakfast meeting prior to the Service Area Plan meeting.


VII. Other Items


Discussion of October Stakeholders Meeting

Because of the Service Area Plan meeting, the October 28, 2005 stakeholders meeting has been changed to October 3, 2005, 11am 2pm. AHCI will draft an announcement for this meeting and it is requested that each county make plans to provide transportation for consumers. The Steering Committee will meet from 9 11 am prior to the stakeholders meeting. Both meetings will be held at the Holiday Inn Select (across from South Hills Village Mall).


Plans for the Next Steering Committee Meeting on September 16, 2005

Sherry Snyder will attend the next meeting to discuss the Harrisburg State Hospital Assessment Tool.


The Committee will discuss the presentation of the service area plan.


The Committee will agree on how many beds each county will be responsible for reducing.


VIII. Follow-Up Items/Tasks Needed before Next Meeting


Valerie Vicari will send Tawnya Lewis the tracking tool used for involuntary/voluntary admissions.


Valerie also requested that someone from the Steering Committee attend the September 9, 2005 Western Area CSP meeting. Mary indicated that would not be possible; but there would be a representative at the next meeting.


Mary Fleming will redistribute the Announcement/Talking points to the Steering Committee.


Kim Patterson will revise/summarize the Assessment Tool with the additional comments submitted from the Steering Committee, C/FST and Harrisburg representative.


Kim Patterson will schedule the first Assessment Discharge Committee meeting during the week of September 12, 2005.