Mayview Service Area Planning Steering Committee
December 16, 2005
I. Members Present: 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, Kim Patterson, Brandi Mauck Phillips, Rick Rach, Patricia Valentine, Valerie Vicari, and Deb Wasilchak
Kelly Burda (
Members Absent: Laverne Cichon, Steve Splyler, Laura Steiner, Janice Taper, and Linda Zelch
Introductions: The Steering Committee was introduced to Rick Tully, a consultant that will be working on the financial model for the project.
II. Review of Meeting Summary from October 3, 2005
The minutes were reviewed from the October 3, 2005 meeting. The Steering Committee did not have any questions or comments.
III. Timeframe for Unit Closures
The Steering Committee discussed that if discharges occurred prior to July 1, 2006, the State may not be in a position to provide adequate funding. However, each administrator agreed that they would move forward with planning preparations prior to July 1, 2006.
The Committee discussed the following items related to the planning phase:
á The State may consider providing adequate funding if the committee asks for CHIPP funding. In terms of the State FY 06/07 budget, Pat will discuss with Joan Erney and Valerie Vicari will raise the issue within DPW.
á The Committee needs to identify the infrastructure development needed and the services required for people to successfully sustain living in the community.
á What are the expectations of the State in developing a financial model? What about timing and whether or not to stop admissions?
á Long term planning needs and funding sources need to be considered. This includes using reinvestment dollars as a possibility for some funding.
á State budget appropriations would be based on a July 1st discharge date. Funding for consumers discharged prior to July 1st would also have to be identified prior to this date.
The Steering Committee agreed that inviting Joan Erney to the January or February meeting would be helpful to the planning stages of the bed closures. Pat Valentine offered to invite Joan. Some questions that the Committee would like to address include the following:
á What, if anything is earmarked for State FY 06/07? Does the State budget have funding identified for these bed closures?
á Would the possibility of counties purchasing beds from the State hospitals on their own be an option?
Any insight/update on the issues related to the
revenue generated from the sale of
The Steering Committee requested information regarding the legislative inquiries about State hospital closures. Rich Kuppelweiser informed AHCI that the inquiry came from Republican Victor Lescovitz.
IV. Assessment & Discharge Committee Update
Kim Patterson provided an update on the Committee and described the final assessments. The patient list has been finalized and results in 64 planned assessments, with only a few patients on this list residing in the state hospital less than two years.
Kim reported that the first Clinical Assessment was completed. The Family/Consumer Assessments have not yet been started. The Family/Consumer Assessments will move forward, starting with the social workers contacting the families and sending out information/consent forms. AHCI has contracted with the CFSTs to conduct the interviews and they will begin once the patients have been oriented to the process and the necessary consent forms are returned.
Due to Medicare Part D issues that needed to be addressed by year-end, Rich Kuppelweiser requested an extension for the assessments that were planned for December. It was agreed that the original 40 assessments would be completed by February 3, 2006. The remaining 24 assessments will be completed by February 28, 2006.
Kim Patterson requested that nominations for facilitators and recorders be forwarded to her. She will then send out information that outlines the specific responsibilities, activities, and time requirements of these positions.
V. Finance & Data Needs Committee Update
Rick Tully met with each of the County administrators in November 2005 for their input on developing the financial model for the MRSAP. As a result of these meetings, the following three themes emerged:
á The administrators were concerned about costs to the Counties, and the sources of available funds. The administrators felt that there would not be sufficient funding to support infrastructure and the needs of consumers without additional funds.
á The development of the financial model must also include long term needs (i.e. infrastructure/service capacity/future needs) of those to be discharged in addition to addressing immediate needs.
á All agreed that the identification of funding sources and a sound financing mechanism to realign service delivery and funding must be in place for this to be successful. Each of the Counties was open to participating jointly in low incidence, resource intensive service capacities, such as residential treatment facilities.
Rick identified areas that will be helpful with the planning/development/analysis of the financial model. They include the following:
á By working with Rich Kuppelweiser and others from Mayview, identify the tipping point where fixed and variable costs will measurably decrease. Rick will set up a meeting with Rich to discuss in further detail.
á Determine the costs and the funding sources for those being discharged before June 30, 2006.
á Define infrastructure. It should be defined by each County.
á Determine the potential needed capacity for long term care (LTC). A question was raised about whether there will be a State-run LTC facility. Is there a statutory obligation for funding and/or provision?
á Review base service cost data by County to develop rates. Pat Valentine commented that the group needs to look at how to define County base services, and identify whether there is a comparable HealthChoices service. Then an analysis and review of how services could be delivered differently to maximize available funds.
á Review payor mix of consumers in the state hospital. Few consumers are dual eligible, but many become Medical Assistance eligible upon discharge. Strategies to maximize consumer eligibility for MA need to be developed.
VI. Follow-up Stakeholders Meetings
The Steering Committee committed to holding a stakeholdersÕ meeting every quarter. Because Joan Erney is planning another regional meeting, it was agreed that the meetings should be coordinated. At this meeting, details regarding the results of the assessments will be provided along with gaining input from consumers/family members on the process.
Because each County will be holding its own public hearings, they should forward each of their documents as well as information to regarding the timing of these so an AHCI representative can attend.
VII. Other Items
AHCI is planning to set up a website related to the Mayview Regional Service Area Planning progress. The initial plan is to limit access to only the Steering Committee members.
AHCI will need to review the MH Plan from each county and develop a unified template to write the SAP. Each County needs to send this information to AHCI.
Valerie Vicari raised the issue of Goals 2 and 3 within the Service Area Process. These will be discussed at the January meeting.
A meeting will be coordinated with the County administrators and Rick Tully to discuss estimated unit costs by County for program funded services. The desired outcome would be to identify rates for these services.
The Steering Committee agreed that due to the possibility of inclement weather, the January 20th and February 17th meetings will begin at 11:00 a.m. and conclude around 2:30 p.m. Should the Pittsburgh Public Schools cancel classes, the Steering Committee meeting would also be cancelled.