Meeting Minutes
Webster County
MH/DD Planning Committee
Meeting Minutes

Webster County Disabilities Alliance
Planning Meeting
September 3, 2009

Present: Gregg Kreamer, Beth Stuhr, Lis Ristau, Deb Delp, Richard Scisco, Ken Hays, Kim Motl, Martha Miller, Linda Smith, Mary Augustus, Teresa Naughton

  1. Welcome was given.
  2. June minutes were approved.
  3. CPC/Case Management Report:
    1. In July, Webster County implemented a new bill-paying system.  This created a new chart of accounts, MIS changes to allow communication with the auditor’s office.
    2. Non-federal share for Medicaid services decreased with the stimulus package.  In May, zero dollars were paid for the non-federal share of Medicaid services, equaling around $500,000.  Webster County will receive no additional state dollars for FY09 or FY10. 
    3. Irene is concerned for FY11.
    4. There is a Mental Health Work Group with two goals, to hold counties harmless and simplify the system so it is equitable and efficient.
    5. Irene reviewed the Statistics.  It is difficult to find beds for people needing inpatient services for mental health.  Commitments were down in August.  CPC Applications are holding steady.  The Friendship Center averages 45 people in daily attendance during the week, 31 on weekends.
    6. In Case Management, 206 people are served.  Janet Gadbury was a case manager, is now doing the social work piece only.  She will help Ken and Irene with individuals who do not have Targeted Case Management but need help.  She may help on occasion with transportation when a person without any supports is at the hospital and needs a way home.  Her case management position will not be filled; case managers will have caseloads of 34-36, which is still in compliance with rules.
    7. A County Management Information System is being make so counties can share basic CPC Application Information (have they received services, and if so in which county).  Through that system, the hope is that the legislature can receive their requested information.  Target date for implementation keeps moving.
    8. A meeting with Charlie Krogmeyer was scheduled for September 1, it has been moved to October 20. 
    9. State Payment Program will cease, but there is no information on how soon this will be.  New people coming into the system will be affected.
    10. Acute Care Task Force is looking at Crisis Stabilization Units, School-Based Services, the Role of the MHC, Jail Diversion, Psychiatric ER Screenings, Sub-Acute Short-Term Residential Care, and the Chapter 229 Commitment Process.  Members of committees include CPC, Protection and Advocacy Staff, and Mental Health Center Staff.  A report is due at the end of September. 
    11. Helen Miller’s Artful Dodger project is focusing on individuals with mental disabilities.  Artists have decorated window panes.  An event, to include a program and a silent auction, will be held Saturday October 3 in the afternoon.
    12. A committee is looking at Mental Health Institutes.  Four in Iowa are in Cherokee, Clarinda, Independence, and Mount Pleasant.  By law one MHI must be closed. 
    13. The State is looking at the Disabilities Services System.  There’s a PowerPoint by Kelly Pennington, Bill Gardam, and Pam Alger; they are looking at taking this on the road.
    14. Slots for individuals on the HCBS Intellectual Disabilities waiver have been set by the counties.  As of July 2010, counties cannot set the number of slots.  What will happen in the future is unknown.
  4. Provider Reports:
    1. Fort Dodge Community Schools: Lis is now the Principal at Hillcrest in addition to her current duties.  Youth Shelter Care wrote a grant to provide a counselor to schools.  They’re very excited about this since they are seeing more and more children with mental health issues.  There seems to be an increase in Autism Spectrum Disorders.  Some students, through the Pride Program, have accessed the Friendship Center.  They have enjoyed it.
    2. Iowa Workforce Development: Service delivery system has changed.  Staff will greet people as they come in, learn why there are there.  The Navigator funding was cut at the state level, so one full-time equivalent employee and two part-time equivalent employees were laid off. 
    3. Iowa Vocational Rehabilitation Services: Tacey Orrin has been hired for 18 months, using stimulus money, to help job-ready individuals find employment.  Efforts are being focused to help dislocated workers with disabilities.  There are around 40 new people to serve.  Work is also being done at the schools, to get transition kids as soon as possible.
    4. LifeWorks: HCBS Certification was extended effective September 1, after a lengthy desk audit process that started in April.  In the first week of August, CPAs completed their field work for the annual financial audit.  The DHS Financial Audit for individuals in the Residential Care Facilities is nearly complete.  LifeWorks was overpaid because IME did not load new rates for SSA, but this was expected.  National accrediting body CARF will be in to survey October 21-23.  PICA landscaped at the vocational site, following a plan required by city ordinance.  This saved dollars that will be used to replace an AC unit that stopped working.  Kiwanis approached LifeWorks to start an Aktion Club.  The club’s first meeting will be September 10, with meetings being held the 2nd and 4th Thursdays of the month at 4pm at First Baptist Church.  Incident reporting rules for “major incidents” have changed, and will be implemented November 1 utilizing the state’s ISIS system.  LifeWorks is preparing the annual report and looking at data.  Data has shown huge decreases in consumers served.  Four years ago 190 individuals were served in vocational services.  Last year 107 were served.  Individuals served in the workshop decreased from 131 four years ago to 79.  Individuals served in Community Employment decreased from 54 to 23 in four years.  Day Activities is the only program showing growth, increasing from 37 people to 44 people in four years.
    5. Northwoods: Must spend a lot of time, between staff time and a consumer meeting, determining how to use $5.02 for residents’ benefit.  Some errors found were caused by Income Maintenance Workers, who are completely overwhelmed.  Northwoods is celebrating their 20th anniversary, modestly.  Community Support Staff have been reduced by one person, possibly more in the future.
    6. Action: The current census is 41.  They are hiring a male nurse who will start on the 22nd.  They will have a Bachelor’s level student doing a community health practicum who currently works in the critical care unit.
    7. Genesis: Has had lots of referrals recently.  They have a three-year T-XIX audit.  It is difficult to find psych evals.  Dr. Barloon is not serving people living outside the Ames area.
  5. Committee Reports:
    1. Acute Care: Jim has a grant.  Law enforcement is at the table.  Irene is interested in Crisis Stabilization needs. 
    2. Education: October 29 will be the Legislative Dinner.
    3. Community Employment: Work has been done on a PowerPoint for service clubs.  SCORE made recommendations for changes.  Joan Lara is joining their group.
    4. Admin Rules: Charlie Krogmeyer will be coming October 20.

Next meeting will be Thursday October 1.

Teresa Naughton, Secretary