Meeting Minutes
Webster County
MH/DD Planning Committee
Meeting Minutes

Webster County Disabilities Alliance
Planning Meeting
March 10, 2011

Present: Clark Fletcher, Ken Hays, Irene Blair, Jim Burr, Diana Johnson, Linda Smith, Deb Delp, Brian Schmidt, Lis Ristau, Teresa Naughton

  1. Diana welcomed all present.
  2. No corrections to the minutes were noted.
  3. CPC Report:
    1. The Statistical Report was shared. 
      1. Irene explained upcoming factors that will affect the fund balance.  Expenditures in January and February are down because DHS is holding onto Medicaid bills.  Irene shared information about the Federal Medical Assistance Percentage (FMAP) rates.  There was a decrease in the FMAP and therefore a decrease in the non-Federal share, through the Federal Stimulus.  The FMAP is going back up, with the end of the stimulus.  Additionally, FMAP will go even higher than it originally did because Iowa’s economy is relatively strong compared to other states.  It will go up to around 40%, with the actual amount to be determined.   Irene is worried about the next year; she does not believe Webster County will qualify for any State dollars.
      2. Irene noted there were 18 emergency commitments, and that they were seeing an increase in kids’ needs.  There were quite a few new CPC files.
    2. Tammy Swanson is a new case manager.  Janet Gadbury had a knee replacement, and Megan Lamoreaux had her baby and is on leave. 
    3. Actual savings from the Federal Stimulus last year was $677,837.
    4. Irene shared information about the Money Follows the Person grant.   The State targeted to move 500 individuals from institutions to the community.  They missed the goal and the grant was extended.   As of December 2010, 118 individuals have transitioned out of the Intermediate Care Facility for Individuals with Intellectual Disabilities since September 2008.  40 individuals have successfully completed 365 days of MFP services and have transitioned to Home and Community Based Services (HCBS).  113 individuals are “active” as of November 8, 2010.  For Webster County, two individuals have moved from ICF level care and one is in the process.
    5. Irene reported that Iowa Medicaid Enterprise (IME) is proposing to back off of Pre-Vocational Training pre-authorization.  IME was going to require pre-authorization for other services, and have not done so yet.
    6. Webster County received zero state dollars for fiscal year 11. 
    7. There are currently slots for HCBS that are controlled by the Counties, and they will be controlled soon by the State.  Irene plans to give slots to anyone who needs them.
  4. Legislation
    1. There are two bills that would impact service funding.  The bills are Senate File 481 (formerly Senate Study Bill 1077) and House File 626 (formerly House Study Bill 83).  Both bills propose movement away from a county system to something larger (regional or state).  Both bills mention pending changes with the Affordable Care Act.  The legislature wants the State to be more involved.  According to Representative Dave Heaton, the State will determine all the rates.  There is a proposal from Iowa Health System to consider a pilot project in Fort Dodge.  Deb Albrecht presented to a house subcommittee in Des Moines.  The proposal is very conceptual at this time, and would involve integrating medical care for individuals with Mental Health issues.  This would be done because people with mental health issues often have decreased health outcomes.  Trinity Regional Medical Center is applying to be an Accountable Care Organization. 
  5. Provider Reports
    1. Fort Dodge Community School District: There will be a town meeting regarding preschool at the Library with Daryl Beall.  There will be a parent meeting at Butler school regarding the future plans for the elementary schools.  Cuts to allowable growth and the budget bring concerns.  The schools have had to cut about $1 million dollars in the last three years.
    2. Vocational Rehabilitation:  No report.
    3. LifeWorks: The work for Electrolux is done since the plant is closing.  This was a good job, providing varied work for individuals with varied skills.  Work has been done to procure other contracts and work crews, but the loss still hurts.   Provider cost reports and cost-settlements have included a 2.5% margin, necessary because reports are historical yet set rates going forward.  Rate-setting from a projected report is not allowed for most services.  When the governor mandated cuts, provider rates were cut by 2.5%.  DHS also interpreted that the 2.5% margin should be eliminated as well, as shown by cost settlements recently received by providers.  Work is being done to address this concern.  We continue to be on-target to open a new home March 15th.  Also, Northwoods and LifeWorks continues to work together on sharing space at the vocational site .
    4. Northwoods Living, a Service of Opportunity Village:  Northwoods is having their annual review from the Department of Inspections and Appeals.  The review is concluding with an exit review at 9am today.  Linda affirmed that work continues on the agreement between Northwoods and LifeWorks.  There will be a fundraiser walk May 1.  Northwoods is working on Strategic Planning.  There are openings at Parkview.  Staff have been affected by flooding, surgeries, and cancer.
    5. Berryhill Center for Mental Health:  Patient contacts have increased 10%-12% in the past year.  Around the state, Mental Health Centers are being told they have to make cuts.  The Berryhill Center continues to wait for the 18-month, July 2008 to December 2009 cost report settlement.
    6. Friendship Center:  Has over 120 members and is open 6am to midnight.  A question was asked about how many hours the peer staff work per week.  Three work around 27 hours per week, others work around 20 per week.  They had a Valentine Party with food, which was well attended.  In may they will be cutting DART trips from one per month to two trips; they will plan only to go to see the Iowa Cubs and to attend the Spencer Fair.  Members are being asked to make sure they sign in/out. 
    7. Action Program:  The census is 39.  They intend to apply for a Megallan RFP, focusing on holistic care.  The RFP would address the need to improve medical outcomes for individuals with mental illness.  It would involve more prevention and education, to decrease hospitalizations and ER visits.  There were three admissions last month.
  6. Strategic Plan Goals:
    1. Acute Care/Crisis: Met at the Atrium Center and did a mini Alternatives to Violence Workshop.  The Berryhill Center and Community and Family Resources are working together to hold a training on Mental Health First Aid in the Atrium at Trinity in April
    2. Education: Had a legislative forum February 25.  Three legislators, Tom Shaw, Daryl Beall, Dave Tjepkes attended.  The committee will meet again in July.
    3. Co-Occurring Disorders Committee: Met yesterday.  There will be a training April 28 at the Foxboro Center, members of the committee will receive notification.  There will also be a Compass EZ training via teleconference.


Next meeting: Thursday May 5 at 7:30am.

Respectfully submitted,
Teresa Naughton, Secretary