Albemarle CPMT Charlottesville CPMT Joint Committee Meeting Minutes Wednesday, September 19, 2018 County Office Building 401 McIntire Road, Second Floor Room 235 Present: Phyllis Savides, Jennifer Wells, Katie Ralston, Kevin Kirst, Kaki Dimock, Diane Kuknyo, Erin Callas, Neta Davis, Hope Robinson, Misty Graves, and Lori Allshouse. Absent: Martha Carroll and Katrina Lee Guests: Barret Stump-Private Provider-Director of Layfette School Samantha Tran, Nicole Aquino and Eric Moy-UVA Nursing School Quorum: Albemarle: Yes Charlottesville: Yes Phyllis Savides called the meeting to order at 3:32. Phyllis asked Ms. Stump to speak to the CPMT regarding her billing dispute with the CDSS. Ms. Stump shared that Lafayette is a private day school that has been serving Charlottesville since 1999. They work with children that are emotionally disabled, schizophrenic, high functioning Autism to name a few examples. Lafayette school signed a contract with CDSS, which includes a rate sheet. The rate sheet indicates that there are 13 billable days in August; however, the students are only actually in the school building for 8 of those days. Ms. Stump shared that she was informed by CDSS that CSA would not pay for days when the students are not in the building. Ms. Stump claimed that given the CSA contract was signed prior to the POSO being submitted, CDSS should uphold the agreement and pay the invoice as submitted. Phyllis said that since legally, Charlottesville and Albemarle are two separate CPMTs, she clarified that this dispute is with Charlottesville CPMT. Kaki, as Chair of the City CPMT, responded that she and others would look into the issue and contact Ms. Stump within a week to give a status update. In regards to the contract, Kevin pointed out that the CPMT may need to revise next year’s contract to clarify what it means by services rendered to insure that providers understand what the CPMT is looking for with regards to billable services. He also noted that it may be worth looking at other private day providers to be sure the CPMT knows what they are purchasing, as it relates to billable days. . Agenda Item: Review & Approval of the Agenda/ Acceptance of Consent Agenda Presenter: Chair Discussion/Summary: Phyllis needs a motion to approve the consent agenda from Charlottesville and Albemarle. Documents/Resources: September 2018 Agenda, August 2018 Minutes, August Financial Reports sent by email. Next Steps/Action(s) Taken: Kaki Dimock made a motion to approve the consent agenda for Charlottesville, which was seconded by Erin Callas. Hope Robinson made a motion to approve the consent agenda for Albemarle, which was seconded by Kevin Kirst. Both motions passed. Agenda Item: Action: CSA Provider Agreement Revisions for September Presenter: CSA Coordinators Discussion/Summary: There were no agreement revisions for Albemarle for September. Charlottesville had one that was approved today for Grafton. The biggest issue was background checks. The City Attorney wanted to be sure that employees were not working with clients until their background checks were clear. Documents/Resources: Katie passed out the Grafton provider agreement to Charlottesville CPMT Next Steps/Action(s) Taken: Kaki Dimock made a motion to accept the revisions on the provider agreement for Grafton, which was seconded by Diane Kuknyo. The motion passed. Agenda Item: Action: Local Policy Revision Presenter: CSA Coordinators Discussion/Summary. Tabled until next month Documents/Resources: Next Steps/Action(s) Taken: will be added to October agenda Agenda Item: Presentation-Work Plan Update Presenter: Phyllis Savides and Kaki Dimock Discussion/Summary: Goal One was updated to take out strategies that have been accomplished and add the multicultural expectations submitted by Program. Goal Two is directly related to the work of the data committee finalizing the data dashboard and the elements that we should track, analyzing data on a cycle. The data workgroup can revise the goal as appropriate. Goal Three had to do with increasing visibility of the CPMT. Presentations were made at BOS and City Council but there were other audiences included. (State Leg, Parents, school boards) Goal Four had to do with CPMT structure including Program’s role. Tim Breedlove as Program chair talked about what communication should be between FAPT, Program and CPMT. Discussion touched on having Program chair attend CPMT, Program meeting quarterly, getting feedback from FAPT and feedback regarding provider impact and strength. Phyllis said this is what the small group tried to pull together by looking at the formal work plan and discussion from the retreat. Did we get this right? Did we miss something? There was a fair amount of discussion about inclusion of everybody taking account of different cultures and there were feelings that some services were not available. A letter was sent out to providers giving them guidance on what expectations we had. It was not in the contract and several providers gave feedback that they were unable to meet those expectations. Phyllis is hearing there is a question on whether we want to make changes to the practice model, as it is referenced in the contract that providers sign. Kevin feels we should review it to confirm what is in place and if anyone has a concern, it can be addressed. Phyllis clarified that we would review the entire practice model. Phyllis and Kaki agree that the Data workgroup can review goal two. Goal Three: What is the best way to create a story of CSA that could be presented to the BOS, City Council, School Boards and families/parents? Possibly a creation of a template/presentation that can be modified to fit the audience who is hearing the presentation. Phyllis is proposing that this mirrors what was discussed at the retreat. Did we get this right for moving forward, Kevin says yes. Kaki said there have been no other presentations since last Fall for the Albemarle BOS, Charlottesville City Council and respective School Boards. CPMT has given public comments to OCS and the legislature. Phyllis asked if we want to move to another group or if we want to do another presentation for BOS, City Council and School Board. Kevin said he has to do a yearly CSA update anyway so it would make sense to re-visit presenting to the BOS, etc. Phyllis also said that we should tackle how to get feedback from families/parents. Lori asked about considering use of social media to give the public awareness of CPMT. Kaki does not believe the general public needs to know about CPMT/CSA but we do need to focus on the families and groups that do need us. CPMT should flex advocacy muscles (public notice for example) and Phyllis believes we use appropriate advocacy groups to accomplish this. Goal Four Kaki said that data should be reviewed in the 2nd quarter rather than the first to make sure all the data is available. Service Gaps would be done in the 3rd quarter. We need to obtain regular feedback from FAPT and gather data from the cost containment group. We need to finalize Program’s guidance. We need the Program chair to attend CPMT, would like Program to meet quarterly. Right now, Program will meet in October and is looking to elect a chair. Documents/Resources: Updated work plan Next Steps/Action(s) Taken: informational: Review of practice model will be added to the October agenda. Phyllis will come up with a written communication that she will send to Program with guidance. Agenda Item: FAPT Update Presenter: CSA Coordinators Discussion/Summary: There is nothing to report for September Documents/Resources: Next Steps/Action(s) Taken: informational Agenda Item: Review of Routine Foster Care Expenses/FAPT Approved Expenses Presenter: CSA Coordinators Discussion/Summary: There were no questions from CPMT Documents/Resources: Albemarle/Charlottesville documents sent by email Next Steps/Action(s) Taken: Informational Agenda Item: CSA Coordinator Update Presenter: CSA Coordinators Discussion/Summary: Exciting news that the Charlottesville CPMT is having an Audit due in November. It is the Self-Assessment Workbook, which is the same that the County completed last year. Documents/Resources: none Next Steps/Action(s) Taken: Katie will need information from Charlottesville CPMT members to complete the audit. In addition, will share information with CPMT as she progresses. Agenda Item: OCS Communications Presenter: CSA Coordinators Discussion/Summary: There were no OCS Communications to share with CPMT. An Email was sent out about new CPMT member training. Documents/Resources: none Next Steps/Action(s) taken: Jennifer will forward the training email out to members Agenda Item: Program Committee Update Presenter: CSA Coordinators Discussion/Summary: no update Next Steps/Action(s) Taken: Program will meet in October and hope to elect a Chair. Phyllis will send a letter to Program with guidance regarding their meeting frequency and focus. Agenda Item: Data Committee Report Presenter: Kaki Discussion/Summary: Nothing to report for September Documents/Resources: none Next Steps/Action(s) taken: Kaki plans to bring the data to the October meeting showing 5-year trends. Agenda Item: Cost containment/Quality Control Workgroup Presenter: Phyllis Savides Discussion/Summary: In July, a report came out on the work done so far. A letter was sent out to providers with the contracts asking providers to provide justification when raising their rates. The Workgroup was interested in how to empower the caseworkers to ask questions of providers regarding progress. Caseworkers should be encouraged to request more timely and real time information about what work is being done and progress. Phyllis is sharing some of the feedback from some of the providers and she feels it is important for us to be aware of what outpatient therapists are asking for. Phyllis said that this illustrates the dilemma facing the work group. We cannot make the providers do this but we are suggesting/requesting that outpatient therapists develop a plan of care (template) and a monthly report template where with the invoice the therapist would submit this form. It could be a way of keeping the FAPT and Case Managers informed in what is really happening. If we can get good information this way, it might make more sense to purchase the services at the rate. Not just, accept the rate without holding the provider accountable for describing what they are doing. The work group did want CPMT to approve these documents. It is simply a request that would be asked of the therapists. Many providers are not accepting Medicaid or insurance. CSA is the best payer. Documents/Resources: Letter and Plan documents sent out Next Steps/Action(s) taken: CPMT agreed that we should send out the letters to the providers and Phyllis will report. Agenda Item: Other Business from CPMT Presenter: Kaki Discussion/Summary: nothing for this month Documents/Resources: n/a Next Steps/Action(s) taken: Presentation Schedule October: Private Provider Rep-Hope Robinson for DePaul November: Charlottesville City Public Schools-Katrina Lee December: Phyllis Savides adjourned the meeting: 4:56 Next scheduled meeting: October 17, 2018 Respectfully Submitted: Lisa Jordan