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Meeting Materials (PDF) Open in new window AGENDA INARF Board of Directors Meeting Friday, September 27, 2013 11:00 a.m. – 12:30 p.m. I. Call to Order, Welcome and Introductions II. Modification to the Agenda III. Approval of Minutes IV. Review of Financial Statements V. Association Focused Reports and Discussion - Membership Support Committee - Industry Infrastructure Committee - Training and Professional Development Committee - Leadership Development Steering Committee - Direct Support Professionals of Indiana Annual Conference Results - Strategic Plan – Review and Next Steps VI. Industry Focused Reports and Discussion - Governmental Affairs Committee - Innovation and Systems Change Committee - Waiver Reimbursement Reform - CMS Activity on HCBS Definition VII. Adjournment -- Board Minutes The INARF Board of Directors Meeting and Member Forum were held on September 27, 2013 at Easter Seals Crossroads, 4740 Kingsway Drive in Indianapolis. The INARF Member Forum convened at 10:00 a.m. with the INARF Board of Directors meeting immediately afterwards. Present: Steve Sacksteder, Chair Dan Griffin, Vice-Chair Jonathan Burlison, Secretary (via telephone) Marie Dausch, Treasurer Bettye Dunham, Rauch, Inc. Debbie Bennett, Hillcroft Services, Inc. Dan Griffin, Dungarvin of Indiana, LLC John Niederman, Pathfinder Services, Inc. Holly Piggott, ResCare, Inc. (via telephone) Susan Rinne, LifeDesigns, Inc. Jane Wear, Cardinal Services, Inc. Absent: Clint Bolser, LOGAN Community Resources, Inc. Steve Cook, AWS, Inc. Jill Dunn, Immediate Past Chair Patrick Cockrum, Sycamore Services, Inc. Guests (in Person): Rick Adams, Dungarvin of Indiana, LLC Jim Allbaugh, Carey Services, Inc. John Dickerson, The Arc of Indiana Randy Krieble, The Arc of Indiana Jeff Frady, Indiana MENTOR Bill Hadar, Developmental Services, Inc. Julia Huffman, Noble of Indiana, Inc. Michael Lintner, Marshall-Starke Developmental Center, Inc. Satrina McDonald, FSSA Jason Meyer, Passages, Inc. Dick Rhoad, Wabash Center, Inc. Ann Robertson, IPMG, Inc. Jill Smith, The Arc of Indiana Mike Stone, Impact Strategies Inc. Onias Taruwinga, Mosaic-Terre Haute Member Forum Guests (via Webinar): Donna Belusar, ADEC, Inc. Clint Bolser, LOGAN Community Resources, Inc. Tammy Boltz, Blue River Services, Inc. Bob Bond, ResCare, Inc. Alicia Boyd, Alicia M. Boyd, CPA PC Kim Fledderman, Developmental Services, Inc. Amy Flint, St. Vincent New Hope Janessa Gerber, LifeDesigns, Inc. Leslie Green, Stone Belt Arc, Inc. Joy Greeney, Advocacy Links Jan Griffeth, Bethesda Lutheran Communities Herb Grulke, In-Pact, Inc. Megan Gumbel, MDC Goldenrod, Inc. Rick Hall, Mutual of America Jessica Hammett, Hillcroft Services, Inc. Tonia Hassinger, Developmental Service Alternatives, Inc. Yadira Howe, Indiana MENTOR Lynn Ihlenburg, Quality Community Services Linda Johnson, Arc of Wabash County, Inc. Robin Klakamp, Developmental Services, Inc. Danie Lowe, Blue River Services, Inc. Kelly Mitchell, Southern Indiana Resource Solutions, Inc. Daniel Norris, LifeDesigns, Inc. Matt Ottiger, ResCare, Inc. Kelly Schneider, Easter Seals Rehabilitation Center Kirk Stoltzfus, The Arc of LaGrange County Pam Verbarg, Wabash Center, Inc. Lynn Walker, Easter Seals Arc of Northeast Indiana Ruth Ann Widman, Jay Randolph Developmental Services, Inc. Staff: Kim Opsahl, President/CEO Barb Young, Vice President/CFO Christiaan Campbell, Director – State Use Program Keith Digman, Director-Member Support & Advocacy Nanette Hagedorn, Director – Membership Engagement & Development Elizabeth Patel, Coordinator – Communications & Advocacy INARF Member Forum I. Call to Order, Welcome & Introductions Steve Sacksteder welcomed attendees and called the meeting to order. He introduced John Dickerson, Randy Krieble, and Jill Smith from The Arc of Indiana. II. Discussion: Using My Life, My Choice with ICF/DD Programs John Dickerson of the Arc of Indiana introduced Indiana’s “My Life, My Choice” program, an initiative designed to empower self-advocates when making decisions regarding community living options. “My Life, My Choice” is an interview process based upon a successful model implemented in Maryland that uses specially trained self-advocates to interview their peers. “My Life, My Choice” began by working with individuals residing in nursing facilities, with the goal of presenting community living options and assessing the level of interest individuals had in exploring those options. In a second round of interviews, interviews took place with individuals residing two large private ICFs/DD. After 1,000 successful interviews, 100 persons have asked to further explore community living. According to current DDRS policy, interviews will now be extended to those who have been residing in supervised group living settings for five years or more. Randy Kriebleexplained how self-advocates conduct interviews using questions and prompts on iPads. Each question is crafted to avoid persuading interviewees to answer in any specific way. Individuals and/or their guardians may opt not to participate in the interview process. They may also request for staff to assist with the interview. A total of ten trained interview teams consisting of self-advocates and support staff conduct interviews with individuals; family members are invited to participate as well. Interviews take place in locations which are comfortable for the individual. In the event that they elect to explore community-based living options, the Bureau of Developmental Disabilities Services (BDDS) will follow up to determine next steps. Satrina McDonald of BDDS stated that “My Life, My Choice” is an important part of the Family & Social Services Administration’s (FSSA) efforts to develop a more consumer-centric culture. Individuals will not be persuaded to leave group homes. She clarified that in the event that individuals choose to leave group home settings, group home vacancies will be filled. Mr. Dickerson closed by asking for input from INARF members on the “My Life, My Choice” program. III. Board Chair Report A. Strategic Planning Update Mr. Sacksteder welcomed three new CEOs to the INARF family: Jim Allbaugh of Carey Services, Inc., Jason Meyer of Passages, Inc. and Donna Belusar of ADEC. Mr. Sacksteder also reported that INARF’s strategic planning process was moving forward, with a final draft of the strategic framework document in the works. Strategic planning facilitator Mike Stone of Impact Strategies would be presenting the document to the INARF Board immediately following the Member Forum. A comprehensive strategic planning document will be available at year end. B. October CEO Roundtable Mr. Sacksteder requested that members submit topics for the upcoming CEO Roundtable to be hosted on October 25 at Easter Seals Crossroads. Ideas for CEO Roundtable topics may be submitted to Kim Opsahl. IV. President/CEO Report A. Federal Issues Kim Opsahl advised regarding the United States Department of Labor (DOL) recently issued regulation that companion workers will no longer be exempt from overtime pay. The September 2015 implementation date will allow states to adjust funding mechanisms accordingly. Overall, companion workers are not widely utilized by Hoosier disability service providers, and are most often found in homecare and aging settings. Ms. Opsahl also reported that ACCESS, a national association representing disability services providers, has cited concerns that CMS is requiring states to comply with its draft rules relative to defining home and community based services. The proposed rule was published in May 2012and could have significant impact for pre-vocational and residential services. INARF will continue to monitor this issue both in terms of issuance of the final rule, as well as to what extent CMS is requiring states to comply with the draft provisions. Lastly, Ms. Opsahl reported that federal budget drafting is taking place, with much debate regarding the debt ceiling. Any negative fiscal impact on Social Security may affect persons with disabilities, and INARF will follow budgetary developments closely to determine whether action on behalf of providers is necessary. B. Waiver Reimbursement Reform Ms. Opsahl reported that FSSA has approved an additional 1% increase in certain Medicaid Waiver rate reimbursement, bringing the effective January 1, 2014 increase to 2%. Services that will be impacted include Respite Care, Residential & Habilitation Services; and Community Habilitation Individual & Facility Habilitation Individual. In addition, discussions regarding Healthcare Coordination are progressing well, with DDRS Director Nicole Norvell aiming to submit a waiver amendment seeking approval to add Healthcare Coordination in the very near future. C. Legislative Update Ms. Opsahl reported that interim study committees are still meeting, with the Commission on Developmental Disabilities slated to hold a fourth meeting in October before adjourning for the year. INARF, The Arc of Indiana, DSPIN, and the Indiana Institute on Disability & Community all testified before the Commission throughout the summer. DSPIN was invited to testify for a second time this week in order to follow up on issues related to DSP educational programming and reimbursement. INARF and DSPIN will follow-up to reinforce that these issues should be studied further before taking action; the intent of DSPIN’s testimony was to start a conversation and begin meaningful work toward a more professional DSP workforce. The recent Health Finance Commission meeting focused on the one year extension of the Healthy Indiana Plan (HIP). Of note was the change in eligibility requirements allowing those earning up to 100% of federal poverty level to access HIP. Those earning amounts between 100% and 200% of the federal poverty level may access health insurance through the newly established healthcare marketplaces. INARF will continue to monitor interim study committee activity as the interim period draws to a close. INARF Board of Directors Meeting I. Call to Order, Welcome and Introduction Steve Sacksteder, INARF Board Chair, welcomed those in attendance. II. Modification to the Agenda There were no modifications to the agenda. III. Approval of Minutes The August 27 Board of Directors meeting minutes were presented and reviewed. MOTION 13:28 Bettye Dunham moved to approve the August 27 meeting minutes as presented. Dan Griffin seconded and the motion carried IV. Review of Financial Statements Marie Dausch reported that the August financial statements reflect a positive position of eighty-nine thousand three hundred dollars ($89,300) from operations and ten thousand seven hundred dollars ($10,700) from an unrealized loss on investments for a total increase in net assets of seventy eight thousand five hundred dollars ($78,500). Ms. Dausch reported that the Finance Committee met and reviewed the annual report from the investment advisor regarding INARF’s portfolio and suggestions for Investment Guidelines. The Committee discussed the overall level of satisfaction with services provided and recommended that staff perform a request for proposals process for investment advisory services to ensure that fees and performance expectations are competitive. The Committee also reviewed fiscal management policies with only minor changes noted. Lastly, the Committee had a brief discussion regarding a member’s request to pay dues via credit card. The consensus was for staff to decline the request due to excessive fees that would be incurred by INARF. MOTION 13:29 Marie Dausch moved to approve the August financial statements be filed for audit. Dan Griffin seconded and the motion carried. V. Standing Committee Reports A. Membership Renewal Nanette Hagedorn reported that the membership renewal process for institutional members would launch on October 1, and requested that the Board support the process by initiating contact with member organization CEOs to encourage renewal. Ms. Hagedorn will share CEO contact requests with each Board member. B. Industry Infrastructure Committee John Niederman reported that the Committee recently discussed how to facilitate member-to-member purchasing and will continue to further explore this subject. C. Training & Professional Development Committee Holly Piggott reported that the Committee has been focused on developing the 2014 INARF Annual Conference and upcoming webinars related to training. She noted that the INARF & Arc of Indiana Legislative Briefing and Legislative Awards events will be rescheduled; an announcement regarding these events will be made in the near future. Ms. Piggott reviewed additional upcoming INARF events, including the following: Fraud & Embezzlement: Lessons from the Trenches (webinar) on October 22; Person-Centered Planning & Individual Support Plan Facilitator Training on October 23-24; High Risk Plans: Is Your Staff Good or Are You Lucky? on November 12; HIPAA HITECH: Understanding Your Obligations Under the New Omnibus HIPAA Rule, which will take place on a date to be determined; Instructional Strategies Training on December 3 and the 2014 INARF Annual Conference on March 13-14. D. Leadership Development Steering Committee Jane Wear reported that the second Technology Summit was a success, with 117 people in attendance. The increase in sponsors and vendors involved in the event resulted in additional revenue as compared to the previous year’s event. Ms. Wear encouraged the Board to attend upcoming professional development events and thanked them for their support. E. Direct Support Professionals of Indiana Annual Conference Results Keith Digman reported that the Direct Support Professionals of Indiana (DSPIN) Conference was a success, with 145 people in attendance. The Conference focused on the need for DSP advocacy, and concluded with DSPs writing letters of support to Governor Pence, thanking him for issuing a proclamation declaring September 9-13 DSP Recognition Week and urging him to support the direct support profession. VI. Industry Focused Reports A. Governmental Affairs Committee Kim Opsahl reported that the Rate Reform Work Group, chaired by Steve Cook, made great strides in its efforts to promote Healthcare Coordination as a Medicaid Waiver service. Ms. Opsahl noted that INARF is continuing work on issues related to Managed Care, and presented comments to the FSSA Aged, Blind and Disabled (ABD) Task Force, and recently offered testimony before the Task Force. In addition to these formal opportunities for comment, INARF participated in a recent meeting between fellow Long-Term Services and Supports advocates and FSSA Secretary Debra Minott and her team. This provided an additional opportunity to share INARF’s concerns, relative to this issue. It is anticipated that the Task Force’s draft report will be released in October with a 30 day period for public comment, and the final draft of the report must be submitted to the Health Finance Committee by December 15. The Committee has also been working on issues related to voluntary group home conversion, with a current focus on the “My Life, My Choice” interview process. Committee members hope to see transparent, fair interviews with an efficient vacancy and referral processes when individuals choose to move out of the group home setting. Ms. Opsahl noted that DDRS’ Supervised Group Living Conversion Task Force would function as a vehicle to advance discussions regarding voluntary group home conversion. In addition, INARF will work closely with The Arc of Indiana as the “My Life, My Choice” program is introduced and implemented. B. Innovation & Systems Change Committee Mr. Digman reported that the Committee continues to work on key issues, including treatment of individuals with dual-diagnosis, electronic health records, and working with the Bureau of Quality Improvement Services (BQIS). The Dual-Diagnosis Work Group has been researching crisis intervention and support options, and will author a white paper outlining the key components of a crisis intervention system for Indiana. Maureen Gahan of Stone Belt Arc, Inc. gave an in-depth presentation to the Committee regarding her organization’s use of Electronic Health Records. The Technology Work Group will follow up with Purdue University and other entities specializing in health information management to determine best practices. The Committee recently met with Shelly Thomas of BQIS to discuss key issues including deemed status and the provider re-approval process. During this meeting, the Committee also discussed trying to achieve better alignment between the state’s assurances made to CMS through its waiver applications and accreditation standards. Moving forward, BQIS wishes to focus on quality improvement over compliance and will continue working collaboratively with the Committee. C. CMS Activity on HCBS Definition Ms. Opsahl reported that ACCSES issued an action alert related to recent CMS activity around the definition of home and community based services. She encouraged Board members to review the action alert and take any additional steps they deem necessary. VII. Strategic Plan-Review and Next Steps Mike Stone of Impact Strategies presented a strategic framework document to guide INARF’s strategic planning work. This document is the result of the Board’s strategic planning discussion held in late July. He reviewed the updated mission and vision statements; noting the need to distinguish INARF, as a trade association, from its provider members. Mr. Stone reviewed INARF’s core values of access, choice, and options in services, noting that INARF must allow the core values to guide policy positions and everyday work. After reviewing the attached framework, Mr. Stone explained that next steps will include working with staff and the INARF Executive Committee align the Association’s resources with the framework. Mr. Stone encouraged Board Members to review the strategic planning framework document and share feedback with Ms. Opsahl and the INARF staff. VIII. Adjournment The next Board of Directors Meeting will be held on October 25, with a CEO Roundtable to be held immediately afterwards. Both events will take place at Easter Seals Crossroads in Indianapolis. Respectfully submitted, ___________________________________________ Jonathan Burlison, Secretary JB/ecp