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Meeting Materials (PDF) Open in new window INARF Board of Directors Meeting Friday, January 24, 2014 11:00 a.m. – 12:00 p.m. Easter Seals Crossroads 4740 Kingsway Drive, Indianapolis AGENDA I. Call to Order, Welcome and Introductions II. Modification to the Agenda III. Approval of Minutes IV. Finance Committee Report - Review of Financial Statements V. Association Focused Reports and Discussion - Upcoming Events and Activities - Membership Renewal Update - 40th Anniversary Activities VI. Industry Focused Reports and Discussion - HCBS Definition – Analysis & Implications - Results: Joint Meeting on Quality - Waiver Targeting/Intake Process VII. Other Business VIII. Adjournment -- Board Minutes The INARF Board of Directors Meeting and Member Forum were held on January 24, 2014 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 Marie Dausch, Treasurer Jill Dunn, Immediate Past Chair Clint Bolser, LOGAN Community Resources, Inc. Steve Cook, AWS, Inc. Bettye Dunham, Rauch, Inc. Debbie Bennett, Hillcroft Services, Inc. Patrick Cockrum, Sycamore Services, Inc. John Niederman, Pathfinder Services, Inc. Holly Piggott, ResCare, Inc. (via telephone) Susan Rinne, LifeDesigns, Inc. Absent: Jane Wear, Cardinal Services, Inc. Guests (in Person): Rick Adams, Dungarvin of Indiana, LLC Jim Allbaugh, Carey Services, Inc. Donna Belusar, ADEC, Inc. Shane Burton, Developmental Services, Inc. Jeanine Coleman, Noble of Indiana Kent Fletcher, Snug Harbor Home Health, Inc. Leslie Green, Stone Belt Arc, Inc. Bill Hadar, Developmental Services, Inc. Julia Huffman, Noble of Indiana, Inc. Michael Lintner, Marshall-Starke Developmental Center, Inc. Cathy McNulty, Strategic Indiana Provider Network Matt Ottiger, ResCare, Inc. Julie Reynolds, BDDS Onias Taruwinga, Mosaic-Terre Haute Donald Weikle, Peak Community Services, Inc. Julia Wicks, Houston Group Homes Guests (via Webinar): Dawn Akins, ADEC, Inc. Thomas Atchison, In-Pact, Inc. Michelle Boxell, Cardinal Services, Inc. Alicia Boyd, Alicia M. Boyd, CPA PC William Cochrane, Mosaic – Northern Indiana Ellen DeMartinis, Opportunity Enterprises, Inc. Amy Flint, New Hope of Indiana Etelka Froymovich, Residential Services, Inc. Herb Grulke, In-Pact, Inc. Megan Gumbel, MDC Goldenrod, Inc. Jessica Hammett, Hillcroft Services, Inc. Bobbie Harsh, Residential CRF, Inc. Nancy Hoffman, Arc of Wabash County, Inc. Karla Horrell, Evansville Association for the Blind Mary Hunnicutt, Passages, Inc. Lynn Ihlenburg, Quality Community Services, Inc. Linda Johnson, Arc of Wabash County, Inc. Jody Kitch, New Hope Services, Inc. Jennifer Lantz, IPMG, Inc. Dan Lowe, Blue River Services, Inc. Scott Martin, Crowe Horwath, LLP Jason Meyer, Passages, Inc. Kelly Mitchell, Southern Indiana Resource Solutions, Inc. Ann Robertson, IPMG, Inc. Sally Russell, ADEC, Inc. Kelly Schneider, Easter Seals Rehabilitation Center - Evansville Catherine Strother, First Chance Center Heather Van Ness, Advocacy Links, LLC Lynn Walker, Easter Seals Arc of Northeast Indiana, Inc. Staff: Kim Opsahl, President/CEO Christiaan Campbell, Director-Research & Program Development Keith Digman, Director-Advocacy & Program Development Nanette Hagedorn, Director-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 at 10:00 a.m. He introduced guest speaker Julie Reynolds, Policy Director for the Bureau of Developmental Disabilities (BDDS). II. New BDDS Policy Director: Introduction & Discussion Julie Reynolds introduced herself as an industry veteran, having worked for INARF members Developmental Services of Indiana, Inc. and Noble of Indiana prior to accepting her position as BDDS Policy Director. In this capacity, she is focused on aligning BDDS policy and procedures with the needs of consumers. Through this effort, Ms. Reynolds and her team recently discovered concerns with the waiver targeting process. As a first step, Ms. Reynolds and her staff are working diligently to reach affected persons and connect them with case management resources. She expressed concern that families bear a great burden when loved ones are waiting for Waiver services, and reiterated Family and Social Services Administration Secretary Debra Minott and Division of Disability and Rehabilitative Services Director Nicole Norvell’s commitment to improving this process to ensure that the needs of those being served are better met. On a related note, improvements to the case management system are being considered to determine how the system may better serve consumers. Ms. Reynolds then discussed the Advocare case management system and the new provider portal which will allow agencies to view monthly reports, 90-day checklists, ICAP scores, and other information specific to individuals receiving services. The Provider Portal will be tested in February, with the goal of going live on March 1. In addition, agencies that utilize state line budgets will have access to a web portal for budget submissions, with an anticipated launch date in March or April. Ms. Reynolds explained that the Advocare system offers other technical opportunities for providers, and may serve as a conduit for Direct Support Professional training. III. Board Chair Report A. Annual Conference Mr. Sacksteder encouraged members to register for the upcoming Pre and Annual Conferences, noting that early bird registration is open until February 10. In addition to thirty educational sessions, the Pre and Annual Conference will feature a dual-diagnosis track offered by Conference Partner Meridian Health Services. B. 40th Anniversary Preview Mr. Sacksteder commended the efforts of the Marketing Subcommittee as it endeavors to design and execute an exciting marketing campaign recognizing INARF’s 40th anniversary. C. Quarterly Professional Interest Section Meeting Mr. Sacksteder encouraged all members to participate in the February 20 Quarterly Professional Interest Meeting to take place at the Fountains Banquet and Conference Center in Carmel. In addition, he shared that the Annual Membership Meeting and INARF Board meeting will be held on Tuesday, February 25 at the Hyatt Regency in downtown Indianapolis. This event will feature a luncheon with State Auditor Suzanne Crouch as a special guest speaker and will include an afternoon visit to the Statehouse. IV. President/CEO Report A. Federal Issues Kim Opsahl reviewed federal issues of interest to the provider community, including the recent Centers for Medicare & Medicaid Services (CMS) rule around Home and Community Based Services (HCBS). This rule will go into effect in March. The rule provides implementing regulations for 1915 I services, defines person-centered planning requirements, provides states an option to combine multiple populations into a single waiver, provides CMS with additional compliance options when working with states, and perhaps most importantly for INARF members defines and describes requirements for home and community based settings. The final version of the rule focuses on the characteristics of home and community versus the more prescriptive previous versions. In describing these characteristics, CMS provides a fair degree of detail as it relates to residential settings. Though, while it is clear, the HCBS settings definition applies to all HCBS services, CMS delays providing more specific guidance for other services, opting to provide it in policy, at a later date. INARF’s national partners, the American Network of Community Options & Resources (ANCOR) and the American Congress of Community Supports & Employment Services (ACCSES), are both actively engaged in discussions with CMS as these important policies are considered. In an effort to educate the public, CMS held a webinar on January 23 which will be replayed again on January 30. ANCOR and ACCSES will hold webinars as well; information regarding these activities will be made available to INARF members via email. Next, Ms. Opsahl discussed a recent Department of Justice (DOJ) findings letter issued to Rhode Island, which outlines the DOJ’s opinion regarding facility based habilitation and employment. In this letter, the DOJ found that Rhode Island was overly reliant on facility based services to the detriment of community based services. Through a series of recommendations, the DOJ directs the state of Rhode Island to rebalance its system of services and supports toward community based options. The provider response to the DOJ’s findings was generally supportive, so long as the system and associated funding supported the shift toward community based services. Lastly, the Supreme Court heard Harris v. Quinn, a case regarding in-home workers; at issue is whether a non-union worker must pay union dues for contract negotiations that benefited all workers. A decision in this case is expected in June. Overall, INARF does not anticipate that the decision will impact Indiana’s Direct Support Professional workforce. B. Industry Update Ms. Opsahl then reviewed state legislative issues, noting that INARF is not advancing any specific legislative agenda this legislative session. That being said, INARF is actively monitoring bills which may impact members, including: • HB 1004, which would allow vouchers for pre-kindergarten classes. • HB 1036, which attempts to level the playing field for Child Care Development Fund eligibility between religious-based child care facilities and secular facilities. • HB 1045, which would expand the responsibilities of occupational therapists. This bill was introduced during the 2013 legislative session but was not signed by Governor Pence • HB 1272, which addresses art therapy licensure requirements. This bill does not appear likely to pass this session. However, INARF is interested in feedback from members who provide this service as to the impact licensure might have on the current delivery system. • HB 1351, which introduces a Supplemental Nutritional Assistance Program (SNAP) pilot program to restrict food benefits to those items that provide sufficient nutritional value as identified by FSSA. This bill also includes drug testing requirements for TANF recipients. • SB 44, would require FSSA to assemble an electronic health data workgroup and report findings to the Health Commission next fall. • SB 232, which came out of the Commission on Developmental Disabilities. This bill mandates performance of a study regarding the treatment of dual-diagnosis individuals. • A related bill, SB 248, has passed the Senate and directs FSSA to report on comprehensive crisis intervention services. There is no additional information about how FSSA may reconcile these similar bills. Ms. Opsahl reminded members that rate restorations for Waivers and Group Homes went into effect on January 1. Group Home rate restorations are pending CMS approval. Once received, adjustments will be made retroactively. Ms. Opsahl also noted that DDRS published an Objective Based Allocation (OBA) bulletin which clarifies how OBA and Algo scores were calculated. The Association had requested this guidance since the inception of the OBA process. She publically thanked DDRS Director Norvell and her team for their efforts to publish this important information. Ms. Opsahl also thanked Dan Stewart with Achieva Resources and Tracy Mitchell with Bradley & Associates crediting their advocacy and persistence with making a positive impact on this issue. INARF’s rate reform work continues, and the Association will submit final recommendations regarding Wellness Coordination next week. In addition, INARF is also meeting with Bureau of Rehabilitation Services Director Kylee Hope and her staff to discuss opportunities to provide recommendations to improve the results based funding model forVocational Rehabilitation Services. Additionally, INARF continues to meet with the Bureau of Quality Improvement Services (BQIS) and an INARF work group will address targeting persons needing Waiver services with the goal of helping members prepare respond to the anticipated increase need for services. Lastly, INARF is also working with members to develop recommendations for the group home referral process and Structured Family Caregiving. Ms. Opsahl then discussed recent efforts to realign INARF staff roles and responsibilities in light of the INARF Board’s Strategic Framework. With an eye to better serving the needs of members and ensuring staff talents are leveraged across the organization, INARF staff have been reorganized around programmatic and operational lines. Of note, Barb Young, Vice President Finance/CFO and Nanette Hagedorn, Engagement & Development Director are charged with managing the organization’s operations. Christiaan Campbell, in the new role of Research & Program Development Director, and Keith Digman, Advocacy & Program Development Director are charged with building and enhancing INARF’s program offerings to ensure they are in line with member needs. Future INARF communications will provide members with additional details regarding staff restructuring. Finally, Ms. Opsahl previewed the new INARF website, which will allow better functionality for members, an enhanced member directory, and more robust information and resources to benefit the provider community. The new site will go live on January 30th. V. Adjournment 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 November 21, 2013 Board of Directors meeting minutes were presented and reviewed. MOTION 13:37 Jill Dunn moved to approve the November 21 meeting minutes as presented. Marie Dausch seconded and the motion carried IV. Finance Committee Report A. Review of Financial Statements Marie Dausch reported that INARF financial statements from December 31, 2013 reflect a positive increase in net assets from operations of ninety eight thousand eight hundred thirty one dollars ($98,831), an unrealized gain on investments of twenty five thousand eight hundred forty four dollars ($25,844), and a realized gain of seventeen thousand five hundred fifty dollars ($17,550) for a total increase in net assets of one hundred thirty nine thousand two hundred twenty six dollars ($139,226). MOTION 13:38 Marie Dausch moved to file the December financial statements for audit. Steve Cook seconded and the motion carried. V. Association Focused Reports and Discussion A. Upcoming Events and Activities Holly Piggott reported on recent professional development events, noting that the November 2013 Quarterly Professional Interest Section Meeting hosted one hundred eighty eight participants, and the January 15 Pieces to the Group Home and Waiver Puzzle training hosted forty-five participants. The Instructional Strategies Training originally scheduled for December 3 was cancelled due to low interest. Upcoming professional development events include a HIPAA HITECH training scheduled for January 28. There are a total of thirty-nine registrants to date. Registration will launch soon for the February Quarterly Professional Interest Section. Ms. Piggott also provided a status update on the INARF Pre and Annual Conference, reporting that there are twenty participants registered for the Conference, seven participants registered for the Pre-Conference Leadership Symposium, and six members registered for the Member Reception and Dinner. Exhibitor opportunities are filling quickly, with a total of thirty-one booths reserved to date and forty thousand five hundred dollars ($40,500) in sponsorships received. B. Membership Renewal Update Susan Rinne reported that membership renewal is concluding, with seventy-one members committed and five members that have yet to respond to requests. INARF staff will reach out to these members to offer additional support and encourage renewal. Two members have confirmed that they will not commit to INARF membership in 2014. C. 40th Anniversary Activities Ms. Rinne reported that the Marketing Subcommittee has made great strides with the development of a marketing plan to promote INARF’s 40th Anniversary. Activities related to the Anniversary will be previewed during the Annual Membership Meeting on February 25. In addition, the Committee is working with staff to design a comprehensivecommunications plan for both INARF and Smart Partners Alliance. VI. Industry Focused Reports & Discussion A. HCBS Definition – Analysis and Implications Ms. Opsahl reported that the Centers for Medicare & Medicaid Services (CMS) have released the Home & Community Based Services (HCBS) final rule, which includes a definition of home & community-based services. This definition includes language that can impact the provision of Day Services. Neither ANCOR nor ACCSES have expressed objections, and both organizations will hold informational webinars in the near future. Once guidance is received from CMS, the state will need to determine whether services are in compliance and what steps are needed to bring them into compliance. B. Results: Joint Meeting on Quality Bettye Dunham and Steve Cook reported that the Innovation & Systems Change Committee and the Industry Infrastructure Committee held a joint meeting facilitated by Kathy Davis on December 18. The purpose of this meeting was to identify the root causes of recent quality concerns and to determine how INARF and the provider community can better support agencies in need. Meeting participants identified several factors which contributed to agency turmoil, including lack of management oversight/involvement, staff competency, and disengaged boards of directors. In addition, it appears a lack of communication between state regulating agencies may have contributed, as well. Participants determined that next steps include the identification of provider needs and available resources, research of key quality indicators, and the eventual development of a provider assistance program to support agencies in need. MOTION 13:39 Steve Cook moved for the Board to endorse the joint Innovation Systems Change and Industry Infrastructure Committees’ recommended action steps. Jonathan Burlison seconded and the motion carried. C. Waiver Targeting/Intake Process Ms. Opsahl reported that the Division of Disability and Rehabilitative Services (DDRS) has identified a large number of individuals stalled in the waiver onboarding process. In support of DDRS, INARF is convening a work group to examine system issues and identify short and long-term solutions. INARF is encouraged by open dialog with Julie Reynolds, Policy Director for BDDS and the agency’s commitment to address this issue. VII. Other Business No other business was identified for discussion. VIII. Adjournment The next Board of Directors Meeting will be held on Tuesday, February 25 in conjunction with the INARF Annual Meeting. Both events will take place at the Hyatt Regency, located in downtown Indianapolis. Respectfully submitted, ___________________________________________ Jonathan Burlison, Secretary JB/ecp