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Meeting Materials (PDF) Open in new window INARF Board of Directors Meeting Friday, April 25, 2014 11:00 a.m. – 12:30 p.m. Easter Seals Crossroads 4740 Kingsway Drive, Indianapolis Training Room 1 & 2 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 - Finalize President/CEO Performance Evaluation - Upcoming Events and Activities - Committee Structure & Appointments - Strategic Framework Implementation VI. Industry Focused Reports and Discussion - Update: Quality Conversations & Activities - Administrative/Legislative Update - HCBS Settings Rule & Implications VII. Other Business VIII. Adjournment -- Board Minutes The INARF Board of Directors Meeting and Member Forum were held on April 25, 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 Jill Dunn, Immediate Past Chair Holly Piggott, Secretary Jim Allbaugh, Carey Services, Inc. Debbie Bennett, Hillcroft Services, Inc. Steve Cook, AWS, Inc. Susan Rinne, LifeDesigns, Inc. Jane Wear, Cardinal Service, Inc. Absent: Patrick Cockrum, Vice Chair Marie Dausch, Treasurer Jonathan Burlison, Bridges of Indiana, Inc. Bettye Dunham, Rauch, Inc. Dan Griffin, Dungarvin Indiana, LLC John Niederman, Pathfinder Services, Inc. Pam Verbarg, Wabash Center, Inc. Guests (in Person): Rick Adams, Dungarvin Indiana, LLC Shane Burton, Developmental Services, Inc. Anne Davis, BQIS Connie Dillman, Tangram Leslie Green, Stone Belt Arc, Inc. Linda Johnson, Arc of Wabash County, Inc. Bill Hadar, Developmental Services, Inc. Michael Lintner, Marshall-Starke Developmental Center, Inc. Cathy McNulty, Strategic Indiana Provider Network Jason Meyer, Passages, Inc. Dick Rhoad, Wabash Center, Inc. Ann Robertson, IPMG Jane Ruff, Hopewell Center Connie Sanders, Janus Developmental Services Guests (via Webinar): Bob Bond, ResCare, Inc. Tony Euler, Rauch, Inc. Janessa Gerber, LifeDesigns, Inc. Joy Greeney, Advocacy Links Matt Harrington, LOGAN Community Resources, Inc. John Hickey, ResCare, Inc. Yolanda Kincaid, Carey Services, Inc. Jennifer Lantz, IPMG, Inc. Dan Lowe, Blue River Services, Inc. Danie Norris, LifeDesigns, Inc. Louise O’Connell, First Chance Center Sally Russell, ADEC, Inc. Kelly Schneider, Easter Seals Rehabilitation Center - Evansville Catherine Strother, First Chance Center Angie Tyler, Tangram Lynn Walker, Easter Seals Arc of Northeast Indiana, Inc. Staff: Kim Opsahl, President/CEO Barb Young, Vice President/CFO Christiaan Campbell, Director-Research & Program Development Keith Digman, Director-Advocacy & Program Development Nanette Hagedorn, Director-Engagement & Development Terri Dye, Administrative Assistant/Membership Support Harley Ehrman, Communications & Marketing Coordinator 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 Anne Davis, Director for the Bureau of Quality Improvement Services (BQIS). II. New BQIS Director: Introduction & Discussion Anne Davis introduced herself as director of the Bureau of Quality Improvement Services. Her primary focus in assuming this role is to get the Bureau focused on quality improvement. Ms. Davis shared that she has been with the State since 2010 as the former State Director of Special Education and then became the Director of Individualized Learning in which all programs for underserved children came under her purview. Prior to working for the state, Ms. Davis worked with the City of Hammond School District for 18 years in which she was an Administrator. She was responsible for revamping the district’s special education programs to make them more inclusive by shifting the focus on what additional services may be needed. Ms. Davis shared this is the mindset she brings to her role with BQIS. After hearing from INARF members, colleagues, consumers and guardians it seems clear that quality improvement has been lacking, she wants to focus on how we know that services are being provided appropriately, not just about the monitoring and compliance. Additionally, she hopes to incorporate opportunities to giving recognition to providers who have good practices in place. Ms. Davis then discussed what she has learned thus far is that there are a lot of processes and systems that do not always make sense. She believes if one does not know why or what the purpose of something is, it cannot be made better. She intends to focus her efforts toward building four (4) components to quality improvement, sot that the Bureau is not only in the business of identifying problems, but about also supporting efforts on how to address them. • Defining and clarifying compliance by assuring policies and process are clear and understandable. • Looking at data in a proactive manner in order to find trends and patterns to help the provider make better decisions about the work they do every day • Improving processes related to incident reports, complaints, and mortality review, including responding more effectively to that data. • Providing support and technical assistance. How to help providers know what is available? What resources and trainings are available to respond to the data? Ms. Davis explained that she wants the Bureau to be about not only the business of problems, but about how to address it. Ms. Davis shared that she looks forward to a great partnership between the Bureau and member providers. She encouraged members to have open conversation and dialogue with her. III. Board Chair Report A. Quarterly Professional Interest Section Meeting Mr. Sacksteder encouraged all members to participate in the upcoming May 15 Quarterly Professional Interest Meeting to take place at the Fountains Banquet and Conference Center in Carmel. B. Association Activities & Updates Mr. Sacksteder welcomed new Board of Directors members Jim Allbaugh, Carey Services, Inc. and Pam Verbarg from Wabash Center, Inc. Next, he announced new institutional member, Goodwill Industries of Northeast Indiana and three (3) new associate members, Ann Overmyer, US Automatic Fire & Security, and Gibson. Mr. Sacksteder shared that Costa Miller and Jim Hammond will be presented with the ANCOR Legacy Leader Award in May. Mr. Miller’s children will be accepting the award in his honor and Mr. Hammond will also be present. The new Executive Committee members are Patrick Cockrum and Holly Piggott. Jonathan Burlison and Dan Griffin remain on the Board as members at large. The last function of the previous executive committee was the President/CEO’s performance evaluation for Ms. Opsahl after the complete of a full year in her new position. Lastly, he announced that, Ms. Opsahl will graduate summa cum laude from the Indiana University Robert H. McKinney School of Law. Ms. Opsahl was commended on her achievement. IV. President/CEO Report A. INARF Activities of Note Kim Opsahl began by introducing INARF’s new Communication and Marketing Coordinator, Harley Ehrman. Ms. Ehrman will be involved with publications, website development, marketing activities and grassroots support. B. Federal Issues Kim Opsahl reviewed federal issues of interest to the provider community, including the Centers for Medicare & Medicaid Services (CMS) recently published Home and Community Based Services (HCBS) Settings Rule toolkit which includes four (4) tools: 1.) a summary of regulatory requirements, 2.) a schematic of the “heighten scrutiny process”, 3.) technical guidance on settings that isolate, and 4.) exploratory questions to assess residential settings. Next, she shared the Rhode Island and DOJ Consent Decree around employment and day services. The decree is a result of DOJ’s findings of over-reliance on facility based employment and day habilitation. The decree is essentially a 10 year rebalancing plan to move toward more community-based day and employment options. It is projected to impact 3,250 individual statewide. The target populations groups are: transition age youth, sheltered workshop participants and day habilitation participants. Other key features of the decree are: Outreach, Education and Support; Provider Capacity; Interagency Collaboration; Funding; Quality Assurance; Data Collection & Monitoring. Overall targets for most individuals in the system are at least 20 hours per week in Integrated Employment, with a balance of up to 40 hours per week in Integrated Day Services. Some exception processes are available and require completion of vocational assessment, trial work experience, outreach and education, and benefits counseling. C. Industry Update Ms. Opsahl then shared the Governmental Affairs Committee (GAC) will be meeting to finalize the agenda for the 2015 legislative session. It is an important session in that it is a budget setting session. INARF Work Group Activities • Rate Reform Initiatives continue. The work group is finalizing the RHS daily rate recommendations. The group also continues their discussion around day services and finding a solution to the ratio system for facility based services. • BQIS Activities included those discussed by Anne Davis earlier. INARF continues to meet with BQIS on a monthly basis. The purpose of those meetings is to address accreditation requirements and provide clarity on what deemed status means within the system. • Waiver Transition group is wrapping up its work to identify recommendations for improving the manner in which new individuals enter the system and begin services. This group will also be tapped to assist in drafting the Association’s comments to the CIH Waiver. • The Group Home Advisory Workgroup will be meeting with Locket Phillips and Julie Reynolds in May to discuss ways to improve the group home referral and vacancy process • Shared Living Development (Structured Family Caregiving) work group continues to meet to develop recommendations to improve the use and availability of this service. The group anticipates submitting recommendations to be incorporated into the CIH Waiver re-write. • INARF continues to work with our case management members to better identify issues and concerns. State Administrative Issues • The Office of Medicaid Policy and Planning recently announced plans to launch a Managed Care Pilot that will involve 75,000 individuals. The target group does not include dual eligibles, nursing facilities and ICF/DD enrollees, HCBS Waiver enrollees, and MFP enrollees. Benefits included are primary care, acute care, prescription drugs, behavioral health, emergency services, and transportation. Carve-outs include Medicaid Rehab Options (MRO), 1915(i) services, dental, First Steps, IEPs. A Request for Information from prospective vendors was published April 16 with responses due back by May 1. An Request for Proposals is anticipated about mid-May with a vendor selection to be made late Fall and the program going live January 1, 2015. • As a result of testimony provided at the DD Commission, the Division was asked to complete a gap analysis of services for individuals who are dually diagnosed. The Division is working with the University of New Hampshire Institute on Disability on this project which is anticipated to be complete this fall. The analysis includes a report of findings and a set of recommendations and considerations for improving the system. These recommendations will be based on a Tertiary Care Model which focuses on improving the infrastructure of the system as a whole making sure there are appropriate specialized services for populations that have unique needs and circumstances and then a crisis intervention component available to all. An electronic survey will to be sent to all providers for feedback, phone interviews with families and focus groups with different constituencies to talk thru some of the issues. • Community Integration and Habilitation Waiver is up for re-write to be submitted on July 1 with effective date of October 1. As a means to gather stakeholder input, the Division is currently seeking feedback on the current Waiver. INARF staff are currently analyzing the current waiver to identify recommendations for changes and improvements. INARF recommendations will be shared with members, who are encouraged to submit comment, as well. • OMPP is continuing to make progress on efforts to transition to 1634 status, which aligns eligibility for Medicaid with Social Security disability eligibility. This will not likely impact a large number of individuals our members served. 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 February 25, 2014 Board of Directors meeting minutes were presented and reviewed. MOTION 14:7 Jill Dunn moved to approve the February 25 meeting minutes as presented. Debbie Bennett seconded and the motion carried IV. Finance Committee Report A. Review of Financial Statements Barb Young reported that INARF financial statements from March 31, 2014, reflect a positive increase in net assets from operations of fifty seven thousand eight hundred seventy ($57,870), an unrealized gain on investments of fourteen thousand eight hundred sixty four dollars ($14, 864), for an overall change in net assets of seventy two thousand seventy hundred thirty five ($72,735). MOTION 14:8 Jane Wear moved to file the March financial statements for audit. Steve Cook seconded and the motion carried. V. Association Focused Reports and Discussion A. Finalize President/CEO Performance Evaluation Mr. Sacksteder reported that the executive committee completed Ms. Opsahl’s performance evaluation for the first full year in her new position. He thanked the Board members for their feedback that was considered in the evaluation. Minor adjustments to the performance criteria were approved by the Executive Committee meeting. Ms. Opsahl reviewed the 2014 President/CEO Performance Goals with the Board. B. Upcoming Events and Activities Holly Piggott reported on the 2014 INARF Annual Pre-Conference and Conference events, noting that there were 95 participants in attendance at the Pre-Conference Leadership Symposium. In addition she reported that there were 75 participants in attendance at the Member Reception and Dinner. For the Annual Conference there were 211 full, and 103 one-day registrations. There were 79 exhibitors in attendance. Ms. Piggott also reported on the upcoming professional development activities. On May 6 and 7 there will be a Person-Centered Planning & Individual Support Plan Facilitator training, which is sold out. In addition on May 8 and 9 the Training and Professional Development Annual Conference Planning Retreat will be held in Michigan City and the Quarterly Professional Interest Section Meeting will be held on May 15 at the Fountains Banquet and Conference Center. C. Committee Structure and Appointments Ms. Opsahl reported that typically April is the time to make adjustments to committee appointments but that is being delayed about a month to realign committees based on the strategic framework. The changes are focused on putting a more formalized process in place to provide clarity on roles, responsibilities, and purpose. D. Strategic Framework Implementation Ms. Opsahl provided an update on the Strategic Framework. Over the past months staff and committees have developed various objectives and tactics to further each position statement. To this end, she shared an overview of the statements and various objectives which details committee assignments and operations areas. As work towards these objectives moves forward, regular progress reports will be provided. VI. Industry Focused Reports & Discussion A. Update: Quality Conversations and Activities Steve Cook reported on activities of the Innovation & Systems Change Committee (ISC) and the Industry Infrastructure Committee (IIC) resulting from their joint effort to improve and address quality. The ISC has primarily focused on developing a survey to collect information on member expertise, experience with outside technical assistance resources, and technical assistance needs. It is hoped the responses received will provide information to design provider assistance resources for members. Christiaan Campbell shared that IIC also contributed to the survey to seek feedback on what quality indicators members monitor and how they measure them. The Committees will meet jointly in May to review progress to date and identify/clarify next steps. B. Administrative/Legislative Update Ms. Opsahl asked if there were any questions on the information shared during the Member Forum. Additionally, she advised that the Governmental Affairs Committee will be meeting next week to discuss the development of the legislative agenda. C. HCBS Setting Rule & Implications Ms. Opsahl discussed the convergence of issues around day and employment services, including the HCBS settings rule, the Rhode Island Consent Decree, and the continuing debate around 14(c). It seems these issues are not subsiding and that we should begin dialogue on where the Association stands on these issues and what role we should be playing in this discussion and in supporting members. The Board was in agreement that they should be proactive and discussed possible approaches. The Board agreed as an intermediate step to have several members of the Board work with Ms. Opsahl and staff to frame the issues. They will bring this back to the Board in May for further discussion. Board members Ms. Rinne, Ms. Wear, Mr. Cook and Mr. Sacksteder volunteered to start the framework with Ms. Opsahl. VII. Other Business No other business was identified for discussion. VIII. Adjournment The next Board of Directors Meeting will be held on Friday, May 23rd. Respectfully submitted, ___________________________________________ Holly Piggott, Secretary HP/tld