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Meeting Materials (PDF) Open in new window INARF Board of Directors Meeting Friday, May 23, 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 & Audit Committee Report - Review of Financial Statements - Audit Report - 990 Review V. Association Focused Reports and Discussion - Upcoming Events and Activities - Committee Structure & Appointments - Strategic Framework Implementation VI. Industry Focused Reports and Discussion - Update: Quality Conversations & Activities - Building the 2015 Legislative Agenda - Employment and Day Services VII. Other Business VIII. Adjournment -- Board Minutes The INARF Board of Directors Meeting and Member Forum were held on May 23, 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 Patrick Cockrum, Vice Chair Jim Allbaugh, Carey Services, Inc. Debbie Bennett, Hillcroft Services, Inc. Jonathan Burlison, Bridges of Indiana, Inc. (via phone) Bettye Dunham, Rauch, Inc. John Niederman, Pathfinder Services, Inc. Jane Wear, Cardinal Services, Inc. Pam Verbarg, Wabash Center, Inc. Absent: Marie Dausch, Treasurer Holly Piggott, Secretary Steve Cook, AWS, Inc. Dan Griffin, Dungarvin Indiana, LLC Susan Rinne, LifeDesigns, Inc. Guests (in Person): Rick Adams, Dungarvin Indiana, LLC Shane Burton, Developmental Services, Inc. Clint Bolser, LOGAN Community Resources, Inc. Connie Dillman, Tangram, Inc. Bill Hadar, Developmental Services, Inc. Rick Hall, Mutual of America Kylee Hope, Bureau of Rehabilitation Services Kim Krofft Lease, IPMG Andrew Ranck, Putnam County Comprehensive Services Jane Ruff, Hopewell Center Patrick Sandy, Easter Seals Crossroads Don Weikle, Peak Community Services Guests (via Webinar): Thomas Atchison, In-Pact, Inc. Donna Belusar, ADEC, Inc. Alicia Boyd, Alicia M. Boyd, CPA PC Janessa Gerber, LifeDesigns, Inc. Herb Grulke, In-Pact Inc. Nancy Hoffman, Arc of Wabash County, Inc. Linda Johnson, Arc of Wabash County, Inc. Dana Kean, IPMG Jennifer Lantz, IPMG Daniel Lowe, Blue River Services, Inc. Jason Meyer, Passages, Inc. Tom Michel, IPMG Angela Murray, IPMG Louise O'Connell, First Chance Center Donna Riedle, IPMG Carolyn Underwood, IPMG Lynn Walker, Easter Seals Arc of NE Indiana Sandy Wing, Pathfinder Services, Inc. Staff: Kim Opsahl, President/CEO Barb Young, Vice President/CFO Christiaan Campbell, Director-Research & Program Development Keith Digman, Director-Advocacy & Program Development Terri Dye, Administrative Assistant/Membership Support 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 Kylee Hope, Director for Bureau of Rehabilitation Services (BRS). II. BRS: Initiatives and Future Direction Ms. Hope thanked the members for having her as a guest and for their feedback, input and ongoing partnership. She began with asking members for feedback, open discussion, and concerns regarding the recent DDRS Quarterly Provider Meeting updates. One update from that meeting is a new policy initiative that has gone to the governor’s office for BRS to focus on transition age students and work in collaboration with schools to ensure they get appropriate employment outcomes. Ms. Hope responded to member questions ranging from policy clarifications to the impact of the Workforce Innovation and Opportunity Act. After much discussion, Mr. Sacksteder thanked her for her insight and partnership. III. Board Chair Report A. Quarterly Professional Interest Section Meeting Mr. Sacksteder reported that nearly 150 members participated in the May 15th Quarterly Professional Interest Meeting. There were great sessions on Web-Based Marketing, the Provider Portal, 1634 Transition and Miller Trusts, Hiring and Retaining Talent and updates from several state agencies. The next quarterly meeting is August 21st and the location is to be determined, as the Fountain’s Conference and Banquet Center is closing. B. Association Activities & Updates Mr. Sacksteder welcomed new Board member Pam Verbarg from Wabash Center, Inc. Next, Mr. Sacksteder shared that on May 4th Costa Miller and Jim Hammond received the ANCOR Legacy Leader Award. The ANCOR Foundation’s Legacy Leader’s Circle honors career-long contributions of outstanding champions in our industry. The program also raises funds to support the development of future leaders. He thanked New Horizons Rehabilitation, Residential Services, Inc., Unity of Indiana, Developmental Services, Inc., Dungarvin, and Hillcroft Services for contributing towards the award. Lastly, the Training and Professional Development Committee (TPD) met earlier in the month to plan the 2015 Annual Conference. The theme will be “Don’t Stop Believin’ – OUR Journey to the Top”. The committee developed many proposed educational sessions of various topics. IV. President/CEO Report A. Federal Issues Kim Opsahl reviewed federal issues of interest to the provider community, including the recent introduction of the Workforce Opportunity and Investment Act which is a bipartisan, bicameral supported bill. The focus of the bill is to modernize and improve the Workforce Development System as a whole. The bill includes focus on Transition Age Youth with a heavy emphasis on “Pre-employment transition services.” Further, there is language in the bill that suggest state vocational rehabilitation agencies are to set-aside fifteen percent (15%) of their resources to address the issue. One element that may be concerning are requirements on the use of special minimum wage certificates. B. Industry Update Ms. Opsahl shared that Governmental Affairs Committee (GAC) is about half way thru their planning for the 2015 legislative session. By June they plan to share a draft public policy agenda with the Board of Directors. Next, it was shared that INARF member, Stone Belt Arc, Inc., hosted a community conversation on the caregiver crisis. Ms. Opsahl, John Dickerson, Executive Director Arc of Indiana and two local legislators were invited to participate in a panel discussion that began with Leslie Green, Executive Director at Stone Belt Arc, talking about the impact of rates and the reduction of rates on their agency. Then an individual served by Stone Belt talked about the importance of Direct Support Professionals (DSP) and the effect of frequent changes in DSP staff. Next a DSP spoke on their experience of delivering services and working in the environment with a shortage of DSPs. Ms. Opsahl shared facts and figures, Mr. Dickerson shared the Arc’s perspective and lastly two local legislators gave their reaction to the information. It was a powerful conversation that would be of value to replicate in other communities. INARF Work Group Activities • Rate Reform Initiatives - The workgroup 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 - 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. • Group Home Referral and Related Issues – INARF’s SGL Advisory Workgroup met with Locket Phillips and Julie Reynolds recently and had a positive conversation about ways to improve the group home referral and vacancy process. One outcome of the meeting deemed useful was that each group home provider would have a single point of contact for Mr. Phillips and his staff so that packets and communication would go thru one person. A notice will go out to providers asking to identify that contact person which will be passed on to Mr. Phillips. The SGL Rate Restoration scheduled for January 2014 still has not gone in to effect. To implement the rate change, the State was required to submit a State Plan Amendment to CMS. Due to concerns with an unrelated issue contained within the amendment, there has been a delay in the approval INARF is engaged in ongoing communication with OMPP on the issue. • Shared Living Development – Shared Living Workgroup continues to meet to develop recommendations to improve the use and availability of Structured Family Caregiving. The group anticipates submitting recommendations to be incorporated into the CIH Waiver re-write. State Administrative Issues • Wellness Coordination – The Division is aware that there is concern about meeting the timelines that have been put into place in terms of getting consumers into the service. INARF has been working with DDRS staff and it is anticipated that members should receive communication from them next week that clarifies the issues and extend the timeframes. • 1634 Transition and ICF/IDD Services – Members received information from INARF regarding a coding issue that occurred within Medicaid with the transition. Indiana is transitioning its Medicaid eligibility process to be a 1634 state, which means those eligible for Social Security Disability are also eligible for Medicaid in Indiana. Some of the income requirements have changed. For individuals not in institutional services or HCBS services, the income limit is $923 a month. For those people in institutional or HCBS services, however, the income limit is $2,163 a month. Individuals in group homes were coded incorrectly and notices of ineligibility were sent in error. INARF was able to work quickly with DDRS, DFR and OMPP to correct the problem. • Waiver Re-Write – There is an opportunity for members to give feedback on the waiver with a deadline of May 25. Internally, INARF has been working on service definitions, the elimination of the 18 month limitation on SEFA; ensuring DDRS is working with stakeholders on compliance with the HCBS settings rule, and addressing monthly summaries. • VR State Plan – Comments are due May 30th. INARF has been working on comments and have received feedback from members. The comments are focused on transition, SEFA, and appropriate funding for them. Particular emphasis is on internships and the funding behind the internship is appropriately structured. • Gap Analysis – Members received a Community Provider Survey that is being done by the University of New Hampshire (UNH) as part of the gap analysis authorized by the Division. Ms. Opsahl encouraged members to respond to the survey and share it with as many staff as possible. INARF is working with UNH to put together an ID/DD Provider Focus Group in conjunction with the next member forum. Interested members for this focus group should contact Ms. Opsahl. • HIP 2.0 – Governor Pence recently unveiled plans on how Indiana would like to approach Medicaid expansion under the ACA using the Healthy Indiana Plan (HIP) which is being called HIP 2.0. There are three elements available: 1.) HIP Employer Benefit Link, 2.) HIP Plus designed for those below 138% of the federal poverty level which has an enhanced benefit package; and 3.) HIP Basic for those that are 100% and under the federal poverty level which is the default and has a reduced benefit package. Public comments are being heard May 28 and 29. The written comment period is thru June 21st. • IPAS Facility Surveys – Indiana Protection and Advocacy Services (IPAS) recently reported on their first quarter of facility surveys. IPAS indicated they had surveyed seven (7) agencies of which five (5) of them had policies in place on workplace safety, access to accommodations and choice in work assignment. The wage range for the Section 14(c) Certificates was from $.01 per hour to $6.71 per hour. Of the agencies surveyed, a total of 9 individuals had transitioned into community employment over the course of the past year. 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 April 25, 2014 Board of Directors meeting minutes were presented and reviewed. MOTION 14:9 John Niederman moved to approve the April 25 meeting minutes as presented. Jane Wear seconded and the motion carried IV. Finance and Audit Committee Report A. Review of Financial Statements Barb Young reported that INARF financial statements from April 30, 2014, reflect a positive increase in net assets from operations of forty three thousand eight hundred seventy five ($43,875), an unrealized gain on investments of twenty four thousand two hundred fifty three dollars ($24, 253), for an overall change in net assets of sixty eight thousand one hundred twenty eight ($68,128). MOTION 14:10 Jill Dunn moved to file the April financial statements for audit. Bettye Dunham seconded and the motion carried. B. Audit Report and 990 Review Clint Bolser reported that Audit Committee reviewed the December 2013 Audit Report and 990 Form and recommended them for approval. The audit report was very clean with no exceptions or recommendations. MOTION 14:11 Jill Dunn moved to accept the Audit Report and 990 Form. Jane Wear seconded and the motion carried. V. Association Focused Reports and Discussion A. Upcoming Events and Activities Keith Digman reported that the Leadership Development Steering Committee and the Training and Professional Development Committee met earlier in the month to plan the 2015 Annual Conference. The committee developed many proposed educational sessions. During the annual planning, the committee members discussed and revised the existing conference outline. Changes under consideration included: • Changing the Pre-Conference/Annual Conference format to a three-day format by eliminating the Leadership Symposium and adding a Leadership “track” to all three days. • Incorporating interactive/entertaining element to Member Reception. • Offering 1.25 sessions without repeats. Part 1 & 2 sessions not to expand beyond 3 hrs. • Featuring Exhibitors on Day Two only with unique placement for Exhibit Partners (including Sponsorship) during Day 1 Reception. Incentives for visiting exhibitors such as door prizes and giveaways. • Adding panel discussions, learning labs or town hall formats throughout using our Industry Partners. • Offering a Closing Session/postnote address including an Awards Luncheon to send off attendees on a positive note (Motivate & Celebrate). • Reversing the inquiry process by extending the initial email inquiry by INARF, requesting the completion of an Educational Session Submission Proposal to be vetted through Program Development and the TPD/LDS Committee members at the extended June 12th meeting (In person ). • Researching CEU’s to be offered for keynote session and for other Designations such as CPAs, Behavioral Specialists, Case Mgrs, etc. B. Committee Structure and Appointments Ms. Opsahl reported that as part of INARF’s ongoing effort to implement the Strategic Framework, staff have been working with the Executive Committee on evaluating the current corporate committee structure and making sure the we were in alignment with the Strategic Framework. The changes are focused on putting a more formalized process in place in order to provide clarity on roles, responsibilities, and purpose. A draft of the recommendations was shared with the Board to get initial feedback. Board members were asked to review them in further depth before the June meeting and provide added feedback. The next steps in the process are to host a meeting of current committee chairs and present them with the proposed recommendations and gather their feedback which will be brought back to the Board for further consideration. C. Strategic Framework Implementation Ms. Opsahl provided an update on the Strategic Framework. INARF staff and committees have reviewed objectives and developed tactics as to how they will contribute toward this framework. Many of these have been put into an operations plan that staff are using to guide their daily activities. It is proposed to the Board that beginning with June’s meeting a position statement from the framework will be presented to the Board and a report given on where we stand with the related metrics. VI. Industry Focused Reports & Discussion A. Update: Quality Conversations and Activities Bettye Dunham 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 committees recently met to review progress since the initial meeting and identify next steps. The original committee charges were: • ISC: research the members deficiencies, competencies, training needs, and what members were doing for quality controls and quality measurements. • IIC: gather publicly available standards and quality assessment processes, in order to develop a system for identifying points of excellence with providers and find a method for identifying providers in crisis. The Committees reviewed the IIC’s progress on developing a quality indicator profile. They recommended the following: • Reduce to 4 or 5 primary key indicators tied to the National Core Indicators. • Work with the rate reform work group to ensure alignment between this effort and their work to identify outcomes for various services. Next steps are to schedule the next joint meeting in June and review ISC deliverables and determine actions for the next phase of the project. B. Building the 2015 Legislative Agenda Jonathan Burlison reported that the Governmental Affairs Committee met in late April to develop the 2015 legislative agenda. The primary focus is on improving members’ ability to recruit, retain, and utilize the necessary resources to deliver high quality services through rate restoration and identified system efficiencies. The framework for the legislative agenda includes tasks to develop data and related information on the impact of rate reduction and the cost of service delivery, the estimated state effort required to restore rates to their 2010 levels, an understanding of where our industry stands relative to other cuts implemented in 2010, and efforts to identify and monetize efficiencies from the daily rate, improved use of electronic monitoring and shared living. C. Employment and Day Services Mr. Sacksteder reported that since last month’s meeting a Board volunteer group and staff met to frame the issues of employment and day services and bring them back to the Board for discussion and action. There are a wide variety of issues and concerns, but it seems prudent for the Association to begin researching the issues and potential solutions. INARF must be at the forefront of the dialogue to shape discussion and ensure all issues are being considered. The following are recommendations: 1.) The Association should approach this issue from a positive perspective. The focus of discussion will be how providers can promote improved access and support for competitive employment, as opposed to framing the dialogue around losing access to services. a. Consistent with this approach, the Association may want to consider setting goals/standards for movement to competitive employment and/or involvement in community based services. 2.) Research should be conducted on the experience of other states and provider organizations who have worked to appreciably address these issues. a. Specifically, the Innovation and Systems Change Committee (ISC) should research the role of public policy in these efforts and identify potential strategies that could be implemented or adapted for use in Indiana. b. The Industry Infrastructure Committee (IIC) should research promising models of practice that begin to move the dial toward more community based services and develop training, tools, and other resources to support members in building and enhancing their competencies in this area. Examples of such programs might include the “make a difference” approach, Stellar Community Grants, business incubator models, etc. After discussion, the Board appeared agreeable with this approach. VII. Other Business Mr. Sacksteder discussed with the Board that after the Chair’s first year tenure there are four (4) Board members on the Executive Committee as opposed to five (5) in the first year due to the Immediate Past Chair stepping down. It is more favorable to continue with the five members on the committee. This will be clarified in the ByLaws, however in the interim, it is not precluded that the Immediate Past Chair continue on the Committee, but a confirmation from the Board is recommended. MOTION 14:12 Patrick Cockrum moved to confirm Jill Dunn continue to serve as Immediate Past Chair for another year. Jim Allbaugh seconded and the motion carried. VIII. Adjournment The next Board of Directors Meeting will be held on Friday, June 27th. Respectfully submitted, ___________________________________________ Holly Piggott, Secretary HP/tld