Meeting
Minutes of
The Governor's Council on Behavioral Health
1:00 P.M., Tuesday, September 11, 2007
The Governor's
Council on Behavioral Health met at 1:00 p.m. on Tuesday, September 11, 2007,
in Barry Hall's Conference Room 126,
Members Present: Richard Leclerc, Chair; Leo Cronan; Stephanie Culhane; James Gillen; Chaz Gross; Mitch Henderson; Joseph Le; Peter Mendoza; Anne Mulready, RIDLC; Neil Corkery, and Bruce Todesco, Mental Health Advocate's Office.
Ex-Officio
Members Present: Craig Stenning and Gene Nadeau, Department of Mental Health, Retardation and Hospitals (MHRH); Jeanne Smith and Sandy Woods, Department of Children, Youth and Families (DCYF); Elizabeth Gilheeney, Department of Justice; Denise Achin, Department of Education; and Colleen Polselli, Department of Health.
Staff: Corinna Roy, Charles Williams, Kristen Quinlan,
and Mary Ann Nassa.
Guests: Lisa Clark, Reckitt Benckiser; and Jen McCarthy,
NAMI
Once a quorum was established, the Chair, Richard Leclerc, called the meeting to order at 1:05 p.m. After introductions were conducted, Richard entertained a motion to accept the Minutes of June 14, 2007. Jeanne Smith of DCYF made the following two amendments to the minutes: Page 7, Paragraph 4, "Ginnie stated that first to three and home based are their next challenge" should be "birth to three;" and on Page 6, UPDATES FROM DCYF, Paragraph 2, it should read that Rhode Island is the only state in the United States that has received three (add) statewide SAMHSA grants. Neil Corkery motioned to approve the minutes and Peter Mendoza seconded the motion. All were in favor, and the minutes were approved as amended.
BEHAVIORAL
HEALTH DATA ELEMENTS SUBCOMMITTEE
Mitch Henderson reported that they are at 98 percent
completion of phase one which is the collection of metrics which will be
presented on a yearly basis to describe the mental health system. Mitch distributed the Performance Measure List,
Availability, Priority and Responsibilities (See Attachment I). Mitch explained the form which is a list of
all the metrics with their availability, importance and additional comments
about each. He asked that members review
the list and be prepared to vote on it at the October meeting. He stated that once they receive inputs from
DCYF regarding wording, it will be complete.
Mitch stated that their goal is to present metrics in
December when all the metrics become available on an annual basis. At that time, each department will be able to
present their metrics and include other subjective information that rounds out
the "story" on how things are going in their area. The scorecard, which was mentioned at previous
meetings, will illustrate a summary of the data on one sheet of paper with
color coding based on a stoplight to describe how well different areas of the
system are doing.
Kristen Quinlan stated that listed on the last page of the
report are additional metrics still under development.
Elizabeth Gilheeney referred to the last page, LOS in ER
for kids seeking mental health treatment.
She asked what age group is defined within a group noted as kids. Kristen stated that it is birth to eighteen.
Richard Leclerc clarified that the data elements listed on
the first three pages are considered easier to collect than those listed on the
last page which are more of an issue for departments to gather.
Comments and suggests should be e-mail to Kristen Quinlan
at kquinlan@mhrh.ri.gov prior to the
next meeting.
RESPONSE
TO MENTAL HEALTH BLOCK GRANT MEETING
Richard stated that there is a
national meeting held yearly sponsored by SAMHSA and CMS which was attended
this year by Corinna
Mitch highlighted the reverse side
of the document which listed some of the ideas that were discussed at the
conference that he has proposed that the Council adopt (See Attachment II: Consumer-Oriented
Council Changes). Mitch is
submitting these changes to the Council for a vote.
Craig Stenning stated that in
regards to Item No. 6 on Consumer-Oriented Council Changes that the Department has
attempted to get that position approved to be filled, and in this year's block
grant allocation funding at a higher level than previously funded has been set
aside to fill the position. Craig
reported that in the past the position was not a full-time FTE within the State
system, it had been filled as a consultant position. Two requests have been submitted, one to
convert that position into an FTE and allow it to be filled and if that is not
successful, they have asked for permission to fill it as previously filled, as
a temporary consultant position. He received
some feedback last Friday asking for more clarification about the request. Craig stated that this response does not make
him hopeful about the chances of filling this position.
There was some discussion about
Mitch Henderson's recommendation regarding peer specialists. Corinna Roy clarified that Mental Health Consumer Advocates of Rhode
Island
(MHCA) continues to conduct trainings for Peer specialists. Currently
six of MHCA's trained Peer Specialists are actively employed. Two work directly for a CMHO, and four
consult with a variety of providers including working on a daily basis with
consumers living in a transitional shelter dedicated to serving chronically
homeless, mentally ill men and women run by MHCA. Corinna stated that the training is
still offered and that the State is committed to that programming. She further stated that RI is working with a
federally funded technical assistance provider to do additional planning and move
the program to a higher level. Corinna
stated that there is high-quality trainings that will be offered in
Elizabeth Gilheeney asked if the
peer specialists coordinate with the consumer advocate and does the consumer
advocate oversee the peer specialists.
Corinna stated that presently they work for a community mental health
organizations. Therefore, if a consumer
is having a problem with the services that they are receiving or having some
kind of problem with their case manager, this person has the right to
intervene. They have also been able to
intervene in some crisis situations.
Craig Stenning clarified that the
consumer position he referred to earlier is not an ombudsman type position
where people would send formal complaints.
Craig stated that the Mental Health Advocate serves in that role. The position was designed to insure that the
voice of consumers and family members are part of the intricate day-to-day
working of the Division of Behavioral Health.
This position is included as a senior member of the staff so that a consumer
voice would be involved in any new projects, programs or internal monitoring or
review processes.
Richard Leclerc recommended that
over the next few weeks that an ad hoc committee be formed with Mitch Henderson
in attendance and anyone on the Council who can attend to talk about the suggestions
and then make recommendations at the next meeting. Richard stated that some of these suggestions
may have to wait for the next cycle of the block grant, but for now they can
review and prepare for it. He suggested
that he would coordinate with Corinna that a notice be sent to everyone.
BLOCK
GRANT
Corinna Roy distributed a letter
mailed to SAMHSA regarding the block grant submission (See
Attachment III). Corinna thanked
all of those who provided her with feedback on the grant. She pointed out that the difference with this
letter from previous letters was specifically in the second paragraph. Corinna read the second paragraph aloud to
the Council (See Attachment III). Richard
reminded the Council that there is always a timeframe for submission of the
block grant by September 1. Neil Corkery
motioned to ratify the sending of the letter and the submission of the block
grant, and Elizabeth Gilheeney seconded the motion. All were in favor, and the motion was
approved.
Corinna reported that the
Implementation Report will be submitted electronically by December 1. Corinna also reported that the Peer Review
date has been set for October 10th in
UPDATES
FROM MHRH
Craig Stenning reported that Jane Hayward, the Secretariat for
the Department of Health and Human Services, has submitted her resignation
effective October 5, 2007. According to
a press release from the Governor's Office, an interim secretariat will be
named followed by a search for a permanent replacement.
Craig stated that the process for submission of the 2009
budget is underway. The Governor has met
privately with each Department Director individually to begin those
discussions. The actual budget
submissions are due in October 2007. Craig
stated that this budget submission will be the most difficult in recent
history. The general theme of discussion
at both the state and the department level is that they have reached the end of
the line of any further trimming or cuts.
In order to meet this year's budget there will have to be major system
changes and system reforms. At MHRH
those major changes center on a reconfiguration of the
There was some discussion about the different possibilities
and scenarios these initiatives may produce.
Craig stated that they have not yet reached a concrete estimate of the
savings.
Craig stated that during the last few weeks of its
sessions, the General Assembly spent time looking at a variety of proposals
dealing with the Department of Corrections (DOC) and the overcrowded situation
at the Adult Correctional Institution (ACI).
The proposals included major legislative initiatives which would have
changed statutes around sentencing.
Because those discussions came so late in the session, not many of them
saw their way into legislation or completion.
The one that did was based upon an assumption that because of the
capacity of the substance abuse treatment system, there are individuals
awaiting parole and their wait to release is longer because of the inability to
find a treatment spot for them. Therefore,
1 million dollars were placed into DBH's budget to develop a project to address
it. Craig stated that once beyond the
purchasing office, there will be an RFI which will request interested agencies to
respond that have a capacity to provide short-term and long-term residential
treatment, as well as wrap-around intensive outpatient services, for those
individuals who are not necessarily in need of a residential level of treatment
and have some place to live. Previously,
residential has been used as an alternative to housing. Craig reported that the target date is to
actually have people in beds by November 1, 2007. Behavioral Health will do a centralized
assessment to facilitate a good picture for the parole board on which to base
their decisions. In conjunction with the
parole board, they are hoping to assess somewhere between 150 to 170
individuals with hopes that somewhere between 120 and 140 people will actually
get services and get out into the community based upon this project. Some of the performance measures will focus
on the length of time it takes between the day that the parole board calls and
gives the name of the inmate, an assessment is performed by BH, and BH presents
the parole board with a treatment plan.
Neil Corkery questioned if other types of housing and
wrap-around services would be available once they reached capacity. Craig stated that there is a section that
allows for other types of housing and wrap-around services, but they are
targeting the creation of approximately 30 beds, some of them short-term that
would turnover every three months and some would be long-term that would
turnover about every nine months. The
stipulation to apply for those is that there is no capitol money, so they can't
build anything and they can't pay for any buildings. These would be agencies that have a capacity
which has not been purchased previously.
Representative Constantino has insisted that it be documented that these
beds are not beds currently in the system.
Craig stated that in review of the current system, the 30 number is very
doable as far as a capacity which is currently either licensed or would be
available to be licensed and is currently not being occupied. Craig stated that data will be run for the
past two years to make sure that standards are being met.
Craig reported that they are awaiting positive word of
funding regarding the Access to Recovery application which is commonly known as
the Voucher Program for choice in substance abuse services. Craig reviewed the history and requirements
of the grant. He stated that the grant
was submitted at $3.75 million, but if awarded there would be a suggested reduction
in the dollar amount to $2.75 million in the first year; it is not yet clear
how commensurate years would be affected.
Charles Williams reported that the target populations are the same, and
that the Governor's Office received from SAMHSA the suggested reduction in the
first year number of persons served from 600 to 437 with the $1 million cut
during the first year of budget.
Peter Mendoza asked if there is any existing data from
other states. Charles Williams stated
that it was a slow start, but then they were not been able to meet the
demand. Some states have some advantages
that
Regarding tracking, Craig stated that there are some
targeted numbers of how many people would be reached and with reducing the
dollars, there is also a reduction in the target number.
Craig announced the culmination of Recovery Month with the
Voices of Recovery Event at
Craig also announced the NAMI Walk which is scheduled for
October 13, 2007. There will be a team
from the Division of Behavioral Health who will be participating. The walk is a total distance of 3.2 miles and
begins at
UPDATES
FROM DCYF
Jeanne Smith reported that DCYF is making an effort to
develop initiatives to address the budget constraints. DCYF is working with the Department of Human
Services (DHS) to maximize the funding with Medicaid and to expand the programs
and services for children. Jeanne stated
that a team will determine the need for an RFP.
In addition, they are working weekly with DHS and providers to identify
priorities for children, what services are needed, criteria for levels of care,
and rate-setting.
Jeanne stated that residential contracts no longer exist,
but DCYF continues to honor payments from previous contracts until October 1st. She stated that community-based contracts are
on a month-by-month basis, and CIS will continue to operate as-is until spring
2008 because of a delay from CMHS in trying to work out the Medicaid payment
fees.
Jeanne reported that the Family and Community Care
Partnership (FCCP) are looking at a more effective integrated system of care. She stated that a conference bid occurred and
that the bidding period has been extended until October. Questions regarding this FCCP RFP and related
bids can be emailed to lee.baker@dcyf.ri.gov.
Jeanne reported that DCYF continues to develop plans for
transitioning 18-21 year olds out of DCYF. Details can be provided at the next
meeting. Janet Anderson was unable to
attend this meeting because she is recovering from a surgery and that she will
make an effort to attend the next meeting.
Joseph Le asked Jeanne what was going on with Project Early
Start. Jeanne stated that she will
investigate his inquiry and get back to him by telephone. She offered to report on Project Early Start
at the next meeting for everyone's information.
In reference to the children's residential issue which has
been put off until after October 1, Richard Leclerc asked what happens after
October 1. Jeanne stated that it has not
been clearly defined and referred the question to DHS where the dollars have
been transferred.
OLD/NEW
BUSINESS
There was no old or new business.
ADJOURNMENT AND NEXT MEETING
There was no further
business. Upon motion made and seconded,
the meeting adjourned at 2:30 p.m. The
next meeting of the Council is scheduled for Thursday, October 11, at 8:30 a.m. in the first floor Conference Room
126 at the
Minutes respectfully recorded and written by:
Mary Ann Nassa
Secretary, Governor's Council on Behavioral Health
Attachment I: Performance Measure List,
Availability, Priority and Responsibilities
Attachment II: Conference Impressions and Consumer-Oriented
Council Changes
Attachment III: Letter to SAMHSA/Louellen M. Rice