Sandhills Center for MH, DD & SAS
Consumer and Family Advisory Committee
August 21, 2012
Present: Michael Ayers, Stephen Cohen, Loida Colonna, Leann Henkel, Ron Huber, Marianne Kernan, Chris Laughlin, Beth Ann Mellinger, Anthony Pugh,
Lori Richardson, Irma Robledo, Ron Unger and Ashley Wilcox
Excused Absence: Debra Collins, Elaine Hayes and Libby Jones
Unexcused Absence: Carol DeBerry and Allen Little
SHC Staff Present: Mike Markoff; Customer Service Coordinator, and Joni Nall; Customer Service Administrative Assistance
Guests: Anthony G. Carraway, M.D., Medical Director/Chief Clinical Officer; Wendy Deacon, CM/UM Manager; Pam Morgan, Medicaid Waiver Contract Project
Coordinator; Carol Robertson, QM Director; Eric Fox, Division Representative and Stacey Harward, Consumer Empowerment Team staff member.
Presenter & Topic
Discussion
Outcome/Follow-Up
Plan
 The meeting was called to order at 6:15 p.m.
The June 19, 2012 minutes
Ron Huber, CFAC
were reviewed and a
Chairperson
motion was made by
 Call to order

Ed
Daniels
requested
to
rejoin
the
CFAC
committee
following
health
problems
which
have
improved
at
Ronald Unger and
 Review of Minutes
this
time.
seconded by Marianne
 Vote in Member
A motion was made by Ronald Unger and seconded by Marianne Kernan to accept Edward Daniels Kernan to accept the
as a member of the CFAC committee. The motion carried.
minutes as written.
The motion carried.
 Dr. Carraway presented a PowerPoint presentation outlining the following information regarding the
Anthony G. Carraway,
Clinical Advisory Committee:
M.D. – Medical
Director/Chief Clinical
 Purpose – A forum for discussion and approval of clinical treatment practices and community
Officer –
standards of care that are used in the SHC provider network. Additionally, the committee will serve
 Clinical Advisory
a collaborative/consultative role for all clinical departments of the SHC MCO/LME.
Committee – Overview
 Subcommittees – Credentialing, Provider Disputes/Appeals
 Membership – In Network Licensed Practicing Clinicians; Out of Network Licensed Practicing
Clinicians who reside within the SHC geographic area ad who will service as Community Experts
and The SHC Clinical Leadership Team.
 Wendy outlined the following information on the SHC Care/Utilization Management Service
Michael Ayers requested a
Wendy Deacon, CM/UM
Certification Request Reviews:
list of abbreviations and
Manager
definitions used by SHC.
 Care/Utilization
 Certification Review Types, Materials to Submit and When
Mike Markoff directed the
Management Service
 Direct Bill Services (not initially requiring a TAR submission)
committee to the SHC
Certification Request
 Services Requiring a TAR submission
website for a glossary of
Reviews
 This report provided a Legend, which helped the committee understand the multiple abbreviations
abbreviations and
 Service Code
and their meaning.
following the meeting,
Description Support
 B-3 Services that also require the identified documentation.
Mike sent Michael Ayers
Tool
copies of NCDHHS a (30)
 Wendy presented the Service Code Description Decision Support Tool with an overview of the
page glossary and an
following:
addition abbreviations
st
nd
rd
 Review Type – Initial/Prospective – 1 , 2 , 3 Concurrent and Additional Reviews
and symbols list. These
 Age Requirements – Service Restrictions – Dx Requirements – CALOCUS/LOCUS – ASAC
lists will be included in
 Tx History – Medication Review – Updates: LOCUS/ASAM/PCP – Cert Utilization Ratio
September’s CFAC
 Certification Level
packets.
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Presenter & Topic
Pam Morgan, Medicaid
Waiver Contract Project
Coordinator – Medicaid
Waiver Update
Carol Robertson, QM
Director – Quarterly
Incident Report – 4th Qtr.
(April – June 2012)
Carol Robertson, QM
Director – Quarterly
Monitoring Reports –
Routine & Targeted 4th Qtr. (April – June 2012)
Carol Robertson, QM
Director – Quarterly
Complaint Report – 3rd Qtr.
(January - March 2012)
Discussion
Outcome/Follow-Up
Plan
 Pam informed the committee the Sandhills Center Operations/Readiness Review will be conducted on
August 24, 2012 which is approximately 30 days from our “go live” date of October 1, 2012. SHC has
submitted the requested desk top review materials, along with the Plan of Correction on items from the
March visit.
 Our Information Technology Section has identified data analyst staff within the Departments.
Finance/Claims analysis, along with HP Enterprises, are developing the necessary capability to review
claims data to assure correctness of payments.
 SHC has a Clinical/Financial Risk Management Team that meets weekly. The Team is guided by a
Clinical/Financial Risk Management Plan and chaired by our Medical Director/Chief Clinical Officer.
 SHC is developing all of the management reports required by the DMA Contract.
 Authorization guidelines have been developed and staff has been oriented.
 Carol provided the committee with the SHC Level II and III Quarterly Incident Report – 4thd Quarter
detailing the following information:
o Type of Incident: Level II - 186, Level III - 16 = 202
o Consumer Deaths: Level II - 6, Level III - 4
o Restrictive Interventions: Level II - 19
o Consumer Injuries: Level II - 30
o Allegations of Abuse, Neglect, Exploitation: Level II - 42, Level III - 6
o Consumer Behavior and Other Incidents were outlined
 No further trends or patterns were noted in the types of providers submitting reports or the
consumers representing the reports.
 All Level III Incidents are reviewed by the Critical Incident Report Sub-Committee on a monthly
basis. These reports that involve a need for a higher level of care are also presented to the SubCommittee. Information regarding Level III Incidents is forwarded to Dr. Carraway when received
by the Incident Reporting Manager.
 Carol presented the following overview of the quarterly monitoring reports as follows:
 Routine: 1 Provider was monitored during this reporting period
4 AFL site reviews
 Targeted: 35 referrals for Targeted Monitoring were received
o 16 from Incident Reports
o
4 from First Responder/After Hours calls
o 15 from Complaints
 Carol reviewed the Quarterly Complaint Report - 3rd Quarter outlining the following:
 Summary of Complaints Made
o 19 Received by LME
o 13 By or On Behalf of a Consumer
o
6 Not by or On Behalf of a Consumer
 Re: Primary Nature of complaints
o 6 Abuse, Neglect, Exploitation
o 3 Quality of Care
o 5 Access to Services
o 1 Other Issues
Three of our CFAC
members will be
participating in the August
24, 2012 review: Anthony
Pugh, Lori Richardson
and Ron Unger.
Page 2 of 5
The committee requested
a detailed report
regarding the incident
reports in which a member
died specifically those
with the notation that their
death was “unknown”.
This report is being
presented to our Client
Rights committee next
month and will be
included in our CFAC
packets nest month.
Presenter & Topic
Discussion

Mike Markoff, Customer
Service Coordinator –
Consolidated Balance Sheet
and Income Statement –
July 31, 2012
Eric Fox, Division
Representative Consumer Empowerment
Team Updates – August
2012



o 4 Administrative Issues
Information was provided outlining: person making complaint, age of consumer, disability of
consumer, primary nature of complaint and type of services.
 Summary of Actions Taken and Final Disposition
o 14 Resulted in an Investigation
o
5 Did Not Result in an Investigation
o
3 Investigations were Substantiated
o
5 Partially Substantiated
o
6 Not Substantiated
Information was provided outlining: complaints not investigated final dispositions and number
of working days from receipt by LME to completion.
 Total # of working days to resolve - 0-30 days (13)
 Total # of working days to resolve – 31-60 days (4)
 Total # of working days to resolve – 61-90 days (2)
Examples of how the LME is analyzing patterns and using complaint data including, were presented for
both quarterly reports:
o Analyses (patterns)
o Strategies Developed
o Actions Taken
o Evaluation of Results of Actions Taken
o Next Steps
Charts and graphs were presented detailing each complaint received for the quarter.
Carol provided comparison data from same quarter last year.
Reviewed SHC Consolidated Balance Sheet and Income Statement dated 07/31/12, noted the following:
 Total Revenues (YTD)
$
3,167,966
 Total Expenditures (YTD)
$
2,217,313
 Change in Fund Balance (YTD) $
( 950,653)
1. . As per legislation, CFAC members who had their second terms end on or before July 11th, 2012 must
rotate off the CFAC. CFAC members actively serving on July 12, 2012 are now eligible to serve a
third, three year term.
2. The following are updates within the leadership of DHHS:
a. Mike Watson is now the Director of DMA
b. Beth Melcher is now the Deputy Director of Health & Human Services
c. Jim Jarrard is now the Acting Director for MH/DD/SAS
d. Luckey Welch is the Director of DSOHF (Division of State Operated Healthcare Facilities)
and the Director of Cherry Hospital
3. The CFAC shall undertake all of the following:
(1)
(2)
(3)
Review, comment on, and monitor the implementation of the local business plan.
Identify service gaps and underserved populations.
Make recommendations regarding the service array and monitor the development of additional services.
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Outcome/Follow-Up
Plan
Presenter & Topic
Discussion
(4)
(5)
(6)
Committee Reports
Announcements
Outcome/Follow-Up
Plan
Review and comment on the area authority or county program budget.
Participate in all quality improvement measures and performance indicators.
Submit to the State Consumer and Family Advisory Committee findings and recommendations
regarding ways to improve the delivery of mental health, developmental disabilities, and substance
abuse services.
How CFACs accomplish this:
a. receive information from the community, LME/MCO, Division
b. process, analyze, and prioritize the information (use of workgroups)
c. make comment to the Board (advise)
4. Tenancy Support Team Service will be a new state funded service available soon. There are training
requirements. The service will be staffed by a team of 3 members, a QP (Qualified Professional) and
2 Peer Support Specialists. This will hopefully provide some support regarding housing to individuals
affected by displacement due to the IMD (Institute of Mental Disease) rulings.
5. DWAC (Departmental Waiver Advisory Committee) met on July 24th. The primary topics of
discussion were the SIS (Supports Intensity Scale) and Complaints and Grievances. The next DWAC
meeting will be on Tuesday, August 28th from 1-3pm at the McKimmon Center in Raleigh.
Committee membership, meeting minutes and other info available at
http://www.ncdhhs.gov/mhddsas/providers/1915bcwaiver/dwac/index.htm
6. The next State and Local CFAC phone call will be on Wednesday, August 15th from 7:00 pm to
8:00 pm. All CFAC members are invited to listen but it is asked that only the Chair or selected
designee speak during the conference call. The number is 1-888-273-3658. The access code is
2490768#.
7. A total of 4 LME/MCOs (57 counties) have gone live under the Waiver: PBH which is now Cardinal
Innovations Healthcare Solutions, Western Highlands as of 1/1/12, ECBH as of 4/1/12, and Smoky
Mountain as of 7/1/12. Sandhills Center is scheduled to go live on 10/1/12. The remaining 6 entities are
all scheduled to go live on 1/1/13.
8. Information about the implementation of the 1915 b/c Waiver can be accessed at the following link:
http://www.ncdhhs.gov/mhddsas/providers/1915bcWaiver/index.htm
9. Consumers and family members can voice their concerns about the Waiver.
Voice concerns through their CFAC Chair or representative who is the active member at the monthly
IMT (Intradepartmental Monitoring Team) meetings and at public comment time at local Area Board
meetings, DWAC (Department Waiver Advisory Committee) and State CFAC meetings.
 It was brought to our attention, the following CFAC members attended Suicide Prevention 101
presented at Sandhills Center on August 3, 2012: Carol DeBerry, Lori Richardson and Loida Colonna.
 Eric Fox will no longer be assigned to The Sandhills Center as the Consumer Empowerment Team
The AD-HOC committee
contact. Eric was presented with a Service Award from the committee in appreciation for years of
members for the NC
dedication and service advocating for Mental Health. Sandhills Center and the CFAC members will
Innovations Managing
certainly miss Eric as he always kept everyone very informed and also truly cared about our members.
Employer Handbook will
 Stacey Harward will become the new Consumer Empowerment Team contact beginning September
be LeAnn Henkel, and
2012.
Michael Myers.
Page 4 of 5
Presenter & Topic
Discussion
 Ron Huber requested an AD-HOC committee be formed to review the NC Innovations Managing
Employer Handbook – Effective October 1, 2012. Each CFAC member was given a hard copy of the
handbook and was emailed an electronic version as well. CFAC members were asked to review the
handbook for any revisions they find and bring them to the September 2012 CFAC meeting, as Tena
Campbell will be in attendance.
 Community Stakeholder’s Breakfast in Richmond County, scheduled for Thursday September 20, 2012.
Handouts










The Richmond Co.
Stakeholder’s Breakfast
has 3 CFAC members
volunteering to attend: Ed
Daniels, Lori Richardson
and Ronald Unger.
SHC CFAC Meeting Minutes dated 6/19/12.
Service Code Description Decision Support Tool
PowerPoint Handouts re: Clinical Advisory Council – Brief Overview
Care/Utilization Management Service Certification Request Reviews
SHC Consolidated Balance Sheet and Income Statement July 31, 2012
Consumer Empowerment Team Updates – July 2012
SHC Chief Executive Officers Report dated 8/14/12
SHC Board of Directors Meeting Minutes 7/10/12
NCDHHS Special Implementation Update #99 – dated 7/09/12
NC Medicaid Special Bulletin – July 2012
A motion was made by
Irma Robledo to adjourn
the meeting and was
seconded by Chris
Laughlin.
The motion carried.
Adjournment
Future Meeting
Submitted by: Joni Nall
Outcome/Follow-Up
Plan
The next CFAC meeting will be held on September 18, 2012 at 6:15 p.m.
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