19 region 5 stakeholder-2010-08-27 final.docxDocument Transcript
REGION 5 STAKEHOLDER MEETING NOTES
Meeting Date: August 26, 2010
Meeting Time: 11:30am-2:30pm
Meeting Location: Twin Falls
Meeting Facilitator: Ken Coll, BHTWG Team Member
Key Discussion Points:
1. Ken asked the participants how many had seen the WICHE report or where a part of the
WICHE interviews for this region. Many people have NOT seen either the WICHE report
nor participated in the interviews.
2. Ken: BHTWG is a progression of work since 2001-2002 – this current task force began in
April 2009 and is a governor/legislative-initiative.
3. Ken: BHTWG tried to have representatives from all parts of the state that weren’t political.
4. Q: How does this cross with ICSA? A: ICSA sunsets in July 2011 and will be moved to the
5. Q: What is the difference between the responsibilities between two proposed statewide
agencies? A: The Development Board will be on the ground, dealing with the core array of
services provided. The Cooperative will support the Development Board, will ensure intent
is being met; deal with the road blocks.
6. Comment from Participant: The less bureaucratic channels, the better. Concerned about
two state groups.
7. Ken: This is not a reaction due to economics and was in play before recession took hold.
Took the opportunity to learn from other states such as Alaska, Colorado and Montana and
have them tell their stories. Their main point of advice, this would NOT work without a
8. Ken: Discussed the difference between the braided versus blended models. Braided = gives
money but know exactly how it works and how it is tracked. Blended = everyone throws
money into the pot. However, this is an issue for many due to their individual tracking
requirements for funding. Some states have gone to a single contract. Maybe there are
regional contractors in which regions work together as an example. There will be provided
services – just not sure what it is going to look like.
9. Q: How is it not going to be more expensive to have a state/regional level versus going
directly to the provider? A: Not sure however the Work Group is hearing there are
opportunities to be more efficient.
10. Ken: Community Supports could be a grant, could be a special agreement with health-
provider or could be regionally developed as examples
11. Ken: There are 6 goals for this process:
a) Increase access to and availability of services
b) Establish an infrastructure
c) Create viable regional/local community delivery system
d) Efficient use of existing/future resources
e) Increase accountability for services/funding
f) Seek/include input
12. Q: Clarify the role of the Transformation Champion? A: One person hired by the state;
different entities would put monies towards this position; maybe a two or three year
position; needs to understand the system and have credibility; may already be in the state
13. Q: What is the timing? Draft hasn’t changed since January with the exception of the Core
Array of services. This is due in October and concerned about the timing of these meetings
and being realistic as to how much of this input will truly make it into the
recommendations. A: It is definitely a pressured deadline however; we are taking all
feedback into consideration for the October report.
14. Q: With the Regional Development Boards, will there be more regions created? A: The
Work Group isn’t attempting to define regions with this process; it is up to the regions.
15. Q: Regarding the Work Group members, who in this group can discuss the billing processes
generally? Concerned that the people who do the actual work aren’t on the committee. It
does not appear that there are any program managers on the committee. A: Ken discussed
some of the different Committee Members and their experience. He also discussed that this
is the reason for the Stakeholder and the Family and Consumer Group meetings so that the
people on the ground and using the services can express their thoughts. He also discussed
how the different program managers have been invited to the BHTWG meetings and that
these are reflected in the meeting minutes.
16. Q: Will the Work Group put the meeting minutes on the web? A: Yes, Red Sky will obtain all
of the meeting minutes and post to the website.
17. Q: Why is the recommendation that the State will provide Crisis Services? A: These services
are difficult to unbundle. Usually these are connected to court-ordered services, which
make it difficult to separate out.
18. Comment: The primary goal needs to be a data collection format that is consistent across
19. Comment: Need to look at the legal system that prevents people from getting the
treatments that they need.
20. Q: What are the projected costs? Seems to be top-heavy. Will we be truly getting the money
to the consumer with this structure? Would like to know exact numbers. A: At this time, the
exact numbers are not known however the Work Group is relying on the numbers discussed
in the WICHE report.
21. Q: Would this be run by a privatized company? A: Possibly.
22. Q: How will this impact small providers? A: The goal is to make the services more efficient.
23. Q: Would be helpful to know what will be presented to the Governor and ability to impact?
A: Putting forward goals to the Governor but need input based on the 6 goals discussed
through this feedback and through the survey.
24. Comment: Need to ensure outlying areas have access to services.
25. Q: Will PSR’s [Psycho-social rehabilitation] be going away? How will they fit into the core
array of services? A: PSR’s will be captured into the array of services and will be
“unbundled” however the Work Group believes it will be up to the regions to determine how
to “unbundle”. The State Health Interagency Cooperative will help with this.
26. Comment: There is a large investment into PSR; should not go away…will be a great deal of
money to separate. Response: Current systems will be reviewed over time to see if it makes
sense to change.
27. Comment: Regarding the role of the Regional Boards there needs to be incentives to
empower the Board to make decisions – not sure there will be the infrastructure in place.
28. Q: How will this affect school-based services? A: The goals is to make it easier for various
agencies to provide services.
29. Comment: Key groups such as the judicial group need to be engaged as a lot of resources go
30. Q: Is this group trying to restructure similar to the transportation group? Please say no to
this. A: No knowledge of this.
31. Q: Will the report address the next steps? A: Timeline should be in place in the report.
Generally the report will be presented to the Governor on October 31. The Governor will be
presenting the recommendations to the legislative body with specific phases. The earliest it
would be approved is in Spring 2011.
32. Q: How will this address the distrust between the state and private provider community? A:
The organization structure will be very important. The Transformation Champion will help
with the relationships and to ensure the appropriate check points on both sides are in place.
33. Q: With the discussion of the complete restructuring with private providers, is Medicaid
involved? A: Medicaid has been present at every meeting and has committed to making this
34. Q: If PSR is going to change, when will the providers know? If this is going to change it is
important to know as soon as possible due to the current employees going through
expensive certification processes. All PSR must be certified by 2012. A: Not the intent for
PSR’s to go away. Will discuss at next meeting with the Work Group.
35. Comment: Certifications are very different the alcohol/drug certifications and the mental
health certifications. This may affect Medicaid billing.
36. Comment: Would like to see the State Behavioral Agency Cooperative be more nimble.
Response: They are there to ensure fidelity to the goals and will eventually be eliminated
after 2-3 years.
37. Q: With the legislative branch involved, what will be their involvement? [Discussed State
Alcohol and other Drug Rules (IDAPA)] A: Ken anticipates flexibility
38. Q: What is the association between IDAPA rules and Medicaid’s charging per credential? A:
Will be worked out with this process.
39. Comment: Need “Peer to Peer” group/support.
40. Asked for comments on survey either today via hardcopy or by Monday via fax, email or
41. To Do’s/Discussion Items with Marsha and Ken:
Post the WICHE Report on the website [Obtain electronic copy from Marsha]
Post the BHTWG Meeting Minutes on website [Obtain electronic copies from
Marsha of all meetings]
Have Ken assist with highlighted portion of meeting notes