21 region 7 stakeholder minutes-2010-08-18Document Transcript
REGION 7 STAKEHOLDER MEETING NOTES
Meeting Date: August 18, 2010
Meeting Time: 11:30am-2:30pm
Meeting Location: Idaho Falls
Meeting Facilitator: Sam Hulse, BHTWG Team Member
Introduction of Sam Hulse and description of BHTWG by John Hathaway, Regional Director
for Regions 5, 6 and 7. John encouraged questions and feedback from group.
Sam: Overview of 2009 BHTWG creation after WICHE study and explanation of his
appointment as a necessary law enforcement member on the BHTWG. Work Group needs
assistance from stakeholders and consumers on how the plan should be executed.
• Slide 9 – Emphasis by Sam on support of all judicial branches.
• Slide 32 – Add accountability.
Questions and Comments
1. Q: How influential can stakeholders be?
A: Encouraged to give as much feedback as possible especially regarding execution of
the plan since that’s where it has been weak on past attempts at transformation.
Contact RSPR with additional comments, questions or concerns.
2. Q: Will the new electronic medical records system be integrated into the plan?
A: That is an important question that should be addressed. We hope that there will be
integration to prevent duplication of time and money already spent. Please address
concerns on survey form.
3. Q: How will stakeholder feedback be collected and comprised by October 2010?
A: Please make sure your voice is heard by giving input. RSPR was hired to ensure
efficient, accurate and timely results that can be incorporated into the plan that is
submitted to the Governor in October.
4. Q: Two people have recently been let go by Health & Welfare. Was this related to the
A: There’s no indication that this is related.
John: Emphasis of integration that is already in place by uniform standards being
enacted by the government.
5. Q: What is going to the Governor in October? Is it just the proposal or also an
A: Just the plan. The product will to the Governor but implementation will continue to
evolve. The Transformation Champion will be appointed outside of any branch or
agency and will enforce and follow guidelines and strategy inside of proposal.
6. Q: Will initial drafts of the plan be made public?
A: Yes. Your input flushes out the rest of the proposal that is in draft format. The
“things that we must do” are the areas that are not flexible to change.
7. Comment: Concern that institutional memory is limited due to high turnover rate -
always starting over and making the same mistakes at improving system.
8. Comment: The majority of mental health services in the state are provided by private
providers. They must be included in the Cooperative and acknowledged. We can’t
ignore progress and take a different road.
9. Comment: Would like to acknowledge the myth about self-referral. Assessment and
treatment do not need to be separated.
A: This is not in the work of the proposal at this time.
10. Comment: PSR is a dirty word in this area. It is important and should not be left out.
It’s looked at in a negative manner but that’s due to lack of oversight and tracking of
11. Comment: Majority of services provided through Medicaid are reimbursed in 15-minute
increments. Providers are focused on staying within time frame for reimbursement
purposes and service effectiveness is lost. Capacity to serve is lost by 50%.
A: Confirmation from other attendees that this is a problem.
Martha Tanner: Medicaid does not acknowledge mentally ill people who drop out of the
system. They should be looking at database, tracking outcomes and determining costs.
Costs are greater for these individuals when they become incarcerated.
A: We must inch forward and keep pushing. People that care and see deficits are key.
John Hathaway: Is there some way to enforce or force individuals to take meds and stay
Martha Tanner: PSR is key with necessary training.
Comment: There are some really good PSR workers and some really bad PSR workers
out there. This area should be strengthened and utilized for individuals that need it.
PSR should not enable clients. Training and licensure for PSR workers is needed.
12. Q: What happens if a new Governor is elected? How does the left and right
communicate and listen to needs?
A: This is one of our concerns. It’s an inherent problem in our government. We fear
loss of momentum if this is put on the back burner. We will recommend that the
Transformation Champion be elected for two-year terms to avoid being unseated – less
bureaucracy and more accountability. There is legislative support for this.
13. Comment: There is a 43% increase in suicide in the last year. PSR workers and teachers
are serving this population and they are made into bad guys when requesting more
A: We can attempt to resolve this by accountability and data collection. Develop
outcome documentation to show how positive results have come out of systems in place.
14. Comment: With the braided funding system, I fear that the lowest rate will be chosen
when credentialing level dictates a different rate schedule.
A. Different funding pots are braided together. We understand the concern that a lower
standard of care rate is applied to a higher level of care. This is something that we will
build as we go.
15. Comment: Payer must be different than the driver of service delivery. No balance and
services become too micromanaged rather than the quality services that they should be.
16. Comment: Community Supports is a “clubhouse” model already created in Salt Lake
City. It would fit perfectly in the core services pie chart. This was also done in WI. The
challenge is that there is only 1 regional provider per area.
17. John Hathaway: Remember when the feds were going to help with nursing home care.
Federal money started coming in and they had their own standards and surveyors.
Money is a godsend but federal money is never free. There are multiple strings
attached. Care becomes very owneress and cumbersome. Sometimes the payer forgets
that it is our money and they lose sight of this when making rules. It is possible to
influence change up front though. Your presence here today is critical. Please take the
time to document your thoughts and complete the survey.
18. Comment: We must be working with the whole family of mentally ill patient. We need
more studies on children in homes of mentally ill. PSR care should be focused on entire
family. Longitudinal studies show the cycle repeats itself.
19. Comment: There is a lack of understanding of roles amongst PSR, law enforcement, etc.
The conflict is destructive to the consumer. Cooperation is necessary.
Conclusion: We must all work together. It would be ideal to look back in 5 years and see