Meeting Minutes

CDS Family & Behavioral Health Services, Inc.

Meeting: CINS/FINS

Date: August 22, 2014

Time: 9:30 a.m.

Location: Bivens

Date of Next Meeting: August 29, 2014

Attendance: Sam, Pam, Peggy, Zeke, Cassandra, Rhonda

Absent: Jim, Tracey Cindy

I.	Business Operations:

A.	Monthly Budget (Revenue and Expenses)

1.	Sub-topic: Youth Care Worker Budget

Discussion: Expenses are high.

Outcome, Actions, Timeframe:	Please look very closely at your staffing patterns to ensure efficiencies are maximized.

B.	Marketing and Business Development

1. Sub-topic: Electronic communications (Pending)

Discussion:

Outcome, Actions, Timeframe: It was agreed that we would do a three month pilot at Central and see what we learn. Sam will look at the forms we will need to adjust.

2. Sub-topic: Pictures of IYPC

Discussion: Jim would like to share some pictures with Christy Daly that demonstrate the state of IYPC

Outcome, Actions, Timeframe:	Jim needs pictures by August 27th

3. Sub-topic: DJJ Florida Network Contract Reimbursement

Discussion: Jim noted at the EMT meeting of 8/19/14 that historically the Florida Networks payment for outcomes was based on state wide performance. So if some agencies were a slightly higher performer and others lower, it could all balance out state wide if the objectives were met. However, this year payment may be strictly based on an individual agency’s performance. We have arranged to receive a 3 month advance from the Network, however, after that if we have not earned our contractual obligation to date, we must pay the Network back. In July for NR Served we were 24 below target.24 times the unit rate of $1,229 = $29,496. For Res Days we were 42 days below target. 42 times the unit rate of $239.85 = $10,0730.70. That brings our total underperformance to $39,569.70. This means we would owe the Network that amount. Jim proposed we take the following approach to address these utilization issues. 1. All staff needs to be clear on where we are on the numbers needed at all times i.e. where do we stand on any given day and what do we need to accomplish the contractual goal? 2. Identify what has caused our utilization issues? 3. What challenges do we face to meet our objectives? 4. What is the Plan by Region to meet those objectives?

Outcome, Actions, Timeframe:	Brain storming session

Identify what causes our utilization issues:

1. We accommodate families vs. creating expectations. For example as an accommodation we might say, “What is a good time for you or can you make this time?” As opposed to creating an expectation by saying, “The first available appointment time is at 3:30 on Thursday.”

2. No shows are a problem impacting productivity and utilization.

3. We do not fully take advantage of the technology available to us. Are we willing to invest in better technology?

The residential program and non-residential programs are not well connected.

4. We may not be welcoming, by who answers the phone and what they may say.

Not very welcoming: We may say things to like, “Our services are voluntary, and so your son has to want to come participate in the program.”

More welcoming: “I believe we can help you, let me ask you a few questions to get things started.

4. Intake dates may not be readily accessible.

5. The residential length of service expectation varies between shelters.

5. Non-residential counseling expectations for length of service may be too long. For example, transition thinking of 10 weeks rather than 12.

How can we address the challenges faced to meet our objectives?

Have non-residential youth participate in the shelter program as part of their plan

1. Give shelter appointment times to set a tone of expectation for coming at this time.

1. Be more directive about making appointments

2. Make it an expectation for counselors to call participants prior to an appointment

2. Help families establish non-residential appointments prior to discharge from residential.

2. Put stronger efforts into ensuring a successful transition.

3. Seek input from some of our younger staff regarding the use of technology

4. Develop a close the deal mentality/philosophy. Sell the services to parents

4. Move the script on the screening form to the front from the back to make it more prominent

4. Offer incentives for closing the deal.

4. Bring back quarterly structure to recognize staff

4. Approach physicians, dental practioners, health departments and family practices regarding services.

4. Create stronger connections with law enforcement regarding truancy sweeps

4. Do a group orientation for parents.

5. Make program expectations uniform and clear to all staff.

C.	Regulatory Issues

1.	Sub-topic: Posting Requirements

Discussion:

Outcome, Actions, Timeframe: Pending

D.	Human Resource Issues (Staffing and Training)

1. Sub-topic:

Discussion:	No discussion

Outcome, Actions, Timeframe:

E.	Annual Budget Planning and Process

1.	Sub-topic:

Discussion:	No discussion

Outcome, Actions, Timeframe:

II.	Health and Safety: Program/Regional Coordinators

A.	External Inspections

1. Sub-topic:

Discussion

Outcome, Actions, Timeframe:

2. Sub-topic:

Discussion:

Outcome, Actions, Timeframe:

B.	Self-Inspections (Reports, analysis, and recommendations)

1.	Sub-topic: Performance and Risk Management Packets

Discussion: P. 4, Sam noted the value of the longitudinal reviewed several weeks ago at the meeting. For example July Non-residential admissions exceed last year’s admissions by 43% and was by far the best July for the past 5 years. He also noted that from a trend stand point August is typically worse than July for bed days. This July has been about average when compared over the last 5 years. P. 7 IYPE camp dropped our average length of stay for the month,

Outcome, Actions, Timeframe: Sam will ask Laura to e-mail the data reviewed last month. P. 5 Sam will ask Laura to update how the percentages are calculated on this page. P. 6 Laura please remove Zeke, P. 14 Sam will try to get additional input on the 3 day entry requirement,P.18 Managers review cases over 12 weeks carefully, P 25 Pam, please review Discharge status for accuracy, Incident Summary’s No trends were noted.

C.	Incident Reports (Reports, analysis of trends, recommendations)

1.	Sub-topic:

Discussion: Our codes for reporting have changed.

Outcome, Actions, Timeframe:

III.	Quality Improvement

A.	File Audits and Case Record Review (reports and recommendations)

1.	Sub-topic: Q.I. Goals Tracking Training

Discussion: Sam reviewed progress to date on the new tracking system

Outcome, Actions, Timeframe: Liz will try and train those responsible for inputting training next week.

B.	Outcome Management (status, reports, recommendations)

1.	Sub-topic:

Discussion:	No discussion

Outcome, Actions, Timeframe:

C.	Accreditation and Regulatory Requirements

1. Sub-topic:

Discussion:

Outcome, Actions, Timeframe:

D.	Policy and Procedure Updates and/or Review

1. Sub-topic: Contingency Contract Forms

Discussion: F-PR-1200

Outcome, Actions, Timeframe: Update Pending

E.	Participant Complaint and Grievance (specific and quarterly review of trends)

1.	Sub-topic:

Discussion:

Outcome, Actions, Timeframe:

F.	Planning Documents (reports, status of goals and objectives, reformulation)

1.	Sub-topic:	Strategic Plan

Discussion:	Shelter & Non-Residential Utilization

Outcome, Actions, Timeframe: Input due September 30th.

Discussion:	Communication

Outcome, Actions, Timeframe:	Input due September 30th.

Discussion:	Hiring and Retention of Qualified Staff

Outcome, Actions, Timeframe:	Input due September 30th.

Discussion:	Programming: Can it be more effective?

Outcome, Actions, Timeframe:	Input due September 30th.

2.	Sub-topic:	Accessibility Plan

Discussion:

Outcome, Actions, Timeframe:

3.	Sub-topic:	Cultural Competence Plan

Discussion:	No discussion

Outcome, Actions, Timeframe:

4.	Sub-topic:	Input Plan

Discussion:

Outcome, Actions, Timeframe:

5.	Sub-topic:	Community Relations plan

Discussion:	No discussion

Outcome, Actions, Timeframe:

IV.	Risk Management

A.	Risk Management Plan (exposure to loss)

Sub-topic:

Discussion:

Outcome, Actions, Timeframe:

B.	Employee Concerns or Complaints

1.	Sub-topic:

Discussion:	No discussion

Outcome, Actions, Timeframe:

C.	Potential regulatory audits and/or investigation of operations

1.	Sub-topic:

Discussion:

Outcome, Actions, Timeframe:

V.	Information Technology

A.	Technology Plan

1.	Sub-topic:

Discussion:

Outcome, Actions, Timeframe:

VI.	Clinical/Program

A.	Medical and Medication Issues

1.	Sub-topic:

Discussion:

Outcome, Actions, Timeframe:

B.	Counseling and Programming Issues

1. Sub-topic: Needs Assessment & PAT

Discussion: Sam asked for feedback on the Interim Form

Outcome, Actions, Timeframe: will incorporate feedback and send out an August Interim form to be used.

Sub-topic: 30/60 Day Follow up

Discussion: Sam asked how the 30/60 day follow-ups were going.

Outcome, Actions, Timeframe:	O.K. at the present time.

VII.	Other Business:

1.	Sub-topic:

Discussion:

Outcome, Actions, Timeframe:

Respectfully submitted by:

Sam Clark

Name	Date