Meeting Minutes

CDS Family & Behavioral Health Services, Inc.

Meeting: Family Action-Central CINS/FINS

Date: August 9, 2016

Time: 930-1030

Location: Bivens

Date of Next Meeting: September 13, 2016 at 9:30am.

Attendance: Isaiah Harmon, Jessica Bechtold, Mary Simmons, Chelsea Tobias, Corey Collins, Joy Brown, Carlos Aguiire

Absent:

I.	Business Operations:

A.	Monthly Budget (Revenue and Expenses)

1.	Sub-topic: Allocations of budget

Discussion: See Annual Budget Planning and Process

Outcome, Actions, Timeframe:

2.	Sub-topic:	Fiscal Challenges and Staff

Discussion: Jess reminded staff to report any fiscal issues to Jess. Jess will communicate with fiscal directly in order to mitigate any challenges.

Outcome, Actions, Timeframe: ongoing

B.	Marketing and Business Development

1. Sub-topic: Outreach

Discussion: See Outcome Management

Outcome, Actions, Timeframe:

C.	Regulatory Issues

1.	Sub-topic: JJIS Discharges

Discussion: Jess worked closely with Laura on discharge requirements and challenges within the JJIS system. All counselors successfully discharged closed cases from the system and Laura completed discharges for counselors no longer employed by CDS.	.

Outcome, Actions, Timeframe:	Completed on 8/3/16. A BIG thank you to all staff and Laura for the prompt response and for working diligently on this matter.

D.	Human Resource Issues (Staffing and Training)

1. Sub-topic: Live Scan/ Background Screens

Discussion: Jess and Liz discussed challenges and processes for new live screen background checks.

Outcome, Actions, Timeframe: Ongoing. Applicants to obtain live screen at approved vendor. Jess to receive copy of approved vendors list and distribute as necessary.

2.	Sub-topic: CPR/ First Aid Update- Follow-up item.

Discussion:	Jess consulted with Ronda regarding possible CPR/ First Aid contacts for first year hires.

Outcome, Actions, Timeframe:	Jess to wait until new Counselor/Case managers are hired and then will assess as to whether they have had CPR/ First Aid in the past. Jess will contact Ronda for resources if there is a need for face to face training. Pending.

E.	Annual Budget Planning and Process

1.	Sub-topic:	Sub-topic: SNAP Allocations and budget

Discussion: Corey Collins discussed concerns with Jessica regarding allocation of budget.

Outcome, Actions, Timeframe: Jessica spoke with Tiffany on 8/10/16 and clarified any budget allocation concerns. According to Tiffany, budget allocations are accurate within the fiscal department and discussed possible out of date budgets that might exacerbate concerns of inaccuracy. Jess relayed this information to Corey Collins on 8/10/16. Tiffany appreciates follow through on requests to communicate through the chain of commands and requests that we continue to do so. Thank you to all staff for your efforts and support.

2. Sub-topic: Current Fiscal Year Allocations and budget

Discussion: We anticipate a more challenging budget this Fiscal Year

Outcome, Actions, Timeframe: EMT meeting to commence on August 30, 2016 at 9 am to discuss budget allocations for this fiscal year

II.	Health and Safety: Program/Regional Coordinators

A.	Internal Inspections

1. Sub-topic: Complete appropriate drill for the month of August.

Discussion: Joy will be performing the drill this month.

Outcome, Actions, Timeframe:	Due this month.

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

1.	Sub-topic: Monthly Maintenance and safety - Follow-up

Discussion: Jess discussed monthly maintenance inspections with Roy.

Outcome, Actions, Timeframe: Roy confirmed compliance with monthly reviews. A big thank you to Joy for purchasing much needed flash lights for the building in case of an emergency.

2.	Sub-topic: Outlets

Discussion: Family Action experienced challenges with multiple outlets making it difficult to perform daily copying and shredding duties .

Outcome, Actions, Timeframe: Roy had outlets repaired at the end of July

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

1.	Sub-topic: No Discussion

Discussion:

Outcome, Actions, Timeframe:

III.	Quality Improvement

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

Sub-topic: Peer Reviews

Discussion: Peer Reviews are due at the end of September. Please choose two open and two closed charts for review. We will complete peer reviews subsequent to our staff meeting on September 13th, 2016.

Outcome, Actions, Timeframe:	To complete after staff meeting on September 13th, 2016.

Sub-topic: Release for other parent

Discussion: Jess discussed the importance of obtaining releases for other parent when applicable, attempts to obtain adoption paperwork when applicable, copies of legal guardianship or power of attorney when applicable, as well as informing other parent of services.

Outcome, Actions, Timeframe:	This is ongoing. If you are unable to obtain information mentioned above, please document your attempts.

Sub-topic: Tracking forms

Discussion: Jess reminded staff to include goals and objectives in tracking forms in order to appropriately track services.

Outcome, Actions, Timeframes: Ongoing

Subtopic: Charts and signatures

Discussion: Jess asked staff to locate any charts missing supervisor signatures. Jess will continue to go through charts to identify any missing signatures/reviews. Please place charts in need of review/ signature in my basket. I will work diligently to return them to you ASAP. Ideally, I would like the charts within the first week of intake so that signatures and chart reviews can be implemented within an appropriate timeframe.

Outcome, Actions, Timeframe: Ongoing

B.	Outcome Management (status, reports, recommendations)

1. Sub-topic: Low productivity

Discussion: See risk management

Outcome, Actions, Timeframe:

C.	Accreditation and Regulatory Requirements

1. Sub-topic: No Discussion

Discussion:

Outcome, Actions, Timeframe:

D.	Policy and Procedure Updates and/or Review For Your Information from CINS/FINS Meeting

1. Sub-topic: CINS/FINS Probationary Status

Discussion: During the CIN/FINS meeting on August 5th, 2016, attending members discussed the contract standards that CDS failed to meet the required percentages. Laura commented on our attempts to get Florida Network to rerun our completed intakes and needs assessments standard after the data corrections were made.

Outcome, Actions, Timeframe: Programs are to examine practices in their respective areas and bring suggestions for improvements to the August 19th CINS/FINS meeting.

2.	Sub-topic: Medication Provision, Storage, Access, Inventory and Disposal

Discussion: Tracey reviewed policy in association with Kathy’s written comments during the CINF/FINS meeting and staff came to agreement on policy revisions based on CINS/FINS policy and Procedures and QI Standards.

Outcome, Actions, Timeframe: Tracey will follow up with the Florida Network on areas staff was unclear on.

3. Sub-topic: Med Cart Training for Nurses and Super Users

Discussion: During the Cins/Fins meeting, Tracey discussed staff concerns regarding the staff not being able to contact the nurse when she is off duty. We also had a discussion regarding Dr.’s orders vs. court orders. Rhonda and Pam are meeting with Melinda S. from PFSF and the CSU psychiatrist on Wednesday, August 19th and will attempt to get some input from them on this issue.

Outcome, Actions, Timeframe: Tracey will draft some language in the policy around court orders, etc. and send to the group for feedback.

4. Sub-topic: P-1119 Medical and Mental Health Alert Process

Discussion: “…Upon admission to shelter services, the youth and parent or guardian (if available) shall be interviewed about the youth’s current medications. This shall be part of the Medical and Mental Health Assessment screening process. This process will be conducted by a Registered Nurse if one is on premises. Otherwise, this interview will be conducted by on-duty staff and reviewed by the Registered Nurse within 5 business days.

Outcome, Actions, Timeframe: Sam has updated the Intranet noting the highlighted change.

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

1.	Sub-topic: No Discussion

Discussion:

Outcome, Actions, Timeframe:

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

1.	Sub-topic:	Strategic Plan

Discussion:

Outcome, Actions, Timeframe:

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)

1. Sub-topic: Probationary Status

Discussion: Jess gave staff copy of performance report and discussed probationary status. Jess and the staff initially discussed what Family Action is able/unable to influence and change and then divided issues into subcategories (data entry, Staff retention and numbers) in order to problem solve for fiscal year 2016-2017. Jess discussed data entry issues that prevent a participant’s full entry into the system and then had staff identify concerns and solutions for these concerns. According to Joy, many challenges involve distractions and not being notified consistently with errors or missing information. Jess informed Joy that at times it is difficult for data to identify issues when they have not been concerns in the past. Jess continued to note that now that data is aware of what to look for, notifications will be easier in the future. Joy Brown has requested frequent notifications (once a month?) of errors or missing information so that she is able to correct it. As for distractions, Joy has discussed challenges with multitasking (tending to phones, greeting participant families, obtaining screenings and completing data entry). Joy has requested that counselors remain cognizant of their appointment times so that if Joy is unavailable, counselors may greet their clients at their scheduled times.

During and subsequent to the CINS/FINS meeting, Laura Scott discussed the possibility of “red Flags” and/or adjustments within NetMis that does not allow for submissions or continuation to the next screen until certain fields are completed. Laura discussed concerns with the complexities of coding and programing and is unsure if these intricate changes will be possible. Jess discussed these suggestions with Joy Brown and Joy believes that these potential changes will assist her with accuracy.

Jess then addressed staff retention issues and asked staff to identify what they believe to be the biggest challenges for Family Action in reference to the aforementioned sub-topic. In order of importance, staff identified: Salary, little room for advancement, high probability of burn-out and compassion fatigue especially when considering the homogeneity of incoming participant issues and concerns, lowering of morale at the end of the year due to transitions and lack of staff connections/ increases in stressors, and the need for acknowledgement and feedback from “the top”.

The staff members continues to clarify concerns and discussed the lack of opportunity in advancement in status or salary (raises, status changes) which in turn decreases morale and motivation in the years to come. Staff suggested opportunities for raises. Jess will discuss this at subsequent CINS FINS meeting.

Compassion fatigue and burn out were also discussed and identified as a multisystemic issue involving personal and professional influences. Discussions continued to identify possible solutions including education and willingness to implement self-care measures within personal life, notifying supervisor of burn-out and/ or Compassion Fatigue symptoms, supervisor and staff identifying possible contributors that exacerbate symptoms and both supervisor and staff to create personalized/ comprehensive plan to balance responsibilities and decrease current and future burn out/ compassion fatigue triggers. In addition, Jess suggests counselors remain cognizant of the homogeneity of client issues and discuss possible balancing of issues (i.e. if a counselor has a caseload consisting of substance use, all counselors can collaborate to ensure cases are evenly distributed and counselors are assigned varying client issues.) Finally, Staff discussed numbers and outreach. Staff discussed newer outreach methods. Dr. Harmon suggested attending various school meetings/ contacting school secretaries and possible tv ads. Joy discussed her outreach during 30/60 day reviews. Chelsea suggested attending events or getting tables at local NAMI events or other similar mental/behavioral health events in the area. Chelsea also discussed possible contact with News channel WUFT and suggested advertising through their community update.

Outcome, Actions, Timeframe: To address the identified issues and possible solutions (regarding probationary topics) during CINS/FINS meeting on 8/19/16. Jess gave each counselor information on the signs and symptoms of burnout and compassion fatigues as well as ways in which to problem solve each.

Chelsea Tobias submitted a community update/advertisement about CDS/ Services to WUFT on August 9th, 2016. Jess was invited by Mr. Sam Haywood to attend the Deans meeting at Lincoln Middle School on 8/10/16. Jess attended the deans meeting and discussed services and handed out resources (referral forms, flyers, brochures, business cards) to professionals attending the meeting.

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: No Discussion

Outcome, Actions, Timeframe:

V.	Information Technology

A.	Technology Plan FYI

1.	Sub-topic: Williston Computer

Discussion: Jess and Jordan discussed need for laptop once new hire is obtained for Williston. Jess informed Jordan of current state of affairs regarding Counselor/ Case manager candidates.

Outcome, Actions, Timeframe: Jess to inform Jordan of new hire details for Williston so that he is able to repurpose the laptop to that particular individual.

VI.	Clinical/Program FYI

A.	Medical and Medication Issues

1. Sub-topic: See above under Policy and Procedure updates

Discussion:

Outcome, Actions, Timeframe:

2.

B.	Counseling and Programming Issues

1.	Sub-topic: SNAP Update

Discussion: SNAP supervisor, Corey Collins introduced Carlos Aguiire as the new SNAP Case Manager. Welcome Carols!!! Jess, Carlos and Corey discussed tentative meeting times in order to review training requirements, documentation, and SNAP charts. Prior meeting was postponed until new case manager was hired to avoid duplicate meetings. In addition Corey discussed current SNAP happenings (boys 1st cycle group starting in August, a girls group on September 11, 2016 for cycle 2, another girls group starting January 3rd, 2017 and the 4th cycle boys group start date is unknown.) Corey discussed details regarding the new girls group and informed staff of the ways in which referrals can be made.

Corey Collins, SNAP Supervisor is also planning to team up with Green Dot, et cetera, Inc. as a presenter and an eventual certified Live the Green Dot Trainer. According to the company website, the primary mission of Green Dot, et cetera, Inc. is to prepare organizations/communities to implement a strategy of violence prevention that consistently, measurably reduces power-based personal violence (including sexual violence, domestic violence, dating violence, stalking, child abuse, elder abuse and bullying).” It is with hope that we may be able to utilize possible training opportunities in order to inform staff on ways in which to prevent violence in a healthy and safe way. Thank you Corey for all of your hard work and for creating meaningful relationships between community prevention facilities.

Outcome, Actions, Timeframe: Tentative meeting date and time: Corey, Carlos and Jessica to meet on 8/12/16 at 11:00 am. Corey, SNAP training and implementing a new girls group is rigorous and time consuming and I want to extend a big THANK YOU for all of your hard work, your positive attitude and for continuing to make the SNAP program a success.

2.	Sub-topic: Training

Discussion: Jess reminded staff of Fl. Network training , CARF training and HIV/AIDS training requirements. Jess distributed information on Florida DOH online training as well as training packets (for HIV/ AIDS training). By way of request, Jess provided Corey, Joy and Carlos information on the location of each training.

Outcome, Actions, Timeframe: All staff: please complete and document your training in file and drop box. You will receive a separate certificate from the DOH. Timeframe: Ongoing.

3. Failed Referrals

Discussion:	Jess and staff discussed proper ways in which to fail a referral. Jess discussed the importance of documentation and requested that staff document the day and reason failed.

Outcome, Actions, Timeframe: Effective immediately

Reserving Rooms

Discussion:	Jess and staff discussed possible need for reserving rooms for counseling sessions. All staff agreed that currently there is not a need to reserve counseling rooms; however when staff numbers and client numbers increase, they would like to revisit the topic and establish a collaborative agreement including the use of the white boards.

Outcome, Actions, Timeframe: Effective immediately

VII.	Other Business:

1.	Sub-topic:	Name Tags

Discussion: A HUGE thank you to all Family Action Staff for wearing your name tags. This was a topic I planned on broaching as a reminder; however it seems as though this is a non-issue. Your efforts do not go unnoticed and I appreciate you!!!

Outcome, Actions, Timeframe: Ongoing

2.	Sub-topic: Emergency phrases

Discussion: Jess discussed emergency plans during times of crisis with clients. Jess discussed the importance of haptics and proximity (table in between client and counselor, counselor sitting closer to door) and reviewed emergency phrases. One concern and general consensus amongst staff was with regards to practicality. Staff continues to note that during a crisis, it is important to deescalate and utilize crisis intervention. Current emergency options (calling Joy on the phone and reciting the emergency phrases) are seemingly impractical and would be obvious to clients in crisis. When asked for possible suggestions, staff discussed the need to utilize crisis management skills, know the client and discussed possible options reflective of under the table buzzers connected to the front desk/silent warning lights that reach the front. In addition, the phone was identified as being too far from the table. As a result, staff agreed to place the conference room phone on the table. Jess was unsure as to how intricate a possible warning alarm setup might be and noted that she would check into it.	.

Outcome, Actions, Timeframe: Jess to discuss with Roy the next time he is in the office to assess as to whether it would be possible to look into a silent alert system. Jess to discuss with Tracey if alert system is a possibility . Pending.

3.	Sub-topic:	Training topic requests

Discussion:	Jess and staff discussed requests for specific training (suicide training, anger management, possible training by police on ways in which to work with youth who are armed). Dr Harmon suggested getting in contact with the police department for possible training opportunities.

Outcome, Actions, Timeframe: Jess contacted G. Pelham (ASO) on 8/11/16 regarding possible training opportunities. Pending.

4.

Respectfully submitted by:

Jessica Bechtold	8/12/16