2018 Triad Community Advisory Board Meeting · 7/12/2018 · Matt Potter, CFAC Representative,...

2018 Triad

Community Advisory

Board Meeting

July 12, 2018

TRIAD COMMUNITY BOARD AGENDA July 12, 2018 DINNER (SERVED AT 5:00 p.m.)

SPEAKER PAGE PURPOSE 1. Call to Order- Matters of the

PublicLeon Inman, Chair 1 Information

2. Opening Remarks Leon Inman, Chair 2 Information

3. Approval of April 12, 2018Meeting Minutes

Leon Inman, Chair 3 Action

4. Annual Chair Election andReinstatements

Leon Inman, Chair 7 Action

5. Local CFAC Update Matthew Potter 8 Information

6. Presentations

A. Community Relations Report

Ronda Outlaw 9 Information

B. Consumer and Family Advisory Committee Annual Report

Stacey Inman 10 Information

C. Client Rights Annual Report Stacey Inman 11 Information

7. Community Updates Leon Inman, Chair 12 Information

8. Closing Remarks Leon Inman, Chair 13 Information

Adjournment

COMMUNITY BOARD MEMBERS

NAME PHONE EMAIL

Davie County Terry Renegar (336) 416-4158 [email protected]

Julie Whittaker (336) 751-5441 [email protected]

Laurie Cruse (336) 655-2465 [email protected]

Forsyth County Don Martin (336) 339-8064 [email protected]

David Mount (573) 489-5535 [email protected]

Mark Serosky (336) 749-4676 [email protected]

Rockingham County Reece Pyrtle (336) 932-4409 [email protected]

Ron Norwood (336) 613-3570 [email protected]

Felissa Ferrell (336) 342-1394 [email protected]

Stokes County Ronnie Mendenhall (336) 293-3359 [email protected]

Leon Inman, Chair (336) 575-3157 [email protected]

Pamela Tillman (336) 813-2051 [email protected]

CFAC Matthew Potter, Vice Chair (336) 409-3096 [email protected]

mailto:[email protected]













TRIAD AGENDA ITEM

MEETING DATE: July 12, 2018 AGENDA ITEM: 1

SUBJECT: Call to Order – Matters of the Public

BRIEF SUMMARY: Leon Inman, Chair, will call the meeting to order. The public

may address the Community Advisory Board.

REQUESTED ACTION: None

ATTACHMENTS: No

TRIAD AGENDA ITEM


SUBJECT: Opening Remarks

BRIEF SUMMARY: Leon Inman, Chair, will provide opening remarks.

REQUESTED ACTION: Information Only

ATTACHMENTS: No

TRIAD AGENDA ITEM


SUBJECT: Approval of the April 12, 2018 Triad Community Advisory Board

Meeting Minutes

BRIEF SUMMARY: The minutes for the April 12, 2018 Triad Community Advisory Board

Meeting are attached for approval.

REQUESTED ACTION: Approve the minutes for the April 12, 2018 Triad Community Advisory

Board Meeting as presented.

ATTACHMENTS: Yes

Triad Community Advisory Board

Meeting Minutes April 12, 2018

Members Present: Matt Potter, Vice Chair, Felissa Ferrell, Donald Martin, Reece Pyrtle, Mark Serosky, Pamela Tillman, Julie Whittaker

Members Absent: Laurie Cruse, Leon Inman, Ronnie Mendenhall, David Mount, Ron Norwood, Terry Renegar

Staff Present: Derek Bittner, Ronda Outlaw, Jill Queen

Guests: Sarah Potter; Obie Johnson, CFAC Chair; Ronda Tatum, Deputy Forsyth County Manager; Keith Duncan, Cardinal Board member

1. Call to Order

Matthew Potter, Vice Chair, called the meeting to order at 6:04 p.m.

Matters of the Public Any citizen may address the Community Advisory Board. No citizen addressed the Community Advisory Board.

2. Opening Remarks In the absence of Board Chair Leon Inman, opening remarks were made by Vice Chair Matthew Potter. Matthew welcomed everyone to the meeting.

3. Approval of the January 11, 2018 Meeting Minutes The minutes from the January 11, 2018 Triad Community Advisory Board meeting were reviewed.

Don Martin motioned to approve the minutes as presented. Reece Pyrtle seconded the motion. All in favor. Motion carried.

4. Local CFAC Update Matt Potter, CFAC Representative, provided local CFAC updates to the Community Advisory Board. Julie Whittaker read the CFAC Yearly Report to the Board. Matt Potter updated the Board on their recommendation that a letter in support of CFAC be sent to DHHS Secretary Mandy Cohen. He read a prepared draft of the letter.

Julie Whittaker made a motion for the Board to endorse the letter. Don Martin seconded the motion.

All in favor. Motion carried.

5. PresentationsA. Community Relations Report

Ronda Outlaw, Triad Senior Community Executive, presented the Community Relations Report.

Ronda Outlaw led a “4 + 1 Activity” to elicit input from Board members regarding the existence of Community Boards; such Boards are not specified in statutes governing Cardinal Innovations’ new governance structure. “4+4” is an established method, under person-centered thinking philosophy, for obtaining input. The goal is to identify and assure the most effective and efficient methods for obtaining community input. Comments collected were submitted to Nicole McKinney, Cardinal Innovations Community Relations Director. Cardinal Innovations governance Board will review input from all Cardinal Community Boards and render a decision.

Ronda Tatum, Deputy Forsyth County Manager, presented draft allocations for Forsyth County’s FY19 Maintenance of Effort funds (county funds designated for local behavioral health needs). MOE expenditures will be included in the Forsyth County budget.

Mark Serosky made a motion to endorse Forsyth County allocation recommendations that will go to Forsyth Board of County Commissioners for approval. Reece Pyrtle seconded the motion.

All in favor. Motion carried.

B. County Dashboard 2nd Quarter Report [October-December 2017] Ronda Outlaw, Triad SCE, reviewed the summary of the County Dashboard 2nd Quarter Report [October-December 2017].

C. Quality Management Dashboard 2nd Quarter Report [October-December 2017] Jill Queen, Manager of Quality Management, reviewed the Quality Management Dashboard 2nd Quarter Report [October-December 2017].

Here’s the link to give feedback on Medicaid transformation that was discussed at the board meeting tonight.

https://www.ncdhhs.gov/medicaid-transformation

https://www.ncdhhs.gov/nc-medicaid-reform/medicaid-reform-comment-submission-form

https://protect-us.mimecast.com/s/1kP2CADQq7fN89Bzc83I_c?domain=ncdhhs.gov

https://protect-us.mimecast.com/s/eULKCDkYN7c5yBw2I5--B6?domain=ncdhhs.gov

https://www2.ncdhhs.gov/ncinnovations/

6. Community Updates

Matthew Potter, Vice Chair, requested community updates from the Board.

Matthew updated the Board on a transportation pilot being supported by grants from both the I/DD Advisory Committee and the MH/SUD Advisory Committee.

Julie Whittaker addressed the community danger resulting from addiction to heroine and other substances.

Cardinal Board member Keith Duncan thanked the Board for allowing his attendance at the meeting and expressed positive thoughts about the future of the organization under its new management.

Obie Johnson, Triad CFAC Chair, mentioned that the Rapid Response Team got grant from HUD for housing piece of the project.

7. Closing remarks Matthew Potter, Vice Chair, provided closing remarks. Julie Whittaker motioned to adjourn the meeting. Don Martin seconded the motion. All in favor. Motion carried.

Meeting adjourned at 8:27 p.m.

Community Board Clerk Date

https://protect-us.mimecast.com/s/IL-BC4xkmDUBqJrAsWFY4W?domain=www2.ncdhhs.gov

TRIAD AGENDA ITEM


SUBJECT: Annual Chair Election and Reinstatements

BRIEF SUMMARY: The Triad Community Advisory Board will be voting for the positions of

Chair and Vice Chair.

REQUESTED ACTION: Present nominations and vote for 2018 Chair and Vice Chair for the Triad Community Advisory Board.

ATTACHMENTS: No

TRIAD AGENDA ITEM


SUBJECT: Local CFAC Update

BRIEF SUMMARY: Matthew Potter, CFAC Representative, will provide local CFAC updates.


ATTACHMENTS: No

TRIAD AGENDA ITEM

MEETING DATE: July 12, 2018 AGENDA ITEM: 6.A.

SUBJECT: Community Relations Report

BRIEF SUMMARY: Ronda Outlaw, Senior Community Executive, will present the Community

Relations Report.


ATTACHMENTS: Appendix A

TRIAD AGENDA ITEM

MEETING DATE: July 12, 2018 AGENDA ITEM: 6.B.

SUBJECT: Consumer and Family Advisory Committee Annual Report

BRIEF SUMMARY: Stacey Inman, Member Engagement Manager, will review the

Consumer and Family Advisory Committee Annual Report.


ATTACHMENTS: Appendix B

TRIAD AGENDA ITEM

MEETING DATE: July 12, 2018 AGENDA ITEM: 6.C.

SUBJECT: Client Rights and Annual Report

BRIEF SUMMARY: Stacey Inman, Member Engagement Manager, will present the Client

Rights Annual Report.


ATTACHMENTS: Appendix C

TRIAD AGENDA ITEM


SUBJECT: Community Updates

BRIEF SUMMARY: Leon Inman, Chair, will request community updates from the Community

Board.


ATTACHMENTS: No

TRIAD AGENDA ITEM


SUBJECT: Closing Remarks

BRIEF SUMMARY: Leon Inman, Chair, will provide closing remarks.


ATTACHMENTS: No

2016 Board of Directors Meeting

APPENDIX A: Community Relations Report NOTES


July 12, 2018

Copyright © 2016 Cardinal Innovations Healthcare. All rights reserved.

TRIAD COMMUNITY ADVISORY BOARD MEETING

July 12, 2018

July 12, 2018


COMMUNITY RELATIONS REPORT

Ronda Outlaw, LCSWSenior Community Executive

July 20, 201719, 2017


Information provided in this presentation pertains only to the counties in the Cardinal Innovations Healthcare service area. This information is specific to the Cardinal Innovations service area and may not apply to other organizations, providers, stakeholders or individuals outside the Cardinal Innovations service area.

Presentation slides are brief, bullet-points of information and should not be used out of context.

Disclaimer

July 12, 2018


2018 Community Reinvestment Plan

• Medicaid Savings Funds $3.8m• Annual “Reinvestment” in Services &

Supports• 2018 Plan Targets Locally Identified

Community Needso Capital projects, equipment, programso “Requests for Proposals” from community

July 12, 2018


2018 Community Reinvestment Plan

• 240 Proposals Received• Comprehensive Decision-Making Process

o Multiple internal and external reviews tosupport equitable decision-making

o Rating systemo State review

• Over $4m Distributed

July 12, 2018


2018 Community Reinvestments

Triad Awards $521,296

July 12, 2018

County Entity InitiativeForsyth iCan House IDD program expansion

Forsyth School Health Alliance Mobile Integrated Health

Forsyth United Way “Rapid Response” housing

Stokes Children’s Center Parenting classes

Davie Davie County Child residential services pilot

Rockingham School System Trauma training for staff


Highland Avenue Center Update

Exterior & Clinical Services Lobby

July 12, 2018



• Fully Operational!o Forsyth Wellness Centero Behavioral Health Urgent Careo Outpatient Behavioral Health Services

• Coming Late Summer 2018o Primary Care Medical Clinic

July 12, 2018



• Forsyth Wellness Center Opened 3/26/18

o Training & education for members, families,community stakeholders

o Recovery supportso Behavioral health-focused community

meetings and events

July 12, 2018



• Behavioral Health Urgent Care Opened 5/17/18!

o Assessment and linkage to care at any houro “23-hour” observations beds (extended

assessment; awaiting inpatient care; crisis “cool down”)

o Access to inpatient and outpatient care o Transportation to crisis bed & back home

• Crisis and Outpatient Services

July 12, 2018



Daymark Support for Homeless Individuals

July 12, 2018



• Primary Care Medical Clinic Opening TBD

o Joint venture of Novant and Wake ForestBaptist Health

o Bringing much-needed medical care tounderserved community

o Serving those with Medicaid & the uninsuredo Tentative opening late summer 2018

July 12, 2018


Addressing Opioid Use

• Narcan Distribution “Round 3”o Provided to all Triad Counties 5/18o Town Hall 5/1/18

o Narcan Kit Assembly

o Q/A with Cardinal Board Chair Bryan Thompson

• Funderso Round 1 & 2: Federal CURES Granto Round 3: Cardinal Innovations ($1m)

July 12, 2018


Addressing Opioid Use

Narcan Distribution

July 12, 2018

County Round 1 7/17

Round 2 11/17

Round 3 5/18

YTD Totals

Forsyth 72 36 164 272

Stokes 12 16 26 54

Davie 14 41 45 100

Rockingham 24 16 96 136

Numbers = Number of Narcan kits distributed. Each kit contains two doses, as multiple doses may be required for one individual.


Annual MOE* Funds Designations

• Supporting Counties in Identifying Local Needs & Planning for FY18-19 Fundingo Coordinated interface with Cardinal funding

(Medicaid, state, federal funds) o Encourage use of MOE for local needs

without a funding source

July 12, 2018

* MOE = “Maintenance of Effort”; county funds designated for local behavioral health needs



• All County Designations Complete 6/18o Popular Funding Allocations

o Opioid & Substance Use Initiatives (All Counties)

o Integrated Health / Paramedicine Initiatives (Forsyth, Stokes, Rockingham)

o Local Dept of Social Services support (Forsyth, Stokes, Rockingham)

July 12, 2018




• All County Designations Complete 6/18o Popular Funding Allocations (continued)

o Member transportation (Stokes, Rockingham)

o Safety net providers – Unfunded/underfunded costs (All Triad Counties)

July 12, 2018



Forsyth County Update

• Peer Support Specialists o Individuals with “Lived Experience”o Support Others in Their Recovery Journeyo Trained and Certified

o 40 hours - Initial training

o 20 hours - Annual continuing education required

• Expanded Presence in Forsyth County

July 12, 2018



• Hospital-Based Peer Support Serviceso Wake Forest Baptist Medical Center

o Emergency Department (8 am-10 pm, Mon-Fri), with follow up to support recovery

o Internal medicine units

o Hospital Statistics on Substance Use*o 50% of emergency trauma cases

o 30% of all admissions

July 12, 2018

Wake Forest Baptist Hospital data



Supporting Members & Collaborating with Health Care Providers

July 12, 2018



• “Stepping Up” Program Updateo Forsyth “Stepping Up” Process to End

Recidivism (SUPER) Programo National Assoc of Counties (NACo) Initiativeo Goal: Reduce number incarcerated with

behavioral health disorderso Success = First Graduation!

July 12, 2018



First “Stepping Up” Graduation 5/3/18

July 12, 2018


Stokes County Update

• Stokes Community Supports Children o Film Viewing, Speakers & Discussion 4/23/18

o “Resilience: Biology of Stress & Science of Hope”

o Sponsors: Stokes Partnership for Children, Stokes DSS, The Children’s Center, Stokes Arts Council, Cardinal Innovations

o Film addresses prevalence of adverse childhood experiences and their impact on physical health & overall functioning

July 12, 2018



Community Dialogue

July 12, 2018



• NC MedAssist Free Pharmacy Event5/21/18o Free Over-the-Counter Meds & Supplies

(over $100 per individual / family)

o Over 400 Stokes County Individuals / FamiliesServed

o 40 Community Volunteers

July 12, 2018


Davie County Update

Coming July 27, 2018!

• NC MedAssist Free Pharmacy Event o Free Over-the-Counter Meds & Supplies

(valued at over $100 per individual / family)

o Time: 9 am – 2 pmo Location: Brock Recreation Center, 622 N.

Main St, Mocksville, NCo Free Transportation To/From Event (YVEDDI)

July 12, 2018


Davie County Update

• New Collaboration o Participation on community-led Davie County

Aging Services Planning Committee

• Psychosis Simulation Eventso Experience & discussion address stigmao Venues:

o Hospitals (Davie Medical Center, Novant) 5/18

o Community Partners Meeting 5/18

July 12, 2018


Rockingham County Update

• REMMSCO Recovery Homeso Multi-tiered Training Effort Underway

o “Intro to Cardinal Innovations” – Process knowledge to improve / streamline interface

o “Intro to Trauma”; additional trauma training TBD

• Rockingham County Jailo Collaboration to Clarify Roles & Meet Needs

o Participants: Jail, Daymark Recovery, Medical Vendor,Cardinal Innovations

July 12, 2018

Copyright © 2016 Cardinal Innovations Healthcare. All rights reserved.July 12, 2018

COMMUNITY

OPERATIONS

Community Engagement

Community Relations

Member Engagement

Questions


APPENDIX B: Consumer & Family Advisory Committee

Annual Report NOTES


Consumer & Family Advisory Committees

(CFAC)

Annual Report

FY 2017 – 2018

Narratives Submitted by Local CFACs

Compiled by Jane G. Clark, MPA, CSAPC, Member Engagement Director

Final Edits by Beverly Corpening, ECFAC Chair

Alamance / Caswell CFAC Counties Represented: Alamance, Caswell Submitted by: Jeanette Williamson, Chairperson Membership The Alamance-Caswell Consumer and Family Advisory Committee (A/C CFAC) currently has five members representing, I/DD, MH and SUD. The AC CFAC strongly believes in serving consumers and family members. Alamance-Caswell CFAC membership is improving and growing and we continue to seek members from Caswell. At the last Alamance-Caswell CFAC meeting there were two people present from Caswell that we hope to join our CFAC. The A/C CFAC has very active members. Currently there are two members serving on the Executive CFAC, one member serving on the Central Community. CFAC members continue to participate on both local and community level committees in order to provide input from a CFAC perspective. Our CFAC members do community outreach to gain perspective and information in order to represent the consumer and family voices. The Alamance-Caswell CFAC will be working diligently on the LBP and will continue following the six statutory tasks and utilizing comment forms when needed. Alamance-Caswell CFAC Chair has completed their budget for FY 2018-2019 and are looking forward to meeting monthly and gaining more members in order to have a full committee. Outreach & Events Our A/C CFAC continues to work in partnership with community agencies and churches to participate in local events. We were the first CFAC to be showcased in the new Cardinal Innovations Community Newsletter, focusing around CFAC Chair, Jeanette Williamson and her recovery story. Alamance-Caswell CFAC hosted a meeting/event in September 2017 for Recovery month with Ron Osborne, Director of Residential Treatment Services of Alamance as a guest speaker. Several outside agencies, including Ebenezer United Church of Christ (EUCC) Recovery Home for Men attended. Also in attendance was the previous Director of Alamance Coalition Against Drug Abuse (ACADA), as well as the founder of Renewal of the Mind, a Substance Use Support Group. Our CFAC emphasizes the importance to provide time for questions and discussion and this was provided during this event. Our CFAC Chair also made and provided CFAC coffee mugs and provided attendees with wrist bands and gift bags, containing information about recovery, including Recovery Bibles and information about CFAC. In addition, the bags also contained blankets and other personal hygiene items such as toiletries. In the month of March 2018 our Alamance-Caswell CFAC hosted a meeting/event for awareness of I/DD and TBI. The guest speaker was Mollissie Peterson, Advocate and Program Director for Alamance Academy LLC and Jeannie Irby educating everyone about traumatic brain injury advocacy. The Our CFAC members made posters for this event in order to promote awareness. CFAC Member Advocacy & Continuing Education

Two members attended the Statewide CFAC Conference in Statesville, NC. One member attended the Pinehurst Conference, December 7th-8th.

Two members completed WRAP trainings, one including Veteran WRAP. One member attended the Clear and Constructive Voices Summit on March 3, 2018. Two members attended the Executive CFAC Retreat in December 2017. Three members attended the NC TIDE Conference in Wilmington, April 22nd- 25th 2018. One member attended the State CFAC Advocacy Day on May 22nd, 2018.

Goals for the New Fiscal Year

The following are some of the goals that the A/C CFAC is working towards in FY 2018-2019: 1. Our CFAC wants to meet monthly, upon a vote by the full committee.2. Our CFAC continues to collaborate with others in our communities in order to brainstorm ideas and

view problems from all possible areas. We believe that more can be accomplished when we strivetogether for collective advocacy.

3. Our CFAC hopes to establish concrete, measurable goals, in order to do this we will develop a SMARTplan of action. ( Specific, Measurable, Action Oriented, Realistic, Time Bound)

4. Our CFAC plans on adding subcommittees that represent MH, SU and I/DD,5. Our CFAC continues on showing up and speaking up more often within the Community.

We as the Alamance-Caswell CFAC serving two Counties Alamance and Caswell Counties are committed to serve as the voice for mental health, intellectual/developmental disability and substance use disorder services.

Five County CFAC Counties Represented: Franklin, Granville, Halifax, Vance, Warren

Submitted by: Angelena Kearney-Dunlap, Chairperson Membership Our CFAC members serve on the following committees/teams:

Regional CFAC FC COC Community Oversight Board Warren County MH Awareness Planning Committee RJ Blackley Center Quality Assurance Committee CFAC Chairperson has applied to serve on several state level committees.

Outreach & Events CFAC’s community involvement during the past year included:

Collaborating with providers to ascertain what the viable options are in the 5 county area; Encouraged members to attend Community events in the five (5) county area and distribute CFAC

flyers at each event; Received information how Peer Support is assisting those in need with transitions into community. Becoming more aware regarding peer support and advocacy to the elderly & disabled as it relates to

doctor and clinic visits; Distributed power point presentation on CFAC to members and in the community.

CFAC Advocacy & Continuing Education During the past year CFAC members attended the following conferences/trainings:

Five County Stepping Up Joint Committee Five County Mental Health Awareness Public Forum – May 2017 The following presentations were made at our CFAC meetings over the past year:

o Elliott Clark Regular MCO/LME Updates o Shirley R-Flood - Budget Reports & PSS updates (bi-monthly) and Home &

Community Based Services (HCBS) o FC COC QM Staff - Dashboard Reports (quarterly) o FC Staff General updates – Jennifer Munch

CFAC made comments to the Governing Board on an ongoing basis. The following represents some of the comments made during the past year:

Increase in budget for trainings and conferences Transportation needs in the FC area for consumers to get to medical appointments Meaningful supported employment opportunities in rural area are needed Questions concerning deaths associated with one provider from dashboard Student suicide attempt – stayed at MPH for 7 days and was sent home. High suicide rate in the area Increase in consumer injuries according to Dash Board presentation Duplicates in reporting; each agency reports the same incident that causes report to be inflated

Projects that CFAC is Currently Working On

Recruitment in Franklin County (2 visitors) Recruitment in Halifax County (4 new members) Attempting to send CFAC representative to various community events in the 5 county area, especially

Halifax and Franklin Counties.

Mecklenburg CFAC Counties Represented: Mecklenburg

Submitted by: Beverly Corpening, Chairperson Responsibilities The CFACs were established by the North Carolina Legislature to ensure that persons with substance abuse disorders, mental health issues, intellectual disabilities, and their families could advocate on behalf of consumer needs. The Responsibility of the CFACs was mandated in statute as follows:

1) Review and comment on the local business plan a. Mecklenburg CFAC members have fulfilled this statutory requirement for the year.

2) Identify service gaps and underserved populations

a. Mecklenburg CFAC members have fulfilled this statutory requirement for the year.

3) Comment on the Service Array and the Development of Additional Services a. Mecklenburg CFAC members have fulfilled this statutory requirement for the year.

4) Review and comment on the Program Budget

a. Mecklenburg CFAC members have fulfilled this statutory requirement for the year.

5) Participate in all quality improvement measures and performance indicators a. Mecklenburg CFAC members have fulfilled this statutory requirement for the year.

6) Submit findings and recommendations regarding ways to improve the Delivery of IDD, MH, and SUD

Service a. Mecklenburg county comments to state and local entities.

Summary Mecklenburg County is the most populated of the CFACs under the CI catchment area and, like all CFACs, is self-directed and self-governing. The committee added one new member this year. Mecklenburg CFAC has adjusted well to the 6 monthly meetings per year. In addition to internal committee meetings, Mecklenburg CFAC members attend various conferences, trainings, and external meetings throughout the year to hone skills and keep abreast of emerging topics in the fields of mental health, intellectual disability, and substance use. Mecklenburg CFAC representatives attend meetings to the Mecklenburg Provider Network Council, the Community Board, the Crisis Roundtable, and the Cardinal Innovations Board of Directors, the Executive CFAC, the Global Continuum Quality Improvement Board, and Mecklenburg County community programs. Cardinal and Mecklenburg will host the statewide CFAC meeting. Going forward, The Mecklenburg team has elected to focus more on community advocacy. The committee’s strategic plan includes developing partnerships with other stakeholders and community organizations to gather support and help turn plans into action in the community. The committee is taking a step toward this goal this year by hosting a community forum.

In the future, Mecklenburg CFAC would like to see more training and conference information distributed by DHHS staff to the CFAC members. As such, the Mecklenburg CFAC Chair has proposed that the State Legislature be made available for more one-on-one contact with local CFACs. Likewise, the Chair has also proposed that all information be distributed to all local CFAC members when distributed to Executive CFAC members.

Though Mecklenburg CFAC already has many original programs in place for residents, the committee plans to take a more hands on approach in the future. Mecklenburg CFAC is committed to turning the tide for a more positive and gainful life experience for those in need in the Queen City.

Orange / Person / Chatham CFAC

Counties Represented: Orange, Person, Chatham Submitted by: Steve Furman, Chairperson Membership & Responsibilities The OPC CFAC is currently made up of seven members. We are actively seeking new members to fill out the three health categories (IDD/MH/SUD). As a group we make planning and management recommendations about Mental Health, Developmental Disabilities, and Substance Use Disorder services and are mandated to the following tasks:

7) Review and comment on the local business plan – We have spent a lot of time in discussions about meeting once a month instead of every other month, which would entail an extra stipend. We have explored the different avenues available to us in which we could spend the budget money including learning seminars or classes.

8) Identify service gaps and underserved populations – We have discussed the possibility of more cognitive therapy groups being available such as DBT. We also have discussed issues with Group Home availability.

9) Comment on the Service Array and the Development of Additional Services – There are a multitude of services available that we as CFAC Members have not taken advantage of, such as the various learning classes I discussed earlier. We feel transportation services could be improved especially for the members from Siler City and Roxboro.

10) Review and comment on the Program Budget – We spend a lot of time discussing money spent on stipends and workshops, and the changes economically due to new political and legislative policies. We have budget sheets that show us where the money is spent and how much money we are allotted in the fiscal year.

11) Participate in all quality improvement measures and performance indicators – We have appointed two members, one to the Local Provider Network Council and another to the Local Community Oversight Board.

12) Submit to State CFAC Findings and Recommendations regarding ways to improve the Delivery of IDD,MH, and SUD Service – We have submitted a number of findings including information on Housing, Transportation, Group Homes, Stigma, and advice about all of these and more. Suzanne Thompson (State liaison) has been a strong advocate in regards to who we need to communicate with.

Piedmont CFAC Counties Represented: Cabarrus, Davidson, Rowan, Stanly, Union Submitted by: Beverly M. Morrow, Chairperson

Membership The Piedmont Consumer and Family Advisory Committee (Piedmont CFAC) currently have eight (8) members representing I/DD, MH, and SUD. This committee anticipates two (2) new members who will represent MH, I/DD and MH respectively; they have attended one meeting and have committed to attend a second meeting in May where they will be voted in and included in our roster.

The present chairperson, Beverly M. Morrow, was officially voted in as chair in March 2018. Because of her short tenure as the new chair (one full meeting in March) many of the required statutes mandated by General Stature 122C-170 have not been accomplished. Unfortunately the past chair did not carry through the mandated statutes as there were complications. Some of our members are very active, one (1) serving on Cardinal’s Executive Board of Directors, three (3) serving on the Executive CFAC, one (1) serving on the Innovations Waiver Stakeholder Group, and one (1) serving on the GQCI Committee.

Outreach Beverly M. Morrow, Piedmont’s chair, is working diligently to bring the CFAC up to where it should be. The following has been accomplished to date:

1. A presentation was presented by Beverly at the November meeting, Building a Collaborative Effort –Solving a Problem in the Community. Guidelines were given on how to create a strategic plan. Out ofthis effort Piedmont CFAC has determined that people in their communities do not know what CFACis, or what they do, also lots of people have not heard of Cardinal Innovation Healthcare. We arepresently making an effort to constructively and purposely to make a difference in this five (5) countywide problem. Members have come up with ideas and are presently carrying out this endeavor.

2. In regards to Cardinal’s Local Business plan we are working to comment and review specifically ontheir endeavor to carry out the DOJ’s Transition to Community Living: how it was and how it is now.

3. In regards to participating in all quality improvement measures and performances we are looking atCardinal’s Annual Quality Strategy &Performance Improvement Plan. We are looking forward to themany questions we have and have discussed to be answered by Jill Queen, Regional Quality Managerat our May 2018 meeting.

Advocacy & Continuing Education

The good news is that this CFAC is moving forward collaboratively and in a cohesive manner. A few members attended the Statewide CFAC Conference in 2017. Two (2) members attended the NC Council of Community Programs Spring Policy Forum (June 5-6

2017). Two members attended the NC Council of Community Programs Emerging Horizons (December 6-8

2017) in Pinehurst, NC. The members who attended the aforementioned conferences shared with the Piedmont CFAC

membership the interesting facets of the conferences and what they had learned.

Piedmont’s members attended the Clear and Constructive Voices Summit in March 2018 which all CFAC members in Cardinal Innovations catchment area were invited. This was a very productive summit where CFAC members’ voices were heard. Several committees were formed and a plan of action was created. We left the summit with high hopes that the CFACs’ will work to assure that they are functioning as we want and that the quality of life of the individuals we serve will be better.

We as the Piedmont CFAC serving five (5) counties Cabarrus, Rowan, Union, Davidson and Stanley Counties are indebted to serve.

Triad CFAC Counties Represented: Davie, Forsyth, Rockingham, Stokes Submitted by: Triad CFAC members

Membership

Triad CFAC is at full 15 members; however, we need more representation from Stokes, Rockingham and Davie Counties. Triad feels a need to expand our membership to 18 (although current CFAC bylaws limit the number of members to fifteen.)

Triad commends DHHS for restoring three CFAC members to the Cardinal Corporate Board. Triad is pleased to have one of our CFAC members on the Board as well as good local representation on this Board. Triad’s letter to the new Board, stating the need for a more bottoms-up policy for decision making that includes consumer and family member voices, was well received. There will be more communication from Triad to the Corporate Board on this.

Updates

This year has been one of opportunity and one of continued challenges for Triad CFAC. As many of you know our first year of merger (FY 2016-17) with Cardinal Innovations Health Care was disappointing. However, thanks to new leadership at Cardinal, hardworking local Cardinal employees, and the Forsyth County Commissioners, Triad has experienced progress and hope for the future.

Forsyth County funding has restored our Mental Health/Substance Use Disorder Advisory Committee and our Intellectual/Developmental Disabilities Advisory Committee. The increased funding has allowed Triad to not only support old friends, but to add new smaller providers to funding. We also now have a voice in selection of local providers through our Community Board.

The Highland Avenue center is now being referred to as the Highland Avenue Partnership; however all advocacy input was silenced at merger and significant changes and delays were all kept secret. We regret the long delay in opening and the loss of the 16 beds; however, we are pleased with Cardinal’s current efforts to be transparent. At the end of April, we will have the Cardinal Wellness Center opened for a month. It will offer afterhours trainings as needed. At the end of April Daymark will be in the center and open 24/7, offering 23 hour chair service for crisis intervention. At the end of summer we should have an integrated system of care in place, offering primary care done by Wake Forest and Novant Health.

Our local staff has done an excellent job in providing us with Dashboards for our four counties on county funding and explanations on services. Our support staff has accommodated our needs to the best of their ability. We have a good working relationship with local staff.

Recommendations

We would like more information on Cardinal’s funding of services to our area. Triad CFAC finds that Cardinal staff and local Cardinal CFACs together with DHHS, needs to plan a

more effective way to address state statutes.

Triad believes it would be more user-friendly to have the conference/training grant (the Bonnie Schell Scholarship) for registration and hotel/mileage grants for these same conferences/trainings to be handled together instead of going to Executive CFAC for one and local CFAC for the other with separate approvals and processing. (Note: These payments are currently handled separately because the Bonnie Schell Scholarship funds come from the Member Engagement departmental budget and the scholarship is designated specifically for training costs. The Executive CFAC set the expectation that the review process must go to the Executive CFAC for approval, and once approved it goes through Cardinal for payment. Local CFACs have the option to vote to approve payment of hotel and mileage from their local CFAC budget, and once approved it goes through Cardinal for payment.)

Triad finds that having an Executive CFAC has not been an effective plan to address both statutes and advisory to the Corporate Board.

Triad finds that communication with Executive CFAC has been unsatisfactory. Triad finds that we must meet twelve times annually and since we will be conducting Cardinal

business, we would like support for all meetings. Triad CFAC, along with the two advisory committees would like to be included in planning

services/programs at the new Forsyth Wellness Center. Triad is pleased that CFAC corporate board members will be involved in the selection process of

awarding grants for the reinvestment plan. Triad CFAC believes the Forsyth County registry waitlist problem for IDD services needs to be

addressed and some better solution needs to be found. Waiting over twenty five years for a full array of services is simply not acceptable.

Triad believes that Cardinal should change its current policy of no CFAC members on the Client Rights Committee.

Much progress is planned with subcommittees formed at the CFAC summit, but more work needs to be done on involving CFAC members in the initial planning of events. There remains the culture of top down and not bottoms up in planning. Triad CFAC is committed to working with the new leadership staff and new corporate board and local staff to help Cardinal reach its full potential.

Executive CFAC 6 Local Regional CFACs Represented: AC, FC, Meck, OPC, Piedmont, and Triad Submitted by: Bob Crayton, Chair-Elect for ECFAC

Our Vision Cardinal Innovations Healthcare CFACs promotes a community-based support system that seeks to have each person reach his or her full potential. These committees of consumer and family members gives voice to the interests and opinions of persons with needs related to mental illness, intellectual/developmental disabilities, substance use disorders and traumatic brain injuries.

Embracing the dignity of all residents in our communities so that each person may achieve his or her highest level of responsibility in the community.

Promoting the empowerment of consumers and the active involvement of family members.

Membership Our Executive CFAC members serve from the following local Regional CFACs/teams:

Mental Health Intellectual/Developmental Disabilities Substance Use Disorders Beverly Corpening (Meck) Shira Belovics (Orange) Russell Andrews (Meck) Terry Cox (Forsyth) Brad Donohue (Union) George Bridges (Granville) Bob Crayton (Alamance) Angelena Kearney-Dunlap (Warren) John Hufton (Davidson) Beverly Morrow (Cabarrus) Matt Potter (Forsyth) Obie Johnson (Forsyth) Rosemary Lewis (Vance) Gloria Tiller (Meck) Leslie Matthews (Chatham) Janet Sowers (Person) Jeanette Williamson (Alamance)

Executive Summary If there is one thing that is consistent each year in the mental health, substance use, and intellectual and developmental disability system, it is that we again have a new Secretary and a new vision. While we believe that most people serving in these political roles have the right motives, it is not easy on individuals and families when the system is in constant turmoil and debate.

We have had to learn more about advocacy this year both at the local and state levels than ever before. We have written letters, visited our representatives, and taken part in rallies over the last year. State cuts are having an impact on what reinvestments are made in our communities, which we find to be unfair and just not right.

We value and appreciate our relationship with the new Board of Directors and the management of Cardinal Innovations Healthcare and believe that they want our input and take it with genuine consideration. Our CFAC Representatives attends each Cardinal Board meeting, reporting out on our activities and making mention of our concerns.

We have made a genuine effort to get out into our communities and hear the voices of the people we represent by our local Regional CFAC meetings and participating in community events. Many of us have

been trained in Mental Health First Aid, QPR, and WRAP and believe in the effort to train as many people as possible in our communities. We are not sure what the future holds for this system yet we plan to be vocal and to be involved in the continued transformation. This year closes on a positive and proactive note, for several reasons, has been one of opportunity and one of continued challenges and our report includes updates about each of our local Regional CFACs and things they have accomplished over the last year. How Cardinal Innovations’ CFACs Operate: The focus for the Executive CFAC is to meet the six statutory requirements as well as represent to the company’s Board of Directors the needs of the members and their families from all represented counties within the Cardinal Innovations Healthcare (CIH) catchment. This group uses comment forms to provide information and feedback to the Board of Directors. Also, as of January 27, 2018, CIH’s Board of Directors includes 3 CFAC members from across our catchment areas. The focus for the local Regional CFACs is to highlight local issues related to the six statutory requirements and balance those needs in conjunction with overall State priorities (as learned through the State CFAC). These groups use comment forms to provide information and feedback to the Executive CFAC. They can also communicate directly with the CFAC representative who serves on CIH’s Board of Directors. State of the Union for Cardinal Innovations Healthcare CFACs: Achieving our 6 Statutory Obligations and how Cardinal assists with the Tasks

Review, comment on, and monitor the implementation of the local business plan; Community Operations/Member Engagement facilitated quarterly discussions of LBP, providing the document, CFAC members added their feedback to the internal report.

Identify service gaps and underserved populations; Community Engagement to provide overview of the Community Needs Assessment results to supplement CFAC members’ local information.

Make recommendations regarding the service array and monitor the development of additional services; Can use the Community Needs Assessment results which helps identify local gaps and needs, while adding our local knowledge/expertise. One local Regional CFAC now has a voice in selection of local providers through their Community Board. CFACs would like to be more included in planning of services/programs.

Review and comment on the LME/MCO budget; Community Relations/CFO/CAO presented to the Executive CFAC, as well as Member Engagement/ local Regional CFAC Liaisons to local Regional CFACs. We would like more information on Cardinal’s funding of services to our area.

Participate in all quality improvement measures and performance indicators; and Regional QM Manager provided QA/QI summary report. QI/QM staff provided a dashboard review of quarterly and year end data.

Submit to the State Consumer and Family Advisory Committee findings and recommendations regarding ways to improve the delivery of mental health, intellectual/developmental disability and substance abuse services.

Executive CFAC Chair provided quarterly updates on the State CFAC-to-Local CFAC Conference calls. Member Engagement Director, Jane Clark has done an excellent job in providing us with Director’s updates on funding and explanations on services. Support staff has accommodated our needs to the best of their ability. Member Engagement Director also assisted with developing/providing CFACs an annual timeline/ action plan to support meeting our 6 statutory tasks.

Concerns

Medicaid Transformation

Continued budget cuts from the State

Limited service plans utilizing State dollars

Political uncertainty

Transportation and housing needs

The need for well-trained direct care workers

Consumer-operated service providers such as, respite, warm lines and transportation

MH stigma awareness / Community inclusion

Registry waitlist problem for I/DD services with better solution needs to be addressed

Goals

Finish Clear & Constructive Voices Summit subcommittees Plans of Action

Increase local activities and presence

Increase advocacy efforts at the State level

Increase the number of outreach activities, asking each member to participate in at least oneoutreach opportunity

Increase membership and participation and do a better job of orienting new members

Encourage local advocacy by CFAC members and other community members through education andinformation

Increase awareness of Bonnie Schell Scholarship funds available to Cardinal Innovations’ members

Be heard by utilizing all resources available


APPENDIX C: Client Rights Committee Annual Report

[FY 2017 – 2018] NOTES



Annual Report FY 17-18Client Rights Committee

July 2, 2018


Responsibilities of the CRC

1. Monitor Cardinal Innovations’ activities related to client rightsamong providers by reviewing aggregate data on incidents,rights violations, incidents of abuse/neglect/exploitation andrestrictive interventions

2. Monitor Cardinal Innovations’ activities related to client rightsamong providers by random reviews of minutes submitted bycontract agencies

3. Function as a resource to Client Rights Committees of contractagencies

July 2, 2018


Client Rights Committee (CRC) Objectives

The CRC establishes and oversees clients’ rights protections to assure that every client is treated with dignity and respect and receives care in a safe and appropriate environment.

The CRC promotes awareness and educates various stakeholders, including Cardinal Innovations’ Network Providers, members and their family about clients’ rights.

July 2, 2018


How the Objectives are Achieved

CRC members review and analyze data:• For patterns/trends regarding suspected cases of abuse, neglect and

exploitation• For patterns/trends regarding grievances and incident reports including

the use of restrictive interventions• Regarding provider monitoring reviews and noncompliance related to

member rights• Serve as the Client Rights Committee for Employer of Record

individuals including review and decisions of rights restrictions,restrictive interventions and incidents related to rights violations, Abuse,Neglect and Exploitation

July 2, 2018


Brief History

• The Client Rights Committee (CRC) has historicallystruggled to sustain membership.

• We have a small but strong membership currently,although we sadly lost one of our members tountimely death last fall.

• This fiscal year has been one of building up the CRCmembership and establishing concrete goals.

July 2, 2018


Client Rights Committee (CRC) Goals FY 17-18

• Recruit members representative of our communities• Encourage and maintain attendance• Define and begin working on main project

July 2, 2018


June 2017 through July 2018: Established Routine Meeting Schedule

Meetings held at-least quarterly, either by teleconference or in-person. In-person meetings are held at the Cardinal Innovations AC Office quarterly. – June 2017, September 2017, December 2017, March 2018,

and June 2018 from 6:00 – 8:00 pm

July 2, 2018


Next Steps: Update Bylaws, Define Responsibilities

By the end of the fiscal year the CRC plans to accomplish: June 2018- CRC will define main project and the

mandatory review of Quality Management reports will occur.

June 2018 - the review of By Laws and an updated version will be completed.

July 2, 2018


CIH Staff Liaison to the Client Rights Committee

Whitney RobertsonMember Engagement Specialist,

Northern Region

Email: [email protected]

July 2, 2018


Davie County Dashboards

FYTD March 2018

Report data as of May 24, 2018. All graphs are county specific unless otherwise noted.

County Funded Programs*

Milling Manor Group Home

Monarch

Total:

* Please see Appendix A for County Funded Program definitions.

Please note that providers have up to 90 days to submit claims and that this will affect the number of members served and expense amounts on this report. The numbers for

the previous months will be updated each reporting period.

$65,692

$70,692$108,538

FYTD

Expenses

$5,000$10,000 50.0%

$98,538

FY Budget

Amount

Davie Funding

% Spent

66.7%

65.1%

NOTE: County “Maintenance of Effort” funds targeting local behavioral health needs may be managed by Cardinal Innovations or by the county. Data shown here only represents county funds managed by Cardinal Innovations.


FYTD March 2018

Registry of Unmet NeedsNumber of Members Served All Age and All Diagnosis

Number of Members Served by Age and Diagnosis

145133 129

141150

127 123134 132

16 18 14 16 17 16 13 1421

2 3 3 5 4 5 4 3 60

20

40

60

80

100

120

140

160

Jul'1

7

Au

g'1

7

Sep

'17

Oct

'17

No

v'1

7

Dec

'17

Jan

'18

Feb

'18

Mar

'18

Child Members Served by DiagnosisAges 3 through 17

MH IDD SUD

154 155

137 139 137125

136 135119

85 88 85 86 84 85 85 85 84

62 68 6355 58 55 60 59 63

0

20

40

60

80

100

120

140

160

180

Jul'1

7

Au

g'1

7

Sep

'17

Oct

'17

No

v'1

7

Dec

'17

Jan

'18

Feb

'18

Mar

'18

Adult Members Served by DiagnosisAges 18 and over

MH IDD SUD

82

80 80

81

80

82 82 82

81

79

80

81

82

83

Jul'1

7

Au

g'1

7

Sep

'17

Oct

'17

No

v'1

7

Dec

'17

Jan

'18

Feb

'18

Mar

'18

Nu

mb

er o

f M

emb

ers

on

Reg

istr

y

Innovations Registry of Unmet Needs

NOTE: Innovations slots and funding are allocated by the state. MCOs have no ability to fund or expand the number of Innovations slots.

299 288266 280 287

252 259 269251

101 106 99 102 101 101 98 99 105

64 71 66 60 62 60 64 62 69

0

50

100

150

200

250

300

350

Jul'1

7

Au

g'1

7

Sep

'17

Oct

'17

No

v'1

7

Dec

'17

Jan

'18

Feb

'18

Mar

'18

All Members Served Ages 3 and over

All Diagnosis

MH IDD SUD

NOTE: This is a distinct count of members served. Members with multiple diagnosis will only be counted once. The sum of the previous graph will not be equal to the total in this graph.


FYTD March 2018

*Please see Appendix B for Service Category definitions.

Members Served is based on Member's County of Medicaid Eligibility not on the Provider's physical

location.

Expenses by Service Categories is based on the Total Paid Amount.

Members Served and Expenses by Service Category

4

3

2

3

4

10

22

21

18

26

19

63

54

60

77

668

3

3

4

5

5

9

16

18

19

22

25

30

53

58

86

672

0 200 400 600 800

MST

Partial Hosp/Day Tx

Psych Rehab

ACTT (Assertive CommunityTreatment Team)

Community Support

PRTF (Psychiatric ResidentialTreatment Facility)

BH Long Term Residential

1915 (b)(3) Services

ICF

IIHS

Crisis Services

Outpatient ED

Innovations

Inpatient

Emergency Department

Outpatient

Distinct Members Served - Medicaid Funding

Jul'17-Mar'18 Jul'16-Mar'17

$48,840

$7,114

$2,804

$32,398

$5,947

$417,397

$445,837

$56,205

$2,004,368

$200,105

$16,611

$6,178

$2,004,014

$147,712

$39,440

$372,360

$37,578

$29,992

$2,214

$45,682

$28,187

$280,130

$384,463

$61,442

$1,999,802

$135,555

$6,824

$3,117

$2,139,355

$224,607

$62,388

$406,567

$0 $500,000$1,000,000$1,500,000$2,000,000$2,500,000

MST

Partial Hosp/Day Tx

Psych Rehab

ACTT (Assertive Community Treatment Team)

Community Support

PRTF (Psychiatric Residential Treatment Facility)



ICF

IIHS

Crisis Services

Outpatient ED

Innovations

Inpatient


Outpatient

Expenses by Service Category - Medicaid Funding



FYTD March 2018


Members Served is based on member's County of Residence not on the Provider's physical

location.



1

0

3

26

22

29

27

123

0

1

2

22

23

35

40

130

0 50 100 150

Community Support


Partial Hosp/Day Tx

Residential

Community

Inpatient

Crisis Services

Outpatient

Distinct Members Served - State Funding


$859

$0

$7,832

$156,094

$119,980

$158,613

$7,512

$24,868

$0

$4,212

$2,249

$155,707

$121,333

$124,136

$14,326

$13,409

$0 $50,000 $100,000 $150,000 $200,000

Community Support


Partial Hosp/Day Tx

Residential

Community

Inpatient

Crisis Services

Outpatient

Expenses by Service Category - State Funding



FYTD March 2018

Medicaid Member served for Facility Based Crisis & Mobile Crisis Services are based on the

Consumers Eligibility. Expenses by Facility Based Crisis & Mobile Crisis Services are based on the total Adjudicated

Amount.

Members Served and Expense Amounts - Facility Based Crisis & Mobile Crisis Management Services


location.


5

16

3

23

0

5

10

15

20

25

Facility Based Crisis Mobile Crisis Management

Members Receiving FBC & MCM Crisis ServicesMedicaid


8

21

8

28

0

5

10

15

20

25

30


Members Receiving FBC & MCM Crisis ServicesState


$7,099

$2,475

$3,662 $3,540

$0

$1,000

$2,000

$3,000

$4,000

$5,000

$6,000

$7,000

$8,000


Expenses by FBC & MCM Crisis ServiceMedicaid


$9,540

$3,540

$22,574

$4,640

$0

$5,000

$10,000

$15,000

$20,000

$25,000


Expenses by FBC & MCM Crisis ServiceState



FYTD March 2018

*Please see Appendix C for Entity Type definitions.

DAYMARK Recovery Services, Inc.(Cabarrus Center) Comprehensive Community Clinics

Wake Forest University Health Sciences Physician's Group of Hospitals

Monarch Comprehensive Community Clinics

Forsyth Memorial Hospital, Inc. dba Novant Health Forsyth Medical CenterInpatient

North Carolina Baptist Hospital Inpatient

DAYMARK Recovery Services, Inc. - Mobile Crisis Management / After Hours EmergencyAgency

Novant Medical Group, Inc. dba Rowan Psychiatric Associates LIP Group

The Neil Group, Inc. LIP Group

Davie County Emergency Health Corp. dba Davie County Hospital & Wake Forest Baptist HealthHospital

Addiction Recovery Medical Services, PLLC Agency

Access Call Center

Provider Information

Top 10 Providers by Members Served - Davie Entity Type

5,341 5,732 5,257 6,287 5,159 4,233 5,141 4,806 5,644

5 5 5 5 5 5 5 5 5

0

1

2

3

4

5

6

0

2000

4000

6000

8000

Jul'1

7

Au

g'1

7

Sep

'17

Oct

'17

No

v'1

7

Dec

'17

Jan

'18

Feb

'18

Mar

'18

Spee

d t

o A

nsw

er (

secs

)

# o

f C

alls

Total Number of Calls and Speed to Answer

2.6% 2.5% 2.6%

1.7% 1.8%2.9%

2.0% 2.3% 2.1%

0%

2%

4%

6%

8%

10%

Jul'1

7

Au

g'1

7

Sep

'17

Oct

'17

No

v'1

7

Dec

'17

Jan

'18

Feb

'18

Mar

'18

Per

cen

t o

f C

alls

Ab

and

on

ed

Call Abandonment Rate

Access HEDIS Benchmark 8.6% Cardinal Innovations Target 5.0%

0101010203030406

293554

160234

449982

0 200 400 600 800 1000

Other

Neuro Behavioral Center State Institution

County Agency

ADATC State Institution

Inpatient/Outpatient

ICFMR State Institution

Psych State Institution

Comprehensive Community Clinics

Inpatient

Physician's Group of Hospitals

Hospital

LIP Group

LIP

Agency

Total Providers

All Cardinal Innovations Providers by Entity Type

Note: The Top 10 Providers by Members Served is based on member's County of Medicaid Eligibility not on the Provider's physical location.


FYTD March 2018

Members Served by Age and Diagnosis

Members Served and Expense Amounts by Service Category - Medicaid

Members Served and Expense Amounts by Service Category - State

Members Served and Expense Amounts for Crisis Services


Analysis:

Please note that providers have up to 90 days to submit claims and that this will affect the number of members served and expense amounts on this report. The

numbers for the previous months will be updated each reporting period.

Call Center information in the charts above reflect Cardinal Innovations data and are not county specific.

The number of Adult MH Members Served has been trending downward during FYTD1718.

Outpatient services remained the most utilized Medicaid funded service in FYTD1718, while Innovations and ICF services remained the highest in

terms of expense. Compared to the previous fiscal year, Outpatient ED services experienced a decrease in utilization of 52% (63 to 30) and in

expense of 50% ($6,178 to $3,117). Much of this decrease can be attributed to denied claims for a single provider, who has been submitting claims

with a rendering clinician that is not credentialed with Cardinal Innovations as a behavioral health clinician. Inpatient services experienced an

increase in expense of 52% ($147,712 to $224,607), even though utilization decreased by 3% (60 to 58).

Outpatient services remained the most utilized State funded service in FYTD1718, while Residential overtook Inpatient for the service with the

highest expense. Inpatient services experienced a decrease in expense of 22% ($158,613 to $124,136), even though utilization increased by 21%

(29 to 35). This can be attributed to the average length of stay decreasing from 12 days in the first 3 quarters of FY1617, to 6 days in the first 3

quarters of FY1718. Outpatient services experienced a decrease in expense of 46% ($24,868 to $13,409), even though utilization increased by 6%

(123 to 130). This may be attributed to the decrease in billing for Opioid Treatment, which decreased by 47% ($17,729 to $9,445) over the previous

fiscal year.

Compared to the previous fiscal year, Medicaid funded Facility Based Crisis services experienced a decrease in both utilization and expense, while

Medicaid funded Mobile Crisis Management services experienced an increase in both utilization and expense. Utilization of State funded Facility

Based Crisis services remained consistent with the previous fiscal year, but expenses for this service increased by 137% ($9,540 to $22,574). Much

of this increase can be attributed to two members, whose claims accounted for more than 50% of all State funded Facility Based Crisis services in

FYTD1718.

There was an increase in the Call Abandonment Rate in December'17 due to some calls disconnecting between 1-2 seconds or less of the Call

Center receiving the call. Call Center management has rectified the issue, and the rate has returned to normal as of Jan'18.


FYTD March 2018

Appendix A

County Funded Program

Milling Manor Group Home

Major provider with a broad continuum of services to individuals with mental health, intellectual-developmental disability and/or substance use needs, including

same day 'open access' to care.Monarch

Residential services for adults with IDD needs. Services include group living - low, moderate, high; personal assistance.

County Funded Program Description


FYTD March 2018

Service Category


Residential

PRTF


Service to help adults with psychiatric disabilities manage their illness and their lives with as little professional intervention as possible.

ICF

Group settings that serve people across all disability groups.

Psychiatric Residential Treatment Facilities provide residential care to persons under the age of 21 who need 24-hour supervision and specialized

interventions.

Inpatient

MST

Outpatient

Innovations

ACTT


Community Support

Medicaid Waiver for individuals with Intellectual Disabilities.

Additional supports for Medicaid recipients such as Community Guide and Individual Support.

Assertive Community Treatment Team - services received in the community that address functional areas of the identified population.

A long-term residential program for people with behavioral health needs.

Services that are provided in the community.

Community based mental health and substance abuse rehabilitation services and interventions.

Services received in a crisis or emergency situation such as Mobile Crisis and Facility-based crisis.

Hospital emergency department.

Intermediate Care Facility for individuals with Intellectual Disabilities.

Intensive In-Home Services - services provided in the person's home by a small team with at least one Licensed Professional.

Outpatient ED

Mandated service categories effective 7/1/2013.

Appendix B

Community

Psych Rehab

Partial Hosp/Day Tx

IIHS

Definition

Hospital-based psychiatric care.

Multisystemic Therapy is a family and community-based therapy for juveniles.

Services received in the community including evaluation, therapy, and psychiatric care.

Services provided in a hospital Emergency Department on an outpatient basis.

A short-term service for acutely mentally ill children or adults designed to prevent hospitalizations or to serve as a step down for those leaving an

inpatient facility.

Crisis Services


FYTD March 2018

Appendix C

Senate Bill 163Residential Facility located in-catchment but affiliated with another MCO/LME with local Quality Management mandated site visits and limited

oversight required.

Other Other entity not elsewhere defined.

Psych State Institution State run Psychiatric care facility for children and adults.

ICFMR State Institution Intermediate Care Facilities for Persons with Mental Retardation (ICF/MR) - State run Intermediate Care Facility serving IDD Adults and children.

ADATC State InstitutionAlcohol Drug Abuse Treatment Center (ADATC) State Institution-A state run SUD Adult facility which provides medical detox and medically

monitored residential treatment.

County Agency Public health agency.

Neuro Behavioral Center State

Institution

State run medical and nursing care facility for individuals with severe or moderate developmental disability (IDD) and medical conditions of a

serious or chronic nature requiring 24 hour care.

Hospital Non-contracted Hospitals for which we reimburse Emergency Department services and Inpatient services.

Physician's Group of HospitalsA group of physicians, contracting or non-contracting, associated with hospitals but not employed by the facility. Considered non-contracting

unless otherwise specified.

Inpatient Hospital providing contracted behavioral health Inpatient and Emergency Department services.

Comprehensive Community

Clinics

Agency based entities providing a number of services, including assessment, enrollment, Outpatient and Psychiatric services, and serve at least

two disabilities. They are designated points of entry that ensure easy access for members.

Inpatient/Outpatient Hospital providing contracted behavioral health Emergency Department and Outpatient services.

Mandated Entity types effective 11/1/2017.

Entity Type Definition

Agency Agencies provide one or more enhanced clinical/therapeutic/rehabilitative/habilitative service to MH, SUD, IDD, or multiple diagnosis groups.

LIPLicensed Independent Practitioner (LIP) - Individual Clinicians, Therapists, Psychiatrists, Psychologists, etc. that are individually contracted with

the MCO. They provide outpatient services such as therapy, psychiatric care, assessment and testing.

LIP GroupLicensed Independent Practitioner (LIP) Groups are a group of clinicians, Therapists, Psychiatrists, Psychologists, etc. providing outpatient services

such as therapy, psychiatric care, assessment, and testing. They contract with the MCO as a group.

Forsyth County Dashboards

FYTD March 2018



Daymark Recovery Services

Horizons

Triad MH/SUD & IDD Advisory Committees

Labs

Monarch

NC Families United

School Health Alliance

The Enrichment Center

Total:




$16,668

$25,000

$65,000

$154,828

$5,000

$200,000

60.8%

$1,079,895

66.7%

47.5%

$1,542,251

58.3%

FYTD

Expenses

$759,317$1,012,423 75.0%

$50,000

$30,000

FY Budget

Amount

Forsyth Funding

$14,250

$0

$133,333

$15,191

$37,917

$103,219

% Spent

33.3%

0.0%

66.7%

70.0%



FYTD March 2018



10481124 1090

1199 12361163 1150

1236 1258

104 114 112 112 112 93 115 120 117

23 23 24 25 28 29 22 26 280

200

400

600

800

1000

1200

1400

Jul'1

7

Au

g'1

7

Sep

'17

Oct

'17

No

v'1

7

Dec

'17

Jan

'18

Feb

'18

Mar

'18


MH IDD SUD

21052204

20182146 2153

18882003 2022 1986

783 785 777 784 780 783 791 780 793

717 762 740 774 728 680 690 659 660

0

500

1000

1500

2000

2500

Jul'1

7

Au

g'1

7

Sep

'17

Oct

'17

No

v'1

7

Dec

'17

Jan

'18

Feb

'18

Mar

'18


MH IDD SUD

850

839835 832

827 824

808802 803

770

780

790

800

810

820

830

840

850

860

Jul'1

7

Au

g'1

7

Sep

'17

Oct

'17

No

v'1

7

Dec

'17

Jan

'18

Feb

'18

Mar

'18

Nu

mb

er o

f M

emb

ers

on

Reg

istr

y



3153 33283108

3345 33893051 3153 3258 3244

887 899 889 896 892 876 906 900 910

740 785 764 799 756 709 712 685 688

0500

1000150020002500300035004000

Jul'1

7

Au

g'1

7

Sep

'17

Oct

'17

No

v'1

7

Dec

'17

Jan

'18

Feb

'18

Mar

'18


All Diagnosis

MH IDD SUD



FYTD March 2018


location.




37

35

61

86

84

124

207

158

127

204

368

872

521

698

972

7296

32

42

54

75

86

128

128

144

159

198

445

507

511

769

920

7035

0 2000 4000 6000 8000

Community Support

MST



Psych Rehab

ICF

IIHS

Partial Hosp/Day Tx

Crisis Services



Outpatient ED

Innovations

Inpatient


Outpatient



$67,759

$277,123

$2,486,985

$1,670,690

$491,259

$14,275,762

$2,046,363

$1,316,531

$67,853

$1,817,219

$747,366

$107,045

$21,605,410

$2,692,176

$740,965

$3,493,381

$54,355

$378,899

$2,094,003

$1,642,752

$471,262

$14,890,613

$1,107,420

$976,204

$85,636

$1,744,997

$1,551,168

$57,557

$21,679,384

$3,648,760

$917,511

$3,865,709

$0 $10,000,000 $20,000,000

Community Support

MST



Psych Rehab

ICF

IIHS

Partial Hosp/Day Tx

Crisis Services



Outpatient ED

Innovations

Inpatient


Outpatient




FYTD March 2018



location.



3

1

2

20

60

216

298

270

477

2584

0

0

2

26

55

262

310

325

524

2357

0 500 1000 1500 2000 2500 3000

Community Support

Psych Rehab

IIHS


Partial Hosp/Day Tx

Residential

Community

Crisis Services

Inpatient

Outpatient



$1,256

$0

$3,098

$81,968

$85,249

$904,772

$1,317,965

$166,620

$2,477,819

$1,210,011

$0

$0

$11,877

$110,868

$69,071

$1,189,174

$1,262,273

$190,420

$3,304,398

$1,003,905

$0 $1,000,000 $2,000,000 $3,000,000 $4,000,000

Community Support

Psych Rehab

IIHS


Partial Hosp/Day Tx

Residential

Community

Crisis Services

Inpatient

Outpatient




FYTD March 2018



Amount.



location.


20

113

33

138

0

20

40

60

80

100

120

140

160




144129

51

154

0

20

40

60

80

100

120

140

160

180




$44,321

$19,625

$59,957

$21,447

$0

$10,000

$20,000

$30,000

$40,000

$50,000

$60,000

$70,000




$158,405

$21,825

$83,195

$24,918

$0

$20,000

$40,000

$60,000

$80,000

$100,000

$120,000

$140,000

$160,000

$180,000





FYTD March 2018







Insight Human Services Agency

Alexander Youth Network, Inc. Agency

Novant Medical Group, Inc. dba Rowan Psychiatric Associates LIP Group


Keystone WSNC, LLC dba Old Vineyard Behavioral Health ServicesInpatient

Access Call Center


Top 10 Providers by Members Served - Forsyth Entity Type

5,341 5,732 5,257 6,287 5,159 4,233 5,141 4,806 5,644

5 5 5 5 5 5 5 5 5

0

1

2

3

4

5

6

0

2000

4000

6000

8000

Jul'1

7

Au

g'1

7

Sep

'17

Oct

'17

No

v'1

7

Dec

'17

Jan

'18

Feb

'18

Mar

'18

Spee

d t

o A

nsw

er (

secs

)

# o

f C

alls


2.6% 2.5% 2.6%

1.7% 1.8%2.9%

2.0% 2.3% 2.1%

0%

2%

4%

6%

8%

10%

Jul'1

7

Au

g'1

7

Sep

'17

Oct

'17

No

v'1

7

Dec

'17

Jan

'18

Feb

'18

Mar

'18

Per

cen

t o

f C

alls

Ab

and

on

ed



0101010203030406

293554

160234

449982

0 200 400 600 800 1000

Other


County Agency






Inpatient


Hospital

LIP Group

LIP

Agency

Total Providers




FYTD March 2018


Innovations Registry of Unmet Needs – A list of members who are waiting for an Innovations Waiver Slot





The number of Child MH Members Served has been trending upward during FYTD1718.

The number of Members on the Innovations Registry of Unmet Needs has been on a downward trend for the duration of FYTD1718.

Medicaid funded Facility Based Crisis services experienced an increase in utilization of 65% (20 to 33) and an increase in expense of 35% ($44,321 to

$59,957) compared to the previous fiscal year. State funded Facility Based Crisis services experienced a decrease in utilization of 65% (144 to 51)

and a decrease in expense of 48% ($158,405 to $83,195). Most of this decrease can be attributed to a single provider. Both Medicaid and State

funded Mobile Crisis Management services experienced small increases in utilization and expense compared to the previous fiscal year.



Analysis:




Outpatient services continued to be the most utilized State funded service in FYTD1718, even though utilization decreased slightly (9% - 2,584 to

2,357). Inpatient services experienced an increase in utilization of 10% (477 to 524), an increase in expense of 33% ($2,477,819 to $3,304,398), and

continued to carry the highest expense for State funded services.

Outpatient services remained the most utilized Medicaid funded services for FYTD1718, while Innovations and ICF services continued to carry the

highest expense. Compared to the previous fiscal year, Outpatient ED services experienced a decrease in utilization of 42% (872 to 507) and a

decrease in expense of 46% ($107,045 to $57,557). Much of this decrease can be attributed to denied claims for a single provider, who has been

submitting claims with a rendering clinician that is not credentialed with Cardinal Innovations as a behavioral health clinician. IIHS services

experienced a decrease in utilization of 38% (207 to 128) and a decrease in expense of 46% ($2,046,363 to $1,107,420). 1915 (b)(3) services

experienced an increase in expense of 108% ($747,366 to $1,551,168), even though utilization increased by only 21% (368 to 445). Most of the

increase in expense was with Peer Support services, which saw expenses increase by 195% ($313,590 to $926,484) over the previous fiscal year.


FYTD March 2018

Appendix A

NC Families UnitedProvides a 'Family Partner' (family member with service system knowledge) to support families of children with behavioral heath needs. Position is integral to

implementation of the System of Care Expansion Grant that brings new evidence-based child/family services

Triad MH/SUD & IDD Advisory

CommitteesIDD/MH/SUD - Advisory Committees



School Health Alliance

Monarch

NC Families United

Labs


same day 'open access' to care.

Funds transportation for SUD consumers to treatment and programs offered at Residential Treatment Services.

Provides a 'Family Partner' (family member with service system knowledge) to support families of children with behavioral heath needs. Position is integral to

implementation of the System of Care Expansion Grant that brings new evidence-based child/family servicesIntegrated medical/behavioral services in Winston Salem/Forsyth County Schools. Includes 3 school-based clinics that serve elementary, middle & high schools

with outpatient medical and clinical behavioral health services, a mobile medical unit that serves all schools, and MH consults.

RTS Transp

Labs

Residential and respite services for medically fragile individuals with intensive IDD needs.Horizons

'Safety net' provider serving adults with serious mental health and/or substance use issues through a broad continuum of services.



FYTD March 2018

Service Category


Residential

PRTF



ICF



interventions.

Inpatient

MST

Outpatient

Innovations Medicaid Waiver for individuals with Intellectual Disabilities.






inpatient facility.

Crisis Services







ACTT


Community Support




Outpatient ED

Partial Hosp/Day Tx


Appendix B

IIHS

Definition

Community

Psych Rehab


FYTD March 2018

Appendix C


oversight required.



Institution




















Clinics




Rockingham County Dashboards

FYTD March 2018




Total:




$233,850$311,800

FYTD

Expenses

$233,850$311,800 75.0%

FY Budget

Amount

Rockingham Funding

% Spent

75.0%



FYTD March 2018



403 412 402440

411 394 392 383

448

19 25 28 23 23 23 25 30 27

5 3 4 4 2 2 1 1 30

50

100

150

200

250

300

350

400

450

500

Jul'1

7

Au

g'1

7

Sep

'17

Oct

'17

No

v'1

7

Dec

'17

Jan

'18

Feb

'18

Mar

'18


MH IDD SUD

708761

702 722662

631 653 669 644

172 175 174 174 177 172 169 175 175

159 179 182 174 176 165 189 182 164

0

100

200

300

400

500

600

700

800

Jul'1

7

Au

g'1

7

Sep

'17

Oct

'17

No

v'1

7

Dec

'17

Jan

'18

Feb

'18

Mar

'18


MH IDD SUD

130 130 130

127

126 126

125 125 125

122

123

124

125

126

127

128

129

130

131

Jul'1

7

Au

g'1

7

Sep

'17

Oct

'17

No

v'1

7

Dec

'17

Jan

'18

Feb

'18

Mar

'18

Nu

mb

er o

f M

emb

ers

on

Reg

istr

y



1111 1173 1104 11621073 1025 1045 1052 1092

191 200 202 197 200 195 194 205 202

164 182 186 178 178 167 190 183 1670

200

400

600

800

1000

1200

1400

Jul'1

7

Au

g'1

7

Sep

'17

Oct

'17

No

v'1

7

Dec

'17

Jan

'18

Feb

'18

Mar

'18


All Diagnosis

MH IDD SUD



FYTD March 2018



location.



8

12

17

47

34

38

37

44

42

24

175

84

103

196

316

2364

4

17

17

31

31

37

39

39

57

62

74

75

108

170

284

2329

0 500 1000 1500 2000 2500

MST

Community Support



Psych Rehab


ICF

Partial Hosp/Day Tx

Crisis Services


Outpatient ED

IIHS

Innovations

Inpatient


Outpatient



$89,095

$13,860

$621,829

$1,050,302

$186,512

$362,861

$3,876,843

$443,387

$25,418

$109,037

$19,798

$854,900

$4,044,543

$789,764

$273,531

$1,111,231

$43,076

$15,628

$821,714

$561,274

$188,502

$335,972

$4,298,474

$360,569

$42,992

$395,563

$8,072

$615,874

$4,135,620

$710,111

$249,895

$1,193,686

$0 $1,000,000$2,000,000$3,000,000$4,000,000$5,000,000

MST

Community Support



Psych Rehab


ICF

Partial Hosp/Day Tx

Crisis Services


Outpatient ED

IIHS

Innovations

Inpatient


Outpatient




FYTD March 2018



location.



1

1

7

49

96

92

81

777

0

2

8

44

89

102

114

739

0 200 400 600 800 1000

Community Support

Partial Hosp/Day Tx


Community

Residential

Inpatient

Crisis Services

Outpatient



$0

$1,059

$14,255

$381,189

$596,504

$283,827

$58,156

$120,077

$0

$3,705

$30,131

$370,665

$548,249

$436,947

$60,316

$134,008

$0 $200,000 $400,000 $600,000 $800,000

Community Support

Partial Hosp/Day Tx


Community

Residential

Inpatient

Crisis Services

Outpatient




FYTD March 2018



Amount.



location.


6

25

12

51

0

10

20

30

40

50

60




20

42

29

60

0

10

20

30

40

50

60

70




$7,963

$3,781

$29,503

$6,977

$0

$5,000

$10,000

$15,000

$20,000

$25,000

$30,000

$35,000




$24,770

$6,049

$40,903

$10,861

$0

$5,000

$10,000

$15,000

$20,000

$25,000

$30,000

$35,000

$40,000

$45,000





FYTD March 2018



YOUTH HAVEN SERVICES, LLC Agency

The Moses H. Cone Memorial Hospital Inpatient

Faith in Families, Inc. Agency


Neuropsychiatric Care Center, PLLC LIP

Triad Psychiatric and Counseling Center, PA LIP Group

Resolution: Counseling & Development Services LIP Group


Agape Psychological Consortium, LLC LIP

Access Call Center


Top 10 Providers by Members Served - RockinghamEntity Type

5,341 5,732 5,257 6,287 5,159 4,233 5,141 4,806 5,644

5 5 5 5 5 5 5 5 5

0

1

2

3

4

5

6

0

2000

4000

6000

8000

Jul'1

7

Au

g'1

7

Sep

'17

Oct

'17

No

v'1

7

Dec

'17

Jan

'18

Feb

'18

Mar

'18

Spee

d t

o A

nsw

er (

secs

)

# o

f C

alls


2.6% 2.5% 2.6%

1.7% 1.8%2.9%

2.0% 2.3% 2.1%

0%

2%

4%

6%

8%

10%

Jul'1

7

Au

g'1

7

Sep

'17

Oct

'17

No

v'1

7

Dec

'17

Jan

'18

Feb

'18

Mar

'18

Per

cen

t o

f C

alls

Ab

and

on

ed



0101010203030406

293554

160234

449982

0 200 400 600 800 1000

Other


County Agency






Inpatient


Hospital

LIP Group

LIP

Agency

Total Providers




FYTD March 2018

Innovations Registry of Unmet Needs – A list of members who are waiting for an Innovations Waiver Slot





Analysis:




The number of Members on the Innovations Registry of Unmet Needs has been trending downward since Oct’17.

Outpatient services remained the most utilized Medicaid funded service, despite a slight decrease (2% - 2,364 to 2,329) in utilization. ICF services

overtook Innovations as the service with the highest expense, with an increase in expenses of 11% ($3,876,843 to $4,298,474) over the previous

fiscal year. Outpatient ED services experienced a decrease in utilization of 58% (175 to 74) and a decrease in expense of 59% ($19,798 to $8,072).

Much of this decrease can be attributed to denied claims for a single provider, who has been submitting claims with a rendering clinician that is not

credentialed with Cardinal Innovations as a behavioral health clinician. BH Long Term Residential services experienced a decrease in utilization of

34% (47 to 31), and a decrease in expense of 47% ($1,050,302 to $561,274).

Outpatient services remained the most utilized State funded service, and Residential services continued to carry the highest expense for FYTD1718.

Inpatient services surpassed Community services as having the second-highest expense, with an increase in utilization of 11% (92 to 102) and an

increase in expense of 54% ($283,827 to $436,947).

Both Medicaid and State funded Crisis services experienced increases in utilization and expense over the previous fiscal year. The largest increase

was with Medicaid funded Facility Based Crisis services, which increased in utilization by 100% (6 to 12) and in expense by 271% ($7,963 to

$29,503) over the previous fiscal year. The majority of this increase can be attributed to a single provider that just became part of the network in

October of 2017. Medicaid funded Mobile Crisis Management services experienced an increase in utilization of 104% (25 to 51) and an increase in

expense of 85% ($3,781 to $6,977).




FYTD March 2018

Appendix A


Daymark Recovery Services 'Safety net' provider serving adults with serious mental health and/or substance use issues through a broad continuum of services.



FYTD March 2018

Service Category


Residential

PRTF



ICF



interventions.

Inpatient

MST

Outpatient

Innovations

ACTT


Community Support











Outpatient ED


Appendix B

Community

Psych Rehab

Partial Hosp/Day Tx

IIHS

Definition






inpatient facility.

Crisis Services


FYTD March 2018

Appendix C


oversight required.








Institution








Clinics











Stokes County Dashboards

FYTD March 2018



Monarch

Partnership/Insight -HIV - CASP-SA

Total:




$32,180

$136,352$212,259

FYTD

Expenses

$104,173$156,259 66.7%

$56,000

FY Budget

Amount

Stokes Funding

% Spent

57.5%

64.2%



FYTD March 2018



181 182

222 232 224 221 224236 243

20 21 21 25 22 18 19 15 19

8 5 7 8 10 9 8 4 40

50

100

150

200

250

300

Jul'1

7

Au

g'1

7

Sep

'17

Oct

'17

No

v'1

7

Dec

'17

Jan

'18

Feb

'18

Mar

'18


MH IDD SUD

243

272

235 231 228206

236 237 232

88 87 90 90 86 91 86 87 84

82 9276 81 83 86 91 97 99

0

50

100

150

200

250

300

Jul'1

7

Au

g'1

7

Sep

'17

Oct

'17

No

v'1

7

Dec

'17

Jan

'18

Feb

'18

Mar

'18


MH IDD SUD

82

83

82 82

81 81 81

84

83

79

80

81

82

83

84

85

Jul'1

7

Au

g'1

7

Sep

'17

Oct

'17

No

v'1

7

Dec

'17

Jan

'18

Feb

'18

Mar

'18

Nu

mb

er o

f M

emb

ers

on

Reg

istr

y



424454 457 463 452 427

460 473 475

108 108 111 115 108 109 105 102 103

90 97 83 89 93 95 99 101 103

0

100

200

300

400

500

Jul'1

7

Au

g'1

7

Sep

'17

Oct

'17

No

v'1

7

Dec

'17

Jan

'18

Feb

'18

Mar

'18


All Diagnosis

MH IDD SUD



FYTD March 2018



location.



1

1

10

14

17

13

18

25

28

16

44

60

98

86

124

974

1

3

9

10

14

14

18

20

26

35

38

59

64

87

106

957

0 200 400 600 800 1000 1200

MST

Community Support


ICF



Psych Rehab


IIHS

Crisis Services

Partial Hosp/Day Tx

Innovations

Outpatient ED

Inpatient


Outpatient



$11,607

$710

$323,513

$1,584,951

$20,165

$108,535

$123,117

$516,789

$264,139

$3,155

$878,052

$2,020,588

$11,016

$451,489

$79,891

$489,650

$2,319

$6,278

$266,846

$1,243,591

$18,249

$93,633

$100,663

$292,323

$246,580

$20,892

$759,038

$2,186,877

$7,326

$500,709

$94,217

$575,712

$0 $500,000$1,000,000$1,500,000$2,000,000$2,500,000

MST

Community Support


ICF



Psych Rehab


IIHS

Crisis Services

Partial Hosp/Day Tx

Innovations

Outpatient ED

Inpatient


Outpatient




FYTD March 2018



location.



1

3

22

31

49

48

297

3

4

18

32

42

50

294

0 100 200 300 400


Partial Hosp/Day Tx

Residential

Community

Inpatient

Crisis Services

Outpatient



$0

$3,125

$91,075

$144,372

$225,568

$27,544

$121,494

$2,592

$22,292

$81,933

$129,625

$231,187

$19,458

$89,423

$0 $50,000 $100,000 $150,000 $200,000 $250,000


Partial Hosp/Day Tx

Residential

Community

Inpatient

Crisis Services

Outpatient




FYTD March 2018



Amount.



location.


2

14

6

34

0

5

10

15

20

25

30

35

40




21

36

6

32

0

5

10

15

20

25

30

35

40




$1,540 $1,615

$13,503

$7,390

$0

$2,000

$4,000

$6,000

$8,000

$10,000

$12,000

$14,000

$16,000




$28,526

$5,602$7,737

$4,709

$0

$5,000

$10,000

$15,000

$20,000

$25,000

$30,000





FYTD March 2018



YOUTH HAVEN SERVICES, LLC Agency




Insight Human Services Agency

PQA Healthcare, Inc. Agency




Access Call Center


Top 10 Providers by Members Served - Stokes Entity Type

5,341 5,732 5,257 6,287 5,159 4,233 5,141 4,806 5,644

5 5 5 5 5 5 5 5 5

0

1

2

3

4

5

6

0

2000

4000

6000

8000

Jul'1

7

Au

g'1

7

Sep

'17

Oct

'17

No

v'1

7

Dec

'17

Jan

'18

Feb

'18

Mar

'18

Spee

d t

o A

nsw

er (

secs

)

# o

f C

alls


2.6% 2.5% 2.6%

1.7% 1.8%2.9%

2.0% 2.3% 2.1%

0%

2%

4%

6%

8%

10%

Jul'1

7

Au

g'1

7

Sep

'17

Oct

'17

No

v'1

7

Dec

'17

Jan

'18

Feb

'18

Mar

'18

Per

cen

t o

f C

alls

Ab

and

on

ed



0101010203030406

293554

160234

449982

0 200 400 600 800 1000

Other


County Agency






Inpatient


Hospital

LIP Group

LIP

Agency

Total Providers




FYTD March 2018






Analysis:




The number of Child MH Members served has been trending upward for FYTD1718. The number of Adult SUD Members served has been trending

upward since Sep’17.

Medicaid funded Outpatient services continued to see the highest utilization for FYTD1718. Innovations and ICF services continued to carry the

highest expense, though ICF services experienced a decrease in utilization of 29% (14 to 10) and a decrease in expense of 22% ($1,584,951 to

$1,243,591). BH Long Term Residential services experienced a decrease in utilization of 20% (25 to 20) and a decrease in expense of 43% ($516,789

to $292,323), compared to the previous fiscal year.

Outpatient services continued to be the State funded service with the highest utilization, and Inpatient services continued to carry the highest

expense for FYTD1718. Expenses for Outpatient services decreased by 26% ($121,494 to $89,423) compared to the previous fiscal year. Partial

Hospitalization/Day Treatment experienced an increase in expense of 613% ($3,125 to $22,292) even though utilization increased by only one

member (3 to 4). Sixty-nine percent ($15,279 of $22,292) of the FYTD1718 expenses can be attributed to one member.

Medicaid funded Facility Based Crisis services experienced an increase in utilization of 200% (2 to 6) and an increase in expense of 777% ($1,540 to

$13,503). Medicaid funded Mobile Crisis Management services also experienced an increase over the previous fiscal year, with an increase in

utilization of 143% (14 to 34) and an increase in expense of 358% ($1,615 to $7,390). State funded Facility Based Crisis services experienced a

decrease in utilization of 71% (21 to 6) and a decrease in expense of 73% ($28,526 to $7,737).




FYTD March 2018

Appendix A


Monarch

Substance use prevention and treatment services.Partnership/Insight -HIV - CASP-SA


same day 'open access' to care.



FYTD March 2018

Service Category


Residential

PRTF



ICF



interventions.

Inpatient

MST

Outpatient

Innovations

ACTT


Community Support











Outpatient ED


Appendix B

Community

Psych Rehab

Partial Hosp/Day Tx

IIHS

Definition






inpatient facility.

Crisis Services


FYTD March 2018

Appendix C


oversight required.








Institution








Clinics











Triad Community OfficeQuality Management Dashboard

FYTD March 2018

## ##

Report data from June 1-3, 2018

Region

Southern

Mecklenburg

Triad

Northern Region

Central

10%57,300 8,146Five County 14%

106,535

124,734

11%

12%

14%

15%67,434

13%

Incidents

The number of Level II Incidents reported in the Triad catchment area during the 3rd Qtr. of FY1718 represents an increase of 24% (121 to 150) compared to the

2nd Qtr. of FY1718. The biggest increase was with Incidents involving Member Behavior, which increased by 40% (77 to 108) over the previous quarter, and they

were also the most common type of Incident for the 3rd Qtr. of FY1718 (72% - 108/150).

Medicaid Population - FYTD March 2018

Members

Served

17,651

19,537

12,881

17,952

9,806

% Eligible in

Cardinal

Innovations

Population

25%

33%

19%

23%

12%

Eligible

Population

134,372

181,074

% Served

46 53 48 47 29 45 44 48 58

6.16

6.806.40

5.97

3.74

6.225.84

6.29

7.68

0.00

1.00

2.00

3.00

4.00

5.00

6.00

7.00

8.00

9.00

0

10

20

30

40

50

60

70

Jul'17 Aug'17 Sep'17 Oct'17 Nov'17 Dec'17 Jan'18 Feb'18 Mar'18

Level II Incidents Count & Rate of Incidents Per 1,000 Members Served

Level II Incidents Rate/1,000 Members Served

FYTD: July 2017 - March 2018


FYTD March 2018

Incidents (continued)

There were 15 Restrictive Interventions reported in the Triad catchment area during the 3rd Qtr. of FY1718, which represents a decrease of 50% (30 to 15) over the

previous quarter. In the 3rd Quarter, there were 13 Level II Physical Restraint Standing and 2 Level II Physical Restraint Seated. There have been no Level III

Restrictive Interventions reported in the Triad catchment area for FYTD1718.

Level III Incidents reported in the Triad catchment area in the 3rd Qtr. of FY1718 increased by 100% (15 to 30) compared to the previous quarter (2nd Qtr. of

FY1718). The largest increase was among Incidents involving Member Behavior, which increased by 250% (2 to 7), but Member Deaths also increased by 100% (5

to 10), and Incidents involving Abuse, Neglect or Exploitation increased by 86% (7 to 13). Almost all (9/10) of the Member Deaths in the 3rd Qtr. of FY1718 were

due to Unkown Cause. Most of the Member Behavior Incidents during the 3rd Qtr. of FY1718 involved AWOL > 3 Hours (71% - 5/7).

Starting in December of 2017, any incident naming a staff member was automatically classified as Level 3. As a result, the number of Level 2 incidents decreased,

and the number of Level 3 incidents increased, even though the combined number of incidents remained consistent.

6 4 5 4 1 10 8 8 14

0.80

0.51

0.67

0.51

0.13

1.38

1.06 1.05

1.85

0.00

0.20

0.40

0.60

0.80

1.00

1.20

1.40

1.60

1.80

2.00

0

2

4

6

8

10

12

14

16


Level III Incidents Count & Rate of Incidents Per 1,000 Members Served

Level III Incidents Rate/1,000 Members Served


3 2 9 9 12 9 9 3 3

0.400.26

1.20 1.14

1.55

1.24 1.19

0.39 0.40

0.000.200.400.600.801.001.201.401.601.80

0

2

4

6

8

10

12

14


Restrictive Intervention Count & Rate of Incidents Per 1,000 Members Served

Level II Incidents Level III Incidents Rate/1,000 Members Served



FYTD March 2018

The majority 53% (287/537) of Incidents reported during FYTD1718 were due to Member Behavior, of which 79% (226/287) occurred with the CMH population.

17% (89/537) of Incidents reported were due to Abuse, Neglect or Exploitation, of which 65% (58/89) also occurred in the CMH population.

Incidents (continued)

84% (163/195) of the Incidents reported in the Triad catchment area were received within 3 days of the incident being learned during the 3rd Qtr. of FY1718.

There was one Incident of Member Behavior reported in the Triad catchment area that did not have a target population listed, and one Incident of Member Death

that did not have a target population listed for FYTD1718.

Incidents involving Abuse, Neglect or Exploitation comprised 17% (89/537) of the Incidents reported in the Triad catchment area, of which 65% (58/89) occurred

in the CMH population. Another 19% (17/89) of these Incidents involved the ADD population, and 11% (10/89) involved the AMH population.

0

50

100

150

200

250

300

350

Abuse, Neglect orExploitation

Restrictive Interventions Member Behavior Member Death Member Injury Medication Error Suspsension

Incidents by Type & Target Population

ADD AMH ASA CDD CMH CSA



FYTD March 2018

43 43 175 87 69

19.5

100%

0

Total # of Grievances 21%

Please Note: The State benchmark for grievances requires that 90% of grievances are resolved within 30 days of submission. One Grievance was Out-of-

Catchment.

418

1

62

In the Triad catchment area, there were 23 Grievances reported in the 3rd Qtr. of FY1718. This represents an increase of 21% (19 to 23) compared to the previous

quarter. Four of the Grievances reported in the 3rd Qtr. of FY1718 involved PRTF services.

0

0

15

50

2

45

0

2

3

53

118 52

Grievances - FYTD March 2018

3

8

123

1

3

73

All Grievances

176

103

23

6

2

8

15

10

1

1512

0

1

1

0

10

0

34

1

0

0

100%

19.7

17%

99%

0 0 0

100%

18.6

100%

9

1

4 25

1

30

13

32

47

128

52

1

11

31

0

0

39

0

100%

18.3

Total # Grievances Resulting in Investigations

10% 42%

0

311

107

0

0

10%

0

Average Days to

Resolve% Resolved within 30

Days

For Resolved Grievances

Total # Grievances Pending

16.1 17.8

1

0

0

2

51

18

0

Total # Grievances Not Against Provider or MCO

0

Total # of Grievances by

Disability

285

Child

Adult

Unknown

Does Not Apply

Total # Grievances by Age Group

MH Only

IDD Only

SUD Only

Multi-Disability

TBI Only

Unknown

Total # Grievances Against Providers

Total # Grievances Against Cardinal Innovations

0

23

Piedmont

Catchment

Mecklenburg

Catchment

Central

Catchment

Five County

Catchment

8

120

1

23

38

Triad

Catchment

26

14

2

25

0

0

2

0

Measure Subcategory

Does Not Apply

21

4 15 8 11 7 1 9 8 6

0.54

1.92

1.07

1.40

0.90

0.14

1.191.05

0.79

0.00

0.50

1.00

1.50

2.00

2.50

0

2

4

6

8

10

12

14

16


Grievance Count & Rate of Complaints Per 1,000 Member Served

Grievances Rate/1,000 Members Served



FYTD March 2018

Grievances (continued)

2

2

3

3

3

5

6

8

8

18

0 5 10 15 20

Facility not safe, clean, etc.

Complaint Against Department

Ethics

Potential Fraud

Neglect

Abuse

Delay in Treatment

Inadequate Treatment

Individual Budget Tool

Conflict with Provider (disagreement with treatment, diagnosis, etc)

Top 10 Grievances TypesFYTD: March 2018

1

1

2

3

3

3

7

9

10

22

0 5 10 15 20 25

Adult Day Vocational Program

Screening, Triage, and Referral

Other

Medication Administration

Inpatient

Opioid Treatment

Assertive Community Treatment Team

Outpatient Services

Innovations

Residential Services

Top 10 Services with GrievancesFYTD: March 2018


FYTD March 2018

Please note: Cardinal Innovations Quality Management requires any provider receiving out of compliances on selected review items and trending out of

compliance areas to complete a POC as a standard measure to prevent future out of compliances.

In the 3rd Qtr. of FY1718, 4 providers of the 16 reviewed scored 100%. Three providers scored below the 85% target on their NC Provider Monitoring Reviews

during the 2rd Qtr. of FY1718 in the Triad catchment area. (82.3%, 75.5%, 42.2%).

Due to adjustments in scheduling, Innovations AFL reviews were not completed during FY1617, and were completed at the beginning of FY1718. During the 3rd

Qtr. of FY1718, Provider Monitoring Reviews were conducted for 16 providers in the Triad catchment area.

Provider Monitoring Reviews

1

1

4

3

4

41

11

16

17

1

5

3

10

13

19

22

1

1

5

2

4

5

16

14

16

0 20 40 60

Incident

Justified Cause Audit

Grievance Module

Investigation

Block Grant ReadinessReview

Clinical Quality Review

Unlicensed AFL Review

New Unlicensed SiteReview

Innovations SpecificAnnual AFL Monitoring

Concern Module

Cultural Competency

NC Provider Monitoring

Monitoring Reviews

Jul-Sep'17 Oct-Dec'17 Jan-Mar'18

94.6% 92.8% 93.6% 98.2%89.1%

0%

25%

50%

75%

100%

Five County Central Mecklenburg Piedmont Triad

NC Provider Monitoring Review Scores

85% Target

July 2017 - March 2018



FYTD March 2018

Provider Monitoring Reviews (All)

Please Note: Payback values reflect the number of claims involved in each Out of Compliance category. The POC values reflect the number of records involved in

each Out of Compliance issue.

Documentation does not reflect required elements' is the top reason for identifying paybacks for FYTD1718. Four providers were responsible for 50% (89/178) of

the paybacks identified under this category (30, 21, 20, 18 claims). For all four of these providers, the paybacks were the result of NC Provider Monitoring.

9

11 11

18

22

19

0

5

10

15

20

25

Jul-Sep'17 Oct-Dec'17 Jan-Mar'18

Monitoring Review Outcomes

Reviews requiring Paybacks Reviews requiring POC's

July 2017 - March 2018 by Quarter

178

142

9984 82

65 59 48 47 45

174

90

6653

73

38

60

40

17

47

0

200

Do

cum

enta

tio

n d

oes

no

tre

flec

t re

quir

ed e

lem

ents

Pla

n d

oes

no

t in

clude

requir

ed e

lem

ents

Do

cum

enta

tio

n d

oes

no

tre

flec

t tr

eatm

ent

for

dura

tio

n b

illed

Pla

n is

no

t co

nsi

sten

t w

ith

asse

ssm

ent

Pla

n is

no

t p

rese

nt

No

val

id s

ervic

e o

rder

Ser

vic

e p

rovid

ed d

oes

n't

mee

t Ser

vic

e D

efin

itio

n

Ser

vic

e b

illed

do

es n

ot

mat

ch d

ocu

men

tati

on

Sta

ff s

up

ervis

ion

pla

n n

ot

imple

men

ted a

s w

ritt

en

Ass

essm

ent

do

esn

'tsu

pp

ort

lev

el o

f ca

rep

rovid

ed

Top 10 Out of Compliance Trends

Paybacks POCs

FYTD: March 2018


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2018 Triad Community Advisory Board Meeting · 7/12/2018 · Matt Potter, CFAC Representative,...

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