QUALIFIED PROVIDER NETWORK

SUBCOMMITTEE

OF THE LME

August 19, 2002

3:00 p.m.

711 Executive Place; Board Room

PRESENT:     Vince Wagner , Director – Managed Care (chair), CCMHC

Hank Debnam , Area Director , CCMHC                      

Don Harrer , Director – Administrative Services, CCMHC

William H. Robinson, Director – Residential Services, CCMHC

Terri Knight , Director – Developmental Disabilities Services, CCMHC

Debbie Jenkins , Director – Child and Family Services, CCMHC

Densie Lucas , Director – Adult Services, CCMHC

Jerry Bennett , Clients Rights Officer, CCMHC

Terry Eads , Director – Management Information Systems, CCMHC

William H. McDougal, Director – Substance Abuse Services, CCMHC

Stacy Martin , Clerk to the Area Board (recorder), CCMHC

Ronald Butler, Apogee Counseling Services

Karen Campbell

Alice Cartner

Debra Stevenson, CREST

La-Lisa Hewett-Robinson, SR-AHEC

Larry Clubine, KV Consultants & Associates

Jacqueline Cook, S&T We Care, Inc.

Daniel Muldrow, Main Focus

Wendy McClain, Peterkin & Associations, Inc.

I. Welcome

Hank welcomed everyone to the Center and thanked them for coming. He stated that this subcommittee is very important and requires everyone’s input and energy. Hank then gave a brief overview of the process of writing the plan and sending it through to the various people who will have to "bless" the plan prior to forwarding to Secretary Carmen Hooker Odom for final approval.

II. Introductions

Vince introduced himself and asked everyone to go around the room and introduce themselves.

III. Brief Overview of Qualified Provider Network Section

Ensures the presence of a network to provide services to both target and non-target populations.

Will create a list of all providers (and what they have the capacity to serve) then ascertain whether those providers would like to be part of the provider panel. If the provider does not wish to be part of the network, then the LME must ask them why not.

Develop natural supports (i.e. faith-based community)

Determine gaps in services and who can fill those gaps.

Obtain guidance from the State on how to best serve populations who "fall through the gaps."

IV. Target Populations

Vince asked each program director at CCMHC to give a description of the target population for their disability areas.

Although the use of the target populations isn’t scheduled to come into effect later, use of target populations will begin early next year in response to utilizing the IPRS (Integrated Payment Reporting System).

The question was raised regarding the number of people who currently seek services at CCMHC who will not be included in the target population.

- Debbie responded that most are in the target population and that CCMHC is not seeing many who are outside of the target population.

The State is in the process of defining best practice. Some "talk therapy" will be removed from the array of services available for certain populations.

V. Tasks/Objectives to be Completed

Vince referred members to page 15 of the Plan which was mailed out to them last week and identified the following items listed:

- Identify what population currently serving plus all persons receiving services elsewhere who are Cumberland County residents.

Debbie interjected that there are four times the number of residential Level III beds in the community than are needed by the community.

- Monitor aspects of the provider network. Still question regarding authority to withhold payment or remove from list for those who do not meet expectations.

- There a number of policies needing to be created (i.e. consumers informed of resources and given choice).

Use outcomes and report cards.

Time line for full implementation is between now and 2007; therefore it will be phased in over a four-year period.

Out-of-county children who come to Cumberland and obtain services are suppose to come with the money to serve them. There are Cumberland County children sitting on waiting lists for services.

Don was asked to explain financial reporting requirements.

Debbie described the Uniform Portal process.

Additional Tasks identified:

- Identify current list of service providers by the services they provide, target population, specialty, capacity (can get list through licensing board or registry).

- Send out mailer to all providers to invite them to join the network of providers. If they decline, find out why and report this to the State.

- Provide an access map of the network. Require three separate providers within 30-mile radius of clients’ residence.

- Comprehensive assessment of service capacity (Summary/Conclusion)

identify gaps and surplus

identify money if gap exists for a target population and then find someone to provide the service

determine what to be done if the gap is with a non-target population

- Identify generic community resources (faith-based) to provide supports to non-target populations.

- Describe ways qualified providers will be providing supports, education, and assistance

- Determine method for providing informed consumer choice.

Debbie communicated the need to look at competencies. People have training and expertise to provide services they claim they can and want to. There currently exists licensed facilities with staff 3who do not meet competencies. Need to be able to demonstrate competencies through training and supervision to ensure quality of services.

VI. Round Robin

Stacy will mail out target populations, array of services, plus the seven-item task list that Vince discussed today so that members will have by the next meeting.

VII. Set Meeting Schedule

The next meeting is scheduled for Monday, August 26^th at 3:00 at the Executive Place Board Room. (same location as this meeting).

VIII. Adjournment

There being no further business, the meeting adjourned at 4:40 p.m.

1. Identify current list of all qualified service providers by service population and target populations served.\2. Comprehensive assessment of service capacity along with summary and conclusions.

 

3. A qualified provider network development plan.

 

4. Identification of generic community resources, such as faith-based groups, to provide services and supports to non-target populations.

 

5. Describe the ways qualified providers will be supported in receiving education and training, information regarding best practices, etc.

 

6. Method for providing consumer choice (informed)

 

7. Provide an "access map" for the network.

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