QUALIFIED PROVIDER NETWORK

SUBCOMMITTEE

OF THE LME

October 7, 2002

3:00 p.m.

711 Executive Place; Board Room

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

                         Densie Lucas, Assistant Area Director, CCMHC

                         Terri Knight, Director – Developmental Disabilities Services, CCMHC

                         William H. Robinson, Director – Residential Services, CCMHC

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

                         Debbie Jenkins, Director – Child and Family Services, CCMHC                    

                         Stacy Martin, Clerk to the Area Board, CCMHC

                         Karen Campbell, Campbell & Associates

                         Daniel Muldrow, Main Focus

                         Richard Varela, KV Consultants and Associates

                         Letsie Generette, RACA Services and Bryan and Associates

                         Curtis McCrimmon, Evergreen Health Care Services

                         Helen Wilson, Evergreen Health Care Services

                         Alice Smith, Peterkin & Associates & IPA

                         Cleveland Wilson, Your New Beginning

I.          Welcome                    

• Mr. Wagner welcomed everyone to the meeting and extended his appreciation for members taking time out of their busy schedules to participate.

II.        Introductions

• Mr. Wagner introduced himself and asked everyone to go around the room and introduce themselves.

III.       Agenda Adjustments

      None

IV.       Approval of Minutes from September 30, 2002

Regarding the last bullet under Item VII, Ms. Lucas clarified that billing guidelines refers to IPRS while the discussion on the extension refers to HIPPA.  Minutes were accepted as written with the noted change.

V.        Update from “Training/Technical Assistance/Education Subcommittee”

• Mr. Varela reported that the subcommittee met last week following the Qualified Provider Network meeting and have created a document (See ATTACHMENT A) they hope to have incorporated into the document that the LME will submit.

• This subcommittee will meet again next Monday, October 21^st at 2:00 p.m.

• Mrs. Jenkins informed members that Senator Rand’s Bill has passed and is now law.  It stipulates that all human service agencies must submit information to Raleigh regarding who is placed out of county as there will be a process by which the county who is sending clients out of county for services also sends money to the receiving county for educating the client.  Additionally, Mrs. Jenkins reported that any facility whose license has been revoked or suspended or has received a Type A or B penalty, the owner, principal, or an affiliate cannot get a license or be enrolled with Medicaid for any new service.  The State will establish temporary rules and all reports must be in Raleigh by January.

• There was discussion regarding the State’s training and technical assistance component not keeping up with training mandates.  There was question regarding who has liability when training is provided erroneously.  Anyone can access the list of State-certified NCI trainers on their web site.  CPR and First Aid Trainers can be obtained from Red Cross.

• Ms. Smith pointed out that sadly, many current providers won’t qualify for the Provider Network because they do not have the capacity to track and report data to the LME.

VI.       Discussion of Qualified Provider Network Grid Comments/Ideas for Implementation

• Mr. Wagner requested that members continue to review grid and provide input on how providers are incorporating into their organization and how they interpret what’s written.

• Consumer choice must be ensured.  This is true regardless of who provides the services.  It will be imperative for the policies and procedures of the LME to reflect that the LME and  others are not influencing the choice of consumers and steering them to particular providers.  Any provider qualified and in the network should be considered.

• Need to complete the needs assessment.  If there is only a need for 10% of the services offered in the community, must determine how to handle.  Therefore, the likelihood of every provider getting business is low.

• Need to determine if the network will be open or closed.  If the network will be open need to determine how that is going to be defined in terms of providers becoming members of network.

VII.     Review Qualified Provider Network Questionnaire

·        Mr. Wagner distributed the draft of the questionnaire with changes recommended at the last meeting.  This is ready for mailing.  (Attachment B, page two)

VIII.    Review of Cover Letter

·        Mr. Wagner distributed a cover letter to accompany the questionnaire (Attachment B, page 1). 

·        Members recommended that the questionnaire be put in memo form and come from Mr. Wagner as the Chair of the Provider Network Subcommittee of the LME instead of the Managed Care Director.

IX.       Round Robin

• Mrs. Jenkins provided copies of a brochure brought in by Mr. Wilson on Firm Foundations (See ATTACHMENT C).  The committee recommended that Mr. Wilson invite a member of Firm Foundations to these meetings to ensure they are aware of the needs of the community in response to mental health reform.

X.        Next Meeting

·        The next meeting is scheduled for Monday, October 14, 2002; 3:00 p.m.

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