QUALIFIED PROVIDER NETWORK

SUBCOMMITTEE

OF THE LME

November 25, 2002

3:00 p.m.

711 Executive Place; Board Room

MEMBERS   Tracey Jackson, Lutheran Family Services

PRESENT:     Alice Smith, Peterkin & Associates and IPA

                        Karen Campbell, Campbell & Associates

                        Helen Wilson, Evergreen Health Care Services

                        Alice Carter, Loving Care Habilitation Services

                        Daniel Muldrow, Main Focus

                        Michelle Davis, Davis & Associates and Lloyd & Associates

                        Arethia Robinson, Tricare Home

                        Cleveland Wilson, Your New Beginning

                        Leon Slocumb, Cardinal Clinic

                        Ira Taylor, Hosanna Youth Facility

                        Sandra Taylor, Hosanna Youth Facility

                        Rhonda Washington, Easter Seals

                        Lassendu Suito, Easter Seals

                        Sharon Melvin, Release It and Let Go

                        Jimmy F. Hendley, Sr., Community Provder

                        Letsie Generette, RACA Services/Bryant & Associates

                        Caroline Stiles, Firm Foundations

                        Dewey “DJ” James, QMHP

                        Melissa M. McAllister, Precious Haven

                        Kiya Thomas, QDDP

STAFF            Debbie Jenkins, Director – Child and Family Services, CCMHC

PRESENT:     Densie Lucas, Assistant Area Director, CCMHC

Vince Wagner, Director – Managed Care, CCMHC

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

Stacy Martin, Clerk to the Area Board, CCMHC

I.          Welcome/Introductions                     

            Members introduces themselves and gave a brief overview of their agency.

II.        Agenda Adjustments

None

III.       Approval of Minutes 11-18-02.

            Minutes were approved with the addition of Vince Wagner listed as Present.

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

·        Additions were made to training topics to include fire setters, MR/MI, person-centered planning, target populations, best practices, etc.

·        Additional recommendations include:  yearly calendar of training and updates sent to all providers, study modules, and develop form for requests for technical assistant.

V.        Discussion of Qualified Provider Network/Development Enrollment

·        Mrs. Jenkins shared that tentative dates for public forum are December 17^th during lunch and December 19^th in the evening to be held in the Pate Room at the Main Library.  Will present basic information and intend to call on providers involved with the process to help explain. 

·        The plan will be submitted in January.

·        Since some of the providers present had not yet received the memo regarding State Plan/Survey of Interest of Possible Providers, this was distributed (ATTACHMENT A).

·        There was discussion regarding preference of members on how to handle enrollment into the network.  The general consensus was to have annual open enrollment with additions to membership throughout the year based on need.  Initial enrollment will be established January 2003. 

-     If already drawing down State/Medicaid funds, apparently the provider already meets criteria’ therefore, they will be considered in the initial “pot.”

-     Network must match community; therefore if there is an over-abundance of services in a particular service area, not all will be part of the network.

-     Having a license does not automatically gain you entrance into the network.  Providers must meet qualifications.

-     Will be identifying gaps in the community and sharing this information with the community and putting out RFPs.

-     Mrs. Jenkins pointed out that CCMHC has all reports of problems within facilities from the Division and this will play a role in determining network membership.

-     Provider panel will consist of data sets listed in the State Plan.

-     Annual needs assessments will be conducted to determine what services are needed to be developed in the community.

-     There is a requirement for the availability of a minimum of three providers (employed by different agencies) who can provide services to consumers within a 30-minute or 30-mile radius of clients’ house.

-     There will be a review panel created consisting of family members, consumers, CCMHC, advocacy groups, members of other agencies, etc., to place providers on the provider panel.

-     Part of the process will include educating the public as caregivers have cited a problem with having adequate information to make informed decision regarding appropriate services and placements for their loved ones.

-     Mr. Wagner will develop an application process for consideration.

VI.       Discussion of Mechanisms for the Arbitration and Resolution of Grievances/Complaints by Providers

·        Mr. Wagner proposed a formal arbitration committing consisting of a minimum of:  one LME representative, one CFAC representative, and a provider representative from each of the service areas (Adult, Child, Substance Abuse, DD). Additionally, the person with the grievance/complaint may be present with the approval of all parties.

·        Will write up and provide next week for review by this committee.

VII.     Round Robin

·        Mr. Wagner  clarified that the QPN Subcommittee will continue to meet but with less frequency.

·        Mrs. Jenkins distributed an updated grid with some changes (ATTACHMENT B).

·        Policies required in this section are very prescriptive; therefore, they will be written and forwarded to Executive Committee and the Area Board for approval.

·        Mrs. Jenkins commented that there have been over 100 resources identified, mostly faith-based, and will be put into a Resource Guide and shared with this committee.

VIII.        Next Meeting

            Monday, December 2, 2002 at 3:00 p.m.

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