Member Advisory Council: Minutes, March 2008

March 13, 2008
Senator Inn, Augusta

Attendees: Jeff Crane, Eric McVay, Paula Greenleaf, Stephanie Crystal, Ronnie Lowell, Karen Evens, Tammy Swasey-Ballou, Leticia Huttman, Melanie Sachs, Eric Meyer, Pat Caporino, Simonne Maline, Alexis Lyon, and Brianna Boucher

Absent: None

Welcome and Lunch

The meeting and lunch convened at the Senator Inn, in Augusta, Maine, at 12:30 p.m.
Melanie welcomed everyone to the first Member Advisory Council meeting, and gave a brief overview of the Member Advisory Council Manual as well as the agenda.

Introductions

Members shared their thoughts about what they hope this council can do or achieve.

The majority of thoughts were: voices need to be heard, to make it the best system it can possibly be, and to spread the word about APS Healthcare
Other thoughts included: material needs to be simplified, have the material looked at by consumers to make sure it is user friendly, to have APS Healthcare expand to include other disability groups

Eric Meyer also gave a welcome to the council

We’re off to a good start. As of last week providers had made requests for 115,000 different services for members. Turnaround of requests has been within 24 hours.
APS Healthcare hopes to have significant impact in the areas of tracking access to care, including wait lists. One member asked about “black listed” clients and their ability to access care. Eric stated that for all Maine members, we look at the clinical need and if someone is eligible for service. If APS Healthcare is aware of a situation, we will work with the Department to see what can be done to resolve it.
Eric talked about how hard it can be to discuss quality and our mission when budget cuts are in the daily news. It may be hard to separate our work from the larger discussion of resources and services at times.
Currently we have twenty-five employees working in our South Portland Office.

Purpose of Member Advisory Council

Structure

Meetings will be held quarterly and will run 12:30pm until 4:00pm.
Dates for those meetings are as follows; June 12, 2008, September 11, 2008 and December 11, 2008. Lunch will always be included.

The Member Liaison will chair the meeting. The APS Healthcare Member Services Manager will chair in the Member Liaison’s absence. Simonne Maline will be starting with APS Healthcare on Monday March 17, 2008 as our Member Liaison.

The Member Liaison is a resource to consumers and family members for information, problem solving and outreach from a peer point of view.

Tasks for this Council

Review paperwork – up until now, many materials have gone to member groups such as Advocacy Initiative Network, GEAR and Maine Parent Federation, as well as DHHS Member Material Work Groups, for review.
It was suggested that APS Healthcare material should be in size 14 point font for the ease of members
Data and information. It is a great aspect of our contract. It will help to keep everyone informed of what is going on in the system, and help us to make improvements together.

Overview of APS Healthcare

We discussed the mission and operations of APS Healthcare with a power point presentation.
There was concern with the Renegotiated Authorization Process. There was a feeling among the Council members that a provider may not truly explain the decision and get a fully informed agreement from the member. It was decided to discuss this further at the end of the meeting.
Pat Caporino talked about APS Healthcare Quality Management Plan, its purpose, and the Council’s role.

Current Projects

Council Members agreed to table other agenda items in order to discuss the Renegotiated Authorization process. Members felt strongly that there should be some other way of notifying the member that there has been a change from the original request for service.

One suggestion was to have the member present or on the call when there is the initial conversation between the provider and APS Healthcare Care Manager.
One member suggested that just as providers get a written confirmation of the renegotiated amount, that members should as well. It was proposed that members receive a letter via U.S. mail that confirms the authorization.
Council agreed that the recommendation to APS Healthcare should be to send a written confirmation letter to the member. Melanie to follow up and report back to Council members as soon as possible.

Reminders

APS Healthcare Open House – spread the word! April 22, 2008 from 3pm-7pm in the South Portland Office; invitations will be sent and emailed
W-9 Forms need to be in to Melanie by the next meeting
APS Healthcare Member Expense Forms need to be in to Melanie 30 days after the date of meeting (by April 17th)
The date for the next meeting is June 12, 2008; Augusta will be the location for all meetings – location to be announced

Action Items

Email Member Newsletter ideas to Melanie
Email Member Handbook suggestions to Melanie
Melanie will get back to the Council via phone and email as soon as possible regarding the Renegotiated Authorization letter