Member Advisory Council: Minutes, Sept. 2008

September 11, 2008
11 King Street, Augusta, ME
12:30-4:00pm

Attendees:  Eric McVay, Stephanie Crystal, Vicki McCartney, Karen Evans, Patrick Caporino, Troy Henderson, Leticia Huttman, Joan Smyrski, Kelly Bickmore, Priscilla Seimer, Tammy Swazey-Belleau, Kelly Parnell, Sara Godfrey and Simonne Maline

Announcements

Simonne Maline, Member Liaison, APS Healthcare

• Priscilla Seimer has joined APS Healthcare as the Member Services Manager 
• Alexis Lyon has transitioned from Member Services to Provider Relations

Review of Agenda:  Additions

• PAC and MAC combined meeting discussed with agreement to develop joint work with the PAC as a standing agenda item
• Discussed a “Thank You” meeting for those that have served on the council and intent to plan this.

Introductions and Handouts

• NAMI Grading States (2009) – Mental Health Services Survey
• New contact list
• National Consensus Statement on Mental Health Recovery (from Simonne’s conference in Philadelphia)
• Update APS Organizational Chart
• Member Advisory Council Minutes from June 12
• Provider Advisory Council Minutes from April 22 and July 23

Review of Common Understandings

• No Cell Phones – Speak up when talking – wait for someone else to finish speaking before you speak – maintain a humorous and positive attitude – remember that this is an advisory group not an advocacy group – APS Healthcare provides direct feedback on recommendations – respect everyone else’s opinion even if you disagree – confidentiality – chocolate at each meeting!
• Suggestions for Common Understandings:
  • Change no cell phones to turn them on silent or vibrate
  • Have the meetings be a safe environment such as no shouting, no swearing, and no pounding fists
  • Possibly invite a self-advocate
  • This is a public meeting but it is open to anyone that wants to come.  Let people know in advance who will be visiting the meetings

Outreach for Member Advisory Council

• There are up to 21 positions available on the Council.  The Council is interested in including a teenager, a family member or young adults to join the Council.  Members will invite others from these groups to join, with an eye to ensuring geographic representation from across the state.
• The Council agreed that this meeting location met the groups’ needs.  There was discussion about ensuring teleconference ability for members from Aroostook and Washington counties.
• A rumor (incorrect) was discussed about the MAC being “closed” to new members.  The Council would like an announcement to counter this incorrect information. 

Review of Current Quality Assurance Data

Patrick Caporino, APS Quality Improvement Manager, facilitator

• Presentation of the Maine ASO Quality Improvement Program – Dashboard Report June 2008.  It is used as a quick reference for many areas of data that APS is collecting.  The Dashboard covers 12/1/07-6/30/08.  Children’s services often serves kids ages 0-20 and Pat has a special dashboard to capture the numbers for those children.  There was feedback about separating the child/adults with regards to Inpatient and PNMI’s.
• Clarification on Administrative Denials.  An Administrative Denial is when the provider does no provide enough information on the submitted review.  The review is put on hold by the clinician and the provider is notified to contact APS with the required information.  If the provider does not get back to APS the review is Administratively Denied.  Most of the Administrative Denials are reconsidered, authorized and then approved.
• Feedback on the # of services discharged.  Members would like to see the breakdown.  Pat has the specific information with regards to the region and what type of service.
• Due to the large volume of phone calls that came in, APS went from 2 PR specialists to 5.  Members would like to know the breakdown of phone calls between member calls and provider calls.  Members would like to know how many member calls that APS receives in a month or so.

Discussion and Follow-up:

• June 12 MAC meeting minutes were reviewed.  Page 3 needs to be edited.  Meetings otherwise accepted.
• GEAR conference will be held on the 26th and the 27th at the Ramada in Bangor
• National Federation of Families is holding a poster contest for children up to age 16
• Update on assignments: Simonne Maline
  • Troy will be writing up an article for the Member Newsletter.  He will not use the word “client” but “person” or “individual.”
• Bed-Hold Days Policy Change Discussion
  • This was a change in State Policy, not APS policy. APS was tracking and approving bed hold days previously as part of the contract until August 1st.  This does not mean that the member should not leave.  There were a lot of concerns from the members regarding the discontinuation of Bed Hold Days.  The Council felt that there should be some clarification on what this means for the consumer.
  • From DHHS- There is a 30-day cap for bed hold days a year for each individual.  The rate that residences get paid is based on an occupancy rate.  This does not mean that the Providers do not get paid for these leave days or that the members cannot leave.  The providers should probably meet with DHHS staff regionally to clarify the miscommunication with regards to the Bed Hold Days.  DHHS should be contacted if providers are putting out misinformation regarding the Bed Hold Days as these issues need to be addressed. 
  • How to manage Bed Hold Days should be an agenda item for the MAC and PAC combined meeting.  Provider forums for adults and children will be coming up soon for all regions.  When changes like this happen there needs to be more information and education so that providers and members understand all the aspects. 
  • The Members feedback is more important now than ever.  Things are very complex and the consumer voice is very critical
• Level of Care (LOC)
  • LOC Criteria were distributed for future discussion.
• Review Purpose of Member Advisory Council:
  • Review APS Healthcare paperwork for clarity, concise, easy to read
  • Review data and information to advise APS on Quality Improvement from a Member perspective
  • Provide feedback to APS
  • Prioritizing Needs from MAC perspective both Short-term and Long-term

Next Meeting Date, Time, Location

• Next Meeting Date: December 11, 2008 from 12:30 – 4:00
• Next Meeting Location: 11 King Street
• Meeting adjourned at 4:00 pm