COMMUNITY MENTAL HEALTH SERVICES OF MUSKEGON COUNTY MEMORANDUM
Date: August 24, 2007
To: CMH Board Members
From: James M. Elwell, Executive Director Subject: Monthly Activity Report
The following summarizes the activity within the agency for the past month:
• DCH has issued a draft of the proposed capitation rate structure for FY2008. There are substantial changes for the Habilitation Waiver. The new rate setting method will emphasize the age, living situation, and region of the waiver enrollee. In this scenario, Lakeshore would lose around $430,000. It appears that this is the result of Muskegon/Ottawa group home costs that are higher than the statewide average.
• Stability problems with our Avatar system have largely been resolved. We are proceeding with development of the electronic medical record. Ten staff are currently using the online progress note for all their service records. This will be rolled out to all supports coordinators in the next two weeks. Four members of the initial pilot group will begin using an electronic treatment plan within the next four weeks.
• Our on-line training system is now operational and staff have been assigned classes in the new system. All scheduled training is now managed in the system, and we are producing transcripts and other training reports.
• Work with Ottawa on joint training has slowed. There is some indecision with regard to joint ventures, and staff turnover at Ottawa has reduced the resources available to work on future ventures.
• Ottawa CMH has requested our assistance with filling some Occupational Therapy needs created by the loss of staff and termination of contracts with an OT provider agency. We have agreed to meet their emergency demands while they have no resources, and to work towards jointly providing OT services from pooled resources once some capacity has been restored.
• The State has denied our appeal of the calculations of the State General Fund Internal Service Fund. Given that we will likely use all of the Fund this year, the question heard at the hearing has become moot. We may need to renew this appeal at some later time, and we will continue to provide assistance and support to other CMHSPs in dispute on this issue.
• The move of our Family Friend Medicaid program from General Fund to Medicaid has gone more slowly than expected. For many families, the new procedure is not easy. We do expect to complete this by October 1st.
• Contract negotiations sponsored by Michigan Association of Community Mental Health Boards with DCH will resume shortly, and Lakeshore will have two members on the team in the persons of Duane Gaultney and John North. Although they represent all CMH Boards, we will have two individuals with first hand knowledge of coming issues and resolutions. • The CMH Human Resources Committee has re-convened its Workforce Development
Workgroup to implement agency wellness programs and to work with the Quality Improvement unit to further promote cultural diversity and an understanding of cultures throughout the agency. All staff are in the process of completing a cultural competency training via Avatar, and results will assist the group in determining next steps regarding the promotion of an understanding of cultural diversity.
• Staff is working with the Sheriff’s department and Grand Valley State University to create a training DVD for corrections officers, CMH staff, and other law enforcement officials. The training DVD will provide information on mental illness, de-escalation techniques, and signs and symptoms for corrections officers and other law enforcement officials. It will provide information on the judicial process for CMH staff as well as the general public. The DVD will include three or four different programs to address the needs of different audiences.
• The first SOAR training was held on August 15, and 16, 2007 in Holland. Thirty people from Muskegon Ottawa, and Kent counties attended the training. Staff from the Substance Abuse and Mental Health Administration attended the training to ensure that the training is consistent with training throughout the country. The SAMHSA evaluators and MDCH staff were very pleased with the training staff and the seminar that was sponsored by CMHS of Muskegon County and Network 180. The SOAR program provides training to assist people applying for SSI/SSDI Disability Benefits.
• Efforts continue with Congressman Hoekstra’s office to ensure that the earmark for the jail diversion program is funded. It passed the first hurdle of being one of 34,000 earmarks submitted for funding. Only 1,200 of the 34,000 earmarks were submitted to the various House committees and the full House for approval. It will now be up to the conference committee and Senate as well as the President to approve the earmark. The Senate has stripped earmarks from the various appropriations bills for the last two years. Therefore, there are other hurdles to overcome before any funds may be seen.
• CMH is working with several landlords that provide housing for several of the tenants in the HUD I and II program. HUD has lowered the Fair Housing Market rent. As a result, the amount that can be paid to landlords will be lower during the course of the next lease. We are requesting that the landlords accept the lower rent for the balance of the year. If they are unwilling to do so, then the tenant will have to move into a unit that is at the lower rate. This may necessitate a move which can be difficult for the individuals we serve.
• As noted in an earlier report, the Ottawa affiliate was substantially below threshold for the verification of Medicaid services. Since this was very unusual, the Ottawa affiliate began an
investigation to determine what had happened. It appears that the documentation was completed in a timely fashion (as evidenced by a computer date stamp) but due to changes in the routing system, did not get placed into the files. The Ottawa affiliate has made some changes to ensure that the routing system is more efficient and will be verifying Medicaid services subsequent to this change to ensure that a system is now in place that ensures that documentation is in the record when completed.
• Clinical staff members from Muskegon and Ottawa CMHs have completed training in Motivational Interviewing provided by Michael Clark via funds from the Dual-Diagnosis Mental Health Block Grant. Nine of these staff members from the two CMHs will receive further training in order to become certified to train additional agency staff in Motivational Interviewing. It is our intent to have as many clinical staff as possible proficient in this highly effective Best Practice.
• Five CMH staff members who are working to improve services for consumers with substance-abuse problems and mental illness visited Interact's Dual Treatment Program in Kalamazoo, Michigan, on July 31, 2007. We received valuable information, observed groups, and consulted with their executive director.
• Muskegon CMH staff members assigned to Dual-Diagnosis Implementation are meeting and planning an expansion of services. On August 28, 2007, a group entitled "New Choices" will be started to assist consumers in looking at healthy alternatives and options to assist with their recovery.
• On August 1, 2007, agency management staff met with the new Pine Rest CEO/President, Dr. Mark Eastburg and Dr. Denise Gribbon, Chief Medical Officer, in order to discuss services that Pine Rest provides and to focus on collaboration. Pine Rest is eager to work with community agencies and complement each other wherever possible. At least one more follow-up meeting will take place later this fall to discuss improving coordination of care and to identify areas in which we can work closer together.
• During the past month, several CMH staff members have begun to lay the groundwork for forming a local CHADD (Children and Adults with Attention Deficit/Hyperactivity Disorder) support group. This is an opportunity for federal, state, local, and health agencies to work together in order to assist the many families impacted by ADHD. There are currently 235 chapters across the country, with over 20,000 members. CHADD views its purpose as threefold:
To serve as a clearinghouse for Evidence-Based Practice To provide local, face-to-face support
To serve as an advocate for public policy on the many issues these families and individuals face
• A CMH consumer with a developmental disability will have two of his pieces of artwork printed in the Recipient Rights Conference Calendar. His work will be featured in January and October of 2008. These calendars will be available for purchase for a nominal fee this coming October.
• A workgroup composed of staff from Ottawa and Muskegon CMHs and a number of substance abuse treatment agencies from both counties have been meeting for well over a year to draft a consensus agreement aimed at improving services to persons who have both mental illness and substance-abuse problems. The seventh draft of this document was given out this month for review and comment to Muskegon CMH supervisors, psychiatrists, PAs, participants in the August 8, 2007, Community Substance-Abuse Forum, and members of the Interagency Community Services Workgroup. It is hoped that a final draft of this document incorporating constructive input will be available this fall for approval and signature by key human service organizations and stakeholders. This agreement is an important component of the Department of Community Health and Lakeshore Behavioral Health Alliance effort to implement Integrated Dual-Disorders Treatment, a highly effective Evidence-Based Practice, in Ottawa and Muskegon Counties.
• The Clubhouse Advisory Committee, which consists of both staff and members, has been busy this month conducting surveys of Clubhouse members in hopes of further engaging consumers and improving the Clubhouse operation. A telephone/mail survey of approximately 80 inactive members is in process. The plan is to finish this survey by mid September and evaluate the data obtained. The semiannual Clubhouse Satisfaction Survey was also conducted the last two weeks of July. Forty-five surveys were returned, and the data from these surveys will be evaluated as well.
• Whitehall Adult Activity Center (WAAC) continues to be active in the community. A large group enjoyed their visit to the Amber Elk Ranch in Ludington on July 27, 2007. They experienced elk eating corn right out of their hands and were able to pet many other animals. Six individuals volunteered again this year for the litter patrol at the July 24, 2007, Muskegon County 4-H Fair. Another volunteer group of five to six consumers posted over 100 flyers in the Muskegon area for the Village of Lakewood's Fox Lake Fest, held August 3 and August 4, 2007. Proceeds of this festival go toward Fox Lake rejuvenation and parks and recreation. Individuals at WAAC were glad to be part of helping to support the local community.
• Eight individuals receiving supported employment services obtained jobs during the month of July. Two were full-time positions. In addition, two other individuals lost employment in the last month.
• A Wellness Recovery Action Plan (WRAP) open house took place on Wednesday, August 22, 2007. Persons attending heard about the power of recovery in the lives of the WRAP facilitators. They also received information about how they can participate in WRAP groups. • Three WRAP facilitators submitted DVDs to the Copeland Center for consideration to
become advanced WRAP trainers. They should be hearing soon about whether they have been accepted into that training program.
• Two Consumer Affair Liaisons began work on August 20, 2007. The individuals selected for these regular, full-time, County positions are Sheila Kennedy, a certified peer support specialist and WRAP facilitator previously working at ACT part time through the Disability Connection, and April Elliott, a WRAP facilitator. Both women are excited about working in the mental health system to assist in its transformation to a more recovery-oriented system.
• At the August 15, 2007, joint meeting of the statewide Outcomes Advisory Committee and the Michigan Recovery Council, participants were informed by Patrick Barrie from the Department of Community Health that the state of Michigan will proceed with using the OQ-45 as its outcome measurement tool for adults with mental illness. Future meetings of the Outcomes Advisory Committee will be held to determine exactly how this tool will be implemented statewide. The OQ-45 focuses on symptom reduction and does not measure other areas of recovery. While the Recovery Council does not support use of the OQ-45, it will continue to explore recovery outcome measurement tools and how to implement their use across the state.
• In the last month, the agency's Self-Determination Committee held an event focusing on how self direction/self determination can change people's lives. The 67 persons who attended heard seven individuals served by CMH describe how they have regained a sense of wellness, personal worth, and meaningful roles in the community.
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