Community Living Committee
DRAFT MINUTES
Thursday, May 10, 2018
3:00 p.m. to 5:00 p.m.
Hilton Garden Inn, Cary, NC

Members Present: Kerri Eaker, Aldea LaParr, Michael Groves, Mya Lewis, Vicki Smith, Joshua Gettinger, Katherine Boeck, Christina Dupuch, Andrea Misenheimer, Alex McArthur

Members Absent: Brendon Hildreth, Jason Vogler, Sandra Terrell, James Stephenson, Peggy Terhune

Staff in Attendance: Philip Woodward, JoAnn Toomey, Yadira Vasquez

Guests: Karen Luken, Jennifer Bosk

Introduction:

Kerri Eaker opened the meeting welcoming the members and doing an icebreaker activity focused on Mother’s Day.

The minutes from the February 2018 Community Living Committee meeting were reviewed.  Andrea had a question about the minutes regarding a statement made by Linda Kendall Fields about “proprietary information not being allowable with Cardinal Innovations’ involvement.”  Mya made a comment about Vaya Health having information during the Supported Living: Making the Difference RFA process that other Local Management Entities/Managed Care Organizations (LMEs/MCOs) did not have access to.  Philip will contact Linda to clarify her comments and will follow up with the committee. 

After the meeting, Philip checked with Linda and will revise the February minutes to say: Linda Kendall Fields noted that she was involved from the beginning and noticed the issue with how Vaya Health shared information with other LMEs/MCOs and providers.

MOTION: The minutes reflect that we will get clarification.  Vicki Smith made the motion.  Aldea LaParr seconded the motion.  The motion was approved by unanimous vote.

Initiative Updates:

From Planning to Action: Integrated Collaborative Care for People with Intellectual and Developmental Disabilities (I/DD)

Contractor Karen Luken provided an update.  The systems change is coming from learning, contributing, and informing.  There is the goal of informing providers about what is working with the first Project ECHO learning cohort in Halifax and Warren counties (northeastern North Carolina).  Thirteen providers signed up, and 11 are sustaining their involvement after two dropped out.  The learning is helping them provide care for patients with autism.  Some of the challenges include transportation and access to school resources.  Hopefully, there will be a second cohort.

Karen said Cardinal Innovations is funding the NC Pediatric Access Line (NC-PAL), and Duke is providing parent support and family navigators.  Andrea said family navigators are looking for families across disabilities.  Karen said they are examining how to define roles to be accessible but appropriate across knowledge boundaries. 

Karen provided other updates, saying she will lead a Supported Living initiative webinar on transforming care, and she said a website for the From Planning to Action initiative is under development.  The initiative continues to get strong financial support from DHHS, including funds to develop community hubs and family support for children with complex care needs.  Sustainability options include DHHS, Managed Care Organizations as Medicaid Reform occurs, and Health Resources and Services Administration (HRSA) grants.  Karen told the members to let her know if they want more information on a specific topic.

National experts will attend the May 23^rd Summit.  Philip asked who plans to attend the Summit.  Philip, Chris, Kerri, Mya, Christina, and Joshua plan to attend.

Supported Living: Making the Difference

Jesse Smathers from Vaya Health provided a Supported Living: Making the Difference initiative update by phone.  Twenty-eight people have transitioned, and two more plan to soon.  The initiative will have six learning workshops in 2018.  There was a February provider webinar and an April 30^th webinar – 100 people attended each.  Both will be added to the website soon.

Jesse said there were Level 3 needs meetings in Raleigh on April 6^th and 17^th, including 35 people at the April 17^th meeting.  Direct support staff was a big topic of discussion.  Some service definition issues were also identified as well as cross-system navigation and the $135,000 annual limit for waiver services.

Jesse also mentioned the Transforming Care Conference in Asheville May 15^th-16^th.  Melanie Hecker will give a plenary about her life living with autism and bipolar disease.  She will talk about support for these complex needs.

Motion Items:

RFA Discussion:

Cross-System Navigation in a Managed Care Environment (Case/Care Management)

Kerri said that access to navigation services in one community is different than access to navigation services in another community.  Mya asked for the deliverables, and Philip read the primary deliverables for the committee.  Vicki asked if “policymakers” are legislators or people at DHHS.  Philip said Both.  Christina said if the Council votes to fund this application, the Council will have a specific conversation with the applicant.  She also stressed the importance of not calling the initiative cross-system navigation instead of case or care management and also mentioned the limitations of DD Suite in providing detailed application submissions.  Vicki said she wants to ask Chris some procedural questions.  She asked how can an applicant supplement an application, and how do they sell what they are trying to do?  Philip answered that the applicant can submit attachments in DD Suite and that any entity interested in applying is strongly encouraged to attend the Bidders’ Workshop.

MOTION:  Katherine Boeck made a motion that i2i Center for Integrative Health be approved as the applicant selected for the NCCDD initiative entitled Cross-System Navigation in a Managed Care Environment in an amount up to $125,000 per year with a required minimum of 25% non-federal matching funds for a period of up to two years, with Year 1 beginning July 1, 2018 to June 30, 2019 – with the following contingencies:

1. 1. i2i must address how they plan to support and maintain the website for this initiative and ensure that the website will be accessible to people with disabilities, including visual impairments.  Information must also be disseminated non-electronically to be accessible to everyone.

2. i2i needs to be more specific in how information and data will be gathered and used in informing recommendations to successfully address cross-system navigation for people with I/DD and their families.  i2i must ensure that there will be statewide opportunities that include holding regional stakeholder meetings and/or providing financial support for individuals and family members traveling to meetings

3. In order to achieve successful systems change for effective cross-system navigation that is responsive to the needs of individuals with I/DD and their families, i2i must establish partners outside of long-term services and supports (LTSS), and reach across various disciplines, including mental health and behavioral health, and involve a variety of relevant stakeholders, including health insurance brokers, as well as representation from LMEs/MCOs and other agencies that provide case/care management.

Aldea LaParr seconded the motion.  The motion was approved by unanimous vote.

Transportation (Application Update)

A member submitted a comment card saying the reasons for the recommendation to deny approving the application for funding received sounded like criticisms of the RFA rather than criticisms of the application.  Katherine said part of the reason why the committee denied approving the application was because of the focus area being near the two largest cities in North Carolina.  Vicki asked if the application asked for rural areas, and Kerri responded that the application did not meet this expectation.  Joshua said if you address the problems in a specific rural area, you can address it in other areas.  He suggested holding off on awarding the RFA to see if NCCDD will get more applications.  Vicki said NCCDD should talk to people in rural areas.  Joshua mentioned Lyft was getting people to doctor appointments, and Kerri said this initiative is not focused only on helping individuals with I/DD get to medical appointments, but it is also about helping them participate in activities in their community after 5:00 p.m.

Vicki suggested Council staff to go back and start again and develop a new RFA for transportation.  Kerri said NCCDD needs to work with the Department of Transportation.  Vicki said the NCCDD is supposed to develop a model rather than fund the whole need.

MOTION: Vicki Smith made a motion to accept the I Get Around: Improving Transportation Options RFA Application Review Committee recommendation not to fund the Transportation RFA application received at this time.  The Community Living Committee would like Council staff to go back and investigate this issue and come up with a more viable RFA.  Joshua Gettinger seconded the motion.  The motion was approved by unanimous vote.

Vicki said $150,000 is not enough.  Christina said Vaya Health reached out to Uber and Lyft, and they came back with an amount for hundreds of thousands of dollars.  Aldea suggested alerting other agencies about the funding.  The committee discussed starting a stakeholder workgroup, and Philip mentioned a Duke University research project involving transportation for people with I/DD.A member submitted a comment card saying the reasons for the recommendation to deny approving the application for funding received sounded like criticisms of the RFA rather than criticisms of the application.  Katherine said part of the reason why the committee denied approving the application was because of the focus area being near the two largest cities in North Carolina.  Vicki asked if the application asked for rural areas, and Kerri responded that the application did not meet this expectation.  Joshua said if you address the problems in a specific rural area, you can address it in other areas.  He suggested holding off on awarding the RFA to see if NCCDD will get more applications.  Vicki said NCCDD should talk to people in rural areas.  Joshua mentioned Lyft was getting people to doctor appointments, and Kerri said this initiative is not focused only on helping individuals with I/DD get to medical appointments, but it is also about helping them participate in activities in their community after 5:00 p.m.

Vicki suggested Council staff to go back and start again and develop a new RFA for transportation.  Kerri said NCCDD needs to work with the Department of Transportation.  Vicki said the NCCDD is supposed to develop a model rather than fund the whole need.

MOTION: Vicki Smith made a motion to accept the I Get Around: Improving Transportation Options RFA Application Review Committee recommendation not to fund the Transportation RFA application received at this time.  The Community Living Committee would like Council staff to go back and investigate this issue and come up with a more viable RFA.  Joshua Gettinger seconded the motion.  The motion was approved by unanimous vote.

Vicki said $150,000 is not enough.  Christina said Vaya Health reached out to Uber and Lyft, and they came back with an amount for hundreds of thousands of dollars.  Aldea suggested alerting other agencies about the funding.  The committee discussed starting a stakeholder workgroup, and Philip mentioned a Duke University research project involving transportation for people with I/DD.

Rethinking Guardianship: Expanding Rights - Sole Source Funding

Vicki asked where the money is coming from, and Philip read the funding sources: $30,000 from NCCDD; $75,000 from Money Follows the Person (MFP); and $10,000 from the Transitions to Community Living Institute (TCLI).

Vicki and Christina asked about the TCLI funding.  Philip mentioned the U.S. Department of Justice settlement for individuals with mental health disabilities.  Members asked about one source for funding versus multiple sources.  Vicki said the important thing is we want to see this project succeed.  Christina asked, how will people in that community benefit from the $10,000?  Vicki responded that a change to guardianship law will benefit people from all disability groups involved.  She said NCCDD can help educate stakeholders on guardianship policies.

MOTION:  Vicki Smith made a motion to approve the Executive Committee’s determination that the Jordan Institute for Families at the School of Social Work, University of North Carolina at Chapel Hill, met one or more factors of NCCDD’s Sole Source Funding Policy in order to fund the Rethinking Guardianship: Expanding Rights initiative.  This initiative will be funded up to $115,000 for 18 months (July 1, 2018-December 31, 2019) with the match requirement being met by Money Follows the Person (MFP) Rebalancing Fund and Transitions to Community Living Initiative (TCLI) state funding.  The $115,000 funding includes: $75,000 from MFP; $10,000 from TCLI; and, $30,000 from NCCDD.                                              Michael Groves seconded the motion.  The motion was approved by unanimous vote.

Wrap Up and Reminders

Joshua would like members to contact him if they want to find something enjoyable to do in Asheville for the August meeting.

Philip mentioned the Medicaid Waivers 101 sheet in the committee packets.  Vicki said there are Medicaid Waivers factsheets on Disability Rights North Carolina’s website.

Katherine Boeck motioned to adjourn.  The meeting was adjourned at 4:34 p.m.