Minutes

Agenda item: MSOP Update Presenter: Benson/Hebert
Discussion: General Update

1. Legislative Update:
a. MSOP bonding bill ($47.5M) was signed. Priority considerations will focus on infrastructure. Anticipated we’ll out grow our bed capacity in 2.5 years.
b. Legislative session has seen several bills introduced on new sentencing guidelines for offenders. Nothing agreed to at this time.
c. MSOP was asked to do a fiscal note on freezing the budget at current level ($68.4M) Legislative discussions on increasing costs to counties, now at 10% of daily per diem rate.

2. Community Prep Program now has its 5th participant. 1 of the 5 patients participating has petitioned for provisional discharge. Will potentially be adding more staff as this program expands.
a. Meeting with local county attorneys on end stage treatment and opportunities for patient discharge/release. Looking at necessary treatment modalities.

3. Rule 26 Licensure: Working with Licensing on variances.

4. Training: Working with DOC on joint training efforts.

5. Review Board: Will continue to use the same Review Board as SOS but will be going to separate meetings/dates.


Action items Person responsible Deadline







Agenda item: SOS Presenter: M. Tessneer
Discussion: General Update

1. Legislation:
a. GAMC has been addressed at the legislature. If no action was taken it would have had a $10-20M impact to SOS.
b. Creation of a Coordinated Care Organization is in process. This service is a bridge until other health care options are available. Should not greatly change our utilization.
c. Chemical Dependency rate cut – Govr proposed a 5% cut (no author at this time). While CARE budgets are beginning to move toward the black, this would impact us.
d. We are waiting for the Health and Human Services bill to be released.

2. Brainerd Campus reuse:
a. The White Earth Band has shown interest to use the site for a Native American medical center.
b. They are also looking at the Four Winds program. They want to increase the cultural specific component of the program in hopes of increasing utilization.
c. We are early in the discussion. Any changes would likely be 1-2 years away.

3. Redesign Report Preview:
a. Eveleth: Program will move to a 4 bed or 4 +1 model (Pillager-like). We are working with St. Louis County on licensing issues. If MSOCS does not find housing, we will continue to operate out of the current site.
b. Mankato Crisis: Planning for closure continues. Patients will be diverted to the St. Peter CBHH for short term evaluation and stabilization. County group is looking into reuse of the same building as part of their crisis program. Q: If the county picks up the additional crisis services, how will the cost be covered? Ans: SOS has no money to give. Costs likely to be covered through Mental Health grants through DHS or MA billable services.

4. Layoff Discussion:
a. Layoff letters scheduled to go out next Friday, 4/9/10.
b. Anoka and METO:
i. METO is combining services with the Brainerd/Minnesota Neuro-Rehab Services (MNS)
ii. Both populations are similar in their behavior challenges and many treatment modalities.
iii. METO patients remain longer than necessary - many stay up to 1 year and the average cost of service is approximately $1M per episode.
iv. METO's census runs, on average, at 50% capacity.
v. MNS is facing a change by the Feds in their Rehab Certification. This change goes into effect the end of this fiscal year.
vi. DHS/SOS intends to continue planning as though the no layoff language will change. Our hope is that the no layoff language can be reconciled before we need to move to implementation.
vii. New Neuro-Rehab structure would be:
1. Replace current METO beds --> proposing a 16-bed PERT and two MSOCS run 4-bed or 4+1-bed adult foster homes all within 35 miles of the current METO/Cambridge campus.
2. Replace the current MNS beds --> proposing a 16-bed PERT and two MSOCS run 4-bed or 4+1-bed adult foster homes.
viii. Anoka will be evaluating patient needs and moving medically indicated patients to the SOS nursing home located on the St. Peter campus. Depending on patient need, this action could close a unit.
Comments:
• Management does not have support of the unions to move forward with above proposal(s). It is the county’s job to “work the back door.” Response: This is why SOS is developing the transitional foster care sites and other varied levels of care.
• How does this impact the no layoff legislation? Response: Acknowledge that legislation is in place. Believe proposed plan better serves our patients and helps to address the $17M deficit. Can’t leave METO as it exits. If no layoff legislation remains will need to look at alternate options for Brainerd Neuro-Rehab. We want to keep the Brnd MNS so we can best utilize experienced staff.
• Unions would love to find a win-win.
• Why not just close five CBHH’s to cover costs of deficit? Response: Closure of 5 CBHH’s would have a negative impact on the MH system in the state.

c. Dental Clinics:
i. Dental Clinics are running a $2.6M deficit and have drawn the most attention at the legislature. Employees do great work but there is no funding stream to cover the costs of the program. Still anticipate layoffs.

d. Other:
i. Discussion on insurance contribution for part-time folk.
ii. St. Peter injuries:
1. On-going review of situation.
2. We are looking to increase staff ratios on pm shift where majority of incidents occur.
3. Continue to meet with unions and key SOS leadership assigned to conduct critical analysis of each incident.



Action items Person responsible Deadline




Next meeting:
May 7, 2010
7:30 – 9:30
Lafayette room 6148