1

Virginia Association of Community Services Boards Combined Meeting of the VACSB Board of Directors

VACSB Membership Business Meeting October 6, 2017 Williamsburg Lodge Hotel

OUTCOMES

Board Member Attendance

Gib Sloan Cristi McClanahan Ingrid Barber Laura Totty

Alan Wooten Damien Cabezas Ivy Sager Mary Cole

Angelo Wider Darryl Pirok Jane Carlson Michelle Wagaman

Bea Dahlen Debbie Bonniwell Jim Bebeau Randy Gilmer

Candace Roney Gary Ambrose Jim Sikkema Roshantia Haas

Cheryl Robinette Al Collins Joe Scislowicz

Will Armstrong Shenee McCray Karen Grizzard

Membership Attendance

Alexandria Danville-Pittsylvania Loudoun Rappahannock-Rapidan

Alleghany Highlands Dickenson Middle Peninsula-Northern Neck RBHA

Arlington District 19 Mount Rogers Region Ten

Blue Ridge Fairfax-Falls Church New River Valley Rockbridge Area

Chesapeake Hampton-Newport News Norfolk Southside

Chesterfield Harrisonburg-Rockingham Piedmont Valley

Colonial Henrico Planning District One Virginia Beach

Crossroads Highlands Prince William Western Tidewater

Cumberland Mountain Horizon Rappahannock Area

I. Call to order/Welcome/Introductions – Gib Sloan, Chair, called the meeting to order.

A. Membership Roll Call – Karen Grizzard B. VACSB Board Members Roll Call – Karen Grizzard

Outcome: Karen Grizzard, Secretary, confirmed a quorum was present after the roll calls. Karen reminded those present of the voting process for the meeting:

• Board of Directors shall vote with a show of hands.

• Membership shall use the voting cards. Karen reminded the membership to please keep the cards up long enough for a vote count for each action. Because the meeting is being recorded, everyone is asked to please go to the microphones to ask questions and to make reports.

II. Approval of Outcomes: A. Board of Directors: Approval of July 12, 2017 Meeting

Outcome: Upon motion and second, the Outcomes were approved as distributed. B. Membership Business Meeting: May 5, 2017

Outcome: Upon motion and second, the Outcomes were approved as distributed. III. Additions to the Agenda – there were no additions to the Agenda. IV. Officers Reports

A. Chair: Gib Sloan thanked the VACSB staff for their work hosting the conference. He also extended appreciation on behalf of the Board to all involved in the presentations for instructional sessions as well as the public policy panel session. A lot of information was received from members of the General Assembly, the executive staff, State Board and all stakeholders which has been very helpful, even though we heard some of what we may have not wanted to hear. It is important going back to our communities to continue to get our local boards involved and help them become greater advocates at the local level through the system changes.

B. Past Chair: Al Collins – no report. C. 1st Vice Chair: Bill Brenzovich – no report. D. 2nd Vice Chair: Jim Bebeau reported on behalf of Sandy O’Dell:

• The ED Forum met on Thursday and discussed the financial realignment plan which DBHDS has been required by the General Assembly to create. The plan is in its final draft stages, so it can be processed through the Secretary’s office and forwarded to the General Assembly. The plan will realign the General Funds that come to

2

DBHDS to run the state psychiatric facilities, and (in some way) shift that funding to the community to build up community infrastructure to address the current hospital census crisis. During discussion with DBHDS staff, consultant reports were given, and it was noted that no state is really like Virginia in that we have the last resort legislation and an 8-hour window for ECO’s. These make Virginia unique in trying to create systems change in a reinvestment process. Additional intense discussions are planned, beginning with Tuesday, October 10, November 6, and a retreat scheduled for November 30.

• The Forum discussed 2018-20 draft budget priorities, which were endorsed by the ED Forum and are scheduled for consideration by the membership and the Board of Directors.

• DBHDS presented 2018 budget highlights and the planning process to reach the Governor’s office.

• Reports were given on CCC+ progress.

• David Coe asked everyone to be reminded of the “Ask the Question” survey regarding veterans currently being served in CSBs, which each CSB is encouraged to complete.

E. Secretary/Treasurer – Karen Grizzard gave the following report:

• Howard Cullum was so deserving of the 2017 Gartlan Award. His ongoing advocacy and efforts inspire everyone. We were honored to have Pete Gartlan with us to represent the Gartlan family.

• Karen thanked the member CSBs for 100% dues participation for FY18.

• The Finance Committee met by conference call on July 26, 2017, with the following three (3) Agenda items:

o Review the end of year FY17 budget o Review the proposed revisions for the FY18 budget o Review the proposed FY19 budget for consideration by membership

All were approved to move forward to the Board of Directors for final approval. The Board approved all actions presented at the July 12, 2017 meeting. The FY19 budget was distributed to the membership on August 30, 2017, for a 30-day review in accordance with VACSB policy, with no comments or questions received.

V. Action Items A. Board of Directors: VACSB 2018-20 Budget Priorities Motion: On behalf of the Public Policy Committee, Mary Cole moved that the VACSB 2018-2020 Budget

Priorities be approved. Outcome: The recommendation was unanimously passed by show of hands of Board Members present. Outcome: The recommendation was unanimously passed by member CSBs using voting stanchions. B. VACSB Membership: Clearinghouse Committee authorization for 2018 General Assembly Motion: On behalf of the Public Policy Committee, Mary Cole moved that the VACSB extend authority to the

VACSB 2018 Clearinghouse Committee to review legislation and how it affects the CSB system, be empowered to make decisions and to act on legislative and budget items on behalf of VACSB during the 2018 General Assembly session.

Outcome: The motion was unanimously passed using CSB voting stanchions and show of hands of Board members present.

C. VACSB Membership: Proposed VACSB FY19 Budget Motion: On behalf of the Finance Committee, Karen Grizzard recommended membership approval of the

VACSB FY19 budget. Outcome: The recommendation was unanimously passed using CSB voting stanchions.

VI. VACSB Reports and Updates Jennifer Faison provided the following reports:

• ED Forum agenda was abbreviated due to the conversations on financial realignment with DBHDS. The next steps include future meetings and discussions to talk about short term issues and the bed census. The retreat in November will focus on what packages we can put together to assist in moving people out of hospitals more quickly when appropriate and how we can address what is happening on the front end of the admissions process. The important take away for the membership is the fact that we need to make sure that we are engaged with our state agency partner, particularly around this, because we need to be providing assistance and solutions. The good news is that the Financial Realignment Plan contains four (4) major elements, with DBHDS and the CSBs of a like mind for at least three-quarters of the current draft. Next will be how we envision the money in the system being used more so in the community than it is in the hospital and whether that looks like pre-purchasing bed days or something more like reinvestment. We have some points of intersection with DBHDS.

3

A. CCC+ Implementation. Issues reported from the regions that have implemented, which will be addressed are:

• Provider Reimbursements - We know from experience with ARTS and CCC+ so far, there are ongoing problems some of which stems from the MCOs’ systems not being ready and capable to do what they are supposed to do. VACSB is engaged with DMAS around that issue and will try to step that up and really have VACSB become a clearinghouse for those issues.

• Bob Horne and Beth Rafferty have been taking the lead in the project. Bob has been working with the managed care organizations closely to get standardization of practices and to have an agreement from the health plans on having a single way of doing business for things important to our system. He has had some great successes. At this point, we are talking with the health plans about the authorizations pieces and what can be authorized vs. registered. Jennifer thanked the standardization committee for their work which is to the benefit of all.

• Planning District One has managed care experience of a different sort and has provided us with tips on how to engage the Bureau of Insurance on problems with the managed care organizations. VACSB has previously engaged the Bureau of Insurance and the presented last May on parity, so we will contact them to assist us.

B. Developmental Services

• Conversations on Developmental Disability case management (DDCM) have been ongoing. After one year of serving as the single point of entry for DDCM, the CSBs are looking at the impact on our members and staff. Survey results have provided valuable data which we will use to create a narrative for the CSBs, describing the impact. Jennifer referenced Dr. Barber’s comment from the Public Policy Panel where he said pay is not equal to workload, which came directly from the case management workload survey.

• Streamlining Processes: All Councils have been engaged in a process looking through operating procedures and documentation requirements to find out where there are inefficiencies, duplication procedures and processes that do not make sense. The DD Case Management Workgroup had a checklist that we looked at and said what can we eliminate, where are there efficiencies that we can find. All has been given to DBHDS and they are working on compiling and standardizing it into some way we can look at it and digest it and learn where across the system there are things that we are doing and what kind of paperwork and documentation requirements can we eliminate. We also use this as an opportunity to look internally at the things we do to ourselves that we could eliminate.

• The WAMS conversation is ongoing. DBHDS and the CSB electronic health record vendors are working on a system whereby WaMS and the EHRs can communicate. The deadline for this to be in place in all CSBs is July 1, 2018. Between now and when that gets turned on in your CSB, you do not have to enter data twice, although some CSBs are electing to do so. We are investigating what has happened with the October 1 changes where the ISP function has gone live in WAMS and the impact that freezing those ISP that had been entered already into the system might be. You can still access the ISP without editing ability. VACSB is gathering information to figure out the impact and unintended consequences. Otherwise, the CSBs and FEI (vendor for WAMS) are moving ahead with the data exchange.

C. STEP-VA Implementation – Eighteen (18) CSBs were in phase of implementing Same Day Access. We are looking at the next funding to come online for the rest of the CSBs, which included in the DBHDS budget submission to the Administration for 2018. By the end of FY18, each CSB will have had a consultation on Same Day Access, so the last group coming online will have the same baseline consultation that the earlier CSBs had. The objective is to make sure that we are engaged in processes that create a standardized set of services and supports across our system. The solutions will be different based on what you learn in the consultation, but the baseline level of knowledge is the same in all CSBs.

D. SJ47 Subcommittee - We heard clearly from the SJ47 members that they understand what they did when they pushed to mandate the Step-VA services and supports in the Code of Virginia. They understand that it now needs to be funded as a mandate and that it has a huge price tag. Those 12 legislators are committed to following through on what they started. Delegate Watts, who serves parts of Northern Virginia, said to her colleagues, “I think we here get it, we know what we did, but we have a lot of work to do with our colleagues who are not on the Subcommittee to make sure they understand how this plays out with having it mandated in the Code of Virginia and needing to fund it, especially because this is the big budget”. If we don’t get that money in this biennium, any money that comes online in the next biennium, is going to be harder to spend in a compressed period to get things up and running, so we do need to front load that money as much as we can. We have some good champions and $200 Million is a lot of money and it would be unprecedented to get the full amount in one biennium, but we do have to

4

make sure we are holding the legislators accountable and move ahead. The backup plan, depending on how things work out, would be a need to look at changes in the phase-in dates that are included in the Code of Virginia. Now, it is Same Day Access and Primary Care Screening that must come online by 2019 and all the rest by 2021. There was also an acknowledgement of the SJ47 Subcommittee of the aggressive timeline and Senator Deeds commented that it might be something to review depending on funding. While we are in a bit of a Catch-22 where we do want to make sure there is sustained attention on this and we don’t want to say, we’ll push back the dates, we also don’t want to not have the funding to do what is expected of us. The Committee will most likely have their 2018 legislative package in November, but we do not know what it will look like. They have received reporting from the two (2) workgroups but nothing points in a clear direction now. Most likely, permanent supportive housing will be an item they are supporting. While they don’t understand the model, they have been told the outcomes data available so far with permanent supportive housing are very good.

Other Items Reported by Jennifer Faison:

• DMAS Correction to A Set of Regulations (licensed in residence): VACSB received urgent calls regarding this issue. Other questions came up about some of the regulations that are either in emergency regulations in draft or emergency regulations that are going into effect in anticipation of having permanent proposed regulations. DBHDS has created an issue related to therapeutic day treatment where they have defined counseling by using the Board of Counseling’s definition for the service. An example we have heard is if you are an LCSW you would not be able to provide counseling in that environment because you are not licensed by the Board of Counseling, you are licensed by the Board of Social Work. This would have great impact on the ability of folks providing counseling in the TDT environment right now to continue to do that. VACSB will try to determine how best to make sure that doesn’t get linked together because there is no reason to refer to the Board of Counseling’s definition for counseling for those kinds of services.

• Additional questions have come up regarding registering QMHP-A and QMHP-C. VACSB will follow through on the registration process and the concern for the length of time it could take. In the process of these regulations creating the registry, VACSB joined with DBHDS in submitting our comments. One of the things that people had questions about was the fee. The Department of Health Professions does not receive General Fund dollars, so they are sustained by their fees. From the VACSB perspective, we were concerned with what is the dollar figure that allows you to support enough staff to do this job so that we don’t have to wait for six (6) months to get someone registered and not be able to bill for service delivery. We do not anticipate a backlog but will need to be vigilant about keeping track of how long it is taking folks to get registered in the system. We are unsure what could be done in regulation to require it be done in a certain amount of time, but what we could ask them to do is keep data so there is transparency, so that everyone knows with surety how long it is taking and if there are problems.

• Jennifer encouraged membership communication with her on issues in the system and to provide information that will help her address the issues on behalf of the association. VII. Council Reports

A. Children and Family Services Council:

• Cathy Brown reported that Jennifer covered the issues discussed in the Children’s Council meeting and the Council members will continue to work with VACSB on those. A written report from the Council meeting is ATTACHED with these outcomes.

B. Developmental Services Council – Christi McClanahan provided the following report:

• Karen Kimsey with DMAS provided updates on CCC+.

• DBHDS representatives provided guidance on completing the VIBEs for the individuals on the wait list.

• The Council received information on an upcoming support coordination survey being conducted by the Partnership for People with Disabilities in which twenty-one (21) CSBs will participate. Evaluating factors will include turnover, case management process and recommendations for improvement of the system.

• Outcomes of the last year from the Regional Support Teams were presented, as well as updates from Part C.

• Regional Committee Updates were provided, and the Council talked about the DD Case Management Workgroup which is looking at reducing workload and creating more efficiencies.

• Most of the regions are meeting with their contracted DD case management providers for year-end review to look at what is working well and what we can improve.

• DBHDS indicated they are working on a fix with the WAMs ISP issue. C. Emergency Services Council – Roshontia Haas provided the following report:

5

• DBHDS discussed several projects that are ongoing, including the psychiatric bed registry which continues to have problems. The recent vendor change has rendered the registry useless in emergency services work. DBHDS assured the Council they are continuing to address.

• The new Prescreener form rolled out in July with few bumps. The Council will be focusing on ongoing tweaks to continue improving the form.

• The Council is participating in a workgroup with DBHDS to review regional admission protocols which cover the safety net TDOs. The Protocols were initially written in 2014 without revisions to date. The DBHDS timeline includes an effective date of July 1, 2018. To achieve this deadline, there is clarity needed in the Code when someone is not in custody but needs a TDO bed and there is no other willing or available facility.

• The Emergency Services conference will be held October 26-27 at the Sheraton Roanoke and all CSBs received one complimentary registration.

D. Mental Health Services Council – Shenee McCray provided the following report:

• Demetrios Peratsakis and Stacy Gill talked about a DBHDS/VACSB Clinical Workforce Development Committee, which they would like the Mental Health Council to take the lead on to look at improving the clinical skill-set of CSB staff as well as retention. The Council will roll this out regionally and get more information out to the individual CSBs.

• Stacy Gill also discussed Same Day Access and will put together a workgroup of 9-10 CSBs to review outcomes.

• Jamie Hoyle, Executive Director, DHP, talked about QMHP and the peer registration process.

• Karen Kimsey provided a report to the Council on CCC+. E. Prevention Services Council - Kathy Reed provided the following report:

• Weekly status reports and updates have been requested by Gail Taylor on the Opioid Grant.

• Trainings are underway for the new data system with no go live date set yet.

• Regions continue with suicide prevention initiatives. Virginia did not receive a zero-suicide grant from the Federal government.

• Upcoming Train the Trainer for Mental Health First Aid classes are scheduled in Roanoke and Farmville

• Regarding the Family Wellness Grant in which eight (8) CSBs will pilot a new initiative which would add adverse childhood experiences (ACES) to our processes; there will be a 2-day initial cohort training for 25 participants with ACE interface and then a 4-hour training delivered to the community. The goal is a better understanding of what ACES are and how we can work with our community partners build resiliency in our families.

• The retail violation rate for 2017 increased from 9.5 to 10.1, but we are still below the 21 percent threshold where we could lose Federal funds. CSB Prevention staff spent the last two (2) years “ground truthing” to verify locations and create an accurate registry for the state and we have until June 2018 to complete all the merchant education. As a reminder, each CSB received $10,000 for these efforts, so it is a $400,000 investment in the state, which the system then receives $46M in funds for prevention and treatment.

F. Substance Use Disorders Services Council – Cheryl Robinette provided the following report:

• The Council had discussion on plans to address workforce development regarding credentialing, licensing and recruitment.

• They also heard the discussion with Jamie Hoyle about the registry for QMHPs and the need and how to expand the types of license providers available to provide ARTS services. Ms. Hoyle will research questions and noted that expansion to include other credentialing may require legislative action. There were issues around accepting K-Crept and we were reminded that comments to the Virginia Regulatory Town Hall website is still open.

• Sharon Snow-Killian provided information on the “Ask the Question” campaign and reminded the CSBs that the Executive Directors received a survey and that it is important to complete it. She also reminded the Council of the online trainings for treatment providers for Veterans which have CEUs attached.

• Several DMAS staff addressed operational and policy questions about the ARTS implementation and we learned that Dr. Keats is the new Behavioral Health Medical Director at DMAS who will oversee ARTS.

• Mellie Randall reported the following: o Martha Kurgan who spearheaded and supervised the development of women’s services and

Project Link is retiring. She commented on the tremendous amount of work Martha had accomplished with the Federal Handle with Care Grant. She asked that staff interested in continuing the work in these areas (wrap-around

6

services for pregnant women, treatment with OTPs for pregnant women and maternal SA and exposed infants populations) should contact Gabriella Caldwell-Miller at DBHDS.

o DBHDS and SAMHSA will be partnering on a Federal grant to expand and augment the Link programs with CSBs and Gabriella Caldwell-Miller will be the point person for the Grant.

o Mike Zohab is now the coordinator for the treatment component of the Virginia Opioid Prevention Treatment and Recovery Grant.

o The contract with The Change Company has been renewed so additional ASAM trainings will be offered in 2018. VIII. Standing Committee Reports

A. Administrative Policy Committee - Joe Scislowicz provided the following report:

• The Committee provided feedback to the State Policy Committee on: State Facility and Uniform Clinical and Operations Policies and Procedures, Accreditation and Certification, and Raising of Dilapidated Buildings.

• They will be reviewing the Performance Contract in the coming weeks and will seek proactive Committee support and suggestions earlier in the process and will solicit input from as many as we can. The Committee will look at the contract line by line.

B. Finance Committee – Karen Grizzard had no further report. C. Public Policy Committee – Mary Cole

• Mary Cole thanked those attending Public Policy meetings and reported that turnovers in stakeholder organizations have resulted in new representatives attending the meetings.

• The Committee appreciates the representation from the Councils, and hearing their perspectives on policy issues for which they are passionate.

• Mary issued an invitation to anyone wishing to attend the meetings. D. Regulatory Committee – Debbie Bonniwell provided the following report:

• The Committee recently discussed an expedited credentialing process and discussing with DMAS, which has been determined not possible in the current contracts with MCO’s and in the regulations. We are still asking whether there is a process for back billing to the date of the credentialing application. This has brought up side issues for specific services, such as services that need authorization in advance.

• The Committee continues to monitor monthly Magellan calls which may not continue much longer.

• Took advantage of opportunity to provide robust feedback to Data and Outcomes about the documentation reduction suggestions and ways to streamline services.

• We are hearing about some significant audit activity on the part of DMAS contractors or DMAS staff, which many CSBs have received HMS audits that are pulling 30% of records of certain services. CSBs are being required to print out or provide the records within ten (10) days, increasing the burden on staff to get the records out of EHRs and or the mailing costs involved in printed papers. VACSB is following up on the issues reported.

• Debbie will meet with Jennifer Faison and Sandy O’Dell, ED Forum Chair, on ways the Regulatory Committee can best position for the future.

• Debbie thanked the Committee members and the Councils and VACSB staff dealing with regulatory issues. E. Services Development Committee – Tisha Deeghan – no report. F. Technical Administration Committee – Ingrid Barber provided the following report:

• As a reminder, the Technical Administration Committee works with the following subcommittees: DMC, Human Resources and Finance.

• The Finance Directors Managers met on September 19 at the VACSB office with discussion on various topics, and decided to meet quarterly. The Co-chairs will be Sarah Beamer and Daniel Fair, with Mark Chat as Secretary. The next meeting will be held in January. A focus of the discussion included trainings as 75% of the Directors present have been in the position for five (5) years or less. They will invite DBHDS to a future meeting.

• The Data Management Committee (DMC) is spending an enormous amount of time on data reporting with WaMS. SPQM is at a standstill with more details and information needed before moving forward.

• The Human Resources Subcommittee met at the conference and heard from DBHDS staff. The Subcommittee is planning a December meeting when they will appoint officers.

G. Training and Development Committee – Ivy Sager provided the following report:

• The Committee will begin planning the May 2018 conference and any suggested workshop topics can be forwarded to Kay Springfield.

7

IX. Regional Reports A. Region I – Damien Cabezas/Jim Sikkema – no report. B. Region II – Alan Wooten/Gary Ambrose/Angelo Wider

• Alan Wooten reported the Northern Region CSBs have initiated and scheduled a CCC+ rollout information session in the region. The intended audiences are the staff from fiscal, reimbursement, contracting, compliance, IT and clinical from different program area. The six (6) MCOs and DMAS are scheduled to attend to provide information and answer questions sent in advance. Alan thanked the DS Council representatives who initiated and arranged the event.

C. Region III – Lisa Moore/Randy Gilmer/Jane Carlson – no report. D. Region IV – Laura Totty/Donald Hunter

• Laura Totty shared that RBHA Chesterfield Hanover and Henrico are having a regional Opioid summit on October 26, with a great lineup of speakers and all are welcome.

E. Region V – Sarah Paige Fuller/Bea Dahlen/Darryl Pirok

• Darryl Pirok thanked Jennifer Faison and Becky Bowers-Lanier for the CSB Board Member session. It was recognized that about 10% of the CSB Board Members were present for the conference training. The topic was messaging to the legislators for appropriate advocacy. The group planned to invite all Board Members to attend the conferences and participate in these trainings sessions for more effective Board Member advocacy with the legislators. In Region V, we continue to recruit Board Members and will invite more to the conferences. In Region V, the Prevention Walks continue, and we also continue to advocate for suicide prevention and public awareness and the re-entry programs are progressing

X. Executive Director’s Report – Jennifer Faison reported that she will send an electronic report. She thanked everyone for supporting the Association, as well as attending and participating in the conference.

XI. Other Items/Announcements – no additional announcements. XII. Future Meetings

• VACSB Board of Directors: December 13, 2017 – VACSB Office • VACSB Business/Board Combined Meeting: January 17, 2018, Richmond Hilton Downtown

XIII. Adjourn With no further business, the meeting was adjourned.

STANDARD REPORT FORMAT

COUNCIL OR COMMITTEE REPORT TO VACSB BOARD OF DIRECTORS

October 6, 2017

NAME OF COUNCIL, COMMITTEE: Child and Family Services Council

CHAIRPERSON: Lisa S. Hogge, Ed.S., LPC Director, Youth and Family Services, HNNCSB

ACTION ITEMS (bulleted list with brief description): N/A NEW ISSUES, PROJECTS (bulleted list with brief description):

• Funding continues for Children’s Crisis Response and Child Psychiatry Services. The Region V Crisis Stabilization Program, operated by the Western Tidewater CSB, is slated to open in October 2017.

• The Quality and Outcomes Committee requested the input of C&F Council regarding the use of the DLA in the Same Day Access model. The C&F Council endorses the recommendations of the Regulatory Committee regarding the use of the DLA. The Council truly appreciates the opportunity to offer suggestions and feedback on this critical matter.

PROGRESS REPORT ON PROJECTS, ISSUES (bulleted list with name of project, issue and major accomplishments): September 2017 IACCT updates from Scot Reiner of the Office of Children’s Services

• 306 IACCT inquiries statewide July 2017 o Approximately ½ of these did not move forward in the IACCT Process o 98 individuals moved completely through the IACCT process (64%)

▪ 45: Level C (Residential) ▪ 45: Level B (Therapeutic Group Homes) ▪ 8: Level A (Community-Based)

• IACCT Referrals o Northern Virginia/ Winchester: #1 and Tidewater: #2

• There was consensus among the CSBs who are performing IACCTs that while the process is in its early stages, there will need to be ongoing collaboration with Magellan. IACCT services must be administered in a manner that is consistent with CSB core values of community-based care and the requirements of the DOJ Settlement.

September2017 updates from Janet Lung

• Janet shared her plans for retirement at the end of the month. The group expressed their sincere thanks and appreciation to Janet for three decades of impeccable service and support. Malcolm King will be handling administrative duties in the interim.

• Janet reported progress toward developing a plan to provide CSBs with flexible, supplemental funding to support case management services. Funding may allow for smaller caseloads to work with high needs/complex clients. Applications for competitive selection will be available to CSBs within the next few months.

September 2017 updates from Noels Dianas-Hughes of CCCA

• The new facility director, Dr. T. Peacock, began on Aug 1, 2017. Hospital construction should be complete by mid-October. CCCA continues to utilize beds at Poplar for overflow.

• CSBs are reminded to participate in all Ready for Discharge Census Meetings, two times per month. CCCA Discharge Protocols will be updated soon. The most current version is dated 2014.

• The census at CCCA was lower over the summer. Forty-eight percent of the children served had diagnoses on the Autism spectrum.

September 2017 updates from Dr. Jeffrey Aaron

• Dr. Jeffrey Aaron has a new role in the office of Forensic Services and is currently meeting with the leadership and clinical staff within detention centers to develop a statewide plans to offer case consultation and support to detention-based clinicians. Dr. Aaron is in the process of visiting each region to learn more about their practices and specific needs.

Announcements/Other Comments:

• C&F Council representatives serve on numerous other VACSB Committees as follows:

Quality and Outcomes Committee – Anna Chase and Lisa Hogge (alternate) Public Policy Committee – Paulette Skapars DMC Committee – Doug Billski Regulatory Committee – Lisa Hogge CCC+ Steering Committee – Cathy Brown and Lisa Hogge (alternate) IACCT Residential Advisory Board – Lisa Hogge and Paulette Skapars

• During the September 8, 2017 C&F Council meeting, the vacant Co-Chair position was filled by Ms. Amanda Cunningham, thus creating a vacancy for the Secretary position. Mrs. Cathy Brown was elected as the new Secretary.

Date of Last Council/Committee Meeting: October 5, 2017 Date of Next Council/Committee Meeting: December 1, 2017