WCHO Board Meeting, May 19, 2009

"I go to meetings so you don't have to."

The Washtenaw Community Health Organization receives state, federal and local funds to serve people with developmental disabilities, mental illness, and substance abuse problems in our county. I have started to go to WCHO Board meetings to glean information that might be relevant to people with developmental disabilities and to get a better understanding of what exactly the WCHO does and why.

Much of the time I feel like I am in a Peanuts comic strip listening to the adults talking, who never say anything except,

"blah, blah, blah..."

It comes out a little differently here though - more like,

"blah, blah, ORR, blah ARR. blah, blah, Engagement Center, blah, OOC, blah, blah, blah, Integrated Health Care Management, blah, blah, SAMSA, blah, blah, blah, PIHP, etc."

I have confidence that some of this will be decipherable with time.

Here is what I learned:

Patrick Barrie, the WCHO acting Executive Director, gave the Director's Report:

• The Governor's Executive Order from a couple of weeks ago laid out cuts of $10 million in"non-Medicaid" funds for mental health. CMH Boards will have cuts in funding from 1-5%, with Washtenaw County lucking out at the 1% level, at least so far. This amounts to a $74,000 cut in state funds.
• The governor's order was quickly approved by the legislature, so there is no going back to restore the $10 million, but there may be appeals concerning the distribution of the cuts for the state's community mental health agencies.
• The WCHO is going to get two grants for disease management programs. A phrase repeated several time was "Integrated Health Care" which has something to do with merging behavioral health care with medical health care. Using the phrase is apparently one way to make sure that mental health care is not forgotten in the push for health care reform. Everyone is a bit nervous about how mental health care will fit into the health care system of the future.
• Policies on 1115 waivers (these are Medicaid waivers that allow a flexible use of Medicaid funding) are redone with every administration. Policy changes are expected at the federal level, but so far no one has been appointed to head the Federal Centers for Medicare and Medicaid Services.

At the April WCHO meeting, there was some discussion about the Engagement Center. I assumed that this was something like a clubhouse for people with mental illness, but that would be wrong. As was made clear at the May meeting, it is a place for people who are intoxicated by alcohol or drugs to go. Its purpose is to divert people to a more appropriate setting than a hospital emergency room to sober up. It could be used by people with developmental disabilities if they found themselves in this condition. Not likely for my kids.

The WCHO's Application for Renewal and Recommitment, the ARR, will be submitted to the state in June to renew the contract to provide mental health services. A summary was provided for the Board's approval.

As usual, the Devil is in the details. I doubt that the Board has a much better idea than I do of what the WCHO is promising to do. Under the category of Assuring Active Engagement (there's that word again), the ARR promises full implementation of the "DD Outcomes tool", whatever that is. The agency will also "refine reports to analyze data pertaining to Community Life Domain.." and adopt system-wide the Evidence-Based Practices for Supported Employment (as opposed to practices not based on evidence?). Under Improving the Quality of Supports and Services, something or someone will "move to relational based contract where outcomes and performance targets are established with providers".

My head hurts.

A WCHO sub-committee, the Organization Operation Committee or O.O.C., submitted a preliminary communication regarding management and oversight of certain providers who staff supported living arrangements for particular consumers. Reading between the lines, there have been some problems with this and the committee is reviewing policies for monitoring these providers. An initial assessment indicates that these policies are inadequate. The size of the provider network has contributed to the inability to adequately monitor the provider's performance.

Intriguing. I will find out more. The next meeting of the O.O.C. is on June 3rd, 2009, 8 - 10 am at the Library Learning Resource Center, 4135 Washtenaw Ave., Ann Arbor, near the intersection of Washtenaw Ave. and Hogback Rd.

Martha Bloom, a parent of a DD adult, was sworn in as a new WCHO Board member. She is the VP of the Ann Arbor Area Community Foundation and involved with other families in Intentional Communities of Washtenaw .

More information on the Internet:

• The Calendar where you can find when and where the WCHO and its subcommittees meet.
• A list of WCHO Board Members and contact information.