Issue Summary:  Adult Care Home Resident Safety and how to assure safety became the topic as we reviewed the survey results from the 42 counties that responded to our Adult Care Home survey last fall.  There were no real surprises from the survey.  We are concerned about the delays in getting penalty requests actually filed due to numerous revisions required.  The group believed that the actual penalty review phase was moving as fast as it could with the current demands placed on the penalty review committee.  Issues around consistent enforcement of penalties and other remedies were noted.  Local advisory groups and the community don’t understand why DSS can’t do something.  Many of these are extremely serious issues.  Buncombe is currently attempting to go after an operator with long standing problems using the Senate Bill 10 “compliance history” option.  This has been problematic as the rules are being defined as they go along.  Group was also concerned about the lack of oversight in Mental Health Group Homes and combination facilities.  Mental Health Reform and the discharge of numerous folks to Adult Care facilities we believe will exacerbate the problem.  Conversation then centered around trying to determine if DFS has a plan for how they will accommodate Mental Health reform.  Can the long term care planning process be a vehicle to address any of our concerns?  How has DFS defined the process in Senate Bill 10 around “compliance history”?  These were all questions we had.  We will invite DFS to our next meeting.

Position or Policy Recommendation for Board Action:

The committee recommends that the Association needs to address formally the planning issues related to Mental Health reform and DFS.  How that would be done is left open to the Executive Board.

Side note: Some discussion after the meeting adjourned with Division staff suggested some joint meetings with local Mental Health Directors, the Division of MH, DSS Directors, Division of Social Services and perhaps DFS to hash concerns out now and in the future around reform. This would need to be ongoing.   Individually we have attempted in some counties to address concerns and the Association has had Tara speak at different times, but there is no ongoing, organized effort to work through the issues.

General Information for Dissemination:

Judy Pelt reported on her assignment with the Adult Care Home Rules Rewrite Committee.  She noted that they had been meeting since August and in May their first product, the Discharge policy, is going to the Medical Care Commission.  There has been difficulty in reaching consensus.

APS Management Report format was reviewed.  It is envisioned, based on Association initial input, that a longitudinal experiences report similar to that in Child Welfare would be produced with data compared over a 3-year period.  It would be produced annually and would focus on data such as number of reports by type, living arrangements, confirmed vs. substantiated, authorization for APS, Time Frames, etc.   There would also be a monthly year to date report that would give similar data that you could pull up as needed.  Some ideas about additional data were put on hold as we don’t currently capture that data and it would be major redesign.  Group felt this was a good first step.  Don’t have a timeline for when it will be available. 

There have been parking issues and a request has been made that we locate another meeting place while the GA is in session.  Suzanne Merrill is trying to locate something to accommodate us.