Minutes of CDASS meeting June 27, 2012

Submitted by Anonymous on July 25, 2012 - 8:47am

Minutes of CDASS meeting

June 27, 2012


National MS Society/Colorado andWyomingChapters


Executive Summary:

After this meeting Chanda Hinton will be the new client co-chair as Julie Farrar has a conflict every other month and is co-chairing a related committee on the Long Term Care Advisory Committee. 


This meeting was focused on prioritizing what policy issues will be addressed, evaluating the results from the survey and creating a voting structure. 


The proposed voting structure is that PPL and HCPF do not get a vote because HCPF makes final decisions and PPL works directly for HCPF.  Others get a vote per sheet Linda Skalfen distributed (attached) to assure a client control and adequate representation for others.  In general one must attend three meetings before one has voting rights and if one does not attend for three meetings they will lose voting rights, but can earn back with steady attendance.    If your attendance is not accurately represented on the sheet please speak with John Barry.


Based on discussion and survey results policy work was placed into four buckets:

  1. Norms and task sheet  (is allocation adjustment different from the task sheet).   Task sheet drives the allocation.   Discussion about if we should include allocation and we decided yes allocation is part of this whether new or changed.
  2. Book of Business and protocols - Benefit definition (protective oversight and extraordinary care—goes to LAW subcommittee
  3. Emergencies, hospitalization and acute care, this will include high needs and transition
  4. AR roles and issues 

Bonnie will make sure that all issues identified get put into one of these buckets.

John and Chanda will meet with the cochairs of the three committees and assign the issues that fit under each of these buckets.  Subcommittees may need to recruit more people.  The subcommittees must meet and prioritize the issues including deciding which issues need to come off the table and report back at the next meeting.

The subcommittees must develop a schedule of what they will work on first, second, etc.  HCPF staff will provide support and technical assistance to subcommittees.




Present on phone

Gabrielle Steckman

Sueanne Hughes

Kelly Morrison

Rosilita ???  employee--new

Mark Simon

Robin Bolduc

Tyler Dienes

Sarah ?? HCPF


Present in the room

John Barry

Julie Farrar

Jose Torres

Sarah Roberts

Bonnie Silva

Linda Andre

Phil Stolzfus

Rhyann Lubitz

Jennifer Martinez

Sarah Horning

Don Reister

Marguerite Myers

Joan Bombarden

Gary Montrose

Sam Murillo

Corrine Lindsay

Linda Skaflen

Josh Winkler

Debbie Miller

Ann Dyer

Roberta Acevas


Excused absences noted:

Julie Reiskin

Chanda Hinton


John turned meeting over to Julie and said that they would go through first 5 items as quickly as possible


Julie F had people read the agreements for participation –in previous minutes and on website ---working together, step up and step back, don’t repeat, etc.


Minutes went out electronically, if names were not on attendance list let John know.  There were no comments but if someone has any other corrections let John know via email.    It was mentioned that there is an attendance sheet created by Linda Sklafken.  John said he sent an email out about minutes taking.  Julie R is not here and Jose and Josh will be recording. 


Julie F announced that due to longstanding conflict she was not able to get to every other meeting and she was also going to be the colead of the LTCAC subcommittee that will be dealing with consumer direction broadly including culture change, CDASS, and other issues concerning consumer direction.  She discussed with Chanda who facilitated last meeting and she is willing to take over as co lead for this group and she is willing to take over if that is acceptable.   John Barry said that he spoke to people including Julie Reiskin who said that while she thought Chanda was a great choice that this decision should be made by the group.   Julie will still attend alternate months and be available.   Everyone agreed that Chanda would be a great co-chair for this committee. 


Julie Farrar talked about the new position she would take and how they work together and how we still have direct link to LTCAC.   Julie and John will be co chairs of consumer direction subcommittee and wanted people to email them on about stakeholder perspectives, not necessarily names, on the consumer direction subcommittee of LTCAC.    This committee is specific to CDASS only and their committee will be much broader.  The LTCAC group will focus on culture change getting HCPF and LTCAC and others in a place to accept and truly understand participant direction and person centered care.  Please let Julie Farrar or John Barry know of perspectives.  Corrine asked to define culture change and Julei said they would send this out and send more iinfomration about perspctives they are thinking of.  Julie F will send something out and you can use the LTCAC flow chart as a backdrop for what Julie will send out.    The subcommittee responses are needed in the next few days.


Linda Skalflen did some great work on the attendance record but John wanted to hold off until she arrived.    A handout was provided showing who had been at what meeting.  This was an entry into the matrix work and recommendations.  Jose said that that this chart and rules was a fair way to provide decision making authority.   There should be record of who comes and who does not.  Some other compoents are that HCPF employees should not have votes be ause they already make the rules, in terms of others who need votes include CDASS clients, family members, community advocates, PPL, SEPS, etc.  Ability to vote should demonstrate investment in process, someone who is eligible to vote should demonstrate interest and devotion to CDASS.  A way to do that is to be at three meetings in a six month period.  At meeting number 4 you have a vote, if you miss four meetings your right to vote is removed.  John B asked what constituted unexcused versus excused absence.  Jose said excused absence is determined via communication with co chairs—for example no call and no show is unexcused, if someone is sick that is excused, if the reason is silly is it not excused.   John asked what if someone had excused absences three or four months in a row.  Jose said we did not discuss as much but at some point someone would lose their vote.  Sarah H asked how many excused absences in a row and Jose said three.   If you attend three meetings you can earn them back by attending for three meetings.   Sarah said it is not appropriate to have a vote assigned to PPL because they are our contractor but that it would be OK to keep the SEP vote.  Julie F said that we need to get PPL perspective anyway.   Sarah said that was appropriate and same for the department.   PPL agreed.  Someone asked if we had bylaws?  NO –we had decided in January and February we did not want to focus on rules.   Sarah said this is not a formal group that formal group is the one that will report to LTCAC.  This group should communicate with Julie as the subcommittee person for the LTCAC.  This is a working group to figure out how to implement CDASS so it works well now and so we can expand.   Julie said this was a way to help us get a more formal structure which some of us have been working on for months.  Julie said she wanted  to hear ideas from people but we did want to spend most of the time on survey.  Linda S. said that we had decided some formal structural issues such as the way we should bring issues to subcommittees then to group then back to HCPF but these decisions are in the minutes not in a document.  John said he wanted Julie F to facilitate this as this is a stakeholder issue and John asked if we should modify this or decide now.  Jose suggested to work out details over email.   Send feedback to Julie Farrar and John Barry via email.


Recommendation Matrix:

The matrix was emailed out and put together by Bonnie Silva with suggestions and responses she has made some changes.  We also have the survey results which align somewhat with grid.  Linda took info from Josh and put them in order of priorities off of the survey and put them in order 1-18 for policies and 1-9 on data collection.  (Attach to minutes)  Sarah Roberts thanked Josh and Linda for working on this and said this is the right direction. 


Julie also thanked people for taking the time to fill out the survey.  Linda also said she has the matrix on one piece of paper she had that and handed it out.   (Attached to minutes)


They decided to go through the prioritized issues and bucket them into each group (Admin, Transparency, and Law).   There was discussion about process for prioritizing between the survey and matrix.    Julie Farrar said that the survey was put together by Julie Reiskin, CCDC, and was put together with people being able to rank issues and identify what is important to keep CDASS strong.   Jose said that the email was sent over several weeks and the departmet also sent an email to help get the word out.  About 100 people completely responded.


Implementing CDASS per HB 1243 in all waivers is overarching goals


Top priorities from survey included:


How to reinstitute FAS in cost neutral matter, Julie explained what FAS was –during the pilot if there was money left at end of year half went back to state and half could be used to cover something that was not covered by the state but that would help independence. 


Enhance education for authorized representatives ??? Enhanced training is already in process. 


Work to obtain health insurance for CDASS employees (COMMENT that this is state agency work)

Some important items not in survey included the need to develop help desk guide.  This also is something HCPF needs to decide if they want to do. 


Josh said he did not realize until recently that the rules say personal care can only be provided in the home, that is in direct violation of everything that CDASS stands for and this has to be addressed.  Sarah said this will be fixed and she hired a temp to do extensive research on personal care and personal assistance and that will be fixed. 


Discussion of how to take the issues and assign to groups:   Will we use the same three subcommittees, add some or totally redo the subcommittee issue?

Julie said we may need to reframe the way we think about the subcommittees.


Bonnie will need to resign from the Law Subcommittee because she now works partially for HCPF.   Josh said more or different groups may be needed.  Sarah then said we need to figure out when they are meeting so she can have staff members who can come and provide technical support.   Staff can be involved if the groups all do not meet at the same time.  Julie F. recommended that Lori Thompson be the law subcommittee co chair.  Bonnie will stay involved.  Sarah said discussions should be by consumers and state staff should be there to provide support and advice and they should not be co chairs.    Phil will talk to Jennifer Martinez of Jeffco SEP so there will be a SEP co chair for each.


The group agreed to forgo public comment time to finish the bucket list.


Issues were put into four buckets:


  1. Norms and task sheet  (is allocation adjustment different from the task sheet).   Task sheet drives the allocation.   Discussion about if we should include allocation and we decided yes allocation is part of this whether new or changed.
  2. Book of Business and protocols - Benefit definition (protective oversight and extraordinary care—goes to LAW subcommittee
  3. Emergencies, hospitalization and acute care, this will include high needs and transition
  4. AR roles and issues 


Julie said high needs, respite and transition to and from acute care overlap in many ways and may allow for creativity and can suggested bucketing in unforeseen circumstances and Phil said that items to emergencies would fit there. 


Marguerite asked if there was guideline for ability to manage care?  John said this is something that should be addressed in these issues, meaning NO but one should exist. 


Linda was confused during discussion about task sheet, are we talking about what is done for ASMP or norms task sheet.  Answer is Norms task sheet and that should be renamed to be clear. 

As we redefine the tasks that will drive what the workgroups will become. 


HCPF staff will bring all manuals and data they have to the relevant work groups.


There was a discussion about where the training committee fits in and Linda A said that was about the curriculum and these issues are more focused on client needs and require client input.   Phil said that we could use some of the same members.  


Julie F said we did not need to use the old subgroups, we can do new ones. 

Linda said SEP input is important.

Bonnie said we should not do a training workgroup because the policy has to be decided first then training comes out of that. 


Suggestion –there are three existing groups and four buckets, we can take the existing three groups and form one more and assign each with a bucket and then have them prioritize and bring it back. 


There was discussion about getting some additional people involved these groups –it takes a lot longer to operationally and Sarah want to be able to get these in the queue.    Existing groups are working so we should not change that:


Task sheet, high needs, etc—administration

Book of Business and AR are under law

Transparency should take on data issues


Bonnie can take items and put in to buckets but does not want to put them into groups as stakeholders should do that.   John said that once Bonnie does that he and Chanda will convene a meeting of co-chairs and divvy up the work.   If there are not enough people we will help get people assigned.   All items go into the four buckets will be fit into the three groups.   People did not want to wait till next month to get moving on it.  Subgroups will be meeting before the next large meeting.  

Sarah said she will be out until July 16th but someone in Department needs to know immediately so they can assign resources and get packets and technical stuff together.  Phil will convene department staff and John will help.  The co chairs will determine in a call which items each will do.  This will be reported about in the next meeting as to how this worked. 


Sarah said she was pleased with progress and did not want to belabor it month to month

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