Quick recap

The meeting began with casual discussions about media appearances and payment issues related to HHSC billing through Be Well, with the team exploring potential solutions for erratic payment registrations. The group then discussed upcoming conferences and events, including collaboration opportunities and concerns about Region 3's TRA, TRF, TRY conference call. The latter part of the meeting focused on funding allocations, public records requests, and service delivery challenges, with the team expressing concerns about inadequate funding and the need to advocate for rate increases and sustainable service arrangements.

Next steps

• Noelle: Find out who is over QM at HHSC leadership

• Deirdre: Put Melissa Cade in touch with Sean to share QM audit tools

• Heather: Send final LAR submission to Noelle after meeting with lobbyist today

• Noelle: Send out email today with LAR submission guidelines and ASAP's template for public comment

• Noelle: Submit regulatory reform feedback with TF rule change comments by December 2nd

• Noelle: Send out email today with member portal instructions and rule change worksheet

• Doug: Send list of contract awards to Noelle to distribute to everyone

• Noelle: Distribute contract awards list to all members

• Noelle: Try to do side-by-side comparison analysis of previous funding versus current funding

• Heather: Discuss women and children's funding escalation with Noelle offline

• Doug: Start getting on leadership calls with Noelle and Dr. Laguna

  
  

Summary

HHSC Payment Discrepancy Discussion

The meeting began with casual greetings and a brief discussion about Doug's upcoming appearance on Channel 11 in Fort Worth to promote outreach services in Dallas and Fort Worth. Doug mentioned receiving a grant to provide services across the two cities. The main topic of the meeting was an issue with erratic payments from HHSC, possibly through Be Well, where some payments were registering as zero dollars without apparent billing errors. Doug asked if others had experienced this issue and if anyone had found a resolution.

Payment Processing and System Updates

The team discussed payment issues, with Doug confirming that contracts and fiscal year payments were being processed, though Heather noted they only receive reimbursement grants from HHS without treatment dollars. Noelle reported that Dr. Laguna was investigating a system glitch affecting Be Well billing, while Carrie shared positive news about CCMS implementation at their residential facility, which had received its first payment. The team also briefly discussed the upcoming winter event in San Antonio and the recent ASAP Annual Conference Lone Star Awards.

Conference Planning and Region Concerns

The team discussed plans for upcoming conferences, including a potential collaboration at the Texas conference in early March. Noelle is working on presenter materials and considering sharing a table with others, while Doug suggested coordinating multiple representatives to maximize space. Deirdre raised concerns about Region 3's TRA, TRF, TRY conference call, noting that some team members were not included despite being affected by billing restrictions through NIPAA. The discussion concluded with Deirdre mentioning a disagreement about using HHSC's audit tool during QM audits, though this point was not fully resolved.

QM Tool Partnership Discussion

Deirdre discussed issues with obtaining a QM report tool from HHSC, where she encountered resistance from Marie who insisted they create their own tool despite having a long-standing partnership. Melissa Cade shared that she had created a modified version of the HHSC QM tool for Homeward Bound, and Deirdre offered to connect Melissa with Sean to share and potentially update their tools. Noelle announced that both she and Heather's teams would be submitting LARs by November 24th, and requested that Heather share their draft for review. Noelle also informed the group about the opportunity to submit public comments regarding HHSC's legislative appropriations request, which could potentially lead to rate increases across the board, with comments due the following week.

SUD Funding and Public Records

The group discussed public records requests related to SUD funding, with Jennifer explaining that such requests are routine and should not be seen as threatening. Noelle clarified that the previous concern about the way a request was presented to HHSC was due to its perceived aggressive tone rather than the request itself being problematic. Jennifer and Doug reviewed the distribution of SUD funding, noting that some awards went to LLCs and other non-traditional organizations, and Doug identified that Denton County MHMR received over $2 million in SUD funds along with a CCMS contract, though they lack residential services.

Contract Funding and Resource Allocation

Deirdre discussed a contract request from an organization that had received awards, noting that they were now willing to pay for services, which she found unusual given that they typically use state funding. She expressed concerns about the allocation of CCMS dollars, which are tied to residential treatment and create a disservice by stopping case management upon discharge. Doug and SWagnon shared experiences about the allocation of funds and the closure of facilities due to these decisions. Noelle announced upcoming events, including a Rider 57 rate hearing, a regulatory reform meeting, and a DC trip, and mentioned the launch of a member portal on the website.

CMBHS Audit and Funding Concerns

The group discussed ongoing audits by OIG of CMBHS as part of the Sunset review, with Noelle seeking feedback from members. Heather raised concerns about funding for women and children's programs, revealing that funding was not remaining flat across the state as initially promised, and an open records request was being pursued. Vaughan highlighted issues with detox beds in Region 6, noting a lack of available beds and questioning the basis for regional funding allocations. The discussion also touched on HHSC's strategic initiatives, with Noelle expressing uncertainty about their future plans for mental health and substance use funding.

Provider Funding Allocation Review

The team discussed a records request for provider awards and funding details, with Noelle sharing a list of providers in the group chat. They noted that while the awards show combined TRA, TRF, and other funding categories, it's unclear how the funds were allocated between service types like detox and residential care. Deirdre mentioned Denton County MHMR received $2.7 million in funding but doesn't have a residential facility, prompting questions about their service requirements. The team agreed to analyze previously funded versus current funding and consider reaching out to Eric for insights about Denton and Collin Counties' service arrangements.

Funding Challenges in Service Delivery

The group discussed concerns about funding and service delivery, with Jennifer highlighting how inadequate funding leads to subcontracting and reduced service dollars. Doug suggested including these points in their response to the Sunset Commission, noting that their HIV statewide program funding had been cut to 25% of the original amount. The team agreed to submit comments on the LAR regarding unsustainable rates for residential services and discussed the need to speak up about funding issues, despite being seen as pesky providers. Noelle mentioned she would work on analyzing previous funding data and continue raising these issues in future leadership calls.