illinois regional integrated behavioral health network region reports

Illinois Regional Integrated

Behavioral Health Network

Region Reports

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Region 1

Draft Report

2

Table of Contents

Topics Page #

Region 1 Plan Introduction 3

Background 4

Key Priorities 5

Unique Characteristics and Needs of Region 1:

The Chicago Metropolitan Area 6

Recommendations of Region 1 Stakeholders 6

Innovative Suggestions 9

Measures of Success 10

Conclusion 11

Meetings Letter of Invitation 12

Agenda October 5 13

Minutes October 5 14

Small Group Responses October 5 16

Agenda October 31 22

Minutes October 31 23

Small Group Responses October 31 26

Agenda November 14 29

Minutes November 14 30 Appendices PA 97-0381 32

Institute of Medicine’s Six Aims of Healthcare Quality 36

Questionnaire 37

Region 1 Participation List 39

Psychiatric & Licensed Staffed Beds 41

Statewide & Behavioral Health Primary

Diagnoses Discharges 44

State Operated Hospitals Inpatient Discharges 45

ILHFB Bed Totals 46

Hospital Statistics 47

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Illinois Regional Behavioral Health Networks

For hospital, primary care, mental health, substance abuse,

and other community-based providers.

Note: The content of this report does not reflect the opinion or position of the Illinois Hospital

Association.

Region 1 Introduction

The Region 1 planning process began and likely will continue during a time of paradox.

Seemingly intractable challenges have been balanced by great opportunities that are unfolding

daily. Consumers, parents, and providers alike have been discouraged by tough times and bad

news. Yet, our understanding of behavioral health and substance abuse issues has never been

greater, and our willingness to think creatively and collaboratively about new models of care is

refreshing and profound.

As we enter 2013, health reform is a reality. Among the many positive opportunities presented

by national health reform legislation is the recognition that mental health and substance abuse

issues should be treated like any other illnesses. We must view persons holistically. This

legislation affirmed what we already knew and provided the structure and incentives to

significantly transform health care. It will integrate general health care with behavioral health

care; it will reward positive performance and outcomes; and it will encourage collaboration

across existing provider entities. These opportunities are presented to us at time in which the

mental health and substance abuse services systems are broken.

In 2012, the behavioral health system in Illinois is inadequate to meet the needs of persons with

mental health and substance abuse issues. It is underfunded, fragmented, inaccessible in some

locales, and inconsistent in nature, scope and quality. It is not a system. Rather, it is an amalgam

of loosely organized services. Our state’s fiscal crisis has translated into facility closures,

program reductions and waiting lists. A person with a mental health illness is more likely to

receive services in a jail than in a psychiatric facility; more likely to seek treatment in an

emergency department, in crisis, than to obtain treatment in a less-intensive setting. A person

with a substance abuse illness, in numbers disproportionate to the rest of the population, is

homeless, waiting for one of the few residential treatment slots. Those with a criminal

background do not have many housing options.

Despite a legitimate concern by participants that this planning process will be one more exercise

in futility, close to 100 consumers, parents, providers, agency staff, and advocates gathered on

three occasions to articulate a vision for a system in which every person, regardless of his or her

diagnosis, will receive the right treatment, at the right time, in the right place. Every person will

have access to safe, high quality, effective, efficient, timely, and respectful care. Every person

will have the opportunity to be well, to experience health, to have a life of meaning however he

or she defines it.

“Pie in the sky” dreams? Perhaps. However, is it unrealistic to organize, manage, and finance a

behavioral health care system that works? The participants developing the Region 1 Regional

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Integrated Behavioral Health Network think it is not only possible, they are ready to achieve it.

Following is a compilation of their ideas and recommendations.

Background

On August 15, 2011, Governor Pat Quinn signed into law House Bill 2982 as Public Act 97-

0381, which creates the Regional Integrated Behavioral Health Networks Act. The act provides

a platform to establish Regional Integrated Behavioral Health Networks. Its purpose is to ensure

and improve access to appropriate mental health and substance abuse services throughout Illinois

by: organizing systematically all relevant health, mental health, substance abuse, and other

community resources among regional providers; developing a mechanism to use regional

resources efficiently and effectively; and serving as a catalyst for innovation and collaboration.

Under the act, each Behavioral Health Regional Network is required to develop a strategic plan

for its respective region that addresses the inventory of existing services, identifies community

needs, and defines opportunities to improve access to care. The act contemplates a broad-cross

section of the mental health, substance abuse, general health, and social services community that

will be involved in the development and implementation of the plan. Collaboration among all of

the relevant community resources will be essential to accomplish the purposes of the act, and to

build effective, coordinated and comprehensive systems of care.

In partnership with the Illinois Department of Human Services (DHS), Division of Mental Health

(DMH) and Division of Alcoholism and Substance Abuse (DASA), the Illinois Hospital

Association (IHA) and others convened a group of behavioral health providers in the state’s DHS

Region 1 to begin to identify existing services in the region; strategies for improving the

behavioral health services delivery system, including timely and appropriate access to medical as

well as behavioral health services; and ways in which providers can begin working together to

improve not only access to services but importantly, patient outcomes.

This plan outlines the priorities and recommendations for DHS Region 1, articulated by

participating service providers in three Region 1 meetings. At the first meeting held at the State

of Illinois Center, in Chicago, on October 12, participants defined their vision for behavioral

health care services in the future, identified short- term system needs and measures of success.

During the second meeting, held on October 31, participants identified priorities among their

recommendations. In the third meeting on November 14, the group reviewed and provided input

on the first draft of a regional plan. They also provided additional feedback on data sources and

trends they have experienced over the past 12 months.

This plan is a template that recognizes the shortcomings and inefficiencies of the present system,

but also embraces partnerships that promise better coordination of care, across primary medical

and behavioral care, using technology and research to improve outcomes. It is an interactive

process and one that will evolve with a changing health care and economic landscape. It will

depend on the continued commitment of all stakeholders—state agencies, primary medical,

hospitals, human and social service, and behavioral health providers. It builds on community

strengths to achieve a system of care that delivers the right care, at the right time, in the right

place. It is the first of many steps.

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Key Priorities

There should be no wrong door into the system of care for any person, whether a person

enters the general medical door or the psychiatric or substance abuse door.

The system should be coordinated and integrated and include a continuum of care—from

prevention to acute to outpatient to rehabilitative to housing. Clinical protocols, legal and

regulatory policies and requirements, and infrastructure such as financing, information

technology, billing and records, should be designed to support the seamless movement of

an individual—regardless of his or her diagnosis—to the appropriate level of care.

Make the system easy to understand and to navigate for patients/consumers and

providers. Remove redundant processes, simplify billing and reporting, and standardize

administrative requirements, when possible, while allowing flexibility, when necessary.

Establish a system of care that is designed and financed to achieve good outcomes.

Remove incentives to use more expensive levels of care than are necessary.

Appropriately finance the level of acuity and intensity of care necessary to support

treatment and recovery. Remove financing silos that make it difficult for collaboration

and that force patients/consumers into narrowly defined categories that don’t meet their

complex needs.

Develop models for crisis and emergency services that more effectively treat mental

health and substance abuse illnesses in these settings.

Demand the use of evidence-based/ informed practices that reflect scientific knowledge

and research. Demand a commitment to continuous learning and performance consistent

with evidence-based/informed standards. Accept nothing less than the best. Be willing to

pay for the best.

Educate and train the health and behavioral health workforces to practice in an integrated

environment in which patients are treated holistically. Begin with schools and

universities; include medical residencies and traditional health professions such as

nursing; include persons who interact with children and adults in their natural settings

such as teachers or pastors.

Demonstrate to our elected leaders how they can support an effective, efficient,

accountable, high quality, accessible, culturally competent, recovery-oriented system of

care.

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Unique Characteristics and Needs of Region 1: The Chicago Metropolitan Area

Region 1 encompasses the Chicago metropolitan area. It represents a relatively small geographic

portion of Illinois but a majority of the state’s population. It is diverse: economically, socially,

culturally, racially, and religiously. Whereas rural Illinois regions have limited access defined by

geography, financial resources, and the availability of services and health care professionals, the

Chicago’s access challenges are more about financial, social-economic and cultural barriers.

And, they are about volume; more seek care than what is available. Moreover, for many

Chicagoans, English is their second language. Some are not citizens and are unable to reach out

for services. Some hold cultural and religious beliefs that stigmatize addiction or mental health

illness.

Chicago children are growing up in some neighborhoods where friends and relatives are lost due

to gang violence. Lack of jobs and high drop-out rates contribute to cycles of poverty and unrest.

Crime is an unfortunate, but not unexpected, side-effect of these factors. Chicago-area substance

abuse, community mental health, social service providers and hospitals are operating within this

tumultuous environment as well.

Recommendations of Region 1 Stakeholders

Delivery System Innovation to Improve Access

There was consensus that there is value in focusing on the whole person. Integrating and

coordinating care across systems, including medical and behavioral health, supports this

principle. Moreover, a holistic, person-centered system must consider and attend to a person’s

multi-dimensional needs, i.e., medical, rehabilitative, social, spiritual, housing, vocational and

educational. This holistic approach is necessary if we are going to support the wellness of

consumers/clients/patients. The centerpiece of an integrated system of care is that every door will

be the right door to enter the system.

Recommendations:

The “no wrong door” approach will require articulation of a single vision by all relevant

state agencies, organization of the system of care around consistent policies, financing

and payment rules, and performance objectives.

Specifically, it will require revisions to funding and administrative regulations, which

reflect and support preservation of care delivery silos.

Licensing rules will need to be revised to achieve a unified system.

A coherent system of care must also accommodate differences. Attention must be paid to

cultural and linguistic differences and needs of a culturally diverse population as that

found in the Chicago area.

Innovative models of care should be encouraged—support behavioral health homes;

support medical homes that co-locate behavioral health clinicians in primary care

settings.

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The integrated system of care must be designed so that everyone is on the same team—

the consumer/patient’s team. Teamwork must be rewarded. Every link must be

accountable to other members of the team and to the patient. For example, in an

integrated system, there cannot be a handoff to another level of care unless this level of

care is appropriate for the patient’s condition, is accessible and is available within an

appropriate timeframe.

Financing/Payment

Emerging delivery and payment constructs are anticipated, but there is little concrete

understanding of what it will mean for behavioral health providers. There is limited

understanding of the nature and scope of services that will be offered through the Illinois health

insurance exchange, what will be the scope of Medicaid benefits, benefits for persons who will

be insured under an “essential benefits package,” and who will remain uninsured and dependent

on the state for services. To this point, there is significant concern that persons who do not

qualify for Medicaid or Medicare, and have no insurance, are being left with too few options or

none at all. This group of persons has been disenfranchised by funding cuts in recent years. As a

consequence, they present in acute care settings or in our jails.

Recommendations:

The payment system must be flexible.

It must be adequate.

It must be timely.

It must reward the performance expected and desired.

Funding must be driven by clinical need not by eligibility for a funding category. It must

be designed to support persons who may not meet Medicaid eligibility but present with a

mental health or substance use illness and need treatment.

Providers are embarking on new models of care that will require them to assume risk.

They will need support that will vary according to their size, capitalization and expertise.

There is value in supporting the provider community’s ability to manage the care they

provide rather than have proprietary companies assume the risks and management.

Funding should be available for innovative models that represent collaboration across

general medical and behavioral care.

Eliminate the DHS contractor used to process bills. Use savings for services. Establish a

data-driven system as a replacement.

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Quality

The President’s New Freedom Commission on Mental Health recognized in its landmark report

that there is a disconnect between what we know scientifically about mental health illness and

what is practiced. The Institute of Medicine has observed that there is a lag in the behavioral

health community in adopting evidence-based practices. It also has found that the principles that

apply to general medical care also apply to behavioral health care—care must be safe, effective,

efficient, timely, patient-centered, and equitable.

Recommendations:

Scarce resources must be reallocated to address programs that work using evidence-

informed and-based practices. Use of evidence-based/informed practices must cross all

providers and all levels of care. We should be measuring outcomes and incentivize

programs that demonstrate good or improved outcomes.

Examples of evidence-based practices for inpatient care: reduction and elimination of the

use of restraint and seclusion; limiting use of multiple antipsychotics without clinical

justification; and good discharge planning.

Outpatient care evidence-based practices include ACT Teams, WRAP or recovery action

plans.

Workforce

There are service desserts in Illinois–places where there are no psychiatrists or mental health or

substance abuse professionals, and where there are no hospitals, or mental health centers or

substance abuse providers. In Chicago, the issue is not as much the absence of professionals as it

is access to the professional. It is not as much the absence of mental health centers as it is

waiting lists for services in mental health centers that have lost funding and the capacity to serve

all who present to them.

And, we are not training a sufficient number of psychiatrists to meet current and expected need.

The primary care physician is already treating a large number of persons with psychiatric

conditions, but primary care physicians are also in short supply. After implementation of the

Affordable Care Act in 2014, the models supported under that Act depend on a large number of

primary care physicians to support it. There are not and will not be enough PCPs to support it.

In addition to a shortage of physicians trained to treat mental illness and addictive disorders,

there also is a shortage of nurses that will grow as the needs of an aging population requires more

health care. Shortages exist for all mental health professionals.

The shortage of professionals specifically trained to serve persons with mental and substance use

disorders is an issue.

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Recommendations:

The shortage of psychiatrists to attend to the growing number of persons who need

evaluation and medication management could be addressed in part by expanding the use

or telemedicine/technology.

There should be a centralized server supported by the state to permit Chicago-area

psychiatrists to treat persons who otherwise may not have access to a psychiatrist.

State law must be reviewed to remove any barriers to the use of telemedicine. For

example, psychiatrists are not paid the same amount for a telepsychiatry service as a face-

to-face encounter. With protections in place, we may want to permit physicians licensed

in another state to provide psychiatric services to a patient in Illinois. Medicaid payment

should adequately reimburse providers at both the host and the receiving site.

Technology

Technology, specifically, the electronic health record, will be a necessary ingredient in the

integrated health system and will be necessary to accomplish the clinical goals of integration,

which include timely, accurate information about the patient’s care. Electronic billing, and

computerized systems that simplify the reporting and billing systems, also will be necessary to

reduce costs and support communication and service delivery across systems. Consumers should

have access to electronic clinical information as well.

Recommendations:

Use technology such as telemedicine to expand access, not only to rural areas but also to

patients/consumers who may have language barriers or hearing or other disabilities that

limit mobility.

Support adoption by the behavioral health community of the electronic medical record to

enable sharing of relevant clinical information about a patient/consumer across general

medical and behavioral health providers.

Establish a centralized telemedicine server that is secure. Provide local

connections/machines to providers in underserved areas.

Innovative Suggestions

There were a few innovative suggestions that can be implemented immediately or in the short

term. They include the following:

Provide a dedicated fund for acute care (defined as emergency crisis and/or inpatient

care) of persons who do not have public or private insurance. This could be similar to the

original Emergency Psychiatric Services (EPS) funds DMH administered in the past.

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These funds had been eliminated when CHIPs was originally established, but there is not

a dedicated line item for EPS funds that are available statewide.

Establish a central data base of information about services available and their capacity.

Provide a mechanism (electronic) to ensure the information on the database is timely and

providers can easily access information when attempting to find a service for a

client/consumer/patient. Something akin to a LinkedIn page may work for this purpose. A

regional newsletter or page may also work.

Provide cross training to clinicians in health and behavioral health disciplines to support

communication across systems, identification of symptoms and timely intervention.

Measures of Success

Region 1 participants also identified measures of success for the system they were

recommending. They include the following:

Fewer presentations by persons with mental health and substance use illness in hospital

emergency departments, which would reflect an improvement of access to community

services, psychiatrists, or primary care.

Fewer admissions to a level of care that is more acute than needed, e.g. inpatient care, or

inappropriate, for patient/consumer needs, e.g. nursing homes.

Fewer readmissions to hospitals when a lower level of care would appropriately meet

patient needs, if available.

System can be accessed by any person through any door, i.e., primary care, mental health,

substance abuse, are all doors to a comprehensive, coordinated system.

The system is not organized around funding streams, but is available to every person,

regardless of funding source.

And, this “system” has consistent and rational administrative requirements (regulations)

across all provider groups, including medical and behavioral health; electronic medical

records that are accessible to all care givers; professionals in each system are trained to

recognize symptoms of health or behavioral health issues; the education system provides

cross training.

Fewer persons waiting for mental health and substance abuse services. Shorter waits for

these services when there is a list with the ultimate goal of no waiting lists.

New delivery models integrate primary and behavioral care, incorporate evidence-based

practices, measure and reward improved patient/consumer outcomes, involve provider

collaboration appropriate for the community they serve.

There will be fewer persons with either a mental or substance use condition in jail or

prison.

There will be less homeless persons with mental health or substance use conditions.

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Conclusion

These recommendations reflect the expertise and experience of clinicians and consumers of

mental health and/or substance abuse services. They reflect their concerns that the behavioral

health system in Illinois is fragile to the point of breaking. These recommendations must now be

translated into an action plan that includes measurable objectives. Some of the recommendations

will require legislation, some regulatory changes, some additional funding, and some flexible

thinking. All of these recommendations will require the collective leadership of everyone—from

the state’s leaders to every provider to every person who interacts with the health and behavioral

health systems.

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August 20, 2012

Name

Title

Organization

Address

City, State Zip

Dear:

Persons with mental and substance use illnesses in Illinois must navigate a complex amalgam of services

that are inconsistently available and accessible. Many seek care in crisis because they cannot obtain

timelier, appropriate care. Our state and federal fiscal crises have translated into the loss of essential

behavioral health services throughout the state, but particularly in rural Illinois. Yet, despite these

challenging circumstances, we can also identify opportunities to improve care. Some of these

opportunities stem from health reform; others are being generated by our own strategies to serve our

patients and communities. One such opportunity is being presented to us by the enactment of House Bill

2982 – Public Act 97-0381, which creates the Regional Integrated Behavioral Health Networks Act.

The purpose of the Regional Integrated Behavioral Health Networks Act is to ensure and improve access

to appropriate, high quality mental health and substance abuse services throughout Illinois. Recognizing

regional characteristics, the Act provides a platform to systematically organize all relevant health, mental

health, substance abuse, and other community resources among regional providers. And, it provides a

mechanism through which providers may integrate behavioral and other health care. To use resources

wisely, it defines each region to be consistent with existing Department of Human Services regions.

Under the Act, each respective Behavioral Health Regional Network must develop a strategic plan that

addresses the inventory of existing services, identifies community needs and defines opportunities to

improve access to care. The Act contemplates a broad-cross section of the mental health, substance abuse,

health, and social services community will be involved in the development –and implementation—of the

plan. Collaboration among all of the relevant community resources will be essential to accomplish the

purposes of the Act and to build effective, coordinated and comprehensive systems of care.

We would like to invite you to participate in the first Behavioral Health Regional Network meeting for

DHS Region 1. The meeting will take place Friday, October 5, 2012 at the Michael Bilandic Building,

5th

Floor, Room C-500 at 160 N. LaSalle, Chicago, IL. The meeting will take place from 9:00 am to

12:00 Noon.

If you have any questions or concerns, please contact: MaryLynn Clarke at 217-541-1154 or

[email protected] or Dan Wasmer at 773-908-6267 or [email protected].

To confirm your attendance, please contact Stacey Dunlap at 217-541-1152 or email your response to

[email protected].

Thank you,

MaryLynn McGuire Clarke

Sr. Director, Health Policy & Regulation Illinois Hospital Association

Dan Wasmer Associate Director Region Services Illinois Department of Human Services, DMH

mailto:[email protected]



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Illinois Behavioral Health Network Meeting – Region 1

October 5, 2012, 9:00 am – 12:00 pm

Michael Bilandic Building

160 N. LaSalle

5th

Floor, Room C-500

Chicago, IL

Agenda

I. WELCOME.......9:00 am................Dan Wasmer, Associate Director Region Services,

DHS Division of Mental Health &

Rick Nance, Administration Bureau of Program Management,

DHS Division of Alcoholism and Substance Abuse

II. OVERVIEW OF INTEGRATED REGIONAL BEHAVIORAL HEALTH

NETWORKS ACT (HB 2982/PA 97-0381)........9:10 am................MaryLynn Clarke,

Senior Director, Illinois Hospital Association

III. DEVELOPING A PLAN FOR REGION 1…9:20 am............Maureen Slade, Director,

Stone Institute of Psychiatry, Northwestern Memorial Hospital

IV. REGIONAL PLAN DISCUSSION GROUPS…9:35 am ................................ Groups

A. Defining your vision for the behavioral health system in Illinois:

o What should the behavioral health system look like three years from now?

o What would be the key components of the new behavioral health system?

o Are there immediate actions that could be taken to improve access to

behavioral health services in this region? If so, what are they?

IV. SMALL GROUP REPORTS ...............................10:45 am............ Group Facilitators

V. SETTING PRIORITIES & NEXT STEPS .........11:45 am................. Maureen Slade

o Provider Questionnaire

VI. ADJOURNMENT & NEXT MEETING ............12:00 pm ................ Maureen Slade

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October 5, 2012, 9:00 am – 12:00 pm


160 N. LaSalle

5th Floor, Room C-500

Chicago, IL

Meeting Minutes

I. Welcome

Dan Wasmer, deputy director for regions, Department of Human Services, Division of

Mental Health (DMH) and Rick Nance, administrator, bureau of program management,

DHS Division of Alcoholism and substance Abuse (DASA) welcomed meeting

participants to the first Region 1 meeting, at 9:00 a.m. They described the purpose of the

meeting: to convene a broad cross- section of the health, social service, and behavioral

health communities in Region 1, to develop a plan for that region that reflects its unique

resources and needs. This Region meeting is one of five DHS Regions that have met to

develop plans for their areas, pursuant to legislation creating the Regional Integrated

Behavioral Health Networks Act, which became effective on January 1, 2012.

There were approximately 99 participants in the meeting. See attached list.

II. Overview of HB 2982 (PA 97-0381) - The Regional Integrated Behavioral Health

Networks Act

MaryLynn Clarke, senior director, Illinois Hospital Association, provided an overview of

the Regional Integrated Behavioral Health Networks Act (P.A. 97-0381), which requires

the Department of Human Services to facilitate the development of Regional Behavioral

Health Networks in each DHS region. The Act creates a platform for providers and

community interests to improve access to behavioral health services by identifying

resources as well as needs. The Act supports collaboration among providers, and it

supports integration of general health and behavioral health services. It contemplates new

delivery models that will develop under federal health reform legislation and state

initiatives. In addition to regional planning efforts, the legislation also created the

Regional Integrated Behavioral Health Networks Steering Committee, which must be

comprised of state agencies. This statewide steering committee must support the work of

the regional planning groups by providing technical expertise and coordinating efforts

among planning regions. The Regional Plans will be communicated to the Governor and

to the Illinois General Assembly annually.

III. Regional Plan Discussion Groups

Maureen Slade, director, Stone Institute of Psychiatry, Northwestern Memorial Hospital,

served as the facilitator for Region 1. She directed participants to divide into four groups,

each of which would address four questions related to their vision for the behavioral

health and health systems in Illinois:

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(1) What should the behavioral health system look like three years from now? (2) What

would be the key components of the new behavioral health system? (3) Are there

immediate actions that could be taken to improve access to behavioral health services in

this region? If so, what are they? (4) And, how is success defined? i.e., what are the

measures of success?

IV. Small Group Reports

The four groups reported on their findings. The information from the break-out groups is

included in the attached document.

V. Setting Priorities & Next Steps

The information collected at the meeting will be assembled by IHA. A focus on priorities

and developing specifics of the plan will be examined at the next meeting. A more

detailed summary of the meeting and a list of participants are attached.

VI. Adjournment & Next Meeting

Ms. Slade noted that the next meeting will be held Oct. 31 at 8:30 a.m. She adjourned the

meeting at 12:00 pm.

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Small Group Responses

Region 1 October 5, 2012

Question 1: What should the behavioral health system look like three years from now?

No wrong door for any person; one entry for mental health and substance abuse and

general health care patient

Access for all people, regardless of funding ability or source; do not disenfranchise

unfunded by eliminating funding for them

Serve the “whole” individual, necessitating revisions to current providers’ eligibility

criteria

Integration of and seamlessness across types and levels of care: substance abuse, mental

health and physical health

o An example would include a multi-specialty practice

o One Site or Virtual

o Seamless transitions child/adult/geriatric

Strong community-based system

o Staff – trained, professional, quality, adequate number of staff

o Housing – safe, affordable, accessible, partnership with CAEH

o Heightened awareness of resources; service connections in neighborhood of

choice

o Technology to connect linkages and slot availability

Single system – paperwork, EHRs, eligibility

Care coordination: proper “handoffs” from different provider systems

Define system’s continuum of care to include a range of providers

Shift focus to wellness and sustenance of recovery

Incentivize hospitals to be able to provide care to non-funded patients

Medical Detox, NMRO – lack of coordination of care for these folks or lack of money?

Prevention money

LOC – how do we get a patient in one “system” connected to other systems? Care

coordination?

Need to develop “community health workers”

“Prosumers” – don’t forget the value they bring – redefine this term to include

community health workers

Gaps in connecting to other systems, LOC, “step downs”, first responder EMS

Expand system providers to include CJs, schools, EMS, housing. Lessen the gap of

disparate systems.

Adequate transition; need for new laws

Identify all sources of funding such as counties and townships, private foundations;

coordinate all types of funders. Bring all to the same table

Longer range planning – state contracts for multi-years, rather than annual.

Money – timely payments, adequate rates, proper incentives, payment systems

recognizing outcomes, efficient processing (clear definitions) of claims.

Medicaid payment continues to be an issue

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Rates – need to be increased for Behavioral health, especially capacity grants, and

primary care

Regional HUD continuum decides what new requests/awards are submitted.

Collaborative decisions, Peer decisions.

Referral to EP MH without ER

o Direct referral to Cook County Mental Health Center

o Unfunded population

Common document/communication

Electronic record and referral

Redefine mindset of clinical professionals

Care Coordination Entities

o CCE’s

o Demonstration Projects

o Creation of Health Homes

Hub & Spokes

Care for Special population

o Children/Adolescent

o Language

o Geriatrics

Financial Support for Peer mentors and Rec. Support Specialty

More Providers with medical detox and treatment capability

More options for dually diagnosed

o Developmentally Disabled

Individualized and Holistic wrap around and funding to support this type of delivery

Birth to Death – Prenatal – special population

Evidence-based and informed

o Paid for outcome

o Assistance in implementation

Care coordinators

o Access to provider to understand MH + SA + DD

Cross training with provider & auxiliary settings, e.g., housing

Family support, treatment and involvement

Prevention

o Proactive vs. reactive

Access to care

o Lower threshold/non-acute

Med/MD education re: pharmacology – Protocol

o Include substance abuse and mental health in screenings in Primary Health

Payment incentive to do screening for MD

Education of Medical/Nurse/MD

o Univ./Med to educate

Tracking compliance of patient – quick re-entry

Protocol for ER services – pre acute admission/waiting

Team integration

Best practice models

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Housing

o Choice of where to live

o Social determinates of health – supportive services – housing nutrition,

employment

Adolescent

Integrated Data (EMRs, Criminal Health/BH)

Electronic Records – Funding to enhance technology

Trained workforce

Peer driven services

State system that works (responsive, billing system, streamline)

Multilingual, culturally appropriate/diverse systems

Supportive employment

Evidence-based practices (long term – ongoing – continuum of services)

Managed care – Aetna vs. Illini Care

Issues with authorizations

Health information exchange

Question 2: What would be the key components of the new behavioral health system?

Recognition of everyone’s level of expertise

Financial investment in outcomes

Community based care with proper supports is more fiscally sound. Adequate money for

each level of care

Appropriate “assignment” of care to appropriate provider type or level of care

What mechanism do we need to bring it all together?

Rethink multi-disciplinary teams to multi-provider type teams; reimbursement needs to

catch up with our patient’s needs.

Transportation

Home-based behavioral health care; providers go to the patient

Consumer choice, preference, involvement

Increase available choices, recognizing geographic disparities not by funder-defined

areas

Telehealth for specialty care (psych and PCS) so much more to do with technology

Open up availability for students, fellowship – increase scholarships

Multi-cultural, lingual providers lacking

Infrastructures...look at what funding does not pay for but need to run a business. Can

jobs for consumers help in this?

Stigma – wellness – the system currently forces people to fit into LOC

Increase screenings

Care Coordination; co-location to have staff (the right staff) available

Single claim submission (one clearinghouse)

Standardize rules, including MCO, reduce redundancy

Inter-disciplinary training

More options for treatment

19

o Spectrum

o More options for insured/not insured

More bilingual services

Early intervention and prevention

Funding Source (federal/state) to implement an effective integrated network – payer

system that works

Relationship between funding and outcomes

Wellness as a family systems approach not just “identified patient”

Creative re-allocation of state services/funding

Workforce development, training, universities

Psychiatry resources limited in some communities – telemedicine – physician/nurse

practitioners/psychologists

Physician numbers to handle Medicaid expansion are low; will require concerted

attention

“Community” oriented service models – Community Health Workers

Training of physicians on mental health issues

More Robust model of training for employment development

Behavioral Health Care homes (e.g. community mental health center)

Children/Adolescent services integrated – if primary issues are chronic mental illness

Consumer involvement – peer support – designed for specific population

Outreach/education of public around behavioral health

Creative Partnering between providers

o Care Coordination Entities

Family Unit Planning

Access to health information exchange

Increase Medicaid rate to at least national median

Streamline coordination of care – equal funding

Coordinate substance use treatment with mental health through contracting or other ways

Lack of Leadership – be able to coordinate with Department of Corrections and

corrections-related agencies

Leader of mental health & substance abuse should be a cabinet position

Money for Department of Corrections

Question 3: Are there immediate actions that could be taken to improve access to


Fund projects to measure success

Service package for Medicaid Rehab Option services needs total revamp

o Utilization criteria, more in pot

Resource (housing) availability for Suburbs and City

Legislation to more form with more expansion

IMD rule and how it affects hospitals

Develop stronger relationship between providers to foster care coordination

Archaic regulations need to be outlawed

Break state silos between DASA/DMH and HFS

20

Eliminate Medicaid 4 prescription limit

Strong media campaign on impact (of funding inadequacy on access)

Decide core more services to be funded

Telepsychiatry; telehealth

Prompt Payment for Services

Broaden unfunded requirements

o Eligibility criteria

o Wiser expenditures – not just acute

Integrating children and DCFS – start coordination

Redefine/change payment and systematic incentives

Develop resource network

o By region – call 1-800-Help

Break down barriers to agency partnerships – joint projects – meetings – leadership

Regional Newsletter

Linked in Group

Communicate with Associations, trade support, legislatures, move to use regional

network as political force

Break down barriers between agencies and hospitals

Terminate Value Options

Integrate Systems (MH, SA, DD, etc.)

Obtain data from HFS to assist in systems design and planning

Bridge Subsidy program expansion

EPSDT Expansion

Increase services for non-Medicaid population

BH providers in similar areas collaborate, share resources, cross-training

Re-open back of the yard clinic

Ensure communication (documentation) with primary care every time a patient is seen by

behavioral health

Add public mental health services (e.g. criminal justice)

Integrated Care Philosophy

o Psych Issues

o Substance Abuse

Case Manger to have access to all

Accountability to have people follow up for integration

Updated database

Funding flexibility

Fund several community based

Managed care entity to coordinate case management and medical necessity

Universal expectations – consistency

Administrative cost covered – regardless of changes

Flexible money

Comprehensive care – OB, ER, SA, Psych

Common list of services available to all regions

Reinstate emergency funds for unfunded people

21

Expand capacity for inpatient treatment

Increase standard rates

Increase alcohol tax to support/strengthen behavioral health success

Central server – accessmydoc.com – “Tele-Anything”

Affordable medications

Question 4: How do we measure success?

Decrease in homelessness

Improved participant experience; consumer and patient satisfaction

Lower number of hospital and other services readmissions, fewer number of inpatient

bed days (of patients who could be treated in another setting appropriate for his or her

needs)

Fewer ED presentations; shorter wait times in ED

Increased Access to appropriate level of care; no or shorter wait lists

More Prosumer (CRSS) involvement

Improved population and individual health outcomes

Lower Number of behavioral health consumers in jails and corrections; and fewer

persons with mental illness in IMD nursing homes.

24-7 Access to Care (non-acute, integrated med/BH/SA-Med Rec. individualized service

net program, seamless client)

Non-acute based

Individualized – access, service delivery

Quick re-entry from acute

Seamless/portable medical record

Reasonable, consistent, timely payment

co-efficient – wise spending

“Group ownership” of clients – multidisciplinary

SMIs don’t die 25 years younger than general population

Reduction in cost of state operated facilities

Reduced wait times/improved access to appropriate level of care

A single state-wide vision/plan for behavioral healthcare

Service delivery that results in cost containment

Reduction of stigma/improved understanding acceptance of mental health

Integration of trade organizations

22

Behavioral Health Regional Network Meetings – Region 1

October 31, 2012, 8:30am-11:00am


160 N. LaSalle

5th

Floor, Room C-500

Chicago, IL

Agenda

I. WELCOME...................................................8:30…...Dan Wasmer & Rick Nance

II. SUMMARY OF FIRST MEETING...........8:35 ....................... MaryLynn Clarke

III. FOCUS ON PRIORITIES………………...8:45 ............................. Maureen Slade

Small Group Priority Setting

IV. SMALL GROUP REPORTS.....................10:00 ....................... Group Facilitators

V. PRIORITIES & NEXT STEPS ................10:45 ...................................... Ms. Slade

VI. ADJOURNMENT......................................11:00…......Mr. Wasmer & Mr. Nance

Next Meeting:

November 14, 2012

Webinar

23


October 31, 2012, 8:30 am – 11:00 pm


160 N. LaSalle

5th Floor, Room C-500

Chicago, IL

Meeting Minutes

I. Welcome

Dan Wasmer, DHS Division of Mental Health (DMH) and Rick Nance, DHS Division of

Alcoholism and Substance Abuse (DASA), welcomed participants to the second planning

meeting of Region 1 stakeholders.

II. Summary of First Meeting

MaryLynn Clarke, IHA, provided a summary of the first meeting, during which participants

articulated their vision for the health and behavioral health systems of care. These vision

statements were defined in terms of a three year time frame and included the components of

the system. Participants also identified short term, immediate needs of the mental health and

substance abuse systems of care. And, they articulated measures of success: how they would

know when they achieved their goals and vision. A summary of these recommendations was

shared with the group.

III. Focus on Priorities

Maureen Slade, Northwestern Memorial Hospital and facilitator of the meeting, asked

participants to reconvene in the same groups in which they had convened at the October 12

meeting. Each group was directed to prioritize their recommendations in to their top ten.


The four groups reported on their prioritized recommendations. These are attached to these

minutes and made a part thereof. In addition, the group as a whole engaged in a discussion of

themes that crossed all of the groups’ priorities. Among them are the following:

Provide the services the patient/consumer needs, i.e., patient-centered services.

To improve access, blend funding and eliminate silos.

Develop a user-friendly payment system, including billing, processes for submission,

methodology.

Involve more consumers in the system of care.

Provide services across the lifespan, and include the entire continuum from prevention to

acute to wrap around services.

24

Develop an information system that works: integrates patient records across settings,

respects patient rights, permits providers to talk to each other about relevant things, is

timely, accessible.

Adopt a public health model that is less medical and more recovery focused.

Failures in access to a system of care that meets patient needs by providing care in the

most appropriate level of care for the patient’s condition shifts the locus of care to the

criminal justice system. Our jails and prisons are the largest mental health facilities in

Illinois.

Shift from an emergency access dominated system.

Focus on outcomes.

Develop workforce to meet needs of emerging integrated system of care. push the

boundaries of what disciplines can do; encourage professionals to practice to the full scope

of their licenses; train workers who are able to work in multidisciplinary settings,

including behavioral health and medical care.

Empower front line staff: pay them adequately.

Dan Wasmer described the Division of Mental Health’s Strategic Planning Task Force, which

has been meeting pursuant to legislation also requiring the development of a plan for mental

health services that will be submitted to the governor and the General Assembly. This

legislation is HB 2084. The five Region Plans, including that of Region 1, will be reported to

a Statewide Steering Committee that will serve as the statewide steering committee for both

legislative enactments. There is a meeting tentatively scheduled for November 29, in which a

representative of this Region will join representatives of the other regions to present their

recommendations to the Statewide Steering Committee. These reports will be incorporated

into a plan that is submitted to the governor and to the General Assembly in 2013.

Dan noted the value of the collaborative process such as that occurring in this planning work.

Rick Nance and Dan have agreed to combine meetings with substance abuse and mental

health regional providers. At the provider level, much can be done. We don’t have to wait to

work together. We are not without the ability to get things done. This legislation happened

because someone drafted a bill and got it passed. It may take additional bills to take this work

to another level. This planning effort permits everyone—at the state and provider level—to

get beyond the annual budget cycle and to think strategically.

The discussion concluded with an admonition to all participants by a father of a consumer and

his guest, the mayor of Lincolnwood, to translate the recommendations in the plan to tangible

goals that need funding. Then, find the funding. We need a champion. As a strategy, providers

and advocates should involve their local community leaders, who can be our champions at

home. They, in turn can introduce our needs to elected representatives. We should also

demonstrate ways in which these plans will save money by being more cost-effective,

reducing redundancies, getting the right person into the right milieu.

25


We will prepare a summary of our meeting and a draft plan. This will be shared with meeting

participants before the next meeting, November 14, during which we will comment on the

draft and finalize it.


Ms. Slade noted that the next meeting will be held Nov. 14 at 2:00 p.m. She adjourned the

meeting at 11:00 a.m.

26

Small Group Responses

Region 1 October 31, 2012

GROUP ONE:

Care

Holistic/Person centered

Coordinated/integrated

Eliminate barriers

o Language

o Special Needs – Child/Adolescent

Non-Acute Based – Full Spectrum

Prevention Wellness/Recovery

Easy Access – No wrong door

Family/Client Support System

Community?

Funding

Funding for Basic Needs – Housing and Transportation

Wrap Around Support – Non Medicaid Transportation

Improve Medicaid Rates

Timely Payments

Services for Un-funded

Pro-assessing efficient

Communication/Admin

Standardize Claim Process

Single System

Efficient Processing of claims

U-Mgmt. – Single Claims Submission

Provider Communication Integration

Standardize Set of Data

Electronic Health Record

GROUP TWO:

What about DHS Providers not DIV Contractors Open Door – No Wrong Door

Improve capacity to diagnose and treat

Service Deserts

o Psychiatrist

o Telemedicine

o APN & Clinical Psychologist

Technology to Improve Information Sharing across Silos (CJ/MH) Law Change?

Access to Outpatient Directly from ED or Acute Care (Inpatient)

Medications post ED or Inpatient

27

Rates

Flex Rules at provider level to ease silos impact

Repurpose money to target outcomes

CHIPS for ED overcrowding (Pay for what works)

Vocational and Housing needs to be streamed into BH approaches

Prepare for Health care Reform

Compress with Integrated Health & BH

Look at purchasing differently

Flexibility and provider/consumer level

o Blend from silos

o Across life span

Let providers “re-purpose” contract resources

Buy outcomes more than services or service packages. Such as:

o Stable housing

o Job

o School

o Etc.

GROUP THREE:

BH Homes/CCEs providing integrated/seamless care

Single Claim Submission

Access to Health Information Exchange

Break Down Silos

Prompt Payment

Increase Services for Non-Medicaid Population

Fewer ED Use

Lower # of BH Consumers in Jail; Fewer BH Consumers in IMDs

Reduced Wait Times/Improved Access to Appropriate Level of Care

GROUP FOUR:

Improve Medicaid Rate

Timely Payment

Single Claims System

Services for Unfunded

o Regardless of Ability to Pay/Fewer Restrictions

Eliminate Structure/System

o Silos in DHS & DOC – Cooperation in programs/services/deflection/discharges

from jail at all levels

Cooperation/Communication

o Between Providers/Electronic Medical Records – Development of Coalition,

Partnerships

Full Funding for Spectrum of Care, including:

o Prevention/Recovery/Support

28

Funding Medicaid Streams for breaking barriers to care:

o Transportation

o Housing

o Translation/language/cultural

Consumer, Family, Support System Involvement in Services, Feedback regarding

services and services development.

GROUP FIVE:

Better explanation of planning process and how this process fits.

Access for all people (especially un/under insured) – Inclusive of Rule 132/Rule 2060

Timely Payments and Adequate Rates

Strong Community Based System (Prevent inappropriate placement for services, i.e. jails,

prisons, ER)

Integrated systems including CRSS credentialed consumers, cook county waiver

Workforce development training university = meeting increased demands.

Prevention Money

Eliminate the 4 prescription Drug limit

Effective Integrated Network

o Electronic

o Documentation

o Claims

o Sharing information

o Consistency

o Telemedicine

o Telehealth

Care Coordination; proper hand off to next level of care (continuum of care from

prevention to reintegration)

A common vision for a spectrum of services from engagement to recovery for mental

health and substance abuse

Strong Media Campaign

Recommendation: Region 1 Manage this.

29


November 14, 2012, 2:00 pm - 3:30 pm

Webinar

Agenda

I. WELCOME..............................................2:00 ..…...Dan Wasmer & Rick Nance

II. SUMMARY OF SECOND MEETING.......2:10.........................MaryLynn Clarke

III. REVIEW OF PLAN/PRIORITIES………...2:30.............................Maureen Slade

IV. DISCUSSION..................................................2:45.......................................Everyone

V. NEXT STEPS .................................................3:15.......................................Ms. Slade

VI. ADJOURNMENT......................................3:30...............Mr. Wasmer & Mr. Nance

30


November 14, 2012, 2:00 pm – 3:30 pm

Webinar

Meeting Minutes

I. Welcome

Rick Nance, administrator, DHS/ DASA and Dan Wasmer, associate director, DHS/

DMH, welcomed participants to the third Region 1 meeting. They noted meeting

materials had been sent to them in advance of the meeting. These included a draft Region

1 Plan, which reflects many of their discussions during the first two meetings. They

explained that the purpose of this meeting was to review, comment upon, and contribute

to this Plan.

II. Review of Second Region 1 Meeting

MaryLynn Clarke, IHA, reviewed the second Region 1 meeting. She noted that, during

that meeting, participants resumed participation into small groups, and they prioritized

the recommendations they had made in the first meeting. A copy of these small group

prioritized recommendations had been provided to them in their meeting materials. She

indicated that the Region 1 Plan under discussion today incorporated these

recommendations.

III. Region 1 Plan Priorities

Maureen Slade, Region 1 facilitator and director, Stone Institute of Psychiatry,

Northwestern Memorial Hospital, opened the discussion about the Plan by presenting

priorities of the group. Mr. Nance then reviewed recommendations regarding delivery

system innovations; Mr. Wasmer reviewed financing and payment priorities and

challenges; Ms. Clarke presented workforce and with Ms. Slade quality

recommendations; Mr. Nance presented technology recommendations.

IV. Data

Ms. Clarke reviewed data that had been provided. These data included information about

the number of acute, inpatient hospital psychiatric beds in Region 1; the number of

hospital discharges for persons with behavioral health diagnoses for the years 2007-2012;

and state-operated hospital statistics. Data about community mental health centers and

substance abuse providers will be added to the Plan.

V. Discussion

Participants in the webinar were invited to ask questions or make suggestions. Among the

issues discussed was:

Emergency departments differ in their capacity to provide emergency services tailored to

persons with psychiatric disorders and as a consequence in the level of care they are

31

providing. Can we survey Chicago-area emergency departments about the psychiatric

care they are providing?

Will the current fee-for-service payment model for community services continue in a

managed care payment model? It appears that this is the direction in which payment is

moving.

It was recommended that DHS provide data from FY08 to the present documenting the

budgeted funds and reductions made in each of these years in order to demonstrate the

actual dollars lost to the system. We should also document the number of community

mental health centers and substance abuse programs that have closed.

Cross training of professionals in either and both the behavioral and general health care

sectors should occur.

There should be performance-based contracting.

A defining characteristic of Region 1 is the volume of persons who need behavioral

health services. The large numbers of persons in this urban environment who present for

treatment often experience waiting lists from over-burdened providers. Access is a

function of the capacity to serve the numbers of persons presenting for care.

We should add “prevention” to the continuum of care recommended in the plan. Include

various kinds of prevention activities that should be available. Funding for prevention

services has been reduced; yet it is so important.

Housing also must be included in the continuum of care. An evidence-based practice is

the combination of housing with mental health and substance abuse services.

Support the integration of FQHCs and CMHCs.

VI. Adjournment

The webinar concluded at 3:25 PM.

32

Appendix

Regional Integrated Behavioral Health Networks Act

Public Act 097-0381

An Act concerning health.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 1. Short title.

This Act may be cited as the Regional Integrated Behavioral Health Networks Act.

Section 5. Legislative Findings.

The General Assembly recognizes that an estimated 25% of Illinoisans aged 18 years or older

have experienced a mental or substance use disorder, an estimated 700,000 Illinois adults aged

18 years or older have a serious mental illness and an estimated 240,000 Illinois children and

adolescents have a serious emotional disturbance. And on any given day, many go without

treatment because it is not available or accessible. Recent federal and State fiscal crises have

exacerbated an already deteriorating mental health and substance abuse (behavioral health)

treatment system that is characterized by fragmentation, geographic disparities, inadequate

funding, psychiatric and other mental health workforce shortages, lack of transportation, and

overuse of acute and emergency care by persons in crisis who are unable to obtain treatment

from less intensive community alternatives. The failure to treat mental and substance use

illnesses has human and financial consequences: human suffering and loss of function; increased

use of hospital emergency departments; increased use of all medical services; increased

unemployment, and lack of productivity; lack of meaningful engagement in family and

communities; school failure; homelessness; incarceration; and, in some instances, death. The

citizens of Illinois with mental and substance use illnesses need an organized and integrated

system of care that recognizes regional differences and is able to deliver the right care to the

right person at the right time.

Section 10. Purpose.

The purpose of this Act is to require the Department of Human Services to facilitate the creation

of Regional Integrated Behavioral Health Networks (hereinafter "Networks") for the purpose of

ensuring and improving access to appropriate mental health and substance abuse (hereinafter

"behavioral health") services throughout Illinois by providing a platform for the organization of

all relevant health, mental health, substance abuse, and other community entities, and by

providing a mechanism to use and channel financial and other resources efficiently and

effectively. Networks may be located in each of the Department of Human Services geographic

regions.

Section 15. Goals.

Goals shall include, but not be limited to, the following: enabling persons with mental and

substance use illnesses to access clinically appropriate, evidence-based services, regardless of

where they reside in the State and particularly in rural areas; improving access to mental health

and substance abuse services throughout Illinois, but especially in rural Illinois communities, by

33

fostering innovative financing and collaboration among a variety of health, behavioral health,

social service, and other community entities and by supporting the development of regional-

specific planning and strategies; facilitating the integration of behavioral health services with

primary and other medical services, advancing opportunities under federal health reform

initiatives; ensuring actual or technologically-assisted access to the entire continuum of

integrated care, including the provision of services in the areas of prevention, consumer or

patient assessment and diagnosis, psychiatric care, case coordination, crisis and emergency care,

acute inpatient and outpatient treatment in private hospitals and from other community providers,

support services, and community residential settings; identifying funding for persons who do not

have insurance and do not qualify for State and federal healthcare payment programs such as

Medicaid or Medicare; and improving access to transportation in rural areas.

Section 20. Steering Committee and Networks.

(a) To achieve these goals, the Department of Human Services shall convene a Regional

Integrated Behavioral Health Networks Steering Committee (hereinafter "Steering Committee")

comprised of State agencies involved in the provision, regulation, or financing of health, mental

health, substance abuse, rehabilitation, and other services. These include, but shall not be limited

to, the following agencies:

(1) The Department of Healthcare and Family Services.

(2) The Department of Human Services and its Divisions of Mental Illness and

Alcoholism and Substance Abuse Services.

(3) The Department of Public Health, including its Center for Rural Health.

The Steering Committee shall include a representative from each Network. The agencies of the

Steering Committee are directed to work collaboratively to provide consultation, advice, and

leadership to the Networks in facilitating communication within and across multiple agencies

and in removing regulatory barriers that may prevent Networks from accomplishing the goals.

The Steering Committee collectively or through one of its member Agencies shall also provide

technical assistance to the Networks.

(b) There also shall be convened Networks in each of the Department of Human Services'

regions comprised of representatives of community stakeholders represented in the Network,

including when available, but not limited to, relevant trade and professional associations

representing hospitals, community providers, public health care, hospice care, long term care,

law enforcement, emergency medical service, physicians trained in psychiatry; an organization

that advocates on behalf of federally qualified health centers, an organization that advocates on

behalf of persons suffering with mental illness and substance abuse disorders, an organization

that advocates on behalf of persons with disabilities, an organization that advocates on behalf of

persons who live in rural areas, an organization that advocates on behalf of persons who live in

medically underserved areas; and others designated by the Steering Committee or the Networks.

A member from each Network may choose a representative who may serve on the Steering

Committee.

Section 25. Development of Network Plans.

Each Network shall develop a plan for its respective region that addresses the following:

34

(a) Inventory of all mental health and substance abuse treatment services, primary health

care facilities and services, private hospitals, State-operated psychiatric hospitals, long

term care facilities, social services, transportation services, and any services available to

serve persons with mental and substance use illnesses.

(b) Identification of unmet community needs, including, but not limited to, the following:

(1) Waiting lists in community mental health and substance abuse services.

(2) Hospital emergency department use by persons with mental and substance use

illnesses, including volume, length of stay, and challenges associated with

obtaining psychiatric assessment.

(3) Difficulty obtaining admission to inpatient facilities, and reasons therefore.

(4) Availability of primary care providers in the community, including Federally

Qualified Health Centers and Rural Health Centers.

(5) Availability of psychiatrists and mental health professionals.

(6) Transportation issues.

(7) Other.

(c) Identification of opportunities to improve access to mental and substance abuse

services through the integration of specialty behavioral health services with primary care,

including, but not limited to, the following:

(1) Availability of Federally Qualified Health Centers in community with mental

health staff.

(2) Development of accountable care organizations or other primary care entities.

(3) Availability of acute care hospitals with specialized psychiatric capacity.

(4) Community providers with an interest in collaborating with acute care

providers.

(d) Development of a plan to address community needs, including a specific timeline for

implementation of specific objectives and establishment of evaluation measures. The

comprehensive plan should include the complete continuum of behavioral health

services, including, but not limited to, the following:

(1) Prevention.

(2) Client assessment and diagnosis.

(3) An array of outpatient behavioral health services.

(4) Case coordination.

(5) Crisis and emergency services.

(6) Treatment, including inpatient psychiatric services in public and private

hospitals.

(7) Long term care facilities.

(8) Community residential alternatives to institutional settings.

(9) Primary care services.

Section 30. Timeline.

The Network plans shall be prepared within 6 months of establishment of the Network. The

Steering Committee shall assist the Networks in the development of plans by providing technical

expertise and in facilitating funding support and opportunities for the development of services

identified under each of the plans.

35

Section 35. Report to Governor and General Assembly.

The Steering Committee shall report to the Governor and General Assembly the status of each

regional plan, including the recommendations of the Network Councils to accomplish their

goals and improve access to behavioral health services. The report shall also contain

performance measures, including changes to the behavioral health services capacity in the

region; any waiting lists for community services; volume and wait times in hospital emergency

departments for access to behavioral health services; development of primary care-behavioral

health partnerships or barriers to their formation; and funding challenges and opportunities. This

report shall be submitted on an annual basis.

Section 99. Effective date.

This Act takes effect January 1, 2012.

HB2982 Enrolled LRB097 10532 KTG 51304 b

Public Act 097-0381

36

The Institute of Medicine’s Six Aims of Healthcare Quality:

1. Safe: Care should be as safe for patients in health care facilities as in their homes;

2. Effective: The science and evidence behind health care should be applied and serve as the

standard in the delivery of care;

3. Efficient: Care and service should be cost effective, and waste should be removed from

the system;

4. Timely: Patients should experience no waits or delays in receiving care and service;

5. Patient centered: The system of care should revolve around the patient, respect patient

preferences, and put the patient in control; and

6. Equitable: Unequal treatment should be a fact of the past; disparities in care should be

eradicated.

Recognizing that aims must be accompanied by observable metrics, the IOM defined sets of

measurements for each aim. For example:

Safe: Overall mortality rates or the percentage of patients receiving safe care;

Effective: How well evidenced-based practices are followed, such as the percentage of

time diabetic patients receive all recommended care at each visit;

Efficient: Analysis of the costs of care by patient, provider, organization, and community;

Timely: Waits and delays in receiving care, service, or results;

Patient centered: Patient and family satisfaction; and

Equitable: Differences in quality measures by race, gender, income, and other

population-based demographic and socioeconomic factors.

Institute of Medicine. (2006). “Improving the Quality of HealthCare for Mental and

Substance-Use Conditions”. Crossing the Quality Charm: Adaptation for Mental

Health and Addictive Disorders. A. Daniels, M.J. England, Ann Page, J.M. Corrigan.

(Eds.) Washington, DC: National Academy Press.

37

Regional Behavioral Health Network – Region 1

Provider Questionnaire

1. Wait Times

Over the past year, has your facility experienced longer wait times for patients to

receive services due to transportation, available placements, etc.? If so, what

primary factors contribute to the delays?

On a scale of 1-5 how big a problem are wait times for your facility? (1= very

important – 5 = not important at all) ______

Have you documented these delays?______ If so, what data do you have?

2. Security Concerns

Have you had to utilize security to maintain patients who are at your facility

waiting for a transfer? ______

On a scale of 1-5 how big a problem is security concerns related to delayed

transfers? (1 = very important, 5 = not important at all) ____ What data do you

have to document security issues? ______

If so, what data do you have?

3 Patient Volume

Have you seen an increase in the number of mentally ill and or substance abusing

patients being served at your facility in the past year?

On a scale of 1-5 how important is this issue to your facility?

What data do you have available to demonstrate these increases?

4. Transportation

Is transportation to appropriate care for unfunded patients a problem in your area?

On a scale of 1-5 how big a problem do you believe this is? ______

What data is available to document this problem?

5. Admissions

38

Over the past year have you had to admit more patients with mental illness or

substance abuse problems to non-behavior health units in your hospital because

you could not locate appropriate care elsewhere either inside or outside your

facility? _____

On a scale of 1-5 how big a problem do you believe this is? _______

What data do you have available to document this issue?

6. Please add any additional issues or trends experienced at your facility over the

past year and what data you have to document the issue.

7. Would you be interested in continuing to dialogue with other behavioral health

providers in your region through meetings, trainings, and workshops?

8. Would you be interested in working with other providers in the region on

common network issues such as transportation, regulatory barriers and other

system design issues? Please indicate which issues would be helpful to you.

9. Any other items (including data) you would like to share about this planning

process or materials that are related to this effort?

39

Region 1 Participation List

ACMHAI

Ada S. McKinley Community Services, Inc.

Adapt of Illinois

Advocate Christ Medical Center

Advocate Illinois Masonic Medical Center

Advocate South Suburban Hospital

Advocate Trinity Hospital

Aetna Better Health, Illinois

Alexian Brothers Behavioral Health

Hospital

Alexian Brothers Center for Mental Health

Alternatives, Inc

Asian Human Services, Inc.

Association for Individual Development

Association House of Chicago

Behavioral Services Center

Bremen Youth Services

Caritas

Cathedral Shelter of Chicago

Catholic Charities

Chicago Children's Center for Behavioral

Health Saints Mary & Elizabeth Medical

Center

Chicago Department of Public Health

Chicago Read Mental Health Center

Circle Family HealthCare Network

Claudia & Eddie's Place, NFP

Community Behavioral Healthcare

Association of IL

Community Counseling Centers of Chicago

Community Mental Health Board of Oak

Park Township

Confidential DUI Services

Cook County Adult Probation

Corporation for Supportive Housing

DePaul Family and Community Services

DHS - Elgin Mental Health Center

Doctors Council

Family Guidance Centers

Family Service & Mental Health Center of

Cicero

Gateway Foundation

Grand Prairie Services

Grow In Illinois

Guildhaus Halfway House For Men

Harbor Light Center of the Salvation Army

Hartgrove Hospital

Haymarket Center

Healthcare Alternative Systems

Heartland Health Outreach/Heartland

Alliance

Housing Options

HSI

Human Resources Development Institute,

Inc.

IJEGDA Community, Inc.

Illinois Department of Human Services,

DMH

Illinois Department of Human Services,

DASA

Illinois Dept. of Human Services, DMH

Illinois Health Connect

Illinois Hospital Association

Illinois Psychiatric Society

Ingalls Memorial Hospital

Iroquois Mental Health Center

Josselyn Center

Lester & Rosalie Anixter Center

Leyden Family Service

Leyden Family Service & The SHARE

Program

Loretto Hospital

Loyola Gottlieb Memorial Hospital

Lutheran Social Services of Illinois

Maine Center, Inc.

Mercy Hospital & Medical Center

Metro C & A

Metropolitan Family Services

Mount Sinai Hospital

NAMI of Illinois

NAMI South Suburbs of Chicago

Neumann Family Services

New Foundation Center, Inc.

NorthShore University HealthSystem at

Evanston Hospital

Northwestern Memorial Hospital

PEER Services

Pillars

40

Pilsen Wellness Center, Inc.

Polish American Association

Resurrection Behavioral Health

Rincon Family Services

Saint Bernard Hospital

Solleys' Place

Southwest Community Services, Inc.

Specialist Assistance Services, NFP

Sts. Mary & Elizabeth Medical Center

TASC, Inc.

The Helen Wheeler Center for Community

Mental Health

The Path - Recovery Living for Women

The Salvation Army Harbor Light Center

The South Suburban Council on Alcoholism

& Substance Abuse

The Women's Treatment Center

Thorek Memorial Hospital

Thresholds

Thrive Counseling Center

Trinity Services

Trinity United Church of Christ

Turning Point Behavioral Health Care

Center

University of Chicago

University of Illinois at Chicago

Will County Health Departments, Division

of BH Programs

41

Region 1 Acute Care Hospitals with

Psychiatric Beds

Hospital Name City

Psychiatric

Licensed Beds

Staffed Psych

Beds Oct 1, 2009

Adventist La Grange Mem Hosp La Grange 0 0

Advocate Christ Medical Center Oak Lawn 51 46

Advocate Illinois Masonic MC Chicago 39 35

Advocate Lutheran General Hosp Park Ridge 55 49

Advocate South Suburban Hosp Hazel Crest 0 0

Advocate Trinity Hospital Chicago 0 0

Alexian Brothers Behav Hlth Hsp Hoffman Estates 141 141

Alexian Brothers Medical Ctr Elk Grove Village 0 0

Chicago Lakeshore Hospital Chicago 146 108

Chicago-Read Mental Health Ctr Chicago Children's Memorial Hospital Chicago 18 12

Franciscan St James Hlth/Chi Ht Chicago Heights 0 0

Franciscan St James Hlth/Oly Fl Olympia Fields 0 0

Hartgrove Behavioral Health Sys Chicago 150 150

Holy Cross Hospital Chicago 0 0

Holy Family Medical Center Des Plaines 0 0

Ingalls Memorial Hospital Harvey 68 34

Jackson Park Hospital & Med Ctr Chicago 86 86

Jesse Brown VA Medical Center Chicago John H Stroger, Jr Hsp/Cook Cty Chicago 0 0

John J Madden Mental Hlth Ctr Hines Kindred Chicago Central Hosp Chicago 0 0

Kindred Chicago Lakeshore Chicago 0 Kindred Hosp Chicago Northlake Northlake 0 0

Kindred Hospital Chicago North Chicago 31 26

La Rabida Children's Hospital Chicago 0 0

Little Co of Mary Hosp & HCC Evergreen Park 24 24

Loretto Hospital Chicago 76 60

Loyola Gottlieb Memorial Hosp Melrose Park 12 12

Loyola University Med Center Maywood 0 0

MacNeal Hospital Berwyn 62 52

Maryville Scott Nolan Center Des Plaines 180 56

42

Mercy Hospital & Medical Center Chicago 39 39

Methodist Hospital of Chicago Chicago 52 62

MetroSouth Medical Center Blue Island 0 0

Mount Sinai Hospital Chicago 28 28

NorthShore U Evanston Hospital Evanston 21 17

NorthShore U Glenbrook Hospital Glenview 0 0

NorthShore U Skokie Hospital Skokie 0 26

Northwest Community Hospital Arlington Heights 32 32

Northwestern Memorial Hospital Chicago 29 36

Norwegian American Hospital Chicago 37 36

Our Lady of the Resurrection MC Chicago 0 0

Palos Community Hospital Palos Heights 43 38

Provident Hosp of Cook County Chicago 0 0

RML Chicago Chicago 0 0

RML Specialty Hospital Hinsdale 0 0

Rehab Institute of Chicago Chicago 0 0

Resurrection Medical Center Chicago 0 0

Riveredge Hospital Forest Park 210 210

Roseland Community Hospital Chicago 30 0

Rush Oak Park Hospital Oak Park 0 0

Rush University Medical Center Chicago 70 67

Sacred Heart Hospital Chicago 0 0

Saint Anthony Hospital Chicago 42 30

Saint Elizabeth Hospital Chicago 40 40

Saint Francis Hospital Evanston 0 0

Saint Joseph Hospital Chicago 35 34

Saint Mary of Nazareth Hospital Chicago 120 120

Schwab Rehabilitation Hospital Chicago 0 0

Shriners Hosps for Chld-Chicago Chicago 0 0

South Shore Hospital Chicago 15 0

St Alexius Medical Center Hoffman Estates 0 0

St Bernard Hosp & Hlth Care Ctr Chicago 40 40

Streamwood Behavioral Hlth Ctr Streamwood 162 162

Swedish Covenant Hospital Chicago 34 31

Thorek Memorial Hospital Chicago 20 20

Tinley Park Mental Health Ctr Tinley Park

43

Univ of Chicago Medical Center Chicago 0 0

University of IL Med Ctr Chicago 53 47

Veterans Affairs Hines Hospital Hines

Weiss Memorial Hospital Chicago 10 10

West Suburban Medical Center Oak Park 0 0

Westlake Hospital Melrose Park 33 30

Region Total: 2,334 2,046

Source: Licensed Beds-IDPH Addendum to Inventory of Health Care Facilities

Staffed Beds-IDPH Annual Hospital Questionnaire, 2009.

44

Inpatient Discharges Cumulative % Change

SFY

2005

SFY

2006

SFY

2007

SFY

2008

SFY

2009

SFY

2010

From SFY 2005 to SFY 2010

Statewide 1,723,215 1,714,661 1,724,116 1,715,750 1,677,926 1,651,967 -4.1%

Region 3 85,305 85,313 86,099 85,500 85,807 89,970 5.5%

Source: COMPdata

45

SOH Inpatient Inpatient Discharges

Peds

Adults

Total

REGION FACILITY

SFY

2007

SFY

2008

SFY

2009

SFY

2010

SFY

2007

SFY

2008

SFY

2009

SFY

2010

SFY

2007

SFY

2008

SFY

2009

SFY

2010

1C Madden MHC 0 0 0 0

4,242 4,151 3,654 3,674

4,242 4,151 3,654 3,674

1N Chic-Read MHC 0 0 0 0

1,913 1,788 1,848 1,829

1,913 1,788 1,848 1,829

1S Tinley Park MHC 0 0 0 0

1,721 1,473 1,784 1,823

1,721 1,473 1,784 1,823

Region 1 TOTAL 0 0 0 0

7,876 7,412 7,286 7,326

7,876 7,412 7,286 7,326

2 Elgin MHC 0 0 0 0 1,032 1,031 1,137 1,204 1,032 1,031 1,137 1,204

Singer MH/Dev Ctr 0 0 0 0 728 706 852 850 728 706 852 850

Treatment & Deten 0 0 0 0 4 9 9 6 4 9 9 6


1,764 1,746 1,998 2,060

1,764 1,746 1,998 2,060

4 McFarland MHC 22 13 13 16

696 728 623 717

718 741 636 733


696 728 623 717

718 741 636 733

5 Alton MH/Dev Ctr 0 0 0 0 197 198 191 188 197 198 191 188

Chester MHC 0 0 0 0 107 119 150 115 107 119 150 115

Choate MH and

Dev 78 84 60 65 460 400 364 233 538 484 424 298

Region 5 TOTAL 78 84 60 65 764 717 705 536 842 801 765 601

TOTAL

100 97 73 81

11,100 10,603 10,612 10,639

11,200 10,700 10,685 10,720

No State Operated Inpatient Facilities in Region 3.

Mental Health and Substance Abuse Cases.

Source: Illinois Department of Human Services

Illinois Statistics

Office of Mental Health and Development Disabilities

46

*The Illinois Health Facilities Planning Board discontinued licensing substance abuse beds as a category of service on April 17, 2000. this

category was converted to medical/surgical beds.

47

Hospital Statistics

DMH Hospital Statistics - FY 03 through FY 09

FY 03 FY 04 FY 05 FY 06 FY 07 FY 08 FY 09

Total Presentations (Civil

only)

10,472 10,759 11,233 11,657 11,654 10,812 10,504

Total Admissions (Civil &

Forensics)

9,625 9,609 10,190 11,421 11,349 10,729 10,677

Civil Total Admissions 8,991 8,975 9,580 10,860 10,747 10,139 10,103

Civil Adult 8,870 8,844 9,462 10,770 10,668 10,063 10,045

Civil Child & Adolescents 121 131 118 90 79 76 58

Forensics total 634 634 610 561 602 590 574

Forensics Adult 611 614 593 546 587 573 565

Forensics Child &

Adolescents

23 20 17 15 15 17 9

Total Triage 1,482 1,784 1,653 797 907 673 401

Total Transfers-in 409 414 466 232 211 246 271

Civil total 365 364 410 166 152 184 200

Civil Adult 365 364 410 166 152 184 200


Forensics Total 44 50 56 66 59 62 71

Forensics Adult 43 50 55 66 59 62 71

Forensics Child &

Adolescents

1 0 1 0 0 0 0

Individuals with 3+

admissions Civil only

569 536 592 639 630 585 626

Individuals with 3+


forensics

0.0632 0.0597 0.0617 0.059 0.059 0.055 0.059

FY

03

FY

04

FY

05

FY

06

FY

07

FY

08

FY

09

All Admissions/100,000 78 77 82 92 91 86 86

Total Civil Admissions/100,000 72 72 77 87 87 82 81

Adult Civil Admissions/100,000 97 96 103 117 116 110 109

Child & Adolescents Civil

Admissions/100,000

4 0 4 3 2 2 2

Total Forensics Admissions/100,000 5 5 5 5 5 5 5

Adult Forensics Admissions/100,000 7 7 6 6 6 6 6

Child & Adolescents Forensics Admissions/100,000

1 1 1 0 0 1 0

Co-Occurring Disorders 4,613 5,389 5,417 4,916 4,991 4,569 4,491

48

FY

03

FY

04

FY

05

FY

06

FY

07

FY

08

FY

09

Percent of Co-Occurring

Disorders Admissions

0.48 0.56 0.51 0.43 0.44 0.43 0.42

Numbers shown do not include individuals considered developmentally disabled based upon legal

status at time of episode. Calculation for Admissions 100,000: population

count/100,000=multiplier: number of admissions/multiplier = Admissions/100,000.

Report Date: 07/09/2009 Population Served: 12,419,293 - FY 03 thru FY 09

Utilization of Illinois State Psychiatric Hospitals

FY03 FY04 FY05 FY06 FY07 FY08 FY09

Length of Stay (All) Average 158 196 211 199 200 221 229

Length of Stay (All) Median 16 17 15 13 12 13 13

Length of Stay (Civil ALL) Average 100 119 125 113 104 111 108

Length of Stay (Civil ALL) Median 14 14 13 11 10 11 11

Length of Stay (Civil Adult)

Average

101 120 126 113 104 112 108

Length of Stay (Civil Adult) Median 14 14 13 11 10 11 11

Length of Stay (Civil Child &

Adolescents) Average

23 20 26 33 25 39 22


Adolescents) Median

170 210 394 402 411 426 433

Length of Stay (Forensic Adults)

Average

678 737 841 889 926 1,005 1,077


Median

171 212 394 403 416 427 436

Length of Stay (Forensic Child &


144 180 334 339 338 283 274


Adolescents) Median

127 127 280 353 214 150 282

Average Daily Census (All) 1,512 1,481 1,466 1,440 1,413 1,400 1,377

Average Daily Census (Civil) 942 882 866 844 806 800 778

Average Daily Census (Civil Adult) 935 874 861 840 802 796 775

Average Daily Census (Civil Child &

Adolescents)

8 7 6 5 4 5 4

Average Daily Census (Forensics) 570 599 600 596 607 600 598

Average Daily Census (Forensics

Adult)

561 588 585 582 597 590 593


Child & Adolescents)

9 11 15 13 10 9 6

49


Total Number of Residents & Home

Visits on 7/09/09.

1,410 1,369 1,402 1,322 1,373 1,353 1,319

Total Number of Civil Residents and

Home Visits on 7/09/09.

799 760 791 706 762 742 709

Total Number of Civil Adult

Residents and Home Visits on

7/09/09.

797 757 786 705 757 742 707

Total Number of Civil Child &

Adolescents Residents and Home

Visits on 7/09/09.

2 3 5 1 5 0 2

Total Number for Residential and

Home Visits on 7/09/09

611 609 611 616 611 611 610

Total Number for Adult Residential

and Home Visits on 7/09/09

601 593 595 601 603 601 605

Total Number for Child

& Adolescents Residential and


10 16 16 15 8 10 5


FY 03 FY 04 FY 05 FY 06 FY 07 FY 08 FY 09

Total Separations 10,190 10,058 10,625 11,731 11,496 10,988 10,979

Total Discharges (Civil &

Forensics)

9,772 9,641 10,150 11,498 11,286 10,739 10,708

Civil Total Discharge 9,255 9,052 9,584 10,981 10,729 10,211 10,171

Civil Adult 9,122 8,922 9,468 10,888 10,654 10,131 10,115


Forensics Total 517 589 566 517 557 528 537

Forensic Adults 502 578 553 506 538 517 525

Forensic Child &

Adolescents

15 11 13 11 19 11 12

Total Transfers-Out (Civil

& Forensic)

418 417 475 233 210 249 271

Civil Total 368 359 408 161 138 173 200

Civil Adult 368 359 408 161 138 173 200


Forensics Total 50 58 67 72 72 76 71

Forensics Adult 49 58 65 72 72 76 71

Forensics Child &

Adolescents

1 0 2 0 0 0 0

Report date 07/09/2009 Population Served 12,419,293

http://www.dhs.state.il.us/page.aspx?item=33869


1


Behavioral Health Networks

Region 2

Draft Report

2

Table of Contents Topics Page # Region 2 Plan

Background 3-4

Access 4-5

Funding 5-6

Quality Improvement 6-7

Technology 7-8

Workforce 8-9

Meetings

Letter of Invitation 10

Agenda Nov. 30 11

Minutes Nov. 30 12-13

Small Group Responses Nov. 30 14-16

Agenda Dec. 21 17

Minutes Dec. 21 18-19

Small Group Responses Dec. 21 20-26

Agenda Jan. 11 27

Minutes Jan. 11 28-29

Appendix

PA 97-0381 30-33

Questionnaire 34-40

Region 2 Contact List 41-68

Psychiatric & Licensed Staffed Beds 69-70




ILHFB Bed Totals 73

Hospital Statistics 74-76

3


For hospital, primary care, mental health, substance abuse and

other community-based providers

Region 2


Association.

Background


0381, which creates the Regional Integrated Behavioral Health Networks Act. The act provides

a platform to establish Regional Integrated Behavioral Health Networks. Its purpose is to ensure

and improve access to appropriate mental health and substance abuse services throughout Illinois

by: organizing systematically all relevant health, mental health, substance abuse, and other



Under the act, each Behavioral Health Regional Network shall develop a strategic plan for its

respective region that addresses the inventory of existing services, identifies community needs

and defines opportunities to improve access to care. The act contemplates a broad-cross section

of the mental health, substance abuse, health, and social services community that will be

involved in the development and implementation of the plan. Collaboration among all of the

relevant community resources will be essential to accomplish the purposes of the act and to build

effective, coordinated and comprehensive systems of care.



Association (IHA)and others convened a group of behavioral health providers in the State’s DHS

Region 2 to begin to identify existing services in the region, strategies for improving the

behavioral health services delivery system, including timely and appropriate access to medical as

well as behavioral health services, and ways in which providers can begin working together to

improve access to services and patient outcomes.


participating service providers in three Region 2 meetings. At the first meeting held at FHN

Health System, Freeport, on November 30, 2011, providers defined their vision for behavioral

health care services in the future and outlined priority issues and areas of focus. During the

second meeting at Rosecrance Health Network, Rockford, on December 21, 2011, participants

identified strategies to improve priority areas of concern listed in this plan. In the third meeting

at Family Service and Community Mental Health in McHenry on January 11, 2012, the group

reviewed and provided input on the first draft of a regional plan and provided additional

feedback on data sources and trends they have experienced over the past 12 months.



4


process and one that will evolve with a changing health care and economic landscape and will

depend on the continued commitment of all stakeholders—state agencies, primary medical,

hospitals, and behavioral health providers. It builds on community strengths to achieve a system

of care that delivers the right care, at the right time, in the right place.

1. Access for All Who Need It

First and foremost, providers were concerned about access to behavioral health services

for all residents of the region. Patients and consumers seeking behavioral health care

currently find long waiting lists for outpatient care, hospital emergency department visits,

admission to state-operated psychiatric hospitals, and substance abuse treatment

programs. Persons who are not covered by programs such as Medicaid or Medicare are

particularly compromised by continuous budget cuts. Patient-centered models of care

that work well offer improved access as well as outcomes integrate primarily medical and

behavioral health services. Integrated care will provide the patient and his/ her family

with health services needed for both physical and behavioral health, while also serving

the uninsured, with a hospital approach to health care and wellness.

Primary care integrated with behavioral health services is currently being implemented in

a couple of rural communities and is being introduced to federally qualified health

centers, rural health clinics and family practice clinics. It will be important for these new

integrated service models to coordinate care across and among community mental health

centers, substance abuse treatment and prevention service providers, hospitals, health

departments, and other community-based service providers. A care coordination

component, along with these integrated models, will help patients and their families

navigate their health care journey as they move from assessment, diagnosis, treatment,

follow-up and pharmaceutical compliance.

In addition to care coordination, Region 2 planning participants indicated a need for crisis

stabilization services and ongoing treatment resources for persons in need of care.

Region 2 would like to explore alternative strategies to expand access to behavioral

health services through more appropriate settings to stabilize patients in crisis, provide

counseling to keep patients out of crisis, assist patients with life challenges, and provide

outreach to patients to improve their quality of life through community resources,

employment, housing, etc. Notwithstanding the value of providing alternative services,

providers emphasized the need to maintain access to the full continuum of care, from

acute care to rehabilitative services.

Region 2 planning participants highlighted the need to eliminate “silo” thinking and

management principles within state agencies that minimize the ability of providers to

work across the spectrum of behavioral health programs and services. Understanding the

unique needs of mental health, substance abuse, prevention, and dual diagnosis clients is

important for providers and state agency leaders. However, there is a need for some level

of cross-training, common definitions and language, and standardization that will help

behavioral health providers work jointly towards a more holistic approach to behavioral

and physical health care for clients in Illinois.

5

Recommendations

Integrate behavioral health services and primary care through the use of patient-

centered entities that are funded to support these new strategies. A patient-centered

navigator could be one possible solution.

Coordinate education, advocacy and support for patients and their families who

navigate through the service delivery system.

Identify a consistent, common patient access system to ensure patients receive the

right level of care at the right time and in the right setting (inpatient, outpatient,

treatment, counseling, and prevention).

Provide direct inpatient services before crisis occurs.

Develop one electronic billing system to integrate administrative functions at the state

level and standardize forms and processes.

Develop more outpatient services, crisis stabilization centers and non-traditional

counseling services to keep patients out of the emergency departments of hospitals

and state-operated facilities.

Utilize community-based mental health centers, substance abuse providers, home

health agencies and others to track and monitor patients with chronic conditions to

keep them out of crisis. Electronic HIE may assist here.

Provide resources to link behavioral and physical health providers through the use of

electronics and technology to ensure access to services through all points of entry into

the behavioral and physical health care systems.

Expand access to inpatient beds in areas with long waiting lists and professional

shortage areas.

Facilitate communication between mental health providers and pharmacists to

coordinate the pharmaceutical needs of the patient with physical health conditions to

improve patient education and compliance with the patient’s pharmacy plan.

2. Funding

There was an in-depth discussion on how funding should be redesigned to support

behavioral health services in the future. There was consensus among providers that

funding needs to follow the patient through the system of care. Providers would like to

work with the department and statewide organizations to plan for the use of state, federal

and commercial insurer funds that better meets the needs of patients and their families.

For example, by decreasing emergency department usage, those resources can be used to

provide additional counseling and prevention services. These funds could be used to

6

create alternative strategies such as crisis stabilization centers and medication

management services. In the future, providers agreed that moving to more outpatient

services will help to reduce the cost of care and provide more timely services for patients

and their families. Capitated funding alternatives would allow more flexibility utilizing

funding for locally identified needs, addressing gaps and developing services where

needed most as determined by local stakeholders.

There is a recognition that multiple providers may need to form a collaborative to address

common needs. For example, multiple providers would work together to fund

transportation services in a region or to create alternative setting for service delivery. If

the state currently provides transportation for the involuntary patients, can multiple

providers pool resources to provide transportation for the voluntary patients?

Recommendations

Lead a performance-based funding redesign initiative to define behavioral health

quality indicators, assessment strategies, data collection, analysis, and reporting

requirements across both mental health and substance abuse providers.

Identify public and private sector funding to pilot non-traditional services in the

region and to provide the necessary equipment to connect behavioral health providers

to the state’s health information exchange (HIE) and telepsychiatry services.

Design funding mechanisms that follow the patient through the behavioral health

system and provide support services to clients as they transition from supported living

services to other community-based systems of care.

Provide coverage for the uninsured population in Illinois.

Create administrative service organizations to support to behavioral health providers

in the region, especially for those common services such as transportation, non-

traditional service models, etc. With existing thin administrative margins, this would

make the service delivery system more effective and efficient to operate.

Create one electronic billing system for behavioral health providers to streamline the

different billing processes currently used by different state agencies.

3. Quality Improvement

The planning participants requested that state agencies work closely with existing

providers in the region to identify quality measures for behavioral health clients, to

improve data collection, analysis and utilization, and to develop funding strategies based

upon quality outcomes. The quality improvement process should be driven by

comprehensive and accurate assessments, self-assessments, shared decision-making and

uniform measures when appropriate. Members pointed to DASA’s use of national

assessment uniform measures that assisted substance abuse providers to collect and

utilize common data. Planning participants need more information on evidence-based,

emerging best practices in other state and regions that have improved patient outcomes.

7

Recommendations

Relevant state agencies should engage in a meaningful dialogue with providers

regarding uniform measures needed to assess patient outcomes across the continuum

of behavioral health care service providers.

Encourage use of core measures across the continuum, including outpatient

behavioral health.

Develop training curriculum for behavioral health providers on existing core

measures and best practices to implement a quality improvement program.

Appropriate state and federal should continue to identify best practices and evidence-

based strategies to improve the delivery of quality care.

The Department of Human Services, in partnership with its state partners, should host

training sessions for behavioral health providers to provide a consistent message on

rules related to Emergency Medical Treatment and Active Labor Act (EMTALA) and

patient confidentiality.

4. Technology

Region 2 providers would like the state to assist them in utilizing technology to improve

access to care and create efficiencies in the system. Providers would like to integrate

behavioral health services into the patient’s electronic medical records and have access to

the patient’s complete health record when caring for the patient. Creating an

authorization form for patients to allow their behavioral health provider to have access to

their electronic medical record will assist providers in assessing and treating the

behavioral health needs of their patients.

Providers would also like to better utilize technology to reduce duplication in the

behavioral health system. Patients receive numerous assessments as they move from the

community mental health center to the specialist office to the hospital and back to the

community mental health center. This requirement creates redundancy in the process,

utilizes resources that are unnecessary and delays access to care for the patient and their

family. Providers would like to utilize technology to record assessment information at

the point of entry and build the patient record as they move among health care providers.

Providers would like to work with state leaders to develop standardized forms when

appropriate to collect reliable and consistent data on basic information that is common

across behavioral health providers. Standardized forms will simplify the administrative

process and streamline the data available to providers and the state.

Providers also would like to work with the state and its partners to expand access to

psychiatrists and other specialty providers through telemedicine and telephonic services,

especially in the rural parts of the region. Telepsychiatry is currently working in

8

several communities to provide assessment, treatment, counseling, and follow-up

services. However, the cost of equipment ($20,000) can be a barrier to implementation,

especially in rural community mental health centers and substance abuse centers.

Recommendations

Work with the Office of Health Information Technology (OHIT) and the state HIE

Advisory Committee to integrate behavioral health services into the state’s HIE

planning and implementation strategies.

Convene a network of providers to explore innovative strategies to reduce duplication

in assessments, patient forms, and provider reporting requirements, through

technology programs and software. This duplication increases cost to the behavioral

health system and delays patient care.

Work with state, federal and private funders to identify resources to expand access to

health information and telemedicine equipment.

Create a bed availability central depository system to manage patient intake and

referral process. It is expected that a centralized system will help providers avoid

EMTALA concerns.

5. Workforce

Region 2 providers recognized a need to develop the workforce to manage care in the

new service delivery system. There will be a need for new workers such as care

coordinators and patient navigators, information technology specialists, home health

services, and family and patient educators. Staff from the different specialty care

providers will need to be cross-trained to understand the needs of patients as they move

from one type of behavioral health provider to another, especially for those with multiple

chronic conditions.

Providers continue to struggle with workforce shortages especially in the rural parts of

the region. Utilizing vocational and community college training programs, providers will

work to identify new members of the behavioral health workforce, and in some rural

areas, utilize telemedicine services to access specialty services.

As the workforce changes, the group agreed that new information and professional skills

will be needed by those in the future workforce to address patient care such as: growing

quality measures, cross-training across specialty services, interactions with law

enforcement, primary care integrations, electronic medical records, new billing and

coding data, and ongoing evidence-based practice training. Linkages with higher

education will continue to be a priority as these new members of the workforce are

developed.

The planning participants recommended education services be made available to family

members who can act as first responders to persons in need of behavioral health services.

Current programs designed to train family members should be analyzed and expanded

9

where appropriate. Mental health agencies should have first aid toolkits for families who

serve as first responders.

The group also discussed the need for providers to reach out to other community-based

organizations that link services for patients and families like housing and transportation

services to ensure educational services are available.

Recommendations

Identify new skills needed by the workforce of the future and design payment systems

to fund those provider services (care coordinators, patient navigators, etc.).

Remove regulatory barriers that limit the existing workforce from transitioning to the

new system of behavioral health services.

Work with community colleges and vocational schools to recruit and train new

behavioral health service providers.

Train emergency department physicians, especially in hospitals that do not provide

psychiatric services, to ensure best practices for behavioral health patients are known

and utilized.

Assess current staff salaries and reform reimbursement rates to attract a skilled

workforce.

Provide a forum for providers to discuss the changing workforce needs, identify

existing education resources, discuss potential workforce barriers, and develop a plan

to expand educational services for behavioral health providers.

Develop and provide incentives for workforce shortage areas of the state.

10

November 15, 2011

Name

Title

Organization

Address

City, State Zip

Dear:

As providers, we know that persons with mental and substance use illnesses in Illinois must navigate a

complex amalgam of services that are inconsistently available and accessible. Many seek care from us in

crisis because they could not obtain more timely or appropriate care. Our state and federal fiscal crises

have translated into the loss of essential behavioral health services particularly in rural Illinois. Yet,

despite these challenging circumstances, we can also identify opportunities to improve care. Some of

these opportunities stem from health reform; others are being generated by our own strategies to serve our

patients and communities. One such opportunity is being presented to us by the recent enactment of

House Bill 2982 – Public Act 97-0381, which creates the Regional Integrated Behavioral Health

Networks Act.

The bill establishes Regional Integrated Behavioral Health Networks to ensure and improve access to

appropriate mental health and substance abuse services throughout Illinois by systematically organizing

all relevant health, mental health, substance abuse, and other community resources among regional

providers, to develop a mechanism to use regional resources efficiently and effectively.

Under the Act, each Behavioral Health Regional Network shall develop a strategic plan for its respective

region that addresses the inventory of existing services, identifies community needs and defines

opportunities to improve access to care. The Act contemplates a broad-cross section of the mental health,

substance abuse, health, and social services community will be involved in the development –and

implementation—of the plan. Collaboration among all of the relevant community resources will be

essential to accomplish the purposes of the Act and to build effective, coordinated and comprehensive

systems of care.


DHS Region 2. The meeting will take place Wednesday, November 30 from 10:00 am to 1:00 pm at

FHN Memorial Hospital in Freeport, IL.

If you have any questions or concerns, please contact IHA Staff: Lori Williams, at 217-541-1164 or

[email protected] or MaryLynn M. Clarke at 217-541-1154 or [email protected].

To confirm your attendance, please contact Abby Radcliffe at 217-541-1178 or email your response to

[email protected].

Thank you,


Sr. Director, Health Policy & Regulation

Lori Williams

V.P. Small & Rural Hospital Affairs




11


November 30, 2011, 10:00 a.m. – 1:00 p.m.

FHN Memorial Hospital, 1045 W. Stephenson Street, Freeport, IL

Agenda

I. WELCOME & INTRODUCTIONS ................10:00 ............................... Dan Neal

II. OVERVIEW OF HB 2982 (PA 97-0381) .........10:20..MaryLynn McGuire Clarke

III. REGIONAL PLAN DISCUSSION GROUPS..10:25 ................................. Groups

What should the behavioral health system look like 3 years from now?

What would be the key components of the new behavioral health system?

Are there immediate actions that could be taken to improve access to behavioral

health services in this region? If so, what are they?

IV. SMALL GROUP REPORTS ............................11:30 ..................... Abby Radcliffe

V. SETTING PRIORITIES & NEXT STEPS ....12:15 ............................... Dan Neal

VI. ADJOURNMENT & NEXT MEETING ........1:00 ................................. Dan Neal

12


November 30, 2011

FHN Memorial Hospital, 1045 W. Stephenson Street, Freeport, IL

MaryAnn Abate, Rosecrance

Jennifer Avrand, FHN-Family Counseling Center

Susan Ayers-Krause, Pioneer Center

Eric Benink, OSF SHMC

Karen Beyer, Ecker Center for Mental Health

Barbara Brooks, DHS

David Deopere, Robert Young Center

Emily Dykstra, CGH

Michael Flora, Ben Gordon Center

Michael Freda, Robert Young Center

Ann Gantzer, SwedishAmerican

Robin Garvey, State

David Gomel, Rosecrance

Filiz Gunay, DuPage County Health Department

Karen Hines, Nicasa

Patricia Kates-Collins, DASA

Deb Keaschall, CGH

Patti Kimbel, Vista Medical Center West

Rodger J. Kinard, PhD, Willowglen Academy

Teddi Kruchman, Elmhurst Hospital

Amparo Lopez, DHS Region 2

MaryLynn McGuire Clarke, IHA

Nancy Monroe, RMH

Pamela Morzos, McHenry County Dept. of Health

Deanna Murray, RMH

Diane Murray, Delnor

Dan Neal, FHN

Larry Prindaville, Sinnissippi

Abby Radcliffe, IHA

Linda Rice, Morris Hospital

Jim Sarver, Sinnissippi Centers

Sue Schroeder, Stepping Stones

Rob Schwichow, Sherman

Linda Snelten, Nicasa

Eldon Wigget, State

I. Welcome & Introductions

Dan Neil called the meeting to order at 10:00 a.m. and those in attendance introduced

themselves.

II. Overview of HB 2982 (PA 97-0381)

MaryLynn McGuire Clarke gave an overview of the legislation which requires the

Department of Human Services to create Regional Behavioral Health Networks in each

DHS region to ensure and improve access to behavioral health services. The networks

will work collaboratively to develop region-specific plans. The legislation also created

the Regional Integrated Behavioral Health Networks Steering Committee comprised of

state agencies to coordinate efforts among planning regions.


Participants were divided into groups to discuss three questions: 1) What should the

behavioral health system look like three years from now? ; 2) What would be the key

components of the new behavioral health system? ; and 3) Are there immediate actions

that could be taken to improve access to behavioral health services in this region? If so,

what are they?

13


The four small groups reported on their findings. Information from the break-out groups

is included in the attached document.


Information collected at the meeting will be assembled by IHA. A focus on priorities and

developing specifics of the plan will be examined at the next meeting.


Dan noted that the next meeting will be held Dec. 21 at 10:00 a.m. He adjourned the

meeting at 1:00 p.m.

14

Nov. 30 Small Group Responses


Network is large, need smaller groups, all medical providers linked to mental health

systems within that local region for all patients

Uninsured population should be included, no disparity

Care coordination, individual primary care coordination

Strong partnerships, collaboration, continuum of care meetings, agreements with all

levels (eliminate silos)

Improved communication capability, including access to data, re: patient clinical data

Reduction of duplication

Behavioral health access for all, payers for all seeking care/services

Medical homes include all behavioral health

Plenty of crisis stabilization beds

Federally Qualified Health Centers (FQHCs) need to be a big part of the picture

Demonstrate outcomes better

More community mental health and substance abuse money, state funding

Integrated set of rules, re: confidentiality and have laws align with access needs

EMTALA compliance for all

Allocate resources to region

Open access-service on demand

Interstate agreements established

Increase outpatient services for meds/counseling, etc.

Uniform Screening and Referral Form (USARF) requirements, resource intensive

Merge public policy, licensure mergers

Emergency Department not appropriate holding area, triage crisis establishment needed

Improve med student/med prof education

Distribute mental health professionals proportionately and have enough providers for all

ages to have the capacity to support timely access

Streamline mental health P & C process

No wrong door for persons with behavioral health

Fully integrated approach

Colocation

Stigma reduction

Consumer and family driven care, shared decision making

Not driven by funding sources, driven by medical necessity

Increase in community programming at every level

Increase in crisis, residential innovation, other models

Comprehensive

Explore telepsych laws

Increase in mental health services to intellectual and developmental disabilities

population

Increase in private, local psych beds

15


More home care, more coordination, more long term care for the chronically ill

Increased use of telepsych, telesocial work

Access to needed medication

Central access, criteria the same, continuity

More Standardization is needed

Colocation of entities

More use of evidence-based practices including use of innovative emergency department

behavioral health models

More substance abuse centers

More inpatient beds, residential, housing, and outpatient facilities

Use of crisis stabilization, solution focused

Community education for all (police, EMS, etc.) as first responders are the key

Money should follow clients

Full continuum, prevention, education, assessment, treatment

Outpatient-counseling for all, psychiatry, case management, pre-screener, etc.

Community triage should be used



Make sure that all are involved and there is an incentive to participate

Need for more local partnerships and stronger collaboration, network meetings

Working on electronic medical health records

Look at DCFS area networks/structures and integrate with children services

Use RIN numbers, have central access, local level

Not shifting money away from existing mental health resources

Know resources available

Continuum of care meetings

Fund raising, foundation resources

State should evaluate public spending, misuse of state funds

Incentives for mental health prevention and care

EMTALA adherence

Initiate triage center approach to effectively direct patients to appropriate level of care

Submission of proposals ASAP

No closure of seven state facilities until alternatives/options established

Encourage clients to become registered voters

Governor needs to hear voice of community, let areas of state tell him, and Legislative

reps need to hear voices as well

More community provider representation /state behavioral health strategic planning

process

Funding, uninsured, redefine eligible criteria for services

Suggest pilots for consumers/uninsured, data information to support those pilots and

expand current demonstration projects

Allow providers to manage care and funding for consumers at local level

Information system-interoperability, shared, privacy protections, integrate across system

16

Work on the shortage of psychiatrists

Cooperation program with FQHCs

Medical home for behavioral health

Fund telepsychiatry

17


December 21, 2011, 10:00 a.m. – 1:00 p.m.

Rosecrance Griffin Williamson Campus, Community Room,

1601 North University Drive, Rockford, IL

Agenda

I. WELCOME ........................................................10:00 ............................... Dan Neal

II. SUMMARY OF FIRST MEETING.................10:20 ............................. ..Dan Neal

III. FOCUS ON PRIORITIES…………………….10:25 .................................. Groups

WORKFORCE:

What specific training is needed for existing workforce?

What are the new skills that are needed?

What are regulatory barriers to workforce utilization?

What are the specific training needs for dual diagnosis patients?

PREVENTION:

What are the current prevention services?

What new prevention services are needed?

DELIVERY SYSTEM:

How would you recommend we fill the gaps in the service delivery system?

Are there new models that would be effective in this region?

TRANSPORTATION:

Where are the transportation gaps (unfunded, Medicaid, others)?

What alternatives can you suggest in your community to provide

transportation?

PAYMENT DESIGN:

What services are not currently reimbursed that should be?

How should the payment system by redesigned to better meet the client’s needs?

IV. SMALL GROUP REPORTS ............................11:30 .............................. Everyone

V. SETTING PRIORITIES & NEXT STEPS ....12:15 ....................... Lori Williams

VI. ADJOURNMENT & NEXT MEETING ........1:00 ................................. Dan Neal

January 11, 2011: 10:00 a.m.-1:00 p.m.

18


December 21, 2011

Rosecrance Griffin Williamson Campus, Community Room,

1601 North University Drive, Rockford, IL

Mary Ann Abate, Rosecrance

Susan Ayers-Krause, YSB/Pioneer Center

Carolyn Bengston, Rockford Memorial Hospital

Karen Beyer, Ecker Center for Mental Health

Hugh Brady, NAMI, IL

Robin Cabral, IL Children’s Mental Health Part.

Laura Crain, Woodstock School District #200

Phil Eaton, Rosecrance

Robin Garvey, NAMI, IL

David Gomel, Rosecrance

Ann Guild, Illinois Hospital Association

Filiz Gunay, DuPage County Health Dept.

Gary Halbach, Remedies Renewing Lives

Erin Harsevoort, NAMI IL

Karen Hines, Nicasa

Abby Hornbogen, Provena St. Joe’s-Joliet

Lisa Johnson, Independence Center

Doug Jones, Provena St. Mary’s Hospital


Betty Kinard, Willowglen Academy

Rodger Kinard, Willowglen Academy

Lorraine Kopczynski, Pioneer Center

Sandy Lewis, McHenry County MHB

Bob Lesser, McHenry Co. MHB

Patricia Lindquist, DHS/DMH Region 2

Amparo Lopez, DHS/DMH Region 2

Michelle McMullin, AID

Pamela Morzos, McHenry Co. Dept. of Health

Deanna Murray, Rockford Memorial Hospital

Dan Neal, FHN

Lori Nelson, Family Service & CMH Center

Larry Prindaville, Sinnissippi

Faye Redmond, Advocate Good Shepherd Hosp.

Abby Radcliffe, Illinois Hospital Association

Cassie Reese, Provena St. Joe’s-Joliet

Linda Rice, Morris Hospital

Sue Schroeder, Stepping Stones

Rob Schwichow, Sherman Hospital

Sheila Senn, Centegra Health System


Gail Stickle, KSB Hospital

Ted Testa, Lake County Health Department

Eldon Wigget, MDH

Lori Williams, Illinois Hospital Association


Dan Neal called the meeting to order at 10:00 a.m. and those in attendance introduced

themselves.


Dan gave an overview of the last meeting. He thanked the group and the state for

participating in these meetings. The purpose of the group is to outline a plan for

behavioral health services in this region. The goal of the plan is to improve access to

behavioral health services in the region and work with the state steering committee to

implement changes to the system.


Participants were divided into groups to discuss five topic areas: 1) Workforce; 2)

Prevention; 3) Delivery System; 4) Transportation; and 5) Payment Design. These

priority issues were identified in the first meeting. The questions on these topics will help

identify provider needs in each of the areas.

19


The four small groups reported on their findings. The information from the break-out

groups is included in the attached document.


The information collected at the meeting will be assembled by IHA. A focus on a draft

plan will be discussed at the next meeting.


Dan noted that the next meeting will be held Jan. 11 at 10:00 a.m. He adjourned the


20

Dec. 21 Small Group Responses

WORKFORCE

Question 1: What specific training is needed for existing workforce?

Trauma informed care

Case management and medical services

Cross training

National Alliance on Mental Illness (NAMI)-partner family to family training

Recovery resilience, philosophy

Family members/clients as partners, looking from their perspective

Learning to mend bridges

De-escalation skills (not just for mental health)

Residential or vocational specialist training at community colleges including physical

education in nursing

More training in mental health for primary degree care docs, emergency department, and

other health care providers

Standardized evaluation tool

More education on IL Mental Health Code

Supervision of peer specialists to develop skills-peer supervisors come from clinical

backgrounds

Billing/support data-documentation/coding/billing, etc. Including Billing Medicaid for

wrap. Billable under Rule 132.

Clinical-short term evidence based practice training

Electronic Medical Records (EMRs)

Practice management

Sharing information-community resources, etc.

Increased knowledge and competency for clients with multiple intellectual and

developmental disabilities: triple axis syndrome, mental health, dual diagnosis

More psychiatrists/nurse practitioners that can prescribe-medication management

Education on “new structure”

Primary care integration

Department of Corrections & law enforcement

Fewer health providers for mental health and other disabilities

Training consumers to assist with management of illness, consumer empowerment

Address shortages

Evidence-based practices, evidence-informed practices, best practices (academic partners,

research, training of professionals, dual-diagnosis, co-occurring, co-morbidity)

Technology needs, EMR, meaningful use, e-training, data sharing, telepsychiatry

Family support groups

Question 2: What are the new skills that are needed?

Community-based in home care

Coaching/teaching

Empathy skills, customer service

Cultural competency

Interagency awareness

21

Assessing for suicide

Treating behavioral health as health

Preventing and dealing with violent situations

Parity-pay scale social worker, physician assistant, psychiatric, med intern, residents

Secondary education

Attraction/retention

Existing workforce—train on new system and evidence-based practices

Education for staff to see family perspective

Primary care linkage/engagement

Medical assessment, medication

Empower clients on self-care

Collaboration through networks

Question 3: What are regulatory barriers to workforce utilization?

Allied professionals being able to prescribe

Regulatory issues with home health care

Clarity on what schools can bill for Medicaid

Substance abuse/mental health rules

More family advocate services being billable

Financial barriers, state is too prescriptive

State paperwork requirements, uniform intake forms, etc.

Fear of guardianship and advocacy commission

Office of Investigator General

Credentials needed for Medicaid reimbursements and Medicaid formulary list prior-

authorization times

Ability to share patient information across settings

Stigma among peers/community/workforce

Rates for counseling—hard to get high-quality (qualified) staff. Existing: no raises, leave

Prompt payments from state

Cross train staff

FFS 2060 Rules-132 Rules (grant model moved to fee for services without fee for service

flexibility)-two separate rules make it difficult to bill- plus commercial rates. Duplication

is costly

Family Nurse Practitioner vs. Psychiatric Nurse Practitioner-Peer source payment

impacts billing and prescription differences

Collaboration by departments, regulatory requirements

Standardized assessments

Question 4: What are the specific training needs for dual diagnosis patients?

Assertive Community Treatment (ACT) funding for therapy, teams/too much regulation

Motivational enhancements, stages of change

Dual credentials, cross training

Also refers to developmental disabilities

Tool that addresses mental health and substance abuse

State agencies funding—silos

22

More wrap facilitators trained for wrap

Integrated dual diagnosis model

Number of professionals trained to address population client needs

Question 5: Extra thoughts on workforce shortages

Advance practice nurses, psychiatrists , social workers, and physician assistants are

needed

In home behavioral interventionists

Parent/peer advocates

IT specialists who understand things from a behavioral health level

Collaborative business models to build efficiencies

Resource availability

PREVENTION

Question 1: What are the current prevention services?

Victim’s services

NAMI offerings, education

Mental health first aid

Continued crisis intervention training, Critical Incident Stress Management

Community wide-destabilization

Child adolescent-prevention money gone

Community education-clients and families

School based programs-substance abuse, suicide prevention, early-intervention grants

City prevention programs-RFP

Almost all substance abuse. providers have a prevention arm

Reduction of stigma

Mental health or suicide prevention month

Secondary education services-more connections

Transitions funding would be expanded

Public health-maternal child health screenings

Legal counsel-guardianship issues

Hotline/Crisis Lines-substance abuse & suicide

Crisis intervention training for police

Providing Access to Health (PATH), Assertive Community Treatment, Community

Support Team

Family resource center, family engagement

Partners for success

Perinatal screenings

Wellness Recovery Action Plan (WRAP)

Self-help community support mentoring

Research/training brought into treatment re: co-occurring/co-morbid diagnoses through

screening and training—postpartum , cardiac, chronic conditions

Peer support

23

Question 2: What new prevention services are needed?

Schools social and emotional learning standards-making sure they are doing it, consistent

school based models

Workplaces need stress management

Whole health

Parenting classes

Partnership with faith institutions

Adult and community family

Expanded and integrated screenings-early and periodical

Need for help for those outside of diagnosis

More advocates in court system

Financial resources

Education re: successful prevention models-why are they important

Empirical evidence of success

Stigma-consumer participation

Education for school leaders, teachers, and parents

Engaged Consumer advisory committees (regional/local)

Task force developed to target consumer groups

Convener groups for providers to cut duplication

708 BDS-County Board-for Winnebago Co.

377 Board for development disabilities services

More on mental health side

Community education and data

Health plan coverage of behavioral health and substance abuse prevention

Existing screening tools to address MH

Training on what to do with tool results

Early identification

Access to care

Student education through health classes

DELIVERY SYSTEM

Question 1: How would you recommend we fill the gaps in the service delivery system?

Reauthorization issues-streamline

Medically necessity systems

Fill the gaps

Substance abuse and mental health under one umbrella-shouldn’t be unique to combine

both

Group homes are needed

Illinois should pay for needed care and assist in accessing resources

Restore non-Medicaid funding

Centralized case management-more than substance abuse and mental health-family

advocacy

Avoid duplication in systems- mental health, substance abuse, development disabilities

different providers, cuts have limited service providers, consumer choice

Access-uninsured, prompt payment

24

Record keeping-electronic medical records

More crisis beds-more short term acute care

Child plus AD-90 day window of services Screening, Assessment and Support Services

(SASS), need longer window for SASS for adults

More short term counseling services

Case management services

Integrated care models require change in providers-difficult to navigate; for Medicaid

consumers

Enroll the eligible clients into Medicaid. DHS has one point person to work with at

facility. One person at entrance of facility to get patients enrolled

Speed up Medicaid enrollment process (Elgin model)

Need pharma access-bring meds to client

New psychiatrist changes meds/cost

Home visits (home health-psych follow-up), need to promote

Living room model

Triage center-peer and non-acute model

Triage center model-stabilization, licensed behavioral health care professionals to staff

Safe place-crisis plus brief services

Licensed social worker, nurse

Hospital diversion

CMS funding for triage center

Small comparative studies (pilots-AZ)

Intake needs improved-crisis worker meets with hospital

Continuity of care from triage center to service providers

Capacity in system after hospital

Respite care will keep patients out of emergency department (DuPage County

government pays for respite)

Capacity grants-cutting

Misdiagnosis for development disabilities and mental illness-learned behavior vs.

undiagnosed mental illness

Community integrated living arrangement (CILA’s) to address dual and triple diagnosis-

specialized CILA’s

Focus on employment for adults-stigma

Delivery system is not fully integrated across the behavioral health continuum

Effective continuity of care (referral source vested in successful outcome)

More collaboration, need integration with primary care

Delivery system (agreed upon components)

Question 2: Are there new models that would be effective in this region?

System of care approach-care locally

Coordinated care models- co-locating etc...computers sharing information

Communities mentoring others

Clients need choice

Drive change through evaluation process, evidence based practices

Emergency room-different pathway for psych patients respite, crisis beds

25

Acute care needs, diversion, adult SASS model

Community triage center

Community mental health center liaison to hospital

State Operated Hospitals (SOH’s)-short length of stay, no follow-up-counseling, family

therapy, medication, no alternatives

Integrated services across continuum of service providers, including primary care

Evidence-based practice models are in silos

Early identification, prevention, service delivery, specific services

Managed care/care coordination

Crisis management, efficiencies, single access or multiple points?

Technology use-electronic medical record/telepsychiatry/meaningful use

TRANSPORTATION

Question 1: Where are the transportation gaps (unfunded, Medicaid, others)?

Billing transportation for staff time, etc.

Liability/risk issues

Funding cuts, Medicaid payment

Flexible hours

Some ambulances will not transport mental health patients

Transport can be limited by geography, inadequate bus stops, limited hours

Some local options-hospital community foundation funds but not violent patients

Transportation for children

Abuse of involuntary paperwork

Use EMTALA form instead for transport

Train lines

Public access

Patients to hospital

Trained workers for transit providers

Specific training-like seniors-paratransit senior centers

Barriers to service; hospital, ambulance, outpatient access, co-morbidity e.g. homebound

Options for transportation, identify needs in rural, urban and suburban areas

Funding; legislative barrier, transport restrictions, identify sustainable options

Service delivery; in home, home health

Question 2: What alternatives can you suggest in your community to provide

transportation?

Local solutions, county models

B.H. taxi system/community transport system/van transport, paratransit

Use of stipends (broader)

Transport plus bed broker

Videoconference-telepsychiatry , e-therapy

Transit funding

Use community supports that currently transport, e.g. EMTS/taxi and ambulances;

destigmatize

26

PAYMENT DESIGN

Question 1 and 2: What services are not currently reimbursed that should be? How should

the payment system by redesigned to better meet the client’s needs?

Wellness packages

Medical necessity system plus necessary supports, driven by need of client

Prevention

Global contracting

Flexibility

How large regions manage, how does it work

Community-based waivers

Medically indigent with same access to services

Make payments (30/90 days)

Multiple points of entry with different expectations

Streamline funding system

Pay for non-Medicaid and increase rates, model includes state in some risk

Address eligibility criteria for community services

Services based on need, not funding source

Modify Medicaid prior approval review for medications

Pay for behavioral health homes- not based on capitation, if capitation- monitor to make

sure care not withheld

Global payment that is provider centered to align incentives

Home visit payment

Many services not reimbursed/increased rates

Unfunded/charity care

Peer support

Supported employment teams

Maintenance-stabilization

Recovery based services

Transportation

Psychiatric rates increase

Medical advocacy pay

Linkage case management

Capitated risk based system

Support infrastructure (Administrative Service Organizations, compliance, HR)

Affiliations

Cost efficiencies in community based service; quantify cost to system in “unmanaged”

system-transferred to emergency room, police, jails, etc.; demands on primary care—

repeat access via crisis

Address charity care absorbed by community

Redesign funding strategy; remove silos from DMH/DASA/DCFS, etc. (other states

transferred DOC money to mental health/substance abuse, etc.)

Inform legislators re: cost/benefits-performance based

27


January 11, 2012, 10:00 a.m. – 1:00 p.m.

Family Service & Community Mental Health Center, Community Room,

4100 Veterans Parkway, McHenry, IL 60050

Agenda

I. WELCOME ........................................................10:00 ............................... Dan Neal

II. SUMMARY OF SECOND MEETING ............10:20 ............................. ..Dan Neal

III. REVIEW OF PLAN/PRIORITIES………… ..10:25 ....................... Lori Williams

IV. REGION INFORMATION...............................11:30 .............................. Everyone

V. NEXT STEPS ....................................................12:15 ....................... Lori Williams

VI. ADJOURNMENT ..............................................1:00 ................................. Dan Neal

28


January 11, 2012

Family Service & Community Mental Health Center, Community Room

4100 Veterans Parkway, McHenry, IL 60050

Susan Ayers-Krause, YSB/Pioneer Center

Eric Benink, OSF Saint Anthony

Karen Beyer, Ecker Center

Jayne Braden, Braden Counseling Center

Donna Buss, McHenry County MHB

James Carpenter, Pioneer Center

Andrea Gargani, Hinsdale Hospital

Robin Garvey, NAMI, IL


Filiz Gunay, DuPage County Health Department

Gary Halbach, Remedies Renewing Lives

Craig Harling, Provena St. Joseph, Elgin

Pat Henningsen, Ada S. McKinley

Alison Herrdejs, Consumer

Karen Hines, Nicasa

Doug Jones, Provena St. Mary’s Hospital


Rodger Kinard, Willowglen Academy

Mark Klocek, McHenry Co. MHB

Teddi Krochman, Elmhurst Memorial Hospital

Arthur Krzyzanowski, Thresholds

Lisa LaForge, Family Serv. Assoc. of Elgin

Noel Lemke, Advocate Good Shepherd Hospital

Teri Lindahl, Families Etc.

Patricia Lindquist, State

Amparo Lopez, DMH

Ann May, Family Alliance

Catherine McBride, Advocate Good Shep. Hosp.

Michelle McMullin, AID

Doug Milliman, Professional Consultant

Pamela Morzos, McHenry Co. Dept. of Health

Deanna Murray, Rockford Memorial Hospital

Dan Neal, FHN

Lori Nelson, Family Service & CMH Center

Elias Palacios, Global Behavioral Health, Inc.


Todd Schroll, McHenry Co. MHB

Sheila Senn, Centegra Health System

Jerry Skogmo, Renz Center

Ronald Smith, Consumer


Ted Testa, Lake County Health Department

Elizabeth Thrun, Morris Hospital

Deb Wagner, SwedishAmerican

Charla Waxman, Linden Oaks at Edward

Eldon Wigget, DMH



Dan Neal called the meeting to order at 10:00 a.m. and those in attendance introduced

themselves.

II. Summary of Second Meeting

Dan gave an overview of the second meeting. He thanked the group and the state for

participating in these meetings. The purpose of these three meetings is to outline a plan

for behavioral health services in this region. The goal is to develop a plan to improve

access to behavioral health services in the region and work with a state steering

committee to implement changes to the system.

III. Review of Plan/Priorities

Lori Williams noted that today’s meeting will take the priority issues that were identified

in the first two meetings and begin to craft recommendations to be part of this region’s

29

plan. Comments will be recorded and added to the plan. Lori went through each section

of the draft plan and the group made recommendations for any changes.

IV. Region Information

Some region specific data was collected. This was included in the packets and any

feedback on additional data needed would be appreciated.

V. Next Steps

The information collected at the meeting will be assembled by IHA. The updated draft

plan will be sent to the group for any other changes. This plan will then be submitted to

the State Steering Committee when they begin to meet.

VI. Adjournment

Dan adjourned the meeting at 1:00 p.m.

30

Appendix


Public Act 097-0381































regions.

Section 15. Goals.






31






































Committee.





32













(7) Other.





health staff.




providers.





(1) Prevention.






hospitals.














33








Public Act 097-0381

34


Provider Questionnaire (28 Completed)

1. Wait Times




Staff reductions

Less state hospital beds available and overall psych beds

Inpatient for kids

Population, high medical activity, intellectual and developmental

disabilities diagnosis, availability

Lack of available transport services, nobody wanting to admit uninsured

patients

Placement issues


important – 5 = not important at all)

#5 - 6

#4 - 2

#3 - 2

#2 - 2

#1 - 13

Have you documented these delays?

NO- 6

YES- 14


In agency record keeping system

Social service log of Services to Children and Family (SCF) transfers, data

available at hospital

Numbers of transfers, denials, and delays to SOH(s).

There is a waiting list and not all incoming clients have insurance

Crisis program documents amount of time consult talks to disposition a

patient to the needed level of service

Internally in specific client case records

Adults-intensive services if urgent, 15 days if non-urgent; orientation

group formed. Child and adolescent-seven days if non-urgent, referral to

family night. Psychiatry over two months if non-urgent. Once assessed,

second appointment is delayed in some programs. Non-Medicaid/

uninsured is a challenge.

35

Availability of services (output), particularly psychiatry

Rosecrance Berry campus may have data related to child/adolescent waits

Resource and referral, department documents, all related information

Length of time on wait list, Services for Spanish-speaking families is very

difficult to provide

Clinical case notes, emergency room records, email

No waiting lists, client access all levels of care in one to three days

It is documented on individual evaluations, but not collected or

documented in summary form

Emergency department documents length of stay

We keep data that provides wait times to transfer patients from our

emergency department to outside providers or our own unit

Demand is getting worse

Not documented consistently



waiting for a transfer?

NO- 8

YES- 12

N/A- 5

We do not have security and that increases our risk

1:1 coverage

Sometimes

Security utilized for all psych patients in our emergency department

No, but had a couple of incidents; we are not a residential hospital


transfers? (1 = very important, 5 = not important at all)

#5 - 2

#4 - 3

#3 - 3

#2 - 3

#1 - 4

What data do you have to document security issues?

Sitter and/or security standby hours. Need of the hospital to develop a

“behavioral response team” to address patient issues/concern especially

safety (completed in 2011).

We document number of security watches and injuries that occur in the

emergency department

Security documentation/logs

36

Incident reports, client waiting for ambulance to go to hospital may run or

become physically aggressive

Security may keep data, not sure

911 calls for assistance

Critical incident reporting. Increased evidence of higher activity due to

shorter length of stay inpatient/reduced funding; discharges from State

Operated Facilities/Chester, etc.

Not sure if security has documented length of stay or wait times

Clinical assessments, 1:1 documentation

Quality measures, risk department. Director of quality documents

Data is documented on individual patients but is not collated at this time

Our emergency department/security would have this information related to

this

Crisis management at program level

3. Patient Volume



Yes- 14

No- 3

Staff reductions has resulted in fewer being served

We focus on mental illness/intellectual and developmental disabilities

Minor increase

There is an increase in uninsured volumes of patients which effects the

bottom line and causes hospitals to want to close psych units

Not significantly

Increase by 1/3 in terms of behavioral health presentations from 2nd

to 3rd

quarter


#5 - 6

#4 - 2

#3 - 1

#2 - 2

#1 - 8


Service data statistics

Number of admissions turned away due to bed availability

Not sure

Social service documentation, statistics available at hospital

37

Number of people served are declining due to withdraw of state funding

for unfunded people and the inability of local resources to fund their care

at our community mental health center

Screening

Client member counts (non-duplicated) from 6,000 to 6,500. Client calls

increased to 900 a month

Number of patients seen in emergency department for behavioral health

issues

Number of intake phone calls, number of clients that have to wait for

services

Intake/referral data, capacity limitations

Daily/monthly inquiry, client roster logs

Not collected consistently

Further assessment revealing the underlying diagnosis or misdiagnosis of

Axis I and Axis III diagnosis

Logs, but not consistent date only primary if DX (diagnosis)loss without

transfer

Census always documented

Statistics on length of stay, payer source, referral source information

We have data on numbers of psych evaluations completed and admissions

and discharges, etc.

We are suspending our inpatient services pending State Board approval

None recorded

4. Transportation


NO- 2

YES- 7

It is a concern that there can be long delays in using the transportation

company vs. local ambulance

Public transportation is not sufficient, PACE is limited

At times

For patients that cannot get to appointments it is high

On a scale of 1-5 how big a problem do you believe this is?

#5 - 7

#4 - 4

#3 - 6

#2 - 3

#1 - 7

38


Lock, Northern IL, data

Not sure

Morris has hospital transportation services that provide free transportation

and medical/counseling needs in Grundy county

Limited bus routes (cities with no coverage) and times/days they run

Community analysis 2010, new transportation model began 1-1-12 in

McHenry County but only serves three largest areas, but does not reach

outlying areas

Occasionally have issues, more so the last 9 months

Use of $27,000 in unfunded transportation costs in excess of $10,000 in

funded transportation (Taxi, PACE bus, gas cards)

Crisis reports

Anecdotal data, utilization of agency van service

None

Lack of public transportation systems-no vehicles that people own-no

money to pay for it

We have expense reports documenting how much we have had to pay for

patients who are unfunded and live far away to get home

5. Admissions




facility?

YES- 5

NO- 4

N/A- 6

Not sure

Not an increase, but it is an issue

They wait in the emergency room for days

Try hard to keep them in the emergency department

No effort to place patients from the emergency department in priority

Will only admit to medical units if there is a medical issue


#5 - 1

#4 - 1

#3 - 3

#2 - 1

#1 - 5

39


Unsure, but I know that this is an issue and the hospital does keep data on

this

Data could be drawn from patient census on admitting

Clinical files

No data on this

Social service documentation, statistics available

The emergency room has statistics and we have documented the cases

Overcrowding in the emergency department is more of a problem

Not consistently



Funding reduction-staff reduction-fewer clients being served

Placement (long-term) for those suffering from mental health issues.

Continue to have extended length of stay in the emergency departments

Waiting lists, not sure about documentation

Continuing huge wait lists to be paid by State of IL

State funding has been drastically reduced and delayed resulting in cash

flow issues

Electronic records

Morris does not have a behavioral health unit. In addition to increase wait

times for non-funded patients we are also seeing increase wait times for

patients with insurance due to inpatient psych units running full

Increase in stress related to lack of funding, finances, etc.

Referrals for Community Integrated Living Arrangements, schools, and

Child and Adolescent providers. Group home services presenting with

high-activity behavioral issues with grossly inadequate funding

Increase of heroin admits, higher patient acuity

An ongoing issue has been lack of adequate referrals/placement for

patients with substance abuse. Also, our local county respite program

denies a good number of patients solely based on their medical issues,

which are generally long standing.

Lack of funding, coordination of services

Need to incorporate the peer specialist roles in planning, strategizing and a

part of the whole process to help as change agents

Increase in primary substance abuse services

Increase in length of stay in emergency department, increase in number of

patients without a payer source, increase in difficulty in accessing

community services due to decrease in resources

Lack of child psychiatrists, lower reimbursement

40



YES - 24

We need to have a presentation for legislators to hear some individual, and

family stories, and successes and challenges



system design issues?

YES - 21

Please indicate which issues would be helpful to you:

Systems funding, reductions

Bed availability log for input psych beds would be very helpful

Regulatory issues

Access

Only if the state divisions and department will act on our work

All issues

Development/training

Coordination with services for patients with substance abuse and patients

with high readmission rates

Transportation and regulatory barriers

System design issues

I would be interested in strengthening the collaboration between providers

and family members

Barriers, design, hierarchy (democratic leadership for the human service

model) for better outcomes of staff

9. Any other items you would like to share about this planning process or materials

that are related to this effort?

Would just like to play a part if I have the time

Include representatives from Council on Accreditation, Commission on

Accreditation Rehabilitation Facilities, and Joint Commission. The

accrediting representatives have a national and global perspective on

issues we have discussed.

It was great

Illinois Psychological Association workers should be involved in the

authorizations for hospitalization as opposed to hospitals accepting a

referral under the belief they need to and then finding out they were not

accessed appropriately.

Nice effort, glad to hear what you have done in region 2

41

Region 2 Contact List

Organization Address 1 Address

2

City & State Zip Contact Email

18th Judicial

Circuit Court-

Probation and

Court Services

503 N. County

Farm Road

Wheaton, IL

60187

Donna J.

Pawlowski

[email protected]

A New Way of

Life, Inc.

1258

Thornwood

Lane

Crystal Lake, IL 60014 Executive

Director

Abacus DUI

Program, Inc.

555 Tollgate Elgin, IL 60123 Dennis Dee [email protected]

About Change

Counseling

1532

Weatherstone

Lane

Elgin, IL 60123 Teresa

Castillo

[email protected]

Access Community

Health Network

245 S. Gary

Ave.

Bloomingdale,

IL

60108

Access Community

Health Network

245 W.

Roosevelt

Road

West Chicago,

IL

60185

Access Community

Health Network

1111 Lake St. Addison, IL 60101

Access Community

Health Network

2055 Army

Trail Road

Addison, IL 60101

Access Community

Health Network

526 Main St. West Chicago,

IL

60185

Access Community

Health Network

705 W. Liberty Wheaton, IL 60187




42

Access Community

Health Network

891 S.

Rohlwing

Road

Addison, IL 60101

Access Community

Health Network

431 W. Army

Trail Road

Bloomingdale,

IL

60108

Ada S. McKinley 725 S. Wells Ste. 1-A Chicago, IL 60607 Pat

Henningsen

[email protected]

Addictions

Associates

Therapy, Inc.

322 Peterson

Road

Libertyville, IL 60048 Jim Lucchesi [email protected]

Adult Counseling

And Educational

Services

16 W. Van

Buren St.

Joliet, IL 60432 Juan Miranda [email protected]

Adult Education

Associates

748

Timbercreek

Road

Dixon, IL 61021 Kim

Vanbuskirk

[email protected]

Adventist

Bolingbrook

Hospital

500 Remington

Blvd.

Bolingbrook, IL 60440 Rick Mace [email protected]

Adventist

GlenOaks Hospital

701 Winthrop

Ave.

Glendale

Heights, IL

60139-

1403

Director of

Behavioral

Health

[email protected]

Adventist

GlenOaks Hospital

701 Winthrop

Ave.

Glendale

Heights, IL

60139-

1403

Bruce

Christian

[email protected]

Adventist Hinsdale

Hospital

120 N. Oak St. Hinsdale, IL 60521-

3829

Andrea

Gargani

[email protected]

Adventist Hinsdale

Hospital

120 N. Oak St. Hinsdale, IL 60521-

3829

Michael J.

Goebel

[email protected]

Advocate Condell

Medical Center

801 S.

Milwaukee

Ave.

Libertyville, IL 60048-

3199

Dominica M.

Tallarico

[email protected]

Advocate Good

Samaritan Hospital

3815 Highland

Ave.

Downers

Grove, IL

60515-

1590

Patrick

Barnes

[email protected]












43

Advocate Good

Samaritan Hospital

3815 Highland

Ave

Downers

Grove, IL

60515-

1590

David S. Fox [email protected]

Advocate Good

Shepherd Hospital

450 W.

Highway 22

Barrington, IL 60010-

1901

Karen A.

Lambert

[email protected]

Advocate Good

Shepherd Hospital

450 W.

Highway 22


1901

Faye

Redmond

[email protected]

Advocate Good

Shepherd Hospital

450 W.

Highway 22


1901

Noel Lemke [email protected]

Advocate Good

Shepherd Hospital

450 W.

Highway 22


1901

Catherine

McBride

[email protected]

Affordable DUI

Counseling

570 W.

Broadway St.

Bradley, IL 60915 Michael

Regas

[email protected]

Alexander Zubenko

and Associates

4699 Auvergne

Ave.

Lisle, IL 60532 Alexander

Zubenko

[email protected]

Allendale

Association

P.O.

Box

1088

Lake Villa, IL 60046 Sue Gaddy [email protected]

Allied

Psychological

Services, LTC

501 W.

Peterson Road

Libertyville, IL 60048 Janice

Prepura

[email protected]

Alpha Counseling

Center, Inc.

1112 S.

Washington St.

Naperville, IL 60540 Mary

Kullman

[email protected]

Al-Tech Services,

Inc.

2233 Charles

St.

Rockford, IL 61104 E. Taylor

Reynolds IV

[email protected]

Alternative

Behavior Treatment

Centers

27255 N.

Fairfield Road

Mundelein, IL 60060 Robin

McGinnis,

MSW

[email protected]

Amanecer, Inc. 25W560

Geneva Road

Carol Stream,

IL

60188 Roberto

Almeida

[email protected]

Arlington Center

for Recovery, LLC

1655 S.

Arlington

Heights Road

Arlington

Heights, IL

60005 Donna

Johnson

[email protected]















44

Associates in BH

Care

309 Pheasant

Trl

Lake in the

Hills, IL

60156 Mary Crick [email protected]

Association of

Community Mental

Health Authorities

P.O.

Box 935

Aurora, IL 60507 Maureen

Mulhall

[email protected]

Association of

Community Mental

Health Authorities

P.O.

Box 935

Aurora, IL 60507 Phyllis

Russell

[email protected]

Association for

Individual

Development

309 W. New

Indian Trail

Court

Aurora, IL 60506 Lynn O'Shea [email protected]

Association for

Individual

Development

309 W. New

Indian Trail

Court

Aurora, IL 60506 Michelle

McMullin

[email protected]

Aunt Martha's

Youth Service

Center, Inc.

101 S.

Broadway St.

Aurora, IL 60505

Aunt Martha's

Youth Service

Center, Inc.

3003

Wakefield

Carpentersville,

IL

60110

Aunt Martha's

Youth Service

Center, Inc.

1777 E. Court

St.

Kankakee, IL 60901

Aunt Martha's

Youth Service

Center, Inc.

317 E. Indian

Trail

Aurora, IL 60506

Aunt Martha's

Youth Service

Center, Inc.

76 S. LaSalle Aurora, IL 60505

Aunt Martha's

Youth Service

Center, Inc.

1515 E. Lake

St.

Hanover Park,

IL

60133






45

AVP Counseling &

DUI Services, Inc.

336 W. Maple

St.

New Lenox, IL 60451 Arnold

Pilmonas

[email protected]

Aztec Counseling

Agency, Inc.

231 Ruby St.

Joliet, IL

60435

Karina

Ramirez

[email protected]

Bam House, inc. 431 N.

Genesee St.

Waukegan, IL 60085 Kevin A.

Means

[email protected]

Behavioral

Education and

Treatment, Inc.

1415 W. Lake

St.

Addison, IL 60101 Marsha

Murphy

[email protected]

Ben Gordon Center 12 Health

Services Drive

DeKalb, IL 60115 Michael Flora [email protected]

Boone County

Department of

Health

1204 Logan

Ave.

Belvidere, IL 61008 Executive

Director

Braden Counseling

Center

2580 DeKalb

Ave.

Sycamore, IL 60178 Jayne A.

Braden

[email protected]

Breaking Free, Inc. 120 Gale St. Aurora, IL 60506 Mike Moran [email protected]

Bridges Counseling

& DUI Services

215 N. Main

St.

Algonquin, IL 60102 Sheila

Schmidt

[email protected]

Cap of Downers

Grove, Inc.

4954 Main St. Downers

Grove, IL

60515 Marie

Angelico

[email protected]

Care Clinics, Inc. 522 N. Lake

St.

Aurora, IL 60506 Scott A.

Rocush

[email protected]

Carroll County

Department of

Health

822 S. Mill St. Mt. Carroll, IL 61053 Executive

Director

Centegra Health

Systems

527 W. South

St.

Woodstock, IL 60098 Laura

Walczak

[email protected]

Centegra Health

Systems

527 W. South

St.

Woodstock, IL 60098 Astrid Larsen [email protected]

Centegra Hospital-

McHenry

4201 Medical

Center Drive

McHenry, IL 60050-

8499

Michael S.

Eesley

[email protected]














46

Centegra Hospital-

Woodstock

3701 Doty

Road

P.O.

Box

1990

Woodstock, IL 60098-

3797

Sheila Senn,

PhD

[email protected]

Centegra Hospital-

Woodstock

3701 Doty

Road

PO Box

1990

Woodstock, IL 60098-

3797

Michael S.

Eesley

[email protected]

Central DuPage

Hospital

25 N. Winfield

Road

Winfield, IL 60190-

1295

Mike Tinken [email protected]

Central DuPage

Hospital

25 N. Winfield

Road

Winfield, IL 60190-

1295

Brian Lemon [email protected]

Central DuPage

Hospital

25 N. Winfield

Road

Winfield, IL 60190-

1295

Alison

Johnson

[email protected]

CGH Medical

Center

100 E. LeFevre

Road

Sterling, IL 61081-

1279

Edward

Andersen

[email protected]

CGH Medical

Center

100 E. LeFevre

Road

Sterling, IL 61081-

1279

Emily

Dykstra

[email protected]

CGH Medical

Center

100 E. LeFevre

Road

Sterling, IL 61081-

1279

Deb

Keaschall

[email protected]

Challenge

Behavioral

Healthcare, Nic.

15 Spinning

Wheel Road

Hinsdale, IL 60521 Richard

Kelling

[email protected]

Changes Place 264 N. Phelps

Ave.

Rockford, IL 61108 Jack Phillips [email protected]

Comgraph, Inc. 105 Warwick

St.

Park Forest, IL 60466 Victor

Needham

[email protected]

Community

Behavioral

Healthcare

Association

3085 N.

Stevenson

Drive

#308 Springfield, IL 62703 Sheryl Turpin [email protected]

Community Health

Partnership of

Illinois

157 S. Lincoln

Ave.

Aurora, IL 60505













47

Community Health

Partnership of

Illinois

13711 W.

Jackson Street

Woodstock, IL 60098

Community Health

Partnership of

Illinois

157 S. Lincoln Aurora, IL 60505

Community Health

Partnership of

Illinois

202 N.

Schuyler Ave.

Kankakee, IL 60901

Community

Partnership

Coalition

227 W. Judd

St.

Woodstock, IL 60098 Laura Crain [email protected]

Community Service

Council of

Northern Will

County

719 Parkwood

Ave.

Romeoville, IL 60446 Robert

Kalnicky

[email protected]

Compass

Development, Inc.

619 McCarthy

St.

Lemont, IL 60439 Dawn M.

Valdes

[email protected]

Conventions

Psychiatry &

Counseling

4S100 N. State

Route 59

Naperville, IL 60563 Sandeep

Gaonkar

[email protected]

Cornell

Interventions, Inc.

2221 W. 64th

St.

Woodridge, IL 60517 Pamela Kost [email protected]

Cornell

Interventions, Inc.

2221 W. 64th

St.

Woodridge, IL 60517 [email protected]

Cornerstone

Services

777 Joyce

Road #B

Joliet, IL 60436 Jim Hogan

Counseling

Associates, LLC

3033 W.

Jefferson

Joliet, IL 60435 John

Kizhakedan

[email protected]

County of Kendall 811 W. John

St.

Yorkville, IL 60560 Cheryl

Johnson

[email protected]









48

Criminal Justice

Advocacy for

People M.I.

Gertrude

Rodig

[email protected]

Crossroads

Counseling

Services, LLC

1802 N.

Division St.

Morris, IL 60450 Angela Solis [email protected]

Crossroads

Counseling

Services, LLC

1802 N.

Division St.

Morris, IL 60450 Amanda

Jessie

[email protected]

Crusader

Community Health

1200 W. State

St.

Rockford, IL 61102 Executive

Director

Crusader

Community Health

1100

Broadway

Rockford, IL 61102

Crusader

Community Health

730 W. State

St.

Rockford, IL 61102

Crusader

Community Health

1720 18th St. Rockford, IL 61104

Crusader

Community Health

516 Green St. Rockford, IL 61102

Crusader

Community Health

715 W. State

St.

Rockford, IL 61102

Crusader

Community Health

412 N. Church

St.

Rockford, IL 61103

Crusader

Community Health

809 Cedar St. Rockford, IL 61102

Crusader

Community Health

1149 Railroad

Ave.

Rockford, IL 61104

Crusader

Community Health

10 W. Linden Freeport, IL 61032

Crusader

Community Health

1050 Logan

Ave.

Belvidere, IL 61008

Crusader

Community Health

714 Third Ave. Rockford, IL 61104




49

DeKalb County

Department of

Health

2550 N. Annie

Glidden Road

DeKalb, IL 60115 Executive

Director

DeKalb County

Mental Health

(708) Board

2500 N. Annie

Glidden Road

Suite B DeKalb, IL 60115 Donna

Moulton

[email protected]

Delnor Hospital 300 Randall

Road

Geneva, IL 60134-

4202

Robert

Friedberg

[email protected]

Delnor Hospital 300 Randall

Road

Geneva, IL 60134-

4202

Diane Murray [email protected]

DHS 100 W.

Randolph,

Suite 5-600

Chicago, IL 60601 Barbara J.

Brooks

[email protected]

DHS Patricia

Kates-Collins

[email protected]

Direct Counseling,

Nic.

400 Russell

Court

Woodstock, IL 60098 William L.

Blaul

[email protected]

DMH Eldon Wigget [email protected]

Duane Dean

Behavioral Health

Center

700 E. Court

St.

Kankakee, IL 60901 Herbert

Delaney

[email protected]

DUI & Addiction

Counseling Center,

Inc.

333 E. Route

83

Mundelein, IL 60060 Christine M.

Hinkeldey

[email protected]

DUI and Addiction

Counseling

2210 Dean St. St. Charles, IL 60175 Rita Gennusa [email protected]

DUI Associates 1826 E.

Belvedere

Road

Grayslake, IL 60030 Randy

Edwards

[email protected]

DUI Counseling

Center, Inc/Bayrach

Counseling

Services

9933 N.

Lawler Ave.

Skokie, IL 60077 Scott K.

Bayrach

[email protected]













50

DUI Solutions 129 Phelps

Ave.

Rockford, IL 61108 Norbert J.

Wick

[email protected]

DuPage County

Health Department

111 N. County

Farm Road

Wheaton, IL 60187 Filiz Gunway,

MSW

[email protected]

DuPage County

Psychological

Services/Comm.

Resources

505 N. County

Farm Road

Wheaton, IL 60187 Thomas

Sayers

[email protected]

Ecker Center for

Mental Health, Inc.

1845

Grandstand

Place

Elgin, IL 60123 Karen Beyer [email protected]

Edward Hospital 801 S.

Washington St.

Naperville, IL 60540-

7430

Pam Davis [email protected]

El Puente Latino,

Inc.

2415 N.

Butrick St.

Waukegan, IL 60087 Narcisco Diaz [email protected]

Elgin MH Center,

DHS Region 2

750 S. State St. Elgin, IL 60120 Amparo

Lopez

[email protected]

Elmhurst Memorial

Hospital

155 E. Brush

Hill Road

Elmhurst, IL 60126 Pamela

Dunley

[email protected]

Elmhurst Memorial

Hospital

155 E. Brush

Hill Road

Elmhurst, IL 60126 W. Peter

Daniels

[email protected]

Elmhurst Memorial

Hospital

155 E. Brush

Hill Road

Elmhurst, IL 60126 Teddi

Kruchman

[email protected]

Ely, Patricia &

Associates

2625

Butterfield

Oak Brook, IL 60523 Patricia Ely [email protected]

Employee Health

Consultants, Inc.

101 N.

Virginia

Crystal Lake, IL 60014 Richard S.

Atwater

[email protected]

Family Alliance,

Inc.

2028 N.

Seminary Ave.

Woodstock, IL 60098 Carol Louise

RN-BC

Family Alliance,

Inc.

2028 N.

Seminary Ave.

Woodstock, IL 60098 Ann May [email protected]

Family Counseling

Services of Aurora

70 South River

St.

Aurora, IL 60506 Eric Ward [email protected]















51

Family Etc. 2028 N.

Seminary Ave.

Woodstock, IL 60098 Teri Lindahl [email protected]

Family Service and

Community Mental

Health

4100 Veterans

Parkway

McHenry, IL 60050 Lori A.

Nelson

[email protected]

Family Service and

Community Mental

Health

4100 Veterans

Parkway

McHenry, IL 60050 Chris Gleason [email protected]

Family Service

Association of

Greater Elgin

22 S. Spring

St.

Elgin, IL 60120 Lisa LaForge [email protected]

FHN Family

Counseling

300 Summit St. Galena, IL 61036 Executive

Director

FHN Memorial

Hospital

421 W.

Exchange St.

Freeport, IL 61032 Dan Neal [email protected]

FHN Memorial

Hospital

1045 W.

Stephenson St.

Freeport, IL 61032-

4899

Michael R.

Perry, M.D.

[email protected]

FHN Memorial

Hospital

421 W.

Exchange St.

Freeport, IL 61032 Jennifer

Aurand, PsyD

[email protected]

Foundations

Center, Inc.

5592 Spring

Brook Road

Rockford, IL 61114 Carol Wick [email protected]

Galena Clinic, Inc. 9567 W. US

Highway 20

Galena, IL 61036 Kenneth

Davis

[email protected]

Geneva Community

Mental Health

(708) Board

22 S. First St. Geneva, IL 60134 Greg

Torrence

[email protected]

Global Behavioral

Health, Inc.

303 N. Second

St.

Suite

23A

St. Charles, IL 60174 Elias A.

Palacios

[email protected]

Greater Elgin

Family Care Center

370 Summit St.

#A

Elgin, IL 60120 Executive

Director

Greater Elgin

Family Care Center

1770 Spartan

Drive

Elgin, IL 60123












52

Greater Elgin

Family Care Center

37 S. Geneva

Street

Elgin, IL 60121

Greater Elgin

Family Care Center

510 Franklin

Blvd.

Elgin, IL 60120

Greater Elgin

Family Care Center

190 N. Melrose

Ave.

Elgin, IL 60123

Greater Elgin

Family Care Center

420 May St. Elgin, IL 60120

Greater Elgin

Family Care Center

240 S. Clifton

Ave.

Elgin, IL 60123

Greater Elgin

Family Care Center

949 Van St. Elgin, IL 60123

Greater Elgin

Family Care Center

225 S. Liberty

St.

Elgin, IL 60120

Greater Elgin

Family Care Center

665 Dundee

Ave.

Elgin, IL 60120

Greater Elgin

Family Care Center

1475 Larkin

Ave.

Elgin, IL 60123

Greater Elgin

Family Care Center

450 Dundee

Ave.

Elgin, IL 60120

Greater Elgin

Family Care Center

1730 Berkley

St.

Elgin, IL 60123

Greater Elgin

Family Care Center

901 Center St. Elgin, IL 60120

Greater Elgin

Family Care Center

4100 Veterans

Parkway

McHenry, IL 60050

Greater Elgin

Family Care Center

264 Oak St. Elgin, IL 60123

Greater Elgin

Family Care Center

63 S. Channing

St.

Elgin, IL 60120

Grundy County

Health Department

1320 Union Morris, IL 60450 Kay Lynn

Shoemaker,

BSN, RN

[email protected]

53

Guiding Light

Counseling, Inc.

538 E.

Boughton

Road

Bolingbrook, IL 60440 Kimberly

Duris

[email protected]

Hope for

Tomorrow, Inc.

479 N. Lake

St.

Aurora, IL 60506 Jeffrey S.

Gilbert

[email protected]

ILDS/DHM Region

2

Patricia

Lindquist

[email protected]

Illinois Association

of Rehab Facilities

206 S. Sixth St. Springfield, IL 62701 Janet Stover [email protected]

Illinois Association

of Rehab Facilities

206 S. Sixth St. Springfield, IL 62701 Josh Evans [email protected]

Illinois Children's

Mental Health

Partnership

Robin Cabral [email protected]

INC Board, NFP A

Community Mental

Health Funding

Alliance

P.O.

Box 935

Aurora, IL 60506 Jerry J.

Murphy

[email protected]

Independence

Center

2025

Washington St.

Waukegan, IL 60085 Lisa Johnson [email protected]

Inroads Counseling

and DUI Center,

Inc.

150 S.

Kennedy Drive

Carpentersville,

IL

60110 Donna

Beichel

[email protected]

Institute for

Personal

Development

1401

Lakewood

Drive

Morris, IL 60450 Elizabeth M.

Varnes

[email protected]

Janet Wattles

Center

526 W. State

St.


Director

Jem Treatment, Inc. 2424

Washington St.

Waukegan, IL 60085 Darlene

Maloney

[email protected]

JoDaviess County

Department of

Health

9483 U.S. Rt.

20 West

P.O.

Box 318

Galena, IL 61036 Executive

Director











54

JoDaviess County

Mental Health

(708) Board

330 N. Bench

St.

Galena, IL 61036 Ben Anderson [email protected]

Kane County

Department of

Health

1240 N.

Highland St.

Aurora, IL 60506 Executive

Director

Kankakee County

Department of

Health

2390 W.

Station

Kankakee, IL 60901 Executive

Director

Katherine Shaw

Bethea Hospital

403 E. First St. Dixon, IL 61021-

3116

Gail Stickle [email protected]

Katherine Shaw

Bethea Hospital

403 E. First St. Dixon, IL 61021-

3116

David L.

Schreiner,

FACHE

[email protected]

Kelly's Accurate

DUI

Evaluations/Risk

Education Services

81 N. Chicago

St.

Joliet, IL 60432 Renee Kelly [email protected]

Kendall County

Department of

Health

811 W. John

St.

Yorkville, IL 60560 Executive

Director

Kenneth Young

Centers

1001 Rohlwing

Road

Elk Grove

Village, IL

60007 Mitchell

Bruski

Kevin & Associates 257 N. West

Ave.

Elmhurst, IL 60126 Maureen

Kevin

[email protected]

Kindred Hospital-

Sycamore

225 Edward St. Sycamore, IL 60178-

2197

Cindy Smith [email protected]

Kishwaukee

Community

Hospital

One Kish

Hospital Drive

P.O.

Box 707

DeKalb, IL 60115-

0707

Brad Copple [email protected]

Kishwaukee

Community

Hospital

One Kish

Hospital Drive

P.O.

Box 707

DeKalb, IL 60115-

0707

Laura Desilva [email protected]









55

KP Counseling Inc. 461 N.

Mulford Road

Rockford, IL 61107 Thomas G.

Mlodzik

[email protected]

L.S. Berkley And

Associates

1207 Old

McHenry Road

Buffalo Grove,

IL

60089 Leslie St.

Berkley

[email protected]

Lake County

Health Department

914 Eighth St. Waukegan, IL 60085

Lake County

Health Department

285 E.

Washington St.

Grayslake, IL 60030

Lake County

Health Department

3601 N. Lewis Waukegan, IL 60087

Lake County

Health Department

54 S. Whitney Grayslake, IL 60030

Lake County

Health Department

22333 W.

Erhart Road

Mundelein, IL 60060

Lake County

Health Department

3001 Green

Bay Road

North Chicago,

IL

60064

Lake County

Health Department

2400 Belvidere

Road

Waukegan, IL 60085

Lake County

Health Department

2215 14th St. North Chicago,

IL

60064

Lake County

Health Department

1819 27th St. Zion, IL 60099

Lake County

Health Department

224 W.

Clarendon

Drive

Round Lake

Beach, IL

60073

Lake County

Health Department

3010 Grand

Ave.

Waukegan, IL 60085

Lake County

Health Department

1840 Green

Bay Road

Highland Park,

IL

60035

Lake County

Health Department,

Behavioral Health

Services

3012 Grand

Ave

Waukegan, IL 60085 Ted Testa [email protected]




56

Larkin Center 1212 Larkin

Ave.

Elgin, IL 60123 Dennis L.

Graf, MS

Latino Intervention

Center

54 S. Grove

Ave.

Elgin, IL 60120 Ernest Pujals [email protected]

Lee County

Department of

Health

309 S. Galena

Avenue

Suite

100

Dixon, IL 61021 Executive

Director

Linden Oaks at

Edward

801 S.

Washington


7430

Mary Lou

Mastro

[email protected]

Linden Oaks at

Edward

801 S.

Washington


7430

Charla

Waxman

[email protected]

Marianjoy

Rehabilitation

Hospital & Clinics

26 W. 171

Roosevelt

Road

Wheaton, IL 60187 Kathleen C.

Yosko

[email protected]

Mathers Clinic,

LLC

6180 E. State

St.

Rockford, IL 61108 Ramesh

Vemuri

McHenry County

Department of

Health

2200 N.

Seminary Ave.

Woodstock, IL 60098 Patrick J.

McNulty

McHenry County

Department of

Health

2200 N.

Seminary Ave.

Woodstock, IL 60098 Pamela

Morzos

[email protected]

McHenry County

MHB &ACMHAI

620 Dakota Crystal Lake, IL 60012 Sandy Lewis [email protected]

McHenry County

MHB &ACMHAI

620 Dakota Crystal Lake, IL 60012 Bob Lesser [email protected]

McHenry County

MHB

620 Dakota Crystal Lake, IL 60012 T. Schroll [email protected]

McHenry County

MHB

620 Dakota Crystal Lake, IL 60012 Mark Klocek [email protected]

McHenry County

MHB

620 Dakota Crystal Lake, IL 60012 Donna Buss [email protected]











57

McHenry County

Youth Service

Bureau

101 S.

Jefferson St.

Woodstock, IL 60098 Susan A.

Krause, B.D.

Ed., M.S. Ed,

MBA

[email protected]

MCM Substance

Abuse Center

135 Robert

Palmer Drive

Elmhurst, IL 60126 Martin C.

Manion

[email protected]

Memorial Medical

Center, Chemical

Dependency

Services

527 W. South

St.

Woodstock, IL 60098 Executive

Director

Mercy Harvard

Hospital

901 Grant St. PO Box

850

Harvard, IL 60033-

0850

Jeni Hallatt [email protected]

Midwest Medical

Center

One Medical

Center Drive

Galena, IL 61036 Tracy Bauer [email protected]

Morris Hospital &

Healthcare Centers

150 W. High

St.

Morris, IL 60450-

1463

Mark B.

Steadham

[email protected]

Morris Hospital &

Healthcare Centers

150 W. High

St.

Morris, IL 60450-

1463

Linda Rice [email protected]

Morris Hospital &

Healthcare Centers

150 W. High

St.

Morris, IL 60450-

1463

Elizabeth

Thrun

[email protected]

Morrison

Community

Hospital

303 N. Jackson

St.

Morrison, IL 61270-

3042

Kent

Jorgensen

[email protected]

Motivating

Individuals

3445 Elmwood

Rd.


Director

NAMI, IL Robin Garvey [email protected]

NAMI, IL Erin

Harsevoort

[email protected]

NAMI, IL Hugh Brady [email protected]

Naperville

Psychiatric

Ventures

801 S.

Washington

Naperville, IL 60540 Mary Lou

Mastro

[email protected]













58

NASA Education

Corporation

3305 S. IL

Route 31

Crystal Lake, IL 60012 Donna

McCafferty

[email protected]

New Hope

Counseling Center

275 E. Court

St.

Kankakee, IL 60901 K.A.

Abraham

[email protected]

New Hope

Recovery Center,

LLC

201 N. Third

St.

Geneva, IL 60134 Greg Simpson [email protected]

New Visions

Counseling

Services, Inc.

6912 Main St. Downers

Grove, IL

60516 Gina

Pattermann

[email protected]

Nicasa 31979 N. Fish

Lake Road

Round Lake, IL 60073 Linda Snelten [email protected]

Nicasa 31979 N. Fish

Lake Road

Round Lake, IL 60073 Karen Hines [email protected]

Nicasa 2031 Dugdale

Road

North Chicago,

IL

60064 Tricia

Bowdidge

[email protected]

N. IL Council on

Alcoholism & SA

31979 N. Fish

Lake Road

Round Lake, IL 60073 Linda Snelten [email protected]

Northpointe

Resources, Inc.

3441 Sheridan

Road

Zion, IL 60099 Karl Kopp

NorthShore

University

HealthSystem

Highland Park

Hospital

777 Park Ave.

W.

Highland Park,

IL

60035-

2497

Deborah

Taber

[email protected]

NorthShore

University

HealthSystem

Highland Park

Hospital

777 Park Ave.

W.

Highland Park,

IL

60035-

2497

Jesse Peterson

Hall

[email protected]

Northwestern Lake

Counseling

17 W. Grand

Ave.

Fox Lake, IL 60020 Darlene

Kreiger

[email protected]












59

Northwestern Lake

Forest Hospital

660 N.

Westmoreland

Road

Lake Forest, IL 60045-

9989

Thomas J.

McAfee

[email protected]

Ogle County

Department of

Health

907 West Pines

Road

Oregon, IL 61061 Executive

Director

Omni Youth

Services

1111 West

Lake Cook

Road

Buffalo Grove,

IL

60089 Jay Meyer [email protected]

OSF Saint Anthony

Medical Center

5666 E. State

St.

Rockford, IL 61108-

2472

David A.

Schertz,

[email protected]

OSF Saint Anthony

Medical Center

5666 E. State

St.

Rockford, IL 61108-

2472

Eric Benink [email protected]

Pape & Associates 618 S. West St. Wheaton, IL 60187 Patricia Pape [email protected]

Paramo's

Counseling Center

815 Larkin Joliet, IL 60435 Armando M.

Paramo

[email protected]

Partners in

Treatment

Counseling

Services, Inc.

21016 S. 80th

Ave.

Frankfort, IL 60423 Burnell

Williams

[email protected]

Personnel

Assessment Center,

Inc.

2404 White

Barn Road

Aurora, IL 60504 Kelley

Mathews

[email protected]

Pioneer Center for

Human Services

4001 W.

Dayton St.

McHenry, IL 60050 Lorraine

Kopczynski,

MS

[email protected]

Pioneer Center for

Human

Services/YSB

4001 W.

Dayton St.

McHenry, IL 60050 Susan A.

Krause, B.D.

Ed., M.S. Ed,

MBA

[email protected]

Pioneer Center

Consumer

Ronald E.

Smith

[email protected]












60

Pioneer Center

Consumer

Alison

Herrdejs

Pioneer Center 4001 W.

Dayton St.

McHenry, IL 60050 James

Carpenter

[email protected]

Professional

Consultations, Inc.

745 S. Eighth

St.

West Dundee,

IL

60118 Carole

Milliman

[email protected]

Professional

Consultations, Inc.

745 S. Eighth

St.

West Dundee,

IL

60118 Doug

Milliman

[email protected]

Provena Mercy

Medical Center

1325 N.

Highland Ave.

Aurora, IL 60506-

1461

Diane

McLaughlin

[email protected]

Provena Mercy

Medical Center

1325 N.

Highland Ave.

Aurora, IL 60506-

1461

Maureen

Bryant

[email protected]

Provena Saint

Joseph Hospital

77 N. Airlite

St.

Elgin, IL 60123-

4998

Craig Harling [email protected]

Provena Saint

Joseph Hospital

77 N. Airlite

St.

Elgin, IL 60123-

4998

Eugene

McMahon,

MD

[email protected]

Provena Saint

Joseph Medical

Center

333 N.

Madison St.

Joliet, IL 60435-

6595

Jane Mitchell [email protected]

Provena Saint

Joseph Medical

Center

333 N.

Madison St.

Joliet, IL 60435-

6595

Beth Hughes [email protected]

Provena Saint

Joseph Medical

Center

333 N.

Madison St.

Joliet, IL 60435 Cassie Reese [email protected]

Provena Saint

Joseph Medical

Center

333 N.

Madison St.

Joliet, IL 60435 Abby

Hornbogen

[email protected]

Provena St. Mary's

Hospital

500 W. Court

St.

Kankakee, IL 60901-

3661

Douglas Jones [email protected]

Provena St. Mary's

Hospital

500 W. Court

St.

Kankakee, IL 60901-

3661

Amy LaFine [email protected]













61

R.O.P.E., Inc. 424 10th Street Waukegan, IL 60085 Patricia L.

White

[email protected]

Regional Care

Association

72 N. Chicago

St.

Joliet, IL 60432 Patricia L.

Langehenning

[email protected]

Remedies

Renewing Lives

516 Green St. Rockford, IL 61101 Gary Halbach [email protected]

Renacer Latino,

Inc.

620

Washington St.

Waukegan, IL 60085 Luz R. Gvero [email protected]

Renz Addiction

Counseling Center

Two American

Way

Elgin, IL 60120 Jerry Skogmo [email protected]

Resolve Center 411 W.

Division

Manteno, IL 60952 Dr. James

Simone

[email protected]

Resurrection

Behavioral Health

2001

Butterfield

Road, #320

Downers

Grove, IL

60515 Executive

Director

Right Direction

Services

1415 Pate

Plaza Drive

South Beloit, IL 61080 Monkia T.

Dougherty

[email protected]

Rita's Ministry

(Restoring Inmates

To America's

Society)

150 S.

Lincolnway

North Aurora,

IL

60542 Linda Martin [email protected]

Riverside Medical

Center

350 North Wall

St.

Kankakee, IL 60901-

2901

Christine

Anthony

Christine-

[email protected]

Riverside Medical

Center

350 N. Wall St. Kankakee, IL 60901-

2901

Phillip

Kambic

[email protected]

Riverside Resolve

Center

350 N. Wall

St.

Kankakee, IL 60901 James Simone [email protected]

Riverview

Counseling Center

705 Dodge St. Galena, IL 61036 Executive

Director

Robert A. Moylan 3333

Warrenville

Road

Lisle, IL 60532 Robert A.

Moylan

[email protected]














62

Robert Young

Center

Michel Freda [email protected]

Rochelle

Community

Hospital

900 N. Second Rochelle, IL 61068-

1764

Mark J. Batty [email protected]

Rockford Memorial

Hospital

2400 N.

Rockton Ave.

Rockford, IL 61103-

3681

Carolyn

Bengston,

MD

[email protected]

Rockford Memorial

Hospital

2400 N.

Rockton Ave.

Rockford, IL 61103-

3681

Gary E. Kaatz [email protected]

Rockford Memorial

Hospital

2400 N.

Rockton Ave.

Rockford, IL 61103-

3681

Deanna

Murray

[email protected]

Rockford Memorial

Hospital

2400 N.

Rockton Ave.

Rockford, IL 61103-

3681

Nancy

Monroe

[email protected]

Rockford Rescue

Mission Ministries

715 W. State

St.

Rockford, IL 61102 Sherry Pitney [email protected]

Rosecrance Health

Network

1021 N.

Mulford Road

Rockford, IL 61107 Philip W.

Eaton

[email protected]

Rosecrance Health

Network

1601

University

Drive

Rockford, IL 61107 David Gomel [email protected]

Rosecrance Health

Network

1601

University

Drive

Rockford, IL 61107 Mary Ann

Abate

[email protected]

Rosecrance Health

Network

1601

University

Drive

Rockford, IL 61107 [email protected]

Rush-Copley

Medical Center

2000 Ogden

Ave.

Aurora, IL 60504 Barry C. Finn [email protected]

Sanya Syrstad 3333

Warrenville

Road

Lisle, IL 60532 Sanya Syrstad [email protected]














63

Serenity House

Counseling

Services, Inc.

891 S. Route

53

Addison, IL 60101 Tom Stamas [email protected]

Sherman Hospital 1425 N.

Randall Road

Elgin, IL 60123-

2300

Richard B.

Floyd,

FACHE

[email protected]

Sherman Hospital 1425 N.

Randall Road

Elgin, IL 60123-

2300

Rob

Schwichow

[email protected]

Silver Cross

Hospital

1200 Maple

Road

Joliet, IL 60432-

1497

Lisa Smith [email protected]

Silver Cross

Hospital

1200 Maple

Road

Joliet, IL 60432-

1497

Paul Pawlak [email protected]

Singer Mental

Health & Dev

Center

4402 N. Main

St.

Rockford, IL 61103-

1278

Amparo

Lopez

[email protected]

Sinnissippi Centers,

Inc.

325 IL Route 2 Dixon, IL 61021 Jim Sarver [email protected]

Sinnissippi Centers,

Inc.

325 IL Route 2 Dixon, IL 61021 Larry

Prindaville

[email protected]

Soft Landing

Interventions

1S224 Summit

Ave.

Oakbrook

Terrace, IL

60181 Abdel Fahmy [email protected]

Sojourn House, Inc. 565 North

Turner Ave.

Freeport, IL 61032 Dave Manson [email protected]

Southern Illinois

University, School

of Medicine

P.O.

Box

19604

Springfield, IL 62794-

9604

Robert

Wesley

[email protected]

Spillie and

Associates

1802 N.

Division St.

Morris, IL 60450 Anthony

Spillie

[email protected]

Stephenson County

Department of

Health

10 W. Linden

St.

Freeport, IL 61032 Executive

Director

Stepping Stones

Inc.

1621 Theodore

St.

Joliet, IL 60435 Paul

Lauridsen

[email protected]













64

Stepping Stones,

Inc.

1621 Theodore

St.

Joliet, IL 60435 Peter

McLenighan

[email protected]

Stepping Stones of

Rockford, Inc.

706 N. Main

St.

Rockford, IL 61103 Sue Schroeder [email protected]

Stepping Stones of

Rockford, Inc.

706 N Main St. Rockford, IL 61103 Stephen

Langley

Stonybrook Center,

Inc.

27W281

Geneva Road

Winfield, IL 60190 Frances M.

Walter

[email protected]

SwedishAmerican

Hospital

1401 E. State

St.

Rockford, IL 61104-

2298

William

Gorski, MD

[email protected]

SwedishAmerican

Hospital

1401 E. State

St.

Rockford, IL 61104-

2298

Ann Gantzer [email protected]

SwedishAmerican

Hospital

1401 E. State

St.

Rockford, IL 61104-

2298

Deb Wagner [email protected]

The Advantage

Group Foundation,

LTD

422 Tag Way Crystal Lake, IL 60014 Patrice Owens [email protected]

The Counseling

Center, Inc.

735 Mcardle

Drive

Crystal Lake, IL 60014 Donna

Schmidt-Baer

[email protected]

The Family

Connection

1548 Bond St. Naperville, IL 60563 Liberty Braun [email protected]

The Helen Wheeler

Center for CMH

275 E Court Suite

102

Kankakee, IL 60901 Jackie Haas

The IDS Group,

Inc.

1706 N.

Farnsworth

Aurora, IL 60505 Jim Fisher [email protected]

The Recovery Zone 707 First

Avenue

Rock Falls, IL 61071 Martin

Huntley

[email protected]

Thresholds 4101 N.

Ravenswood

Ave.

Chicago, IL 60613 Debbie

Pavick,

LCSW

[email protected]












65

Thresholds 4101 N.

Ravenswood

Avenue

Chicago, IL 60613 [email protected]

Tools for Life, Ltd. 35 S. Stolp

Ave.

Aurora, IL 60506 Shelley

Simmons-

Fiorito

[email protected]

Traffic School for

Behavior Change,

Inc.

54 N. Ottawa

St.

Joliet, IL 60432 Tamara

Santagelo

[email protected]

Transitional

Alternative Reentry

Initiative, Inc.

19 S.

Broadway

Aurora, IL

0505

Keith Knazze [email protected]

Transitions Mental

Health Rehab

805 19th St. P.O.

Box

4238

Rock Island, IL 61204 Executive

Director

Tricity Family

Services

1120 Randall

Court

Geneva, IL 60134 James R.

Otepka, MS,

LMFT

Tricon Counseling

Centers

380 S. Schmale

Road

Carol Stream,

IL

60188 Richard

Ordlook

[email protected]

Trinity David

Deopere

[email protected]

Trinity Services,

Inc.

100 N. Gouger

Road

Joliet, IL 60432 Art Dykstra [email protected]

Turning Point

Behavioral Health

Care Center

8324 Skokie

Blvd.

Skokie, IL 60077 Ann Fisher

Raney,

LCSW, BCD

[email protected]

Tylers Justice

Center

400 Front St. Stockton, IL 61085 Executive

Director

Valley West

Community

Hospital

11 E. Pleasant

Ave.

Sandwich, IL 60548-

1100

Brad Copple [email protected]








66

Van Matre

HealthSouth

Rehabilitation

Hospital

950 S. Mulford

Road

Rockford, IL 61108-

4274

Kenneth

Bowman

[email protected]

Virginia M. Mejia 1275 W.

Roosevelt

Road

West Chicago,

IL

60185 Virginia M.

Mejia

[email protected]

Visiting Nurse

Association of Fox

Valley

400 N.

Highland Ave.

Aurora, IL 60506 Executive

Director

Visiting Nurse

Association of Fox

Valley

157 S. Lincoln

Ave.

Aurora, IL 60505

Visiting Nurse

Association of Fox

Valley

1130 Sheffer

Road

Aurora, IL 60505

Visiting Nurse

Association of Fox

Valley

500 Tomcat

Lane

Aurora, IL 60505

Visiting Nurse

Association of Fox

Valley

620 Wing St. Elgin, IL 60123

Visiting Nurse

Association of Fox

Valley

56 Jackson Aurora, IL 60505

Visiting Nurse

Association of Fox

Valley

441 N.

Farsnworth

Ave.

Aurora, IL 60505

Vista Medical

Center East

1324 N.

Sheridan Road

Waukegan, IL 60085-

2199

Patricia

Kimbel

[email protected]

Vista Medical

Center East

1324 N.

Sheridan Road

Waukegan, IL 60085-

2199

Barbara J.

Martin

[email protected]





67

Vista Medical

Center West

2615

Washington St.

Waukegan, IL 60085-

4988

Patricia

Kimbel

[email protected]

Vista Medical

Center West

2615

Washington St.

Waukegan, IL 60085-

4988

Barbara J.

Martin

[email protected]

Weckler and

Associates, Limited

483 First St. Antioch, IL 60002 Robert W.

Weckler

[email protected]

Western Lake

Counseling & DUI

Programs, LLC

21 W. Grand

Ave.

Fox Lake, IL 60020 Jeffery R.

Hedien

[email protected]

Whiteside County

Department of

Health

18929 Lincoln

Road

Morrison, IL 61270-

9500

Executive

Director

Whiteside County

Health Department

1300 W.

Second St.

Rock Falls, IL 61071

Whiteside County

Health Department

1308 West

Second St.

Rock Falls, IL 61071

Will County

Community Health

Center

1106 Neal

Ave/

Joliet, IL 60433

Will County Health

Department

501 Ella Ave. Joliet, IL 60433 Randall

Bultman

[email protected]

Will County Health

Department

501 Ella Ave. Joliet, IL 60433 Dr. Joseph

Troiani

[email protected]

Willowglen

Academy, Illinois

701 W. Lamm

Road

Freeport, IL 61032 Betty Kinard [email protected]

Willowglen

Academy, Illinois

701 W. Lamm

Road

Freeport, IL 61032 Rodger J.

Kinard, PhD.,

ACS, DAPA

[email protected]

Winnebago County

Department of

Health

401 Division

St.

P.O.

Box

4009

Rockford, IL 61110-

0509

Executive

Director








68

Winnebago County

Behavioral Health

Steering Committee

401 Division

St.

Rockford, IL 61104 Maichle

Bacon

[email protected]

Woodstock School

District #200

227 W. Judd

St.

Woodstock, IL 60098 Laura Crain [email protected]

Zion Township

Crew, Inc.

1632 23rd St. Zion, IL 60099 Grace

Gamboa

[email protected]




69

Region 2 Acute Care Hospitals

with Psychiatric Beds

Hospital Name City

Psychiatric

Licensed Beds

Staffed Psych

Beds Oct 1,

2009

Adventist Bolingbrook Hospital Bolingbrook 0 0

Adventist GlenOaks Hospital Glendale Heights 61 58

Adventist Hinsdale Hospital Hinsdale 17 17

Advocate Condell Medical Center Libertyville 0 0

Advocate Good Samaritan Hosp Downers Grove 41 36

Advocate Good Shepherd Hospital Barrington 0 14

CGH Medical Center Sterling 0 0

Centegra Hospital-McHenry McHenry 0 0

Centegra Hospital-Woodstock Woodstock 36 24

Central DuPage Hospital Winfield 15 15

Delnor Hospital Geneva 0 0

Edward Hospital Naperville 0 0

Elgin Mental Health Center Elgin

Elmhurst Memorial Hospital Elmhurst 18 18

FHN Memorial Hospital Freeport 0 0

H Douglas Singer Mntl Hlth Ctr Rockford

Katherine Shaw Bethea Hospital Dixon 14 14

Kindred Hospital Sycamore Sycamore 0 0

Kishwaukee Community Hospital De Kalb 0 0

Linden Oaks at Edward Naperville 101 96

Marianjoy Rehab Hosp & Clinics Wheaton 0 0

Mercy Harvard Hospital Harvard 0 0

Midwest Medical Center Galena 0 0

Midwestern Regional Med Ctr Zion 0 0

Morris Hospital & Hlthcare Ctrs Morris 0 0

Morrison Community Hospital Morrison 0 0

NorthShore U Highland Park Hosp Highland Park 13 12

Northwestern Lake Forest Hosp Lake Forest 0 0

OSF Saint Anthony Medical Ctr Rockford 0 0

Provena Mercy Medical Center Aurora 95 72

Provena Saint Joseph Hospital Elgin 30 30

Provena Saint Joseph Med Center Joliet 31 31

Provena St Mary's Hospital Kankakee 25 21

Riverside Medical Center Kankakee 50 50

70

Rochelle Community Hospital Rochelle 0 0

Rockford Memorial Hospital Rockford 20 12

Rush-Copley Medical Center Aurora 0 0

Sherman Hospital Elgin 0 0

Silver Cross Hospital Joliet 20 14

SwedishAmerican Hospital Rockford 32 32

SwedishAmerican MC/Belvidere Belvidere 0 0

Valley West Community Hospital Sandwich 0 0

Van Matre HealthSouth Rehb Hsp Rockford 0 0

Veterans Affairs Medical Ctr North Chicago

Vista Medical Center East Waukegan 0 0

Vista Medical Center West Waukegan 46 42

Region Total: 665 608




SFY 2005 SFY 2006 SFY 2007 SFY 2008 SFY 2009 SFY 2010 From SFY 2005 to SFY 2010

Statewide 1,723,215 1,714,661 1,724,116 1,715,750 1,677,926 1,651,967 -4.1%

Region 2 25,654 23,318 27,005 27,484 27,741 28,116 9.6%

Source: COMPdata

72


Peds

Adults

Total

REGION FACILITY SFY 2007

SFY 2008

SFY 2009

SFY 2010

SFY 2007

SFY 2008

SFY 2009

SFY 2010

SFY 2007

SFY 2008

SFY 2009

SFY 2010


4,242 4,151 3,654 3,674

4,242 4,151 3,654 3,674


1,913 1,788 1,848 1,829

1,913 1,788 1,848 1,829


1,721 1,473 1,784 1,823

1,721 1,473 1,784 1,823


7,876 7,412 7,286 7,326

7,876 7,412 7,286 7,326

2 Elgin MHC 0 0 0 0 1,032 1,031 1,137 1,204 1,032 1,031 1,137 1,204

Singer MH/Dev Ctr 0 0 0 0 728 706 852 850 728 706 852 850

Treatment & Deten 0 0 0 0 4 9 9 6 4 9 9 6


1,764 1,746 1,998 2,060

1,764 1,746 1,998 2,060


696 728 623 717

718 741 636 733


696 728 623 717

718 741 636 733

5

Alton MH/Dev Ctr 0 0 0 0 197 198 191 188 197 198 191 188

Chester MHC 0 0 0 0 107 119 150 115 107 119 150 115

Choate MH and Dev 78 84 60 65 460 400 364 233 538 484 424 298

Region 5 TOTAL 78 84 60 65 764 717 705 536 842 801 765 601

TOTAL

100 97 73 81

11,100 10,603 10,612 10,639

11,200 10,700 10,685 10,720




Illinois Statistics


73

*The Illinois Health Facilities Planning Board discontinued licensing substance abuse beds as a category of service on April 17, 2000.

this category was converted to medical/surgical beds.

74

Hospital Statistics


FY 03 FY 04 FY 05 FY 06 FY 07 FY 08 FY 09


only)

10,472 10,759 11,233 11,657 11,654 10,812 10,504


Forensics)

9,625 9,609 10,190 11,421 11,349 10,729 10,677


Civil Adult 8,870 8,844 9,462 10,770 10,668 10,063 10,045


Forensics total 634 634 610 561 602 590 574

Forensics Adult 611 614 593 546 587 573 565

Forensics Child &

Adolescents

23 20 17 15 15 17 9

Total Triage 1,482 1,784 1,653 797 907 673 401


Civil total 365 364 410 166 152 184 200

Civil Adult 365 364 410 166 152 184 200


Forensics Total 44 50 56 66 59 62 71

Forensics Adult 43 50 55 66 59 62 71

Forensics Child &

Adolescents

1 0 1 0 0 0 0

Individuals with 3+


569 536 592 639 630 585 626

Individuals with 3+


forensics

0.0632 0.0597 0.0617 0.059 0.059 0.055 0.059

FY

03

FY

04

FY

05

FY

06

FY

07

FY

08

FY

09

All Admissions/100,000 78 77 82 92 91 86 86




Admissions/100,000

4 0 4 3 2 2 2




1 1 1 0 0 1 0


75

FY

03

FY

04

FY

05

FY

06

FY

07

FY

08

FY

09



0.48 0.56 0.51 0.43 0.44 0.43 0.42












Average

101 120 126 113 104 112 108




23 20 26 33 25 39 22


Adolescents) Median

170 210 394 402 411 426 433


Average

678 737 841 889 926 1,005 1,077


Median

171 212 394 403 416 427 436



144 180 334 339 338 283 274


Adolescents) Median

127 127 280 353 214 150 282





Adolescents)

8 7 6 5 4 5 4



Adult)

561 588 585 582 597 590 593



9 11 15 13 10 9 6

76



Visits on 7/09/09.

1,410 1,369 1,402 1,322 1,373 1,353 1,319



799 760 791 706 762 742 709



7/09/09.

797 757 786 705 757 742 707



Visits on 7/09/09.

2 3 5 1 5 0 2



611 609 611 616 611 611 610



601 593 595 601 603 601 605




10 16 16 15 8 10 5


FY 03 FY 04 FY 05 FY 06 FY 07 FY 08 FY 09



Forensics)

9,772 9,641 10,150 11,498 11,286 10,739 10,708


Civil Adult 9,122 8,922 9,468 10,888 10,654 10,131 10,115


Forensics Total 517 589 566 517 557 528 537

Forensic Adults 502 578 553 506 538 517 525

Forensic Child &

Adolescents

15 11 13 11 19 11 12


& Forensic)

418 417 475 233 210 249 271

Civil Total 368 359 408 161 138 173 200

Civil Adult 368 359 408 161 138 173 200


Forensics Total 50 58 67 72 72 76 71

Forensics Adult 49 58 65 72 72 76 71

Forensics Child &

Adolescents

1 0 2 0 0 0 0

Report date 07/09/2009 Population Served 12,419,293 http://www.dhs.state.il.us/page.aspx?item=33869




Region 3

Draft Report

2

Table of Contents

Topics Page #

Region 3 Plan Introduction 3

Background 4

Characteristics of Region 3 5

Overarching themes in Region 3 5

Recommendations for Region 3 6

Meetings Letter of Invitation 11

Agenda July 18 12

Minutes July 18 13

Small Group Responses July 18 15

Agenda August 8 20

Minutes August 8 22

Small Group Responses August 8 24

Agenda August 22 28

Minutes August 22 29

Appendices PA 97-0381 31

Questionnaire 35

Region 3 Contact List 37





ILHFB Bed Totals 43

Hospital Statistics 44

3


For hospital, primary care, mental health, substance abuse,

and other community-based providers

Region 3 Note: The content of this report does not reflect the opinion or position of the Illinois Hospital

Association.

Introduction

Budget cuts to human services, on top of a structurally weak and over-burdened behavioral

health system, have seriously compromised access to mental health and substance abuse services

in Illinois, as evidenced by the large and growing number of persons with these conditions.

Many are homeless and incarcerated. Others seek care from hospital emergency rooms.

Communities across Illinois, but especially in our rural communities, are attempting to address a

growing need with few available options. Limited resources, however, have never stood in the

way of a determined community willing to work together to solve a problem. Recognizing the

desire of our rural communities to improve not only access to mental health and substance abuse

services but also their ability to do so well, the Illinois Hospital Association worked with

members of the Illinois Legislature and other advocates to craft legislation that would provide a

platform for communities to act, proactively, to solve a serious problem for their communities.

The Regional Integrated Behavioral Health Act (HB2982/PA-98-0381) was enacted in 2011 both

as a response to a serious deterioration in the mental health system and as a proactive effort to

channel human and financial resources towards the creation of an effective and accessible system

of care. It also sought to capitalize on the opportunities that were being presented by federal

health reform, emerging clinical practices, and new models of care. In 2011, state budget cuts

had decimated many community mental health and substance abuse services. All but a few

programs for the uninsured were eliminated. Hospital emergency departments were overflowing

with persons with mental and substance use conditions in crisis. Our patients were in crisis. The

system within which they sought care was in crisis. There was no clear plan or vision in sight. By

calling for collaboration across providers, innovation, and creative thinking, HB2982 sought to

be a step towards building a system of care. The first step is to identify a vision, goals, and a plan

to achieve them.

The Regional Integrated Behavioral Health Networks Act (HB2982/P.A.98-0381) provides a

platform for the establishment of regional behavioral health networks in each of the five Illinois

Department of Human Services regions and for a DHS-facilitated statewide steering committee

comprised of relevant state agencies and stakeholders. It requires each region to identify existing

relevant mental health, substance abuse, social service and health resources; gaps in services,

including areas in which access to care is seriously limited; and services that are needed to serve

the needs of the regions’ people. This information will be compiled as a regional plan and will be

shared with the statewide steering committee and ultimately with the Illinois General Assembly.

4

This legislation recognizes the urgency of the need to improve access to care and the corollary

need to use community resources wisely and creatively. It establishes a process and forum within

which a variety of community stakeholders can assess what is needed to serve persons with

mental and substance use illnesses within their respective communities and develop a plan to

address these needs. It recognizes that what is needed in one region may not necessarily be true

for another.

It identifies a consultative, supportive role for the Illinois Department of Human Services that

will be executed through a statewide steering committee comprised of several state agencies

responsible for funding or regulating mental health, substance abuse, and health care services.

The state wide and regional committees will interact synergistically to identify opportunities not

only to address current services deficiencies but most importantly to identify ways in which to

integrate behavioral and primary health care and thereby build the health system of the future.

Integration of services is cost effective, and it improves patient outcomes.

A copy of the legislation is contained in the appendices of this report.

Background

Region 3 Planning Process

The Region 3 planning meetings have followed similar such planning meetings in Regions 2, 4,

and 5. Each region has brought together a cross section of the medical, mental health, substance

abuse, social services, and other community entities to identify the nature and scope of the

challenges facing persons who need services for a mental or substance use condition in their

respective areas. They have convened to identify solutions both in the short term and long term,

drawing upon the collective resources of their communities and their commitment to improve

access to high quality health care.

Each region has specific and unique characteristics which are addressed in their respective plans.

The Region 3 likewise, will reflect the unique features, challenges, and opportunities of central

and western Illinois. However, there are themes that run through all of the regions. These

include: a general lack of sufficient resources to meet demand, especially in rural Illinois; use of

crisis and acute services to a large and growing extent because so many less intensive

community services have been reduced or lost; a willingness to embrace integration of care

across primary and specialty behavioral health but little experience doing so; varying degrees of

success and experience adopting technology such as telemedicine/psychiatry to expand

availability of specialty psychiatric services; a shortage of psychiatrists, especially child

psychiatrists; and uncertainty of funding now and in the future.

Providers and community stakeholders all have demonstrated a “can do” commitment to their

patients/consumers and communities through their participation in the planning process, by

sitting at a common table to brainstorm ideas and develop concrete solutions to pressing

community and patient/consumer needs.

5

Characteristics of Region 3

Region 3 is located in central and western Illinois. The region includes four “other urban” cities:

Peoria, Bloomington, Champaign, and Rock Island/Moline. The remainder of the region is rural.

Refer to the Appendices for a description of acute psychiatric beds and services and other data.

Overarching themes in Region 3:

There was consensus around and support of region-specific planning, noting that a

statewide plan will fail to capture the unique characteristics and needs of a specific

region. Consideration also should be given to sub-regions that will have a different

constellation of services, resources, and needs. In Region 3, there are distinct sub-

regions, e.g., Peoria, Champaign, Bloomington, quad Cities, rural.

The lack of psychiatric capacity, particularly for children and adolescents, thwarts the

development of new models of care and use of technology to enhance access. There are

not enough psychiatrists in the pipeline to improve the situation. Use of non-physician

professionals such as APNs or PAs for persons who need medication management, and

other mental health and substance abuse professionals for persons with conditions that do

not require medication or for conditions that may be appropriately addressed by these

professionals is one strategy to address the shortage of psychiatrists. Other ideas may

include easing J1 visa requirements, loan forgiveness for physicians going into child

psychiatry, improving payment rates for psychiatrists.

Telepsychiatry and telemedicine are being used by some; all recognize the value of using

this technology to improve access to care in rural areas of Illinois. There is a range of

experience and understanding of the technology. One hospital is using a software

package that is affordable ($1,000 for license per station) and easy to use. Others are

struggling with the technology and expense. Information about the variety of hardware

and software packages available would be helpful. Staff training and necessary IT

supports needed are also important considerations in implementing telepsychiatry. As

noted above, the biggest challenge with telepsychiatry is finding psychiatrists to do it.

Crisis services are needed for all, but especially for the psychotic patient and the person

with a substance abuse condition. Children have access to SASS services, but there are

limited acute care and psychiatric services available to these children. As a consequence,

they are cycling in and out of the SASS crisis system.

With the closure of Singer Mental Health Center, the region will have fewer inpatient

resources than they have currently. What is currently available is not sufficient to meet

demand. The loss of acute services will shift demand to other venues such as hospital

EDs, community providers, and law enforcement. The loss of capacity in one region also

shifts services demands onto other areas of the state. This occurred when the Zeller

Mental Health Center closed in Peoria.

6

Loss of the SOH also reduces a level of care for patients who require longer lengths of

stay. Private hospitals have experienced an increase in the numbers of patients who

require longer stays than are customary, for these settings and which ordinarily are not

allowed /approved by utilization and quality entities reviewing inpatient care in behalf of

Medicaid, Medicare and others. Use of beds by a long-term patient in a unit designed for

acute stabilization also limits access to this level of care by patients in crisis.

The loss of facilities for persons with developmental and intellectual disabilities also

further strains hospital EDs and inpatient psychiatric units. Other community resources

frequently do not have the staff or expertise to manage a person who is acting out. The

system is not designed to provide ready access to the level of care these persons need.

Rural hospitals are caring for a large and growing number of persons with mental and

substance use conditions, straining the resources of organizations that were not designed

to provide this level of specialized care. The growing use of the ED and hospital beds is

symptomatic of the lack of other community resources. These hospitals appreciate any

and all assistance that supports their efforts to care for persons with mental and substance

use conditions and are eager to collaborate with specialty behavioral health organizations

to improve access to appropriate behavioral health care.

Recommendations

Access to Care: Delivery System Innovation

Region 3 is predominantly a rural region in which services are not consistently available in every

community. Recent budget cuts to the substance abuse and mental health and child care

providers have caused programs to close or to reduce their size and scope. Acute care services

also are limited—there is one state-operated psychiatric hospital where there once had been two;

there is one freestanding private psychiatric hospital providing services to children and

adolescents as well as adults; there are two psychiatric units in acute care hospitals providing

services to adolescents; and there are a handful of acute hospital inpatient psychiatric units in the

region serving adults. Examples of patients waiting days and weeks for an inpatient bed in a

state hospital or any hospital abound.

Access to care is defined by poverty, geographic distances separating consumers and providers,

and shortages of healthcare and behavioral health professionals. Although persons in this region

experience difficulty finding many services, they have almost no substance abuse residential

services available in the region, and they are experiencing waiting lists for child psychiatrists that

are far too long to meet the need of the region’s children.

Recommendations:

Care should be coordinated and integrated across settings. It should include the full

continuum of care, including prevention, early intervention, acute and rehabilitative

services, and wrap around services such as housing, and case/care management. Care

management is essential to support access in a timely manner to the appropriate level of

7

care, to support adherence to a treatment regimen, and to intervene when a person is

unable to obtain services because of family issues or lack of transportation. Care

management is an essential and necessary component of services package for persons

with a serious, chronic illness such as a mental illness.

Crisis capacity needs to be built into the system—either by building a crisis center,

adding crisis beds to a hospital or a residential treatment program. Capital is needed to

support the development of these services.

Observation beds/units in either a hospital or residential treatment center need to be

expanded and developed for those persons who need up to 48 hours of observation. This

is an opportunity for collaboration across systems of care, using community providers

and hospitals, and Emergency medical services (EMS) services. (Note that our laws may

need to be revised to support new crisis models of care.)

The EMS system provides information about the availability of ICU beds in a respective

system. A hospital ED can call the EMS system to determine whether or not an

appropriate ICU or trauma service is available. Explore similar capabilities for

psychiatric beds. This would be challenging, given the different types of patients

facilities and providers are able to treat, but it will provide an additional communications

vehicle for providers and should reduce wait times for persons in hospital EDs.

Inpatient beds are inadequate to meet demand. They should be expanded. No additional

civil beds should be removed from the public system. Attention should be paid to

policies that undermine the continued viability of the private acute inpatient beds.

There needs to be a place and accommodation for the unmanageably violent patient.

Care of such a patient requires one-on-one or more staff 24/7. This is a role the SOH has

assumed in the past. With the closure of SOHs, private hospitals will not have the

physical space to accommodate the violent patient, and they will not have the staff to

provide one-to-one care. The state has been unwilling to pay for this level of staffing. If

the state psychiatric hospital is closed and the private hospital is unable to care for the

violent patient, the person will be directed to the criminal justice system. This puts the

patient in a compromised position because law enforcement is not always willing to take

the patient who may be assaulting staff because they are not equipped to manage the

person. Law enforcement oftentimes sees the ED as the best place for such individuals.

This is an example of the “hot potato” syndrome, in which our patients are unwitting

participants.

Services for Veterans are needed to serve a large Veteran population in the Peoria and

Bloomington communities

Children’s services should follow the EPSDT model.

There is an urgent need to develop specialized services for persons with

intellectual/developmental disabilities.

8

Substance abuse services are limited in this region and should be enhanced. Level I and

II services (ASAM) are not funded sufficiently and are only available on a limited basis.

There are waiting lists for these services. Residential services are no longer available in

this region. There is no medical detoxification. Rural hospitals lack the expertise to

manage a patient who needs specialized detoxification care. Partnerships between

hospitals and DASA providers should be developed to address this population.

Financing/Payment

The uninsured and underinsured patients are the most disenfranchised in the system. State

funding cuts to grants and funding of services for person who do not qualify for Medicaid and do

not have any other insurance have been drastic, leaving these persons with little or no access to

community services. Substance abuse providers have eliminated complete product lines in the

wake of funding cuts; community providers have also eliminated or limited services that are no

longer funded. Non-institutional providers such as psychiatrists and other mental health

professionals may not accept Medicaid let alone those who lack any means of payment. These

persons either do not receive treatment or they receive it in crisis, in an emergency department or

other crisis setting.

Recommendations:

Funding must remain available for persons who do not qualify for Medicaid and have no

other means of funding their health or behavioral health care. The Medicaid domination

of the system is leaving many with no options except emergency departments, the streets,

or jail.

Research and pursue opportunities to obtain federal grants to support innovative services,

children’s services, and other Medicaid options.

Medicaid rule 132 services are defined too narrowly for children, making it very difficult

to find outpatient services for kids.

Eliminate the financing rules that limit specific services to a setting licensed by one

agency. This limits flexibility and choices and adds administrative complexity and costs.

Protect critical access hospital funding which is under threat. They are on the front lines

in many rural communities.

Support agreements between hospitals to provide psychiatric care to patients; support

agreements between hospitals and other community providers. Flexibility is necessary to

address unique characteristics and needs of the rural communities developing such

relationships.

9

Workforce

Integration of behavioral and medical care is good for patients/consumers. To advance

integration between behavioral and other medical care, staff in both sectors needs training.

Primary care physicians need training to enable them to treat patients with psychiatric or

substance use conditions in conjunction with behavioral health specialists and psychiatrists.

Areas in which the PCP can provide traditionally behavioral services: identification of a

psychiatric or substance use disorder, monitoring of a stable patient, prescribing medication for

certain conditions such as depression. Pediatricians can play similar roles.

Recommendations:

Health professionals across the spectrum of medicine, mental health and

substance abuse will need to be cross-trained in each other’s disciplines.

Use non-physician medical professionals to expand the reach of the physicians:

Advanced practice nurses (APNs) are valuable resources especially in delivering

services to children. They also are able to monitor medication and other physical

health needs.

Consider loan forgiveness and other incentives to encourage medical students to

go into psychiatry and to practice in a rural community.

Train all medical students about mental health and addiction issues.

Provide incentives such as scholarships, grants or loan forgiveness for persons to

enter any of the health and behavioral health professions that are not available to

rural communities.

Educate first responders about appropriate ways in which to care for a person

experiencing a mental health crisis.

Educate teachers and others in schools to recognize behavioral health conditions

in their students. Provide resources to the schools to refer students appropriately.

Quality of Care

The right care should be delivered in the right place, at the right time, to every patient.

Recommendations:

Accredit care managers. Standards exist.

Take the American Academy of Pediatrics assessment tool kit to the next level. This

should facilitate care integration across primary and behavioral care.

10

Use evidence-based/–informed practices at every level of care. Fund the use of these

services; disseminate those practices that are available (e.g., SAMSHA has a list of EBPs

on their web site.)

The ACES study provides a predictive model that many in primary care and behavioral

health care could use.

Apply the current Illinois DOC Assist model, which provides phone access for Medicaid

kids to a primary care physician, to adults.

Technology

Telepsychiatry and telemedicine are tools to improve access to all health care in rural Illinois,

including and especially psychiatric care. We are not going to meet the current and growing need

for specialized psychiatric services in rural communities without reaching out to other

geographic areas in which these professionals live and practice. Moreover, our medical schools

are not training enough primary care and psychiatrists to meet current and future demand.

Recommendations:

Medicaid in Illinois should pay a psychiatrist the same amount for a telepsychiatry

encounter as they do for a face-to-face encounter.

Current law requires that a physician be credentialed by an Illinois hospital in order to

provide telemedicine services. If a physician is credentialed by an accredited and licensed

hospital in another state, or he or she is a licensed physician in Illinois, this hospital

privileges issues should not be necessary.

Transportation

Transportation to behavioral health and other healthcare services is frequently a function of a

person’s ability to get to them. Some communities relay on public ambulance services, a few

have a private ambulance company, all have limited options—especially in circumstances

involving a mentally ill person who may be difficult to manage. The Division of Mental Health

pursuant to statute provides transportation to persons with mental illness who are being

transferred to a mental health facility on an involuntary admission status. These services are not

available to an adult who seeks treatment willingly, i.e., is a voluntary patient, or for children and

adolescents. For voluntary adults, this policy may force an individual to choose a status he or she

does not wish; there may be stigma associated with involuntary status; there are legal

consequences to being admitted on an involuntary status (e.g., FOID card denial or revocation).

Recommendation:

Transportation services should be available for the voluntary adult and for children and

adolescents under certain circumstances.

11

June 29, 2012

Name

Title

Organization

Address

City, State Zip

Dear:







patients and communities. One such opportunity is being presented to us by the 2011 enactment of House

Bill 2982 – Public Act 98-031, which creates the Regional Integrated Behavioral Health Networks Act.






region that addresses the nature and scope of existing services, identifies community needs and defines





systems of care.

You are invited to participate in the Behavioral Health Regional Network meetings for DHS Region 3.

The first meeting will take place Wednesday, July 18 from 10:00 am to 1:00 pm, in the Methodist

Atrium Building, 900 Main Street, on the campus of Methodist Medical Center of Illinois, in Peoria.

(Please park toward the back of the lot across from the Atrium.)

Please note that the second meeting is scheduled for Wednesday, August 8, at Bridgeway, Inc, in

Galesburg. The third meeting will be held on Wednesday, August 22, at The Center for Children’s

Services, in Danville. You will receive separate invitations to these meetings.

If you have any questions or concerns, please contact IHA Staff: MaryLynn M. Clarke at 217-541-1154

or [email protected].

Please confirm your attendance for the July 18 meeting by contacting Stacey Dunlap at 217-541-1151 or

email your response to [email protected].

Thank you,

MaryLynn M. Clarke

Senior Director, Health Policy & Regulation



12


July 18, 2012, 10:00 am – 1:00 pm

Methodist Medical Center of Illinois

221 NE Glen Oak Avenue

Peoria, IL 61636-0002

Agenda

I. WELCOME & INTRODUCTIONS ................10:00 ........................ Dean Steiner

II. OVERVIEW OF HB 2982 (PA 97-0381) .........10:20 ............. ..MaryLynn Clarke


o What should the behavioral health system look like 3 years from now?

o What would be the key components of the new behavioral health system?

o Are there immediate actions that could be taken to improve access to behavioral


IV. SMALL GROUP REPORTS ............................11:30 ............... MaryLynn Clarke

V. SETTING PRIORITIES & NEXT STEPS ....12:15 ........................ Dean Steiner

o Provider Questionnaire

VI. ADJOURNMENT & NEXT MEETING ........1:00 .......................... Dean Steiner

Next Meeting: August 8, 2012

Bridgeway, Inc.

2323 Windish Drive, Galesburg, IL

13


July 18, 2012

Methodist Medical Center, Peoria

Stephanie Barisch, The Center for Youth & Family Srvs

Melissa Black, Carle Foundation Hospital

Terry Carmichael, CBHA

Greg Chance, Peoria County Health Department

MaryLynn Clarke, Illinois Hospital Association

Joe Croegaert, DHS/DMH

Laurelyn Cropek, Community Resource & Counseling Ctr, Inc.

Sally Davidson, DHS/DMH

Dennis Duke, Robert Young Center

Sheila Ferguson, Community Elements, Inc.

Carol Flessner, Livingston County 708 Board

Michael Freda, Robert Young Center

Charlene Guldbrandsen, GROW in Illinois

Nancy Greenwalt, Promise Healthcare

Christine Kahl, South Side Office of Concern

Gail Koch, OSF Medical Group

Dietra Kulicke, Chestnut Health Systems

Erin Laytham, Illinois Association of Rehab Facilities

Jordan Litvak, DHS/DMH

Michelle Locke, Graham Hospital

Victor Martino, Rose Medical Association, Inc.

Adam Meuser, Community Health Care, Inc.

Ed Michaels, Center or Children Services

Don Miskowiec, North Central Behavioral Health Systems

Rhonda Nelson, Bridgeway, Inc.

Fred Nirde, Human Service Center

Patrick Phelan, Children’s Home Association of IL

Arlin Pinto, Human Service Center

Thom Pollack, Crosspoint Human Services

John Reinert, North Central Behavioral Health Systems

Caterina Richardson, Tazwood Mental Health Center

Dennis Rodeghero, OSF St. Elizabeth Medical Center

Ernest C. Rose, Rose Medical Association, Inc.

Don Russell, New Directions

Melvia Russell, New Directions

DeeAnn Ryan, Vermillion County MH 708 Board

Amber Sturgeon, Galesburg Cottage Hospital

Bruce Suardini, Prairie Center Health System

Tom Troe, DHS/DMH

Joe Vaughan, Institute for Human Resources

Gary Weinstein, Transitions Mental Health Services

Micky Will, Community Elements, Inc

Rick Zehr, Institute of Physical Medicine & Rehab


Dean Steiner called the meeting to order at 10:00 a.m., and those in attendance

introduced themselves. Mr. Steiner provided a snapshot of the environmental issues

challenging the delivery of behavioral health services in Illinois. Notwithstanding these,

he noted that the group was not there to focus on problems but, rather, to find solutions.


MaryLynn McGuire Clarke provided an overview of HB2982/PA 97-0382, legislation

which requires the Department of Human Services to facilitate the creation of Regional

Behavioral Health Networks in each DHS region to ensure and improve access to

behavioral health services. The legislation provides a platform for providers across the

continuum of care to collaborate, build on existing community resources, identify needed

services, and work collaboratively to develop region-specific plans. Region 3 is the fourth

DHS regional group to meet in 2012. The legislation also created the Regional Integrated

14

Behavioral Health Networks Steering Committee, which will be comprised of state

agencies, advocacy and trade associations, and a representative of each of the five DHS

regions.


Participants were divided into groups to discuss three questions: (1) What should the

behavioral health system look like three years from now? (2) What would be the key

components of the new behavioral health system? (3) Are there immediate actions that

could be taken to improve access to behavioral health services in this region? If so, what

are they?


Mr. Steiner asked a representative of each of the break-out groups to report on their

findings and recommendations. The information from the break-out groups is included in

the attached document.


The recommendations collected at the meeting will be shared with participants before the

next planning meeting. Participants in the second meeting will set priorities and develop

specifics of their regional plan.


Mr. Steiner noted that the next meeting will be held August 8, at Bridgeway, Inc. in

Galesburg, at 10:00 a.m.

15

July 18 Small Group Notes

Group 1

System Components - 3 Years

Integrated – bidirectional for (high utilizers of care)

- MH/SA patients

- Older adults

- DD/MR

Need managed integration

Medical Home

- B.H. Home

Need standard vehicle to reach this

Need community points of access

Intercept model which will ensure quality and lower costs

Need integration of providers (medical, B.H., S.A., DD/MR, Public Health)

Need to reduce regulatory and financial silos

Need Consistency of funding

Development of interceptor points that can deflect from an ED admission

Improved technology and use of it

Telemedicine

Integrated EMR

Key Components

Incentivize integrated organizations with shared risk reward

Education

- Prevention

- Organization cooperation

- Community

- Cross Integration

Balancing regulatory requirements with reality of available resources

Education process of all stakeholders

Health care Navigator

Strategic planning process in local communities throughout region

Immediate Actions

Expand mental health first aid in communities

Include higher education institutions, re: internships

Utilizing recovery model across all settings

Embrace all evidence based models that demonstrate fidelity

16

Group 2

System Components- 3 years

Access/capacity for all (i.e., uninsured)

Cost effective delivery system that is outcome-based, evidenced-based

Enhanced crisis service – Deflection from ED - No cuts

Improved outpatient treatment continuum

Primary Behavioral Integration (MH, CD)

- Reimbursement structure - Parity

- Learning collaborative – Bidirectional

- Screening – CD, MH – (Reimbursement)

Prevention/screening – CD, MH

Reimbursement for consultation between PCP and MH providers

Integrated Medical Record – Access for all providers

Increased use of peer services/community support groups

Reimbursement structure that support full treatment continuum including employment

services (IPS) and housing

Follow-up care

Alternative funding services (i.e., drug companies)

Key Components

Integration– PC/BH

Consistent reliable funding – Update reimbursement rate

Evidence/outcome based

Single regulatory body/streamline regulations

Practical workforce development

ED training that supports integrated delivery model

Timely access to treatment and medications

Community collaboration

Immediate Actions

“Show me the money” Dr. Pinto…

Community education forums – All stakeholders:

Providers

Courts

State Agencies

Law

Schools

Service directory by community

Enhanced crisis services

17

Group 3

System Components - Three Years

Integrated

Interdisciplinary Teams

Funded – Blended pay system

Uninsured compensated

Immediate access

Comprehensive

Integrated medical records

Public policy commit to managed care vs. cost

Preventative vs. reactive

Community agencies funding for EMR

Evidenced based

Aligning clinician to payer

Cohesive language

Easier to access Medicaid and other funding

Key Components

Technology as asset

EPSDT

Person centered/individualized

Ready access

Care Coordination

Structured

Integrated and human services

Community support

Training and education

Salary/compensation

Regulatory regs

Workforce

Consumer accountability

Transportation

Immediate Actions

Telehealth and 3rd

party reimbursement

Consents

Blended funding

Resource link (OSF)

Training

Advocacy

Parity implementation

Pharmacy

- Access to 340B

18

Access to National Health Service Corp

Identifying value

- Common definition

Improve outcomes for clients

Conversations with non-traditional payers

Group 4

System Components - Three Years

On-time payments

Consumer and provider input and participation at all stages of development

More accountability tied to resource allocation (budgeting for outcomes)

Less silos

More consistency in requirements

Access to a full spectrum of services (levels of intensity)

- Expand continuum of services

- Pager issues resolved

- Severity getting care

- Adequate transportation

Valid mean of determining levels of care consistently

Care coordination teams – including all providers

- Conflict-free care coordination

- Consumer oriented

- Flexibility based on specific community needs

- Role of health homes

- Defined referral from primary HC

- Communication back and forth

Common IT system (EMR)

- Appropriate confidentiality safeguards

Workforce expansion

- Peer and para-professional

- Training and curriculum

- Allowing more home based services and community based services (natural

environments)

Community educations

- ER diversion

- Planned health care access

Sustainable financial model (support prevention and early intervention)

- Infrastructure capacity grants

- Government payers (fed, state, county, local)

- Private insurers

- Fed block grant utilized for non-Medicaid services

Unified goal, unified approach

- Direction

19

- Legislation

- Finances/budgeting

- Funding streams that support the whole system

Adult specific vs. child specific services (unique, need recognized)

- Less emphasis on medical treatment model

- More emphasis on global treatment model

Key Components

Care coordination – communication at all levels (funding, providers, accountability)

Health Information Technology (telemed – telepsy)

Adequate funding – sustainable financial modeling – systemic

Integration between state and local planners

Health homes

Less institutional care settings

Full continuum of services

Focus on prevention and early intervention (wellness)

Regional flexibility

Standardized outcome metrics

Recognition of co-occurring treatment

Confidence in state leadership – at department level

ER diversion projects – statewide

Workforce expansion – workforce support

Consumer and provider participation at all levels

Trauma — informed treatment

Evidence – informed treatment

Adequate transportation system to enable access

Immediate Actions

Borrow money to pay down Medicaid backlog

Seek to inform our legislative officials

Establish a coherent vision for behavioral health within Health Care Reform

Immediate coordination between state agencies (DASA, DMH, HFS, Gov, DCFS)

Establish a regional consortium with all key stakeholders (seek to maintain)

Coordination between various planning groups

20


August 8, 2012, 10:00 am – 1:00 pm

Bridgeway, Inc.

2323 Windish Drive Galesburg, IL

Agenda

I. WELCOME ........................................................10:00 ............................ Bill Nelson

II. SUMMARY OF FIRST MEETING.................10:20 ...................... ..Dean Steiner


A. DELIVERY SYSTEM IMPROVEMENT & INNOVATION

1. Define components of an integrated system of care, i.e., one that integrates

behavioral health and primary care and includes the full continuum of care.

What examples of integration currently exist in your region? What models

may work in your region, given your demographics, resources, and needs?

What are next steps to be taken to implement integrated models of care?

2. What behavioral and medical services are available in your region? What

services are not available in your region? In terms of priorities, what services

are urgently needed? What services should be built or developed in the next

few years?

3. What crisis behavioral health services are needed? What crisis services are

available?

4. What transportation is available in your region, for what patients? What is

needed?

B. TECHNOLOGY

1. What is the penetration of electronic medical record, by agency type and

geographic area? What is needed to bring all providers into the electronic

system?

2.Telemedicine and telepsychiatry. Are you using this technology? Would you

like to use it? What do you need to do to use it?

C. QUALITY OF CARE/BEST PRACTICES/EVIDENCE-BASED &

EVIDENCE-INFORMED PRACTICES

1. What EB/best practices are you currently using, for what services or consumer

groups?

2. What EB/ best practices do you plan to implement?

3. What resources would assist you in implementing EBPs?

4. What efforts are you making to ensure and improve quality of care?

21

D. PAYMENT ISSUES

1. What payment policies, models and incentives are necessary to improve

access to the most appropriate levels of care for the patient/consumer’s

condition?

2. What payment incentives and/or models are necessary to support integrated

models of care?

3. What services should be available to a consumer/patient that is not reimbursed

at all or adequately?

E. WORKFORCE 1. What mental health, substance abuse, and healthcare professionals are in short

supplies in your region?

2. What are the training and educational needs of your existing workforce?

3. Are you currently cross training behavioral and other medical professionals?

If so, what tools are you using? What resources do you need to accomplish

this integration?

4. What resources do you need to expand workforce in your region?

IV. SMALL GROUP REPORTS ............................11:30 ............... Group Facilitators

V. SETTING PRIORITIES & NEXT STEPS ....12:15 ........................... Mr. Steiner

VI. ADJOURNMENT & NEXT MEETING ........1:00 ............................. Ms. Clarke

Next Meeting: August 22, 2012

Center for Children’s Services - Danville, IL

22


August 8, 2012

Bridgeway, Inc, Galesburg

Stephanie Barisch, The Center for Youth & Family Srvs

Karen Brauer, Mason District Hospital: Havana Medical

Jennifer Chiras, Children’s Home Association of IL

MaryLynn Clarke, Illinois Hospital Association

Vivian Coeur, Western IL University

Joe Croegaert, DHS/DMH

Laurelyn Cropek, Community Resource & Counseling Ctr, Inc.

Julie Darnell, Children’s Home Association of IL

Renee Donaldson, Advocate BroMenn Medical Center

Laura Domino, Hammond-Henry Hospital

Dennis Duke, Robert Young Center

Carol Evans, OSF Holy Family

Deb Fritz, Knox County Health Department

Carrie Hagen, OSF St. Mary’s Medical Center

Hillary Haggertt, Woodford County Health Department

Joan Hartman, Chestnut

Kimberly Hasselbach, OSF St. Mary’s Medical Center

Gail Koch, OSF Medical Group

Wayne Kubasak, McDonough District Hospital

Denise Jackson, Perry Memorial Hospital

Erin Laytham, Illinois Association of Rehab Facilities

Delinda Leopold, Perry Memorial Hospital

Marlin Livingston, Cunningham Children’s Home

Michelle Locke, Graham Hospital

Wendy Navarro, OSF St. Elizabeth

Bill Nelson, Bridgeway, Inc.

Rhonda Nelson, Bridgeway, Inc.

Fred Nirde, Human Service Center

Linda Parsons, Illinois Valley Community Hospital

Arlin Pinto, Human Service Center

Gretchen Robbins, Carle Foundation Hospital

Ernest C. Rose, Rose Medical Association, Inc.

Don Russell, New Directions

Melvia Russell, New Directions

Patricia Sampson, OSF St. Mary’s Medical Center

John Smith, Western IL University

Alice Snyder, OSF St. Mary’s Medical Center

Amber Sturgeon, Galesburg Cottage Hospital

Amy Tippey, Tazewell County Health Department

Tom Troe, DHS/DMH

Gary Weinstein, Transitions Mental Health Services

Robert Wesley, SIU School of Medicine

Melinda Whiteman, Eagle View Community Health Sys

I. Welcome & Summary of First Meeting

Bill Nelson, chief operating officer, Bridgeway, Inc., welcomed the group to Bridgeway,

at 10 a.m. He then turned the meeting over to Dean Steiner who provided a summary of

the first meeting and the agenda for the current meeting. Mr. Steiner reminded the group

that the goal of the meeting is to develop a plan to improve access to behavioral health

services in the region.

II. FOCUS ON PRIORITIES

Mr. Steiner asked the group to divide into small groups to discuss the following topics:

(1) Delivery system improvement and innovation; (2) technology; (3) Quality of

care/best practices/evidence-based and evidence-informed practices; (4) payment issues;

and (4) workforce.

23

III. Small Group Reports

Mr. Steiner asked a representative of each of the break-out groups to report on their

findings and recommendations. The information from the break-out groups is included in

the attached document.

IV. Setting Priorities & Next Steps

The recommendations collected at the meeting will be shared with participants before the

next planning meeting. Participants in the third meeting will develop the draft of their

regional plan.

V. Adjournment & Next Meeting

Mr. Steiner noted that the next meeting will be held August 22, at Center for Children’s

Services, in Danville, at 10:00 a.m. the meeting adjourned at 1:00 p.m.

24

August 8 Small Group Notes

Group #1

Facilitator: Alice Snyder

1. Increase Telemedicine – ABC

2. Funding – Streams – D

3. Physician extenders – A, D & E

4. Examine PCP training curriculum – E

5. Examine APN training curriculum – E

6. Licensing should be extended to younger range (↓15 years) for APNs – E

7. LCPC, CAADC (A, E) and LCSW

8. Incentivize Evidence Based Practices – C, D & E

9. Education – A & B

*Safe transport of violently psychotic patients

*AMT – Peoria – throughout state

*Expand emergency transport to younger patients. Need more services.

B. Technology

1. OSF – has EHR

2. Improve communication between referring and consulting practitioners

3. All electronic health records should connect w/HIE as it develops

4. Secure method of patient info electric transfer

C. Evidence Based

1. Wrap – Wellness Recovery Action Plans are EBPs

2. Telehealth

3. Employment Assistance programs

Q1 – Now in Region

a. Peoria - MHC and SA

Work with FQHC → soon two days/week

Psych accredited with FQHC

Hope to expand

b. FQHC work with another medical center – Rock Island

c. FQHC – Eagle view

Piecemeal with Bridgeway and others

Need a psychiatrist at least once a week

d. In Tennessee – Cherokee HCT System

MHC w/BH consultant

Incorporate Telehealth

Similar one in OR

e. Wyoming works with EDs (safe rooms)

f. A number of informal becoming formal relationships

g. Need for service Ls already forcing cooperation → need formal descriptions

h. Shopping for available services/modes of cooperation – should be formalized

25

i. Fee-for-service/private grd/now offer integrated services and have for some time

j. Private practice – Letters of Understanding for referrals – contract with reviewing

physicians

k. Chronic D/S patients have tough time getting into pays practices 0 OSF trying to provide

intermediate care to this population

Q2

*Psychiatric care for children is very difficult to acquire. This is true throughout much of the

state.

*Funding streak necessary

*Perhaps more training for PCPs

*Train MORS physician extender

Q3

a. SA is major issue in emergency situations → #1 issue

b. Detox is medical problem

Group #2

A. Delivery Systems/Models of Care

1. Education

2. Motivation/Costs

3. Access/response

4. Develop protocol

5. Strategies

B. Technology

1. Using Telehealth (efficient)

2. Electronic records linking with other providers

C. Evidence Based

1. Outcomes

2. Evidence/performance-based contracting

D. Payment Issues

1. Cost of Telehealth

2. Lack of psychiatry resources/cost

3. Lack of funding for prevention

E. Workforce

1. Psychiatry is limited

2. Acute children’s services are scarce

26

Group #3

A. Delivery Systems

1. Increased volume of BH in EDs brings need for increased inpatient beds

Local communities focus on collaboration and integration, care coordination

Development of workforce

Integration needs to include community services, police, transportation, basic

needs, and education

In-service/training of law enforcement

Support for caregivers

2. Availability to licensed BH professionals

3. Transportation needs increased.

Expand utilization of HAN network to include inpatient BH beds

Create handbook of services (update)

B. Technology

1. Developing EMR or HIE portal

BH behind in EMR

No consistency between chosen EMR

Need strong control over who has access to record and where it goes

2. Utilize available technology to increase services

Technology to provide “instant” access to patients

Bridgeway offers Telemedicine/Telepsych (cannot bill for it)

Incentives for Telepsych

C. Evidence Informed Practices

1. Health department is working with BH to assist with expectations/quality of care

2. Creating a “safe room” in ED with additional staff training

3. Training in mental health first aid

4. Using EBP in Employment Services

5. Using Health Matters

6. Proposal to develop “BH Homes”

D. Payment Issues

1. Observation care not paid beyond 48 hours

2. Re-admission not to be reimbursed

3. Medicaid limiting services – 1*

4. Timeliness of payments

5. Access to affordable meds – 1*

6. Dental care – 1*

7. No services access for unfunded population – 1*

*Top priority

E. Workforce

1. All Psychiatrist

Nurse Practitioners

27

Interventional strategies (training)

Financial resource to pay

Incentive exists to enter field but retention is problem

Recruitment and retention

Group 4

A. Delivery System

1. Integrated care (person centered) with ED diversion component (explore various

models/options

2. $/emphasis in school system and early intervention

3. Allowance of regional planning decision making – empower us to direct resources

– knowing what our regional needs are.

4. Merge affordable housing/transportation

Hard for hospital to get people back to community

Collaboration between in/outpatient settings

5. Post-discharge capability for clients – psych, meds, and counseling

B. Technology

1. Regional telecrisis, telepsychiatry) telemedicine access (e.g.., Iowa services being

provided by Chicago-based psychiatrists)

Assist with ED DC (reimbursement)

Assist hospitals with no psychiatrists to provide appropriate patient care

2. Financial incentive for paperless system, shared access

C. Evidence Based

1. Support funding at lower levels of care to keep people from inpatient, especially

for persons with substance use conditions

2. Need lots of training to support EBP

3. Lack of support for EBP from state. Where’s monitoring for quality? – no data

reporting required

4. Inpatient will be required to implement psychiatric core measures – need

quality/process improvement tracking

5. Expansion and support of WRAP

E. Workforce

1. More e-learning access

2. MH 1st aid curriculum – for front-line responder

3. Critical access hospital grants to trim

4. CIT training

5. Short of APNs and psychiatrists

6. Education of medical community (IHA can be an advocate here)

7. Residency program at Methodist

8. Collaboration of projects/integrated care with/I region for EB practice (best

practice)

28


August 22, 2012, 10:00 am – 12:30 pm

Center for Children’s Services

702 Logan Avenue, Danville, IL 61832

Agenda

I. WELCOME ........................................................10:00 ......................... Ed Michaels

II. SUMMARY OF SECOND MEETING ............10:05 ....................... Dean Steiner/

MaryLynn Clarke

III. REVIEW OF PLAN/PRIORITIES………… ..10:15.. ............ MaryLynn Clarke/

Jordan Litvak

IV. DISCUSSION .....................................................11:30 .............................. Everyone

V. NEXT STEPS ....................................................12:15 .............. MaryLynn Clarke/

Jordan Litvak

VI. ADJOURNMENT ..............................................12:30 ......................... Ed Michaels

29


August 22, 2012, 10:00 am – 12:30 pm

Minutes

Center for Children’s Services

702 Logan Avenue, Danville, IL 61832 I. WELCOME

Edward Michaels, Ph.D., president, The Center for Children’s Services, and host for the

meeting, welcomed everyone to the Region 3 planning meeting.

II. SUMMARY OF SECOND MEETING/REVIEW OF PLAN & PRIORITIES

MaryLynn Clarke, Illinois Hospital Association, asked the participants to review the Region

3 draft plan that had been provided to them and to indicate areas of agreement as well as

suggested revisions. During their discussion about the plan, they made the following

recommendations:

In addition to referencing the shortage of psychiatrists in the area, there are also shortages

of many licensed professionals. Community mental health centers experience difficulty

recruiting and retaining staff because they are not able to pay them as much as other

entities such as a hospital or school.

Telepsychiatry is being used in the region by North Central Mental health Center. They

use telepsychiatry in multiple sites, for psychosocial rehabilitation, intensive outpatient

therapy, Level I addiction services, and for group therapy (after obtaining a waiver for

such from the Division of Alcoholism and Substance abuse). To expand the use of

telepsychiatry in Illinois, Bob Wesley, SIU School of Medicine, recommended that

Illinois pass legislation that payers reimburse the physician the same for telemedicine as

for a face-to-face interaction. He also added that Medicaid payment is low and slow for

all services, including telemedicine. And, many insurers don’t pay for telemedicine.

Legislation is also needed to remove the requirement that a physician, in order to practice

using telemedicine, must both have admitting privileges at an Illinois hospital and be

licensed in Illinois. Every state, including Illinois, has different requirements for a

physician to use telemedicine. These are barriers to its use.

Children’s services are in short supply in Region 3. All outpatient services for kids have a

waiting list, some for up to six months. The only way to access services is through the

crisis SASS system. There is a lack of sub-acute services for kids such as partial hospital

or intensive outpatient services.

Integration between general medical and behavioral health presents opportunities to

improve access and outcomes for persons with mental illness. An example of a Region 3

integrated system of care is the Human Services Center in Peoria, which provides

behavioral health services in collaboration with a FQHC. The group endorsed as a model

to emulate the Human Services Center in Peoria. They offer 8 crisis beds that are open 24

hours a day, seven days a week that is staffed by a registered nurse, a recovery specialist

and other professionals. They also had housing that was funded by a federal grant that has

since expired. Other examples of integrated models of care included St. Mary’s Hospital

and Heritage community mental health center. Integration must be include care

management in order to work. It was observed that integrated care works best with

30

medical homes and mental health services work best with care managers. There is an

array of services in all communities that are not connected and this is a role for the

electronic medical record. Several noted that information goes to the primary care

physician but information seldom is directed to the behavioral health client.

The group recommended blended funding to support these models. The block grant permitted

providers to offer a full range of services and to use the block grant funding to support it. The

loss of grant funding has also reduced provider’s flexibility to develop comprehensive services.

Funding needs to be stable and predictable. A provider should be able to take all comers, not just

those who qualify for Medicaid. They recommended funding that provides a lump sum (e.g., a

grant) that can be used according to the unique needs of the particular community. The Mental

Health Block Grant should be changed in two ways: first, the application should include

integration of medical and mental health and substance abuse. Second, money should be

available for the non-Medicaid population.

Hospitals are caring for many persons with mental and substance use illnesses in crisis. One

recommendation to shore up their ability to meet these demands is for hospitals to have

agreements with each other. Another idea is to adults the Doc Assist phone consultation program

currently available for kids.

The group recommended the addition of early intervention and prevention to the continuum of

care. Examples include family education, suicide prevention in the schools, depression

screening. Some of these services can be provided by a primary care physician including

pediatricians. Funding limitations do not support these services for the non- Medicaid client,

unfortunately.

There are excellent evidence-based screening tools available that can be used in the primary care

setting. The ACES Study provides a predictive model for substance abuse or mental illness that

can be used in medical setting. The American Academy of Pediatricians has a tool kit that can be

sued and enhanced.

Substance abuse services in Region 3 are in crisis. There is an absence of many types or levels of

care: medical and medically managed or monitored detoxification, Level I and II outpatient

services, and residential services. There should be a capacity study done in the region to

determine what exists and what is needed. SBIRT may screen a person but there are not

programs to which to refer the individual.

Priorities for Region 3 include the following:

Education of first responders about mental health and suicide prevention;

Funding related to the patient/client’s need rather than their source of or eligibility

for funding;

This collaborative, region-based and –centric planning process should continue as

an on-going effort;

It should be coordinated with the other planning efforts underway, as well.

The meeting adjourned at 12:30 pm.

31

Appendix


Public Act 097-0381































regions.

Section 15. Goals.





32







































Committee.



33















(7) Other.





health staff.




providers.





(1) Prevention.






hospitals.









34













Public Act 097-0381

35


Provider Questionnaire

1. Wait Times


receive services due to transportation, available placements, etc? If so, what



important – 5 = not important at all) ______

Have you documented these delays?______ If so, what data do you have?



waiting for a transfer? ______


transfers? (1 = very important, 5 = not important at all) ____ What data do you

have to document security issues? ______


3 Patient Volume





4. Transportation


On a scale of 1-5 how big a problem do you believe this is? ______


36

5. Admissions




facility? _____

On a scale of 1-5 how big a problem do you believe this is? _______








system design issues? Please indicate which issues would be helpful to you.

9. Any other items (including data) you would like to share about this planning

process or materials that are related to this effort?

37

Region 3 Invitation List

A & L Counseling Services, P.C.

Accent Counseling, LLC

Action Consultants

Advocate BroMenn Medical Center

Advocate Eureka Hospital

Alcohol and Drug Education Clinic, Inc.

Alcohol and Drug Educational Services

Alcohol and Drug Professionals

Alcohol Chemical Evaluation Services,

DBA A.C.E.S., LTD

Alcohol Education and Intervention

Services, Inc.

Allied Counseling Resources, LTD

Association of Community Mental Health

Authorities

Association of Community MH Authorities

of IL

Aunt Martha's Youth Service Center, Inc. -

Vermillion Area Community Health Center


Great River Community Health Center


Iroquois Community Health Center

Bridgeway, Inc.

Bureau County Health Department

Carle Foundation Hospital

Carle Health Care Incorporated

Catholic Charities

Center for Alcohol and & Drug Services,

Inc.

Center for Children's Services

Center for Human Services

Central Counties Health Centers, Inc. -

Francis Nelson Health Center

Central Counties Health Centers, Inc. -

Urbana School Health Center

Champaign County Mental Health (708) and

DD (377) Boards

Champaign-Urbana Public Health District

Chestnut Health Systems

Children's Home Association of IL

Community Behavioral Healthcare

Association

Community Elements, Inc.

Community Elements/Mental Health Center

of Champaign, Co.

Community Health Care Inc., Christian

Family Care Center HomelessClinic

Community Health Care, East Moline Clinic

Community Health Care, Inc.

Community Health Care, Inc. - Rock Island

Clinic

Community Health Centers of Southeastern

Iowa, Inc. - KHS

Community Health Improvement Center

Community Health Partnership of Illinois

Community Health Care, Inc. Robert Young

Center

Community Resource & Counseling Ctr.,

Inc.

Community Workshop and Training Center

Countermeasures, Inc.

Crosspoint Human Services

Cunningham Children's Home, Inc.

Custom Counseling Services

DHS/DMH

DUI Assessments & Services

DUI Services

Eagle View Community Health System

East Central Illinois Humanistic, Inc.

Ford-Iroquois County Health Department

Frances Nelson Health Center

Fulton County Health Department

Fulton County Mental Health (708) Board

Gage & Associates, Inc.

Galesburg Cottage Hospital

Genesis Medical Center, Illini Campus

Gibson Area Hospital & Health Services

Good Shepherd Foundation of Henry

County, Inc.

Graham Hospital

Great River Community Health Center

GROW in Illinois

Hammond-Henry Hospital

Havana Medical Associates

Heartland Community Health Clinic - East

Bluff

38

Heartland Community Health Clinic -

Integrated Health Center

Heartland Community Health Clinic -

Carver Clinic

Heartland Community Health Clinic

Henderson County Health Department

Henry County Health Department

Hoopeston Regional Health Center

Hopedale Medical Complex

Human Service Center, Fayette Companies

Illinois Alcohol and Drug Evaluation

Services

Illinois Association of Rehab Facilities

Illinois Drop In-MLK Center-Homeless

Illinois Drug and Alcohol Counseling

Services, IDAACS, Inc


Illinois United for Youth

Illinois Valley Community Hospital

Institute for Human Resources

Institute of Physical Medicine &

Rehabilitation

Iroquois Community Health Center

Iroquois Memorial Hospital & Resident

Home

Iroquois Mental Health Center

Jesus is the Way Prison Ministry

Joann C. Milani, PHD, PC

Kewanee Hospital

Kindred Hospital, Peoria

Knox County Health Department

LaSalle County Health Department

LaSalle County Mental Health (708) Board

LaSalle Outpatient

Livingston County Health Department

Livingston County Mental Health Board

Marshall County Health Department

Mason County Health Department

Mason District Hospital

McDonough County Health Department

McDonough District Hospital

McFarland Mental Health Center

McLean County Ctr. for Human Svcs., Inc.

McLean County Health Department

McLean County Mental Health (553) Board

and McLean County Board for the Care and

Treatment of Persons with a Developmental

Disability (377) Board

Mendota Community Hospital

Mercer County Health Department

Mercer County Hospital

Methodist Medical Center of Illinois

New Directions Counseling Center

Nexus, Inc.-Onarga Academy

North Central Behavioral Health Systems

Occupational Development Center

OSF Holy Family Medical Center

OSFMG Community Behavioral Health

Services

OSF Saint Francis Medical Center

OSF Saint James-John W. Albrecht Medical

Center

OSF St. Joseph Medical Center

OSF St. Mary Medical Center

OSF Saint Elizabeth Medical Center

P.A.T.S. Prevention and Treatment Services

Pekin Hospital

Peoria County Health Department

Perry Memorial Hospital

Prairie Center Health Systems

Proctor Hospital

Promise Healthcare

Provena Covenant Medical Center

Provena United Samaritans Medical Center

Psychological Services in the Quad Cities,

PC

Putnam County Helath Department c/o

Bureua County HD

RICCA

Richardson Counseling Center, LLC

River Bend Christian Counseling, Inc.

Rock Island County Health Department

Rock Island County Mental Health (708)

Board

Robert Young Center

Rose Medical Association, Inc.

Rosecrance Health Network

Siefert Counseling Center

South Side Office of Concern

Southern Illinois University, School of

Medicine

St. Margaret's Health

39

St. Mary's Hospital, Streator

Stark County Health Department

TAP Resources, Inc.

Tazewell County Health Department

Tazwood Mental Health Center

The Baby Fold

The Center for Youth and Family Solutions

The Consultants

The Pavilion

Transitions NFP

Tri-County Alcoholism and Drug Services,

LLC

Trinity Regional Health System

United In Jesus Outreach Ministries

Vermillion County Health Department

Vermillion County Mental Health 708

Board

Warren County Health Department

Western Illinois University/Beu Health

Center

Woodford County Health Department

Youth Service Bureau of Illinois Valley

40

Region 3 Acute Care Hospitals with

Psychiatric Beds

Hospital Name

City

Psychiatric

Licensed Beds

Staffed Psych

Beds Oct 1, 2009

Advocate BroMenn Medical Center Normal 19 17

Advocate Eureka Hospital Eureka 0 0

Carle Foundation Hospital Urbana 0 0

Galesburg Cottage Hospital Galesburg 12 12

Genesis Med Ctr, Illini Campus Silvis 0 0

Gibson Area Hosp & Hlth Servcs Gibson City 0 0

Graham Hospital Canton 0 0

Hammond-Henry Hospital Geneseo 0 0

Hoopeston Regional Health Ctr Hoopeston 0 0

Hopedale Medical Complex Hopedale 0 0

Illinois Valley Community Hosp Peru 0 0

Iroquois Mem Hosp & Res Home Watseka 0 0

Kewanee Hospital Kewanee 0 0

Kindred Hospital Peoria Peoria 0 0

Mason District Hospital Havana 0 0

McDonough District Hospital Macomb 0 0

Mendota Community Hospital Mendota 0 0

Mercer County Hospital Aledo 0 0

Methodist Medical Center of IL Peoria 68 64

OSF Holy Family Medical Center Monmouth 0 0

OSF Saint Francis Medical Ctr Peoria 0 0

OSF Saint James-J W Albrecht MC Pontiac 0 0

OSF St Joseph Medical Center Bloomington 0 0

OSF St Mary Medical Center Galesburg 0 0

Ottawa Regional Hospital & HCC Ottawa 26 28

Pekin Hospital Pekin 0 0

Perry Memorial Hospital Princeton 0 0

Proctor Hospital Peoria 18 0

Provena Covenant Medical Center Urbana 30 25

Provena United Samaritans MC Danville 0 0

St Margaret's Health Spring Valley 0 0

St Mary's Hospital Streator 0 0

The Pavilion Champaign 47 45

Trinity Medical Center Rock Island 54 54

Veterans Affairs Medical Ctr Danville




41


SFY

2005

SFY

2006

SFY

2007

SFY

2008

SFY

2009

SFY

2010

From SFY 2005 to SFY 2010

Statewide 1,723,215 1,714,661 1,724,116 1,715,750 1,677,926 1,651,967 -4.1%

Region 3 10,353 10,128 9,649 10,025 10,277 10,738 3.7%

Source: COMPdata


Peds

Adults

Total

REGION FACILITY

SFY

2007

SFY

2008

SFY

2009

SFY

2010

SFY

2007

SFY

2008

SFY

2009

SFY

2010

SFY

2007

SFY

2008

SFY

2009

SFY

2010


4,242 4,151 3,654 3,674

4,242 4,151 3,654 3,674


1,913 1,788 1,848 1,829

1,913 1,788 1,848 1,829


1,721 1,473 1,784 1,823

1,721 1,473 1,784 1,823


7,876 7,412 7,286 7,326

7,876 7,412 7,286 7,326

2 Elgin MHC 0 0 0 0 1,032 1,031 1,137 1,204 1,032 1,031 1,137 1,204

Singer MH/Dev Ctr 0 0 0 0 728 706 852 850 728 706 852 850

Treatment & Deten 0 0 0 0 4 9 9 6 4 9 9 6


1,764 1,746 1,998 2,060

1,764 1,746 1,998 2,060


696 728 623 717

718 741 636 733


696 728 623 717

718 741 636 733

5 Alton MH/Dev Ctr 0 0 0 0 197 198 191 188 197 198 191 188

Chester MHC 0 0 0 0 107 119 150 115 107 119 150 115

Choate MH and

Dev 78 84 60 65 460 400 364 233 538 484 424 298

Region 5 TOTAL 78 84 60 65 764 717 705 536 842 801 765 601

TOTAL

100 97 73 81

11,100 10,603 10,612 10,639

11,200 10,700 10,685 10,720




Illinois Statistics


43

*The Illinois Health Facilities Planning Board discontinued licensing substance abuse beds as a category of service on April 17, 2000. this

category was converted to medical/surgical beds.

44

Hospital Statistics


FY 03 FY 04 FY 05 FY 06 FY 07 FY 08 FY 09


only)

10,472 10,759 11,233 11,657 11,654 10,812 10,504


Forensics)

9,625 9,609 10,190 11,421 11,349 10,729 10,677


Civil Adult 8,870 8,844 9,462 10,770 10,668 10,063 10,045


Forensics total 634 634 610 561 602 590 574

Forensics Adult 611 614 593 546 587 573 565

Forensics Child &

Adolescents

23 20 17 15 15 17 9

Total Triage 1,482 1,784 1,653 797 907 673 401


Civil total 365 364 410 166 152 184 200

Civil Adult 365 364 410 166 152 184 200


Forensics Total 44 50 56 66 59 62 71

Forensics Adult 43 50 55 66 59 62 71

Forensics Child &

Adolescents

1 0 1 0 0 0 0

Individuals with 3+


569 536 592 639 630 585 626

Individuals with 3+


forensics

0.0632 0.0597 0.0617 0.059 0.059 0.055 0.059

FY

03

FY

04

FY

05

FY

06

FY

07

FY

08

FY

09

All Admissions/100,000 78 77 82 92 91 86 86




Admissions/100,000

4 0 4 3 2 2 2




1 1 1 0 0 1 0


45

FY

03

FY

04

FY

05

FY

06

FY

07

FY

08

FY

09



0.48 0.56 0.51 0.43 0.44 0.43 0.42












Average

101 120 126 113 104 112 108




23 20 26 33 25 39 22


Adolescents) Median

170 210 394 402 411 426 433


Average

678 737 841 889 926 1,005 1,077


Median

171 212 394 403 416 427 436



144 180 334 339 338 283 274


Adolescents) Median

127 127 280 353 214 150 282





Adolescents)

8 7 6 5 4 5 4



Adult)

561 588 585 582 597 590 593



9 11 15 13 10 9 6

46



Visits on 7/09/09.

1,410 1,369 1,402 1,322 1,373 1,353 1,319



799 760 791 706 762 742 709



7/09/09.

797 757 786 705 757 742 707



Visits on 7/09/09.

2 3 5 1 5 0 2



611 609 611 616 611 611 610



601 593 595 601 603 601 605




10 16 16 15 8 10 5


FY 03 FY 04 FY 05 FY 06 FY 07 FY 08 FY 09



Forensics)

9,772 9,641 10,150 11,498 11,286 10,739 10,708


Civil Adult 9,122 8,922 9,468 10,888 10,654 10,131 10,115


Forensics Total 517 589 566 517 557 528 537

Forensic Adults 502 578 553 506 538 517 525

Forensic Child &

Adolescents

15 11 13 11 19 11 12


& Forensic)

418 417 475 233 210 249 271

Civil Total 368 359 408 161 138 173 200

Civil Adult 368 359 408 161 138 173 200


Forensics Total 50 58 67 72 72 76 71

Forensics Adult 49 58 65 72 72 76 71

Forensics Child &

Adolescents

1 0 2 0 0 0 0

Report date 07/09/2009 Population Served

12,419,293http://www.dhs.state.il.us/page.aspx?item=33869


1



Region 4

Draft Report

2


Background 3-4

Access 4-5

Funding 5-6

Technology 7-8

Quality Improvement 8

Workforce 8-9

Regulatory Barriers 10

Meetings

Letter of Invitation 11

Agenda Dec. 7 12

Minutes Dec. 7 13-14

Small Group Responses Dec. 7 15-18

Agenda Jan. 6 19


Small Group Responses Jan. 6 22-28

Agenda Jan. 17 29


Appendix

PA 97-0381 32-35

Questionnaire 36-40





State Operated Hospitals Inpatient Discharges 61-62

ILHFB Bed Totals 63


3


For hospital, primary care, mental health, substance abuse and

other community-based providers

Region 4


Association.

Background

On August 15, 2011, Governor Pat Quinn signed House Bill 2982 as Public Act 97-0381, which

created the Regional Integrated Behavioral Health Networks Act. The act provides a platform to

establish Regional Integrated Behavioral Health Networks. Its purpose is to ensure and improve

access to appropriate mental health and substance abuse services throughout Illinois by:

organizing systematically all relevant health, mental health, substance abuse, and other



Under the Act, each Behavioral Health Regional Network shall develop a strategic plan for its


and defines opportunities to improve access to care. The act contemplates a broad, cross-section







Association (IHA), and others, convened a group of behavioral health providers in the State’s

DHS Region 4 to begin to identify existing services in the region, strategies for improving the

behavioral health services delivery system, including timely and appropriate access to medical

and behavioral health services, and ways in which providers can begin working together to

improve access to services and patient outcomes.


participating service providers in three Region 4 meetings. At the first meeting held at the

Mental Health Center of Central Illinois (MHCCI), Springfield, on December 7, 2011, providers

defined their vision for behavioral health care services and outlined priority issues and areas of

focus. In the second meeting at MHCCI on January 6, 2012, participants identified strategies to

improve priority areas of concern listed in this plan. In the third meeting held on January 17,

2012 at MHCCI, the group reviewed and provided input on the first draft of a regional plan and

provided additional feedback on data sources and trends they have experienced over the past 12

months.

4





depend on the continued commitment of all stakeholders-state agencies, primary medical,



1. Access


for all residents of the region. Providers defined the continuum of care to include a

regional and community-based approach to prevention, assessment, coordinated care, and

the necessary follow-up and transition services needed for patients moving from acute

care to community-based services. Providers in this region would like to work with state

and local agencies to develop a regional and community-based collaborative to design the

continuum of care at the community and regional level. Providers indicated that access to

inpatient beds is a priority for this region.

Providers in this region indicated that there is a need to provide alternative services to

acute and crisis care currently being provided by hospital emergency departments.

Region 4 participants would like to explore alternative strategies to provide behavioral

health services in a more appropriate setting to stabilize patients in crisis, provide

counseling to keep patients out of crisis, assist patients with life challenges, and provide

outreach to patients to improve their quality of life through community resources,

employment, housing, etc. Notwithstanding the value of providing alternative services,

providers emphasized the need to maintain access to the full continuum of care, from

acute care to rehabilitative services. This concept of Urgent Care for Behavioral Health

centers would offer more wrap-around services for clients and their families in a more

cost effective manner.

Providers in this region also agreed that a more patient-centered, holistic approach to

health and wellness for patients is a priority. An integrated behavioral and physical

health care system would allow physicians and behavioral health providers to work

together to enhance patient outcomes. In Quincy, the Patient-Centered Medical Home

(PCMH) model is being piloted at the Southern Illinois University (SIU) School of

Medicine Family Practice Clinic where Licensed Clinical Social Workers (LCSW) are

co-located with primary care physicians. This PCMH model is currently being

introduced to federally qualified health centers, rural health clinics, and family practice

clinics around the country and has shown positive outcomes.

However, these models will need to connect with community mental health centers,

substance abuse treatment and prevention service providers, and other community-based

services through a care coordination program. A care coordination program will help

5

patients and their families navigate through health care as they move from assessment,

diagnosis, treatment, follow-up and pharmaceutical compliance.

Recommendations

Develop criteria for the development of alternative settings for behavioral health

services. Providers will need to maintain existing capacity while designing new

system of care.

Develop psychiatric crisis observation beds in hospitals.

Provide treatment in the least restrictive environment.

Expand access to behavioral health crisis teams with consulting physician when

needed.

Develop a regional planning committee to work with DHS as it explores changes to

the behavioral health system in Region 4.

Provide care coordination services for patients and their families who navigate

through the health care delivery system.


health agencies and others, to track and monitor patients with chronic conditions to

keep them out of crisis (within federal law).

Facilitate coordination through electronic medical records, patient tracking

technology and compliance data.

Identify best practices for care coordination at the local level.

Develop linkage agreements to expand coverage of existing services.

2. Funding

There was a lot of conversation regarding future funding strategies for behavioral health

services. There was agreement that existing cuts to the behavioral health system have

resulted in a shift of payments away from community-based services towards more

expensive hospital and long-term care services. Providers would like cuts to mental

health and substance abuse providers restored, so that planning for a more efficient

system of care can be implemented. Long-term funding for behavioral health services

will need to focus on prevention, treatment and follow-up services, based upon patient

outcomes.

6

There was consensus among providers that funding needs to be flexible enough to follow

the patient through the health care delivery system. Providers would like to work with

DHS and statewide organizations to plan for the use of state, federal and commercial

insurer funds that better meet the needs of patients and their families. Over the past few

years, cuts to non-acute care providers have resulted in more acute care patients (or

patients presenting to acute care settings), which increases the cost of care. A serious

plan to provide community-based services will help reduce care costs and provide more

timely services for patients and their families. Funding alternatives are needed that

would allow more flexibility, utilizing funding for locally identified needs, addressing

gaps and developing services where needed most as determined by local stakeholders

Providers would like to work with DHS to identify areas of cost savings to the system,

including lower cost service centers, lower cost transportation options, etc. The cost of

transporting involuntary patients by car is one-third the cost of an ambulance. How do

we transition to a lower cost system using these types of examples?

There is also a recognition that multiple providers may need to collaborate to address

common needs. For example, multiple providers working together to develop training

webinars for providers, recruitment strategies to meet workforce shortages, or to set up

alternative funding and lower cost service options are of interest to this group.

Recommendations

Convene a group of providers to work with DHS to identify lower cost options for

service delivery in the region.

Create behavioral health collaboratives around common needs such as transportation,

alternative service models, etc., to pool resources and implement new models for

patient services.

Explore private and federal funding opportunities to pilot new alternative strategies to

support behavioral health services in the region (crisis centers, care coordinators,

etc.).

Providers need to receive timely payments for services.

Create credentialing opportunities that reflect scope of work for Licensed Clinical

Professional Counselors (LCPC).

Identify accreditation standards for all behavioral health providers.

Provide funding for current unfunded patients.

7

3. Technology


access to care and create efficiencies in the system. Providers would like to integrate

behavioral health services into the patient’s electronic medical records and have access to

the patient’s complete health record when caring for the patient. Creating an

authorization form for patients to allow their behavioral health provider to have access to

their electronic medical record will assist providers in assessing and treating the

behavioral health needs of their patients.




community mental health center. This process creates redundancy in the process, utilizes

resources that are unnecessary and delays access to care for the patient and their family.

Providers would like to utilize technology to record assessment information at the point

of entry and build the patient record as they move through the health care services.

Providers indicated that patient confidentiality rules and regulations need to be followed

throughout the process.

Providers would also like to work with the state and its partners to expand access to

psychiatrists and other specialty providers through telemedicine services, especially

telepsychiatry in the rural parts of the region. Telepsychiatry is currently working in


services. However, the cost can be prohibitive especially in rural community mental

health centers and substance abuse centers.

Recommendations

Continue to work with the Office of Health Information Technology and the state

Health Information Exchange (HIE) Advisory Committee to integrate behavioral

health data into the state’s HIE planning and implementation strategies.

Support behavioral health providers as they link to the state’s HIE, especially small,

non-profit organizations.

Standardize electronic forms and coding to create efficiencies in reporting standards.

Convene a network of providers to explore innovative strategies to reduce duplication

in assessments, patient forms, and provider reporting requirements through




telemedicine equipment, especially for rural providers in the region.

8

Link telemedicine equipment to new crisis stabilization centers to access specialty

services if needed.

Review existing billing practices to identify areas where standardized forms would

provide efficiency in the system.


The group discussed the need to improve data collection, analysis and utilization to

provide more effective and efficient services in the region. With an increasing need to

identify patient needs and deliver high-quality patient outcomes, providers need to

develop quality measures that assess patient outcomes as they move through the

continuum of behavioral health services. There is a real need to develop consistent

outcomes measures for patients regardless of where they enter the system of care.

Providers would like more information on evidence-based practices that improve patient

outcomes and best practice strategies to improve care.

Recommendations

Cross-train providers on key patient measures needed to assess patient outcomes

across the continuum of behavioral health care service providers.

Establish the patient outcomes that will be measured and reported and which

Healthcare Effectiveness Data and Information Set (HEDIS) measures should be used

across the continuum of care.

Develop core measures to be used by the behavioral health care stakeholders to

demonstrate inpatient and outpatient outcomes.

DHS and its state partners should host training sessions for behavioral health

providers to provide a consistent message on rules related to Emergency Medical

Treatment and Active Labor Act (EMTALA) and patient confidentiality.

Establish performance measures to be consistent between departments of DHS

(mental health and substance abuse).

5. Workforce

Region 4 providers recognized a need to develop the workforce that will provide care in

the existing and developing delivery system. There will be a need for new workers such

as care coordinators and patient navigators, information technology specialists, home

health services and family and patient educators. Staff from the different specialty care


9


chronic conditions. Providers would like to establish a pipeline to create a consistent

supply of qualified workers for the industry in the future.

Providers continue to struggle with workforce shortages, especially in the rural parts of

the region. Utilizing higher education training programs, providers will work to identify

new members of the behavioral health workforce. Providers will need to utilize

telemedicine services to access specialty services in rural communities. Providers also

indicated that the industry must also prepare for retirements through succession planning.

The group agreed that new information and professional skills will be needed by those in

the future workforce to address patient care such as: growing quality measures, cross-

training across specialty services, interactions with law enforcement, primary care

integrations, electronic medical records, new billing and coding data, and ongoing

evidence-based practice training. Linkages with higher education will continue to be a

priority as these new members of the workforce are developed.


organizations that link services for patients and families like housing and transportation

services.

Recommendations


to fund those provider services (recovery service specialists, care coordinators, patient

navigators, etc.).

Identify workforce incentives for professional shortage areas to attract providers to

those regions.

Identify core competencies needed for all providers and develop consistent training

for providers.

Provide succession planning training and resources for providers.

Develop locally-based interdisciplinary training for providers.


new system of behavioral health services.

Work with higher education to recruit and train new behavioral health service

providers.

Expand the role of advance practice nurses (APN) in the behavioral health system.

10

6. Regulatory Barriers

This group identified several regulatory rules that prevent patients from receiving

comprehensive and timely services. The group is willing to work with DHS to update

these rules to meet the needs of the behavioral health system moving forward. There

needs to be a review and analysis of rules and regulations across behavioral health

services at both the state and federal levels.

Recommendations

Review Medicare rules that prevent multiple billing for a patient on the same day. It

prevents the coordinated and timely delivery of services for a patient.

The Rule 132 provides licensure inconsistencies that need to be addressed.

The group would like to work with DHS to address inconsistencies related to rules

132, 2090, and 150.

LCPCs should have same privileges and credentialing as LCSWs for billing purposes.

11

November 11, 2011

Name

Title

Organization

Address

City, State Zip

Dear:







patients and communities. One such opportunity is being presented to us by the recent enactment of

House Bill 2982 – Public Act 97-0381, which creates the Regional Integrated Behavioral Health

Networks Act.






region that addresses the inventory of existing services, identifies community needs and defines





systems of care.


DHS Region 4. The meeting will take place Wednesday, December 7 from 11:00 am – 2:00 pm at

Mental Health Centers of Central Illinois in Springfield, IL.

If you have any questions or concerns, please contact IHA Staff: Lori Williams, at 217-541-1164 or

[email protected] or MaryLynn M. Clarke at 217-541-1154 or [email protected].

To confirm your attendance, please contact Abby Radcliffe at 217-541-1178 or email your response to

[email protected].

Thank you,


Sr. Director, Health Policy & Regulation

Lori Williams

V.P. Small & Rural Hospital Affairs




12


December 7, 2011, 11:00 a.m. – 2:00 p.m.

MHCCI, 710 N. 8th Street, Springfield, IL 62702

Agenda

I. WELCOME & INTRODUCTIONS ................11:00 ....................... Jan Gambach

II. OVERVIEW OF HB 2982 (PA 97-0381) .........11:20..MaryLynn McGuire Clarke


What should the behavioral health system look like three years from now?




IV. SMALL GROUP REPORTS ............................12:30 ....................... Lori Williams

V. SETTING PRIORITIES & NEXT STEPS ....1:15 ......................... Jan Gambach

VI. ADJOURNMENT & NEXT MEETING ........2:00 ......................... Jan Gambach

13


December 7, 2011

MHCCI Conference Room, 710 N. 8th Street, Springfield, IL 62702

Lynette Ashmore, LifeLinks Mental Health

Jan Aten, Douglas County MHC

Cory Baxter, DeWitt County Human Res. Center

Jeff Bloemker, Heartland Human Services

Patty Bryant, Passavant Area Hospital

Candace Clevenger, Heritage Behav. Health, Inc.

Vickie Coen, Pana Community Hospital

David Cole, Moultrie County MHC

Debby Cook, LifeLinks Mental Health

Joe Croegaert, DMH

Dolan Dalpoas, Abraham Lincoln Mem. Hospital

Carol Davis, Douglas County MHC

Florine Dixon, Memorial Hospital, Carthage

Jan Gambach, MHCCI

Greg Hager, Pana Community Hospital

Randy Hodgson, Christian County MHA

Chuck Johnson, Blessing Hospital

Doug Kilberg, Locust Street Resource Center

Melissa G. Kulp, Jersey Community Hospital

Roger A. Larson, DeWitt County HRC

Darla Lawson, Sarah Bush Lincoln Health Cent.

Jordan Litvak, DHS

MaryLynn McGuire Clarke, Illinois Hospital Assoc.

Tom Miller, DMH

Sandra Mollahan, St. John’s Hospital

Bruce Morgan, Sarah Bush Lincoln Health Center

Rick Nance, DHS

Ken Polky, Human Resources Center of Edg. & Clark

Matt Obert, Chaddock


Mike Rein, Transitions of Western Illinois

Schlabs, Megan, MHCCI

Susan Shafter, St. Mary’s Hospital, Decatur

Dr. Soltys, SIU School of Medicine

Katherine Suberlak, PCC Community Wellness Cent.

Lora Thomas, NAMI

Susan Weikart, Passavant Area Hospital

Bob Wesley, SIU School of Medicine


Katie Wilson, MHCWI

Orlinda (Speckhart) Workman, Passavant Area Hosp.


Jan Gambach called the meeting to order at 11:00 a.m. and those in attendance introduced

themselves. An overview was given of the current state of problems. Jan noted that the

group was not here to rehash the problems, but to find solutions.


MaryLynn McGuire Clarke gave an overview of the legislation which requires the

Department of Human Services (DHS) to create Regional Behavioral Health Networks in

each DHS region to ensure and improve access to behavioral health services. The

networks will work collaboratively to develop region-specific plans. The legislation also

created the Regional Integrated Behavioral Health Networks Steering Committee

comprised of state agencies to coordinate efforts among planning regions.

14


Participants were divided into groups to discuss three questions. 1) What should the

behavioral health system look like three years from now?; 2) What would be the key

components of the new behavioral health system?; and 3) Are there immediate actions


what are they?


Lori Williams led the small groups to report on their findings. Information from the

break-out groups is included in the attached document.





Jan noted that the next meeting will be held Jan. 6 at 11:00 a.m.

15

Region 4: Group Discussion Responses

December 7, 2011


Adequate inpatient psych beds [no emergency department (ED) boarding]

Adequate substance abuse treatment at all /same levels

o Prevention, outpatient, residential, detox

Coordination, integration, and cooperation between behavioral and medical,

mental health and substance abuse, state agencies, hospitals and health

departments (responsive and flexible structure, better continuity of care)

Establishment of a structure to preserve (ongoing) regional

planning/collaboration/ integration/communication, i.e. build collaborative

planning into state infrastructure, but regional planning/organization must

accommodate local needs; allow national boundaries and relationships to flourish

Electronic health records:

o Adequate compatibility and integration

o Privacy Protections

o HIE and relevant health entities

Universal ‘language’ and formats

Serve those who are under and uninsured and improve access to underinsured

government-funded consumers/patients, and indigent care

Eliminate and reduce stigma

o Increase training across healthcare providers, treat whole person

o Cross-education of behavioral health and medical

Wellness focus and early interventions: recognize, pay, provide

Right care, right time, not in emergency room (ER)

Central data/communication link; access and communication, information sharing

technology, standards to share

Less paperwork, streamlined

Local community having more control, define community integration; community

setting

Adequate payment and cash flow, flexibility in payment system for specific

patient needs, predictable funding from state

Easy access to transportation

Education for providers and law enforcement

o Best practices/evidence-based practices

o Sharing, learning collaboratives

Still having consumer choice

Quality and data, evidence and metric to identify success

16

Urban territory barriers

Follow-up care (pharmacy)

Need assessment services, standardization, access to crisis services, and cross

training for assessments

Nutritional needs

Develop linkage agreements to expand coverage, share resources

Protocols for intake and placements and standardized safety plans

Central regional crisis center and return to community

Adequate workforce

o Psychiatrists to cover needs and for emergencies

o More APNs, mid-level providers

o LCPC same privilege/credential as LCSW – billing, reimbursement

o Funding for employment and psychiatrists and personnel

o Counselors

Telepsychiatry expanded; reimbursement model needed

Crisis stabilization services developed (save acute hospital beds)

Detox: inpatient and outpatient

Resolve regulatory barriers that impeded blended services, i.e., merge substance

abuse, mental health, developmental disabilities (Rule 132), legislation focused on

decreasing repetitious regulations, requirements, paperwork

Address confidentiality barriers across services

More comprehensive children services

Care coordination - - ONE person communication care/ decrease duplication

across services, streamlined services

HIE – care management alert system, universal release of information

Regional (inpatient and outpatient) providers replace individual county providers

o 708 law and ensure coverage for all areas

Medical home:

o Integration behavioral-physical

o Child- Pediatricians: first line of service

o (“no take back’s)

o Utilize federally qualified health centers

Three-legged stool: expand prevention to schools, corrections

Forensic patients competing with chronically mentally ill for money, resources:

o Can there be collaboration and develop system for Mental Health Court

Review group assignments; patient to appropriate services

o Decrease the “not mine” mentality

17

What would the key components of the new behavioral health system?

Resources to deflect ED

o Community services

o Alternative crisis, e.g. detox

ER

o BH resources available to ED

o Peer support/living room model and cross training

Substance Abuse services

o Detox

o Residential

Note: Decreased funding = unused substance abuse and psych beds

and closure of residential and detox programs (i.e. available, but no

staffing or revenue to support the programs)

Housing: Supported and Supervised

o Full continuum of housing and for uninsured and publicly funded

Preparing for changes, be creative

Telepsychiatry, telemedicine

Credible, patient centered focus of care

Better use of community volunteers

Adequate technology

o IT equipment, software and workforce

Data, outcomes and those to do it

Transportation services

Cross-training

Regional crisis beds, urgent care for behavioral health

Assessments: staff, standardized and streamlined

Psychiatrist: available for follow-up and medication management

Involvement/Integration with primary care, co-locate/hand-offs

EMR

o Regional/State HIEs

More Acute beds: better use, stabilize and long-term needs

Adequate workforce

o Psychiatrists to cover needs

o More APNs, mid-level providers

o LCPCs same privilege/credential as LCSWs – billing, reimbursement

Infrastructure to reduce need for state hospitals and hospital acute beds

Care coordination

Regional (inpatient and outpatient) providers replace individual county providers

18

Are there immediate actions that could be taken to improve access to behavioral health

services in this region? If so, what are they?

Effective Discharge Planning

Certified EHR plans (comp. pt.) with capacity to share with any provider

including community mental health centers and substance abuse agencies

Broadband expansion

Behavioral health training in the ED

Increased peer support

Increased staff

Bring more groups to the table, organizing community, work with health

departments

Services for underinsured, J-1 visa for underserved

More information of funding of transportation

Analyze needs of community: continuity and communication

Know what we do well, willing to give up those things we can’t do well

Sharing information about grants

Programs without walls

Tele-medicine

72 hrs. on a PNC-2nd

cert. has to be done by a psychiatrist

Assess utilization of existing crisis beds

Development of crisis bed services statewide, urgent care

Access issues: ED delays, safe discharge/timely

Regional plan for recruitment of providers:

o Therapists, psychologists, dentists, etc.

o Share resources

LCPC federal rules - - needs to be same privilege/credential as LCSW – billing,

reimbursement

APNs, expanding reimbursement coverage

Review rules; eliminate barriers

Mental Health Center, federal quality health centers access, workforce increase

Enhanced and timely reimbursement: remove barriers for authorization

Care Competency in behavioral health: organized effort, education and liaison

19


January 6, 2012, 11:00 a.m. – 2:00 p.m.

MHCCI Conference Room, 710 N. 8th

Street, Springfield, IL 62702

Agenda

I. WELCOME ........................................................11:00 ....................... Jan Gambach

II. SUMMARY OF FIRST MEETING.................11:20 ..................... ..Jan Gambach


WORKFORCE:





PREVENTION:



DELIVERY SYSTEM:



TRANSPORTATION:



transportation?

PAYMENT DESIGN:




V. SETTING PRIORITIES & NEXT STEPS ....1:15 ......................... Lori Williams

VI. ADJOURNMENT & NEXT MEETING ........2:00 ......................... Jan Gambach

January 17, 2011: 11:00 a.m.-2:00 p.m.

20


January 6, 2012

MHCCI Conference Room, 710 N. 8th Street, Springfield, IL 62702

Lynette Ashmore, LifeLinks Mental Health

Jan Aten, Douglas Co. MH


Bruce Carter, The Wells Center


David Cole, Moultrie Co. Mental Health Center

Joe Croegaert, DMH

Carol Davis, Douglas Co. Mental Health

Tom Frederick, Elm Center Rehab Center

Janice Gambach, MHCCI

Richard Gloede, Shelby Co. Com. Services


Sherry Hendricksen, Kindred Hospital, Spring.

Mark Hilliard, Logan Co. Health Dept.

Randy Hodgson, Christian Co. MHA

Pamela Irwin, Central East Alc. & Drug Council


Rosemary Johnson, Apple Behav. Health Couns.


David King, Piatt County Mental Health

Diana Knaebe, Heritage Behavioral Health Inc.

Dietra Kulicke, Chestnut Health Systems, Inc.

Roger A. Larson, DeWitt Co. HRC

Kathy Lee, Memorial Health System

Jordan Litvak, DHS/DMH

Joe Lokaitis, DASA

Trisha Malott, SIU School of Medicine

Tom Miller, DMH

Sandy Mollahan, St. John’s Hospital

Tim Morenz, Macoupin Co. Public Health Dept.

Bruce Morgan, Sarah Bush Lincoln Health Center

Matt Obert, Chaddock

Daniel Perry, Apple Behavioral Health Counseling

Kenneth Polky, Human Res. Center of Ed. & Cl. Co.

Scott Porter, Piatt County Mental Health


J. Michael Rein, Transitions of Western IL

Megan Schlabs, MHCCI

Earl Sheehy, Dr. John Warner Hospital

Randy Simmons, Paris Community Hospital

Kent Tarro, Macoupin Co. Public Health Dept.

Lora Thomas, NAMI

Nancy Weber, Sarah Bush Lincoln Health Center

Susan Weikert, Passavant Area Hospital

Bob Wesley, SIU


Katie Wilson, MHCWI

Orlinda (Speckhart) Workman, Passavant Area Hosp.


Jan Gambach called the meeting to order at 11:00 a.m. and those in attendance introduced

themselves.


Jan gave an overview of the last meeting. She thanked the group and the state for

participating in these meetings. The purpose of the group is to outline a plan for

behavioral health services in this region. The goal of the plan is to improve access to

behavioral health services in the region and work with the state steering committee to

implement changes to the system.

21


Participants were divided into groups to discuss five topic areas. 1) Workforce; 2)

Prevention; 3) Delivery System; 4) Transportation; and 5) Payment Design. These

priority issues were identified in the first meeting. The questions on these topics will help

identify provider needs in each of the areas.


The four small groups reported on their findings. Information from the break-out groups

is included in the attached document.


Information collected at the meeting will be assembled by IHA. A focus on a draft plan

will be discussed at the next meeting.


Jan noted that the next meeting will be held Jan. 17 at 11:00 a.m. She adjourned the


22

Jan. 6 Small Group Responses

Workforce:

Specific Training Needs: -

What are other states doing?

Effective use of bed utilization: core competencies – clinical, resource management

Education/Webinars, free; some existing trainings, but only few can participate, someone

to facilitate/maintain

Standardized approaches/ clinical trainings/ evidence based

Related to Rule 132

Compassion and process training

Regulation differences; different departments all regulated differently and pieced together

over 35 years

Recruitment: Need enough workforce

o RN’s in EDs

o LCSWs in community mental health centers – low $

o LCPC = LCSW / reimbursement equality

o Qualified Mental Health Professionals (QMHPs) – master’s level and experience

o Certified alcohol and drug counselors (addiction counselors)

o Training and finding new managers

Evidence based training/ algorithms

Concurrent charting

Document specialty skills in the new and existing system – by provider group, by

specialty

Cross-training to understand integration of roles and skill sets

o Integration training for behavioral health and primary health

o Cross-training on everything – technical and cultural

o Nurse case managers understanding physician process in telepsych (1-2 weeks)

Prevention and intervention strategies

ER, ICU, med/surg, etc.

Counselors need more information – pharmacy and med. aspects

More information for med. com. of referrals

Law enforcement, first responders, teachers

EMR

Training new staff and continuing education, expectations don’t fit reality for new grads

o University-based training: management, social work, etc., real world applications

New Skills

Looking at WHOLE person

Time management

Technology

23

Communication skills (oral and written)

o Specific writing skills

Skills to put together notes, etc., med necessity

o Professionals need to improve communication skills, conflict resolution

Psychiatrists

Understanding of existing resources

Education for funders and evaluators, to understand therapeutic documentation

Tough to find qualified workforce

o As resources tighten, good for employee to have consistent skills & training

(cookie cutter)

Joint commission – suicide assist for everyone who comes to hospital

Mental health centers and hospitals share staff and resources to manage patient loads

Need common language across industries: law enforcement, mental health centers, etc.

Issues surrounding integration

o Health care professionals need to learn to collaborate around industry needs

Need models of communities that have collaborative structures

o Physicians ignoring recommendation from mental health counselors

o Locally based interdisciplinary training

o Cross cultural integration of all specialties, cross-training, break down silos

o What are all the service needs – established initially, what are the resources

available that matches those up

Training needs to be practical, useful, directed

Peer support – unlicensed/certified: cost to obtain certification, issues related to ADA

Navigator. Unlicensed care coordination

Living room model – set up services outside of ED/hospital

Dual/Multiple diagnosis: developmental disabilities – substance abuse – mental illness –

physical health

Everyone to have a voice and be heard

Regulatory Barriers:

Parity among licenses

o LCPCs, APNs, licensed marriage and family therapist: Fed regulations bar them

from billing Medicare, APN prescription limits, and trainings not eligible to all

(barriers)

Recognizing specialties and utilizing them

Medicare won’t allow medical and psych visits on same day, force integration, but won’t

pay for it

Different behavioral health requirements

24

o Rules: 132 (vs.) 2060 (vs.) 150: are counterintuitive/disagree and prevent services

for those who need, inconsistent / inconsistent in interpretation, and substance

abuse and mental health rules don’t match up for integrated approach

o Rules are woven together, nationally too

o HIPAA

o Confidentiality

Dept. changes need to be passed through provider input

Redundant audits (reform), paperwork

Time spending w/ staff rules, etc.

Payers’ governing rules are competing too

Dual diagnosis training needs:

LCSW – doesn’t mean that person understands each specialty; generalist vs. specialist

Competency training on basic level of care in each area

Physicians training on behavioral health services and needs

Do away with dual diagnosis! Means different things, many definitions

Comprehensive health for the whole person and need patient-centered services

Need specialty services – can’t generalize every service and provider, especially

substance abuse

Specialists and cost balance: overall health outcomes vs. individualized care

Knowing what resources to link to, linkage, referral

Cross-training, case management, integration

Moving from acute to community w/ no follow-up (medical model/Medicaid)

o Recovery-oriented model, ongoing support – will reduce costs

Our service delivery system mirrors what we get funded: fragmented

funding=fragmented care

Continuum: Prevention – Care – Maintenance (NOT discharge)

Behavioral health-Medical (Diagnostic Statistic Manual (DSM) vs. International

Statistical Clarification of Diseases (ICD10))

o More exposure on medical side to behavioral health screening tools needed

o Consistency

o How to integrate will determine training needs

o Medical linkage assessment should include behavioral health assessments

o Payment mechanism must support “warm handoffs”

o Input from medical, need ‘same language’

Mental Illness-Developmental Disability: cultural barriers, billing, misdiagnosis frequent

so that services will be funded, “dumping” game, and placement

Behavioral health-substance abuse

o Workforce needed – behavioral health and substance abuse

High education requirements for low pay and high demand job

25

o Educate workforce: “Substance abuse is part of behavioral health” and “Not my

job” is not an option

o Regulatory issues/billing

o Engaging clients in care

Prevention

A. Current services:

Law enforcement programs (jail, probation)

Schools, training counselors: suicide, depression, high schools, youth groups, etc.

ER screening process, inpatient screening

Peer recovery support services

Employees

Biggest loser

Mental health training for parents

Funded in silos (DASA, 708 boards, Health departments, Federal): disconnect, no

funding for early intervention, competitive grants, mental health First Aid (no funding

received)

Money moving away from prevention to treatment: cuts related to outcomes, short term

funding shift is tough, however long-term prevention strategies will bend the cost curve

Money going to urban – larger services

Prevention Needs

Reimbursable services

Education to teachers and counselors and recommendations

Mental health Screenings in school, education to primary care, adding social workers

(Adams County)

Prevention in primary care, early intervention instead or as well, mental health

professional in office

Best practices guide: what programs work, where are best practices, need research-based

strategies related to prevention and interventions

Focused in-services

Reducing stigma, especially parents, family involvement

Regulatory reformation

Develop crisis services (response system), developmental disabilities beds closing

Define prevention process and outcomes (Population-based? Individual management?)

Smoking cessation

Health risk assessments (HRA)

Nutrition/dietary

Integrated models

Transportation, much could be ‘borrowed’ from hospitals

26

Delivery System

Recommendations to fill gaps in service delivery:

Gaps:

o Hospitals set up for psych in ED

o Set up crisis/stabilization unit: enough funding to meet client needs, personnel

o Supervised residential care – decreased funding: how many 24/7 beds needed?

o Front door – back door coordination: what should the system look like?

o Stigma – R/T mental illness, sexual/physical abuse, depression

o Population requirement to propose preventative services (prevention – schools –

parenting): what if we can’t meet the number?

o Prevention disconnected from treatment

o Get others “in the room” for behavioral health

“Glue” care coordination systems, case coordination – link client to services and also

need to broaden/increase to include: uninsured and fall-out population, integration

Tele-medicine/psych (cost, equipment, setup): reimbursement/Payment and service types,

and reimbursement not required by commercial payers

Transportation

Integration (between primary care & behavioral health – especially initial contact point),

breaking down silos between agencies

Thinking outside of the box, in the community, service access (some are going to

schools), co-location of services

Electronic integration/ EHR / HIE (medical health records)

Innovative ideas: recovery service specialist (recovering patients)

Keep safe, education for non-mental health

Basic services for all regardless of payer

New Models

Regions

Patient-centered medical homes

Transportation

Transportation Gaps:

Accessibility

Rural demographics: distance/miles to travel and no money to reach services

(transportation), un/under insured

MCD Funding: MCR offsets, but doesn’t cover

Funding for Case managers to transport

Education for clients

Public transport issues: not tolerating any behavioral health issues, no public transport,

and waiting times

27

Hospitals currently footing bill for transport back home after ambulanced in (could be

states away – even flights)

State transportation for involuntary admits –extend to voluntary

FY2012 – 1.6million by car; triples with ambulance

Telepsych maintenance

More crisis beds: centralized crisis center w/ telepsych, need to expand existing

Emergency vs. non-emergency transports: aging population in rural with increased

demands

Alternatives

Senior citizen volunteers

Able to use transportation that used to get them there (case managers)

New methodology

Local resources

Needs whole range of possibilities

DOT funding– behavioral health & medical

Payment design

Services not currently reimbursed that should be:

Reimbursement period – not being paid for services provided

Care coordination, Case management (true CM), wrap around services

Transportation

Prevention, early intervention

Community and patient education, community outreach

Psychiatry, Tele-psych

Inter-agency coordination

Limited case consultation

HIT/HIE/EHR: transition support and maintenance

Administrative/overhead

Non-Medicaid: allotted payment every month, take lessons from hospitals on Charity

Care

Medicaid – fee for services (antiquated): Go back to bundling, If stay w/ Fee for Service

(FFS), the fee must keep pace with market value/reimbursed cost (esp. Psych’s)

Tuition Reimbursement – continuing education

Accreditation, auditing, association fees

Closures: reinvest money saved into the continuum of care, at least a large percentage

Fund community-based services

May not see cost savings in first year

Accountable care organizations (ACOs) population dependent and costly to hub hospital

28

Transitional support, step-wise

Capacity grants/support

Services to get people a place to go

CHIPS – coverage for uninsured: no services for uninsured, need outpatient services

(outside of ED) to provide care for uninsured

Smoking cessation, Weight control programs

Populations: Veterans, Foster Care

Timely and consistent contracts

Recommendations on redesigning to better meet client needs

Restructuring of access to care

Reduce waste

All reasonable solutions considered, more ability to decide what is best for the patient

Regulatory requirements minimized, tort immunity

Local models of coordinated care

Grouping issues: behavioral health service is behavioral health

At-risk (via collaboration)

Billing systems standardized coding - including medical-behavioral health

More money for integration

Property tax concerns

Creating environment: What kind of model? medical necessity, etc.

Capacity/outcomes, grant

Decapitated

FFS vs. Block payment/grant: need payment flexibility to serve patients, productive use

of money, based on patient/population outcomes, incentivize outcomes, focus on

efficiencies, audits based on outcomes (substance abuse now)

29


January 17, 2012, 11:00 a.m. – 2:00 p.m.

MHCCI Conference Room, 710 N. 8th

Street, Springfield, IL 62702

Agenda

I. WELCOME ........................................................11:00 ....................... Jan Gambach

II. SUMMARY OF SECOND MEETING ............11:20 ..................... ..Jan Gambach

III. REVIEW OF PLAN/PRIORITIES………… ..11:25 ....................... Lori Williams


V. NEXT STEPS ....................................................1:15 ......................... Lori Williams

VI. ADJOURNMENT ..............................................2:00 ......................... Jan Gambach

30


January 17, 2012

MHCCI Conference Room

710 N. 8th Street, Springfield, IL 62702

Mike Bach, Macon County MH Board

Cory Baxter, DeWitt County HRC

Jeff Bloemker, Heartland Human Services


Bruce Carter, The Wells Center

Don Cates, Cass County MHA


David Cole, Moultrie County MHC

Joe Croegaert, DMH

Barbara Dunn, Comm. Health Improv. Centers

Tom Frederick, Elm City Rehab Center

Jan Gambach, MHCCI

Richard Gloede, Shelby County Comm. Serv.

Craig Glover, Central Counties HC


Randy Hodgson, Christian CMHA

Pamela Irwin, Central East Alcoh. & Drug



David King, Piatt County Mental Health

Diana Knaebe, Heritage Behavioral Health Inc.

Roger A. Larson, DeWitt County HRC

Kathy Lee, Memorial Health System

Paul LeVeque, Ascent Counseling & DUI

Jordan Litvak, DMH

Tom Miller, DMH

Sandy Mollahan, St. John’s Hospital

Tim Morenz, Macoupin County PHD

Rick Nance, DASA

Barbara Nelson, SIU School of Medicine

Roxie Oliver, MHCWI

Scott Porter, Piatt County Mental Health


J. Michael Rein, Transitions of WI

Katie Sarnes, Mason District Hospital

Susan Shafter, St. Mary’s Hospital, Decatur

Lora Thomas, NAMI


Susan Weikert, Passavant Area Hospital


Katie Wilson, MHCWI


Jan called the meeting to order at 11:00 a.m. and those in attendance introduced

themselves.


Jan gave an overview of the second meeting. She thanked the group and the state for






Lori Williams noted that today’s meeting will take the priority issues that were identified

in the first two meetings and begin to craft recommendations to be part of this region’s

plan. Comments will be recorded and added to the plan. Lori went through each section

of the draft plan and the group made recommendations for any changes.

31




V. Next Steps

Information collected at the meeting will be assembled by IHA. The updated draft plan

will be sent to the group for any other changes. This plan will then be submitted to the

State Steering Committee when they begin to meet.

VI. Adjournment

Jan adjourned the meeting at 2:00 p.m.

32

Appendix


Public Act 097-0381































regions.

Section 15. Goals.





33







































Committee.



34















(7) Other.





health staff.




providers.





(1) Prevention.






hospitals.









35













Public Act 097-0381

36



1. Wait Times




Reductions in funding have increase delays in access to care

Bed availability, payer

Placement for behavioral health needs patient and IDPA

Concern with safety issues with inclement weather



#5 - 3

#4 - 1

#3 - 3

#2 - 1

#1 - 7


NO - 5

YES - 5

N/A - 1


ED stats

Documentation, but no data collected

Wait/length of stays can be produced

Emergency department has a log, data has to be hand counted

Patient survey

Funding effects authorization

We are outpatient substance abuse/mental health no state funding so things

work a little different at our agency

Only anecdotal information




NO - 7

37

YES - 9

We have increased security coverage within the past year to address the

issue

Use of local police

New electronic medical record may have report capabilities to drill down

to delay in transfers awaiting placements

On a scale of 1-5, how big a problem is security concerns related to delayed


#5 - 2

#4 - 2

#3 - 1

#2 - 4

#1 - 4


Security staff maintain records

On charts of individual patients

Variance reporting system if issue escalates. Believe it is underreported

by ED staff

We don’t have security staff nor have we had that need

Environmental security committee

Elopement of patient

Number of times police have handcuffed violent people

3. Patient Volume



Yes - 11

No - 2

Needs for services have steadily increased over the past three years while

resources have been decreased

On a scale of 1-5, how important is this issue to your facility? (1 = very

important, 5 = not important at all)

#5 - 1

#4 - 2

#3 - 2

#2 - 4

#1 - 6

38


Internal census data, patient diagnosis

Client intakes and caseloads

Bed availability census

Report available through county mental health

SS department

Is monitored at least monthly for frequent visitors of substance abuse

Patient numbers tracked by number of visits to emergency

department/Month for years 2009, 2010, 2011

Volume data is tracked and admissions

Many of the local providers at capacity or not taking any more clients at

this time

4. Transportation


NO - 4

YES - 3

N/A - 1

On a scale of 1-5 how big a problem do you believe this is? (1 = very important, 5

= not important at all)

#5 - 1

#4 - 1

#3 - 3

#2 - 3

#1 - 4


Costs are tallied internally, delay information

No rural transportation for those in crises

Was a significant problem in the past

Individual patient records, social service documents, case management

data

This is more of a problem for child and adolescent patients

Vehicle rider data

5. Admissions



39


facility?

YES - 6

NO - 5

N/A - 3

Even though we are not equipped to care for these patients

We do not admit to medical floors. If the patient has OD’d they go to ICU

Resourced limited and not appropriate

On a scale of 1-5 how big a problem do you believe this is? (1 = very important, 5

= not important at all)

#5 - 0

#4 - 1

#3 - 2

#2 - 0

#1 - 5


Our social services department has data, psychiatric admissions, and

patient records

We rarely admit to hospital we mostly see community-based people



Low income, non-Medicaid clients have no payment source for mental

health treatment. It has basically been eliminated, Increase in numbers of

uninsured, long waiting lists, knowledge of resources that are open or

closed

Acute bed availability, fewer community services, no access to facilities

Delay in getting patients transferred once admitted to inpatient and

difficulty placing developmentally disabled patients with several behavior

or medically mental illness patients such as adolescent pregnant patients in

wheelchairs on needing oxygen etc.

ED repeater log, audits

Drug seeking behavior in patients, wanting more medications but not

necessarily waiting for treatments



YES-14

Maybe-

40

NO-1




YES-14

Please indicate which issues would be helpful to you.

Hospitals application to this topic, ED especially

Regulatory barriers and system design issues



Medicaid rates need evaluated and adjusted

Thank you for inviting us, would enjoy additional sharing of information

between providers on regular basis

Not at this time as we are piloting sharing billing data, etc., with another

agency at this time

It is a huge undertaking. To assemble so many providers over three dates

across the state and provide a forum to gather input. I have appreciated

being a part of the process and look forward to future developments

41


Organization Address 1 Addr

ess 2

City & State Zip Contact Email

A & E

Behavioral

Health

Associates

2570 E.

Federal

Drive

Decatur, IL 62526 Kenneth

Veon

[email protected]

Abbcon

Counseling

Corporation

603

Monroe St.

Charleston,

IL

61920 William A.

Epperson

[email protected]

Abraham

Lincoln

Memorial

Hospital

200

Stahlhut

Drive

Lincoln, IL 62656-

2698

Dolan

Dalpoas

[email protected]

Accurate

Evaluations

951 Fairfax

St.

Carlyle, IL 62231 Jessica

Daab

[email protected]

Adams County

Health

Department

330

Vermont

St.

Quincy, IL 62301 Executive

Director

Alcohol &

Addictions

Outpatient

Center

525 S.

Grand Ave.

W.

Springfield,

IL

62704 Ramona L.

Kennedy

ramonak@[email protected]

Apple

Behavioral

Health

Counseling, Inc.

8570 Saint

Lukes

Drive

Beardstown,

IL

62618 Daniel

Perry

[email protected]

Ascent

Counseling

408 S. Fifth

St. #1

Springfield,

IL

62701 Paul

LeVeque

[email protected]





mailto:ramonak@[email protected]



42

Blessing

Hospital

Broadway

at 11th St.

P.O.

Box

7005

Quincy, IL 62305-

7005

Chuck

Johnson

[email protected]

Blessing

Hospital

Broadway

at 11th St.

P.O.

Box

7005

Quincy, IL 62305-

7005

Maureen

Kahn

[email protected]

Brown County

Health

Department

120 E.

Main St.

Mt. Sterling,

IL

62353

Bunker Hill

Health Center

144 N.

Washingto

n St.

Bunker Hill,

IL

62014

Calhoun County

Health

Department

210 French

St.

Hardin, IL 62047 Steve

Shireman

[email protected]

Carlinville Area

Hospital

20733 N.

Broad St.

Carlinville,

IL

62626-

1499

Kenneth

Reid

[email protected]

Cass County

Community

Health Clinic

331 S.

Main Street

Front

Virginia, IL 62691-

1571

Cass County

Health

Department

331 S.

Main St.

Virginia, IL 62691

Cass County

Health

Department

8590 St.

Lukes

Drive

Beardstown,

IL

62618

Cass County

Mental Health

Association

121 E.

Second St.

#1

Beardstown,

IL

62618 Don Cates [email protected]

CEC/Civigenics

Inc.

3300

Honeybend

Ave.

Litchfield, IL 62056 Steven

Bryant

[email protected]







43

Central

Counties Health

Centers, Inc.

2239 E.

Cook St.

Springfield,

IL

62703 Craig

Glover

[email protected]

Central

Counties Health

Centers, Inc.

530 N.

Sixth St.

Springfield,

IL

62702

Central

Counties Health

Centers, Inc.

221 N.

11th St.

Springfield,

IL

62703

Central

Counties Health

Centers, Inc.

430 N.

Fifth St.

Springfield,

IL

62702

Central

Counties Health

Centers, Inc.

1100 E.

Adams St.

Springfield,

IL

62703

Central East

Alcoholism and

Drug Council

635

Division

P.O.

Box

532

Charleston,

IL

61920 Pamela

Irwin,

Ph.D.

[email protected]

Chaddock 205 S. 24th

St.

Quincy, IL 62301 Debbie

Reed

[email protected]

Chaddock 205 S. 24th

St.

Quincy, IL 62301 Matt Obert,

LCSW

[email protected]

Chestnut Health

Systems, Inc.

1003

Martin

Luther

King Drive

Bloomington,

IL

61701 Dietra

Kulicke

[email protected]

Chestnut Health

Systems, Inc.

1003

Martin

Luther

King Drive

Bloomington,

IL

61701 Joan

Hartman

[email protected]

Christian

County Health

Department

902 W.

Springfield

Road

Taylorville,

IL

62568







44

Christian

County Mental

Health

Association

707

McAdam

Drive

P.O.

Box

438

Taylorville,

IL

62568 Brent De

Michael

[email protected]

Christian

County Mental

Health

Association

707

McAdam

Drive

P.O.

Box

438

Taylorville,

IL

62568 Randy

Hodgson

[email protected]

Clark County

Health

Department

997 N.

York St.

Martinsville,

IL

62442

Clinical

Counseling

Group & DUI

Providers, LLC

701 S.

Durkin

Drive

Springfield,

IL

Nancy

Crawford

[email protected]

Coles County

Health

Department

825 28th

St.

Charleston,

IL

61920-

9391

Coles County

Mental Health

Association,

Inc.

750

Broadway

Ave. E

Mattoon, IL 61938 Executive

Director

Coles County

MH Board

825 18th

St.

Charleston,

IL

61920 Jeff Lahr [email protected]

Community

Health Centers

of Southeastern

Iowa, Inc.

951

Broadway

Hamilton, IL 62341

Community

Health Centers

of Southeastern

Iowa, Inc.

345 Polk

St.

Warsaw, IL 62379





45

Community

Health

Improvement

Centers

2905 N.

Main St.,

Ste. B

Decatur, IL 62526 Barbara

Dunn

Community

Health

Improvement

Centers

1221 E

Condit St.

Decatur, IL 62521

Community

Health

Improvement

Centers

1221 E.

Condit St.

Decatur, IL 62521

Community

Health

Improvement

Centers

243 W.

Cerro

Gordo

Decatur, IL 62522

Community

Memorial

Hospital

400

Caldwell

Staunton, IL 62088-

1423

Sue

Campbell

[email protected]

Continuing

Recovery

Center

202 W.

Central

Irving, IL 62051 Hugh

Satterlee

[email protected]

Cumberland

Associates, Inc.

120

Courthouse

Square

Toledo, IL 62468 Executive

Director

Cumberland

County Health

Department

132 NE

Courthouse

Square

Toledo, IL 62468

Decatur

Memorial

Hospital

2300 N.

Edward St.

Decatur, IL 62526-

4193

Kenneth

Smithmier

[email protected]




46

DeWitt County

Human

Resource Center

1150 State

Route 54

W.

Clinton, IL 61727 Roger A.

Larson

[email protected]

DeWitt County

Human

Resource Center

1150 State

Route 54

W.

Clinton, IL 61727 Cory

Baxter

[email protected]

DeWitt County

MH Board

121 W.

South St.

Clinton, IL 61727 Edith

Brady

Lunny

[email protected]

DeWitt-Piatt Bi-

County Health

Department

910 Route

54 E.

Clinton, IL 61727

Diel

Counseling, Inc.

444 S.

Willow

Effingham,

IL

62401 Patricia

Diel

[email protected]

Douglas County

Health

Department

1250 E.

U.S.

Highway

36

Tuscola, IL 61953

Douglas County

Mental Health

Center

114 W.

Houghton

Tuscola, IL 61953 Carol

Davis

[email protected]

Douglas County

Mental Health

Center

114 W.

Houghton

Tuscola, IL 61953 Jan Aten [email protected]

Dr. John

Warner Hospital

422 W.

White St.

Clinton, IL 61727-

2199

Earl

Sheehy

[email protected]

DUI Services 301 W.

North St.

Decatur, IL 62522 Joan Lewis [email protected]

DUI Solutions

& Treatment

Alternatives,

Inc.

408 S.

Fifth St.

Springfield,

IL

62701 Delores

Mast

[email protected]










47

Edgar County

Health

Department

502 Shaw

Ave.

Paris, IL 61944

Effingham

County Health

Department

901 W.

Virginia

Effingham,

IL

62401

Effingham

County

Probation

Department

120 W.

Jefferson,

Ste. 102

Effingham,

IL

62401 Cheryl

Meyers

[email protected]

Elm City

Rehabilitation

Center

1314 W.

Walnut

Jacksonville,

IL

62650 Tom

Frederick

[email protected]

Great River

Recovery

Resources

428 S. 36th

St.

Quincy, IL 62301 Ron

Howell

[email protected]

Greene County

Health

Department

310 Fifth

St.

Carrollton, IL 62016

Greenup Health

Center

302 N. Mill

St.

P.O.

Box

817

Greenup, IL 62428-

1062

Hancock

County Health

Department

671

Wabash

Ave.

Carthage, IL 62321

Heartland

Human Services

1200 N.

Fourth St.

Effingham,

IL

62401 Jeff

Bloemker

[email protected]

Heritage

Behavioral

Health Inc.

151 N.

Main St.

P.O.

Box

710

Decatur, IL 62525 Diana

Knaebe

[email protected]

Heritage

Behavioral

Health Inc.

151 N.

Main St.

P.O.

Box

710

Decatur, IL 62525 Candace

Clevenger

[email protected]







48

Hillsboro Area

Hospital

1200 E.

Tremont

St.

Hillsboro, IL 62049-

1912

Rex Brown [email protected]

Hopewell

Clinical

314 N.

Sixth St.

Quincy, IL 62301 Trudy

Myers-

Widmer

[email protected]

Human

Resources

Center of Edgar

& Clark

Counties

118 E.

Court St.

Paris, IL 61944 Kenneth A.

Polky

[email protected]

Illini

Community

Hospital

640 W.

Washingto

n St.

Pittsfield, IL 62363-

1350

Kathy Hull [email protected]

Jersey

Community

Hospital

400 Maple

Summit

Road

P.O.

Box

426

Jerseyville,

IL

62052-

2028

Larry Bear [email protected]

Jersey

Community

Hospital

400 Maple

Summit

Road

P.O.

Box

426

Jerseyville,

IL

62052-

2028

Melissa G.

Kulp

[email protected]

Jersey

Community

Hospital

400 Maple

Summit

Road

P.O.

Box

426

Jerseyville,

IL

62052-

2028

Julie Smith [email protected]

Jersey County

Health

Department

1307 State

Hwy. 109

Jerseyville,

IL

62052

Kemmerer

Village

941 N.

2500 E.

Road

Assumption,

IL

62510 Mike

Havera

[email protected]

Kindred

Hospital,

Springfield

701 N.

Walnut St.

Springfield,

IL

62702 Sally

Hoffman

[email protected]










49

Kirby Medical

Center

1000

Medical

Center

Drive

Monticello,

IL

61856-

1116

Steven

Tenhouse

[email protected]

Liberty

Counseling

Center, Inc.

1429 S.

Main St.,

Ste. A

Jacksonville,

IL

62650 Sandra

Eyman

[email protected]

LifeLinks

Mental Health

750

Broadway

Avenue E.

Mattoon, IL 61938 Debby

Cook

[email protected]

LifeLinks

Mental Health

750

Broadway

Avenue E.

Mattoon, IL 61938 Lynette

Ashmore

[email protected]

Lifeway

Behavioral

Services, Inc.

200 E.

Main St.

Clinton, IL 61727 William

Melton

[email protected]

Lincoln Prairie

Behavioral

Health Center

5230 S.

Sixth St.

Springfield,

IL

62703 Mark

Littrell

[email protected]

Locust Street

Resource Center

320 S.

Locust St.

Carlinville,

IL

62626 Douglas

Kilberg

[email protected]

Logan County

Health

Department

109 Third

St.

Lincoln, IL 62656-

0508

Mark

Hilliard

[email protected]

Macon County

Health

Department

1221 E.

Condit

Street

Decatur, IL 62521-

1405

Julie A.

Aubert

[email protected]

Macon County

MH Board

132 S.

Water St.,

Ste. 604

Decatur, IL 62523 Dennis

Crowley

[email protected]

Macon County

MH Board

132 S.

Water. St.,

Ste. 604

Decatur, IL 62523 Mike Bach [email protected]












50

Macoupin

County Mental

Health Center

320 S.

Locust St.

Carlinville,

IL

62626 Executive

Director

Macoupin

County MH

Board

206 W.

Henrietta

Ave.

Gillespie, IL 62033 Executive

Director

Macoupin

County Public

Health

Department

805 N.

Broad St.

Carlinville,

IL

62626

Macoupin

County Public

Health

Department

109 E.

Maple St.

Gillespie, IL 62626 Kent Tarro [email protected]

Macoupin

County Public

Health

Department/Ma

ple Street Clinic

109 E.

Maple St.

Gillespie, IL 62626 Tim

Morenz

[email protected]

Mason District

Hospital

615 N.

Promenade

P.O.

Box

530

Havana, IL 62644-

0530

Harry

Wolin

[email protected]

Mason District

Hospital

615 N.

Promenade

P.O.

Box

530

Havana, IL 62644-

0530

Katie

Sarnes

[email protected]

McFarland

Mental Health

Center

901

Southwind

Road

Springfield,

IL

62703 [email protected]

Memorial

Hospital,

Carthage

1454 N.

County

Road 2050

P.O.

Box

160

Carthage, IL 62321 Ada Bair [email protected]







51

Memorial

Hospital,

Carthage

1454 N.

County

Road 2050

P.O.

Box

160

Carthage, IL 62321 Florine

Dixon

[email protected]

Memorial

Medical Center

701 N.

First St.

Springfield,

IL

62781-

0001

Edgar

Curtis

[email protected]

Memorial

Medical Center

701 N.

First St.

Springfield,

IL

62781-

0001

Kathy Lee [email protected]

Menard County

Health

Department

1120 N.

Fourth St.

Petersburg,

IL

62675

Mental Health

Authority for

West Central

Illinois

525 S.

Eighth St.

Quincy, IL 62301 Steven

Heimberge

r

Mental Health

Authority for

West Central

Illinois

(MHCWI)

700 SE

Cross St.

P.O.

Box

254

Mt. Sterling,

IL

62353 Roxie

Oliver

[email protected]

Mental Health

Authority for

West Central

Illinois

(MHCWI)

121 S.

Madison

St.

Pittsfield, IL 62363 Katie

Wilson

[email protected]

Mental Health

Centers of

Central

Illinois/Memori

al Health

System

710 N.

Eighth St.

Springfield,

IL

62702 Janice

Gambach

[email protected]

Montgomery

County Health

Department

11191

Illinois

Route 185

Hillsboro, IL 62049 Executive

Director







52

Morgan County

Health

Department

345 W.

State St.

Jacksonville,

IL

62650

Moultrie

County Beacon

401 W.

Water St.

Sullivan, IL 61951 Executive

Director

Moultrie

County

Counseling

Center

2 W.

Adams

P.O.

Box

163

Sullivan, IL 61951 Executive

Director

[email protected]

Moultrie

County Health

Department

2 W.

Adams

Sullivan, IL 61951

Moultrie

County Mental

Health Center

2 W.

Adams

P.O.

Box

163

Sullivan, IL 61951 David Cole [email protected]

NAMI,

Springfield

Lora

Thomas

[email protected]

New Horizons

Substance

Abuse

Counseling

Agency

104 Oak

St.

Pana, IL 62557 Aisha

Yahmeem

Crowe

[email protected]

Northstar DUI

Consulting,

LLC

25 N.

Grand Ave.

E

Springfield,

IL

62702 Jackie

Miller

[email protected]

On The Wings

of Angels, Inc.

1550

Douglas

Drive

Charleston,

IL

61920 Brenda

Sprague

[email protected]

Pana

Community

Hospital

101 E.

Ninth St.

Pana, IL 62557-

1716

Trina

Casner

[email protected]








53

Pana

Community

Hospital

101 E.

Ninth St.

Pana, IL 62557-

1716

Greg

Hager, RN

[email protected]

Pana

Community

Hospital

101 E.

Ninth St.

Pana, IL 62557-

1716

Vickie

Coen

[email protected]

Paris

Community

Hospital

721 E.

Court St.

Paris, IL 61944 Randy

Simmons

[email protected]

Park Place

Center, LTD

201 E.

Morgan St.

Jacksonville,

IL

62650 Ed J. Scott [email protected]

Passavant Area

Hospital

1600 W.

Walnut St.

Jacksonville,

IL

62650-

1136

Chester

Wynn

[email protected]

Passavant Area

Hospital

1600 W.

Walnut St.

Jacksonville,

IL

62650-

1136

Orlinda

Speckhart

Workman

[email protected]

Passavant Area

Hospital

1600 W.

Walnut St.

Jacksonville,

IL

62650-

1136

Patty

Bryant,

RN, MS

[email protected]

Passavant Area

Hospital

1600 W.

Walnut St.

Jacksonville,

IL

62650-

1136

Susan

Weikert,

RN

[email protected]

PCC

Community

Wellness Center

Katherine

Suberlak,

LCSW

[email protected]

Personal

Counseling

Services

2659

Farragut

Drive

Springfield,

IL

62704 Vicki

Vandeveer

[email protected]

Piatt County

Mental Health

1921 N.

Market St.

Monticello,

IL

61856 David King [email protected]

Piatt County

Mental Health

1921 N.

Market St.

Monticello,

IL

61856 Scott

Porter

[email protected]













54

Pike County

Health

Department

113 E.

Jefferson

St.

Pittsfield, IL 62363-

1420

Anita

Andress

[email protected]

Pleasant

Counseling

303 E.

Wood St.

Decatur, IL 62523 Diane

Pleasant

[email protected]

Prevention First,

Inc.

2800

Montvale

Drive

Springfield,

IL

62704 Karel

Homrig

[email protected]

Saint Anthony's

Memorial

Hospital

503 N.

Maple St.

Effingham,

IL

62401-

2006

Mark

Reifsteck

[email protected]

Sangamon

County Health

Department

2833 S.

Grand Ave.

E.

Springfield,

IL

62703 Gail

O'Neill

[email protected]

Sarah Bush

Lincoln Health

Center

1000

Health

Center

Drive

P.O.

Box

372

Mattoon, IL 61938-

0372

Bruce

Morgan

[email protected]

Sarah Bush

Lincoln Health

Center

1000

Health

Center

Drive

P.O.

Box

372

Mattoon, IL 61938-

0372

Timothy

Ols

[email protected]

Sarah Bush

Lincoln Health

Center

1000

Health

Center

Drive

P.O.

Box

372

Mattoon, IL

61938-

0372

Darla

Lawson,

RN

[email protected]

Sarah Bush

Lincoln Health

Center

1000

Health

Center

Drive

P.O.

Box

372

Mattoon, IL 61938-

0372

Nancy

Weber, RN

[email protected]










55

Sarah D.

Culbertson

Memorial

Hospital

238 S.

Congress

St.

Rushville, IL 62681-

1465

Lynn

Stambaugh

[email protected]

Schuyler

Counseling and

Health Services

127 S.

Liberty

P.O.

Box

320

Rushville, IL 62681 Trenton

Chockley

[email protected]

Schuyler

County Health

Department

233 N.

Congress

St.

Rushville, IL 62681

Schuyler

County MH

Board

8 Frances

Drive

Rushville, IL 62681 Kip Wilson [email protected]

Scott County

Health

Department

335 W.

Cherry

Winchester,

IL

62694

Shelby County

Community

Services, Inc.

1810 W.S.

Third St.

Shelbyville,

IL

62565 Richard

Gloede

[email protected]

Shelby County

Health

Department

1700 W. S.

Third St.

Shelbyville,

IL

62565

Shelby

Memorial

Hospital

200 S.

Cedar St.

Shelbyville,

IL

62565 Marilyn

Sears

[email protected]

SIU School of

Medicine

P.O.

Box

19620

Springfield,

IL

62794 Executive

Director

SIU School of

Medicine

P.O.

Box

19620

Springfield,

IL

62794 Dr. Soltys [email protected]







56

SIU School of

Medicine

P.O.

Box

19620

Springfield,

IL

62794 Trisha

Malott,

LCSW

[email protected]

SIU School of

Medicine

P.O.

Box

19620

Springfield,

IL

62794 Bob

Wesley

[email protected]

SIU School of

Medicine

P.O.

Box

19620

Springfield,

IL

62794 Barbara

Nelson

[email protected]

Solution

Counseling and

DUI Services

1306 S.

Sixth St.

Springfield, Il 62704 Lance E.

Marshall

[email protected]

Southern Health

Center of

Effingham

900 W.

Temple

Ave., Ste.

208

Effingham,

IL

62401

Southern

Illinois

Healthcare

Foundation, Inc.

144 N.

Washingto

n St.

Bunker Hill,

IL

62014

Southern

Illinois

Healthcare

Foundation, Inc.

502 W.

Virginia

Ave.

Effingham,

IL

62408

Southern

Illinois

Healthcare

Foundation, Inc.

900 W.

Temple

Ave.

Effingham,

IL

62401

Southern

Illinois

Healthcare

Foundation, Inc.

302 N. Mill

St.

Greenup, IL 62428





57

St. Francis

Hospital

1215

Franciscan

Drive

P.O.

Box

1215

Litchfield, IL 62056-

1215

Daniel

Perryman

[email protected]

St. John's

Hospital

800 E.

Carpenter

St.

Springfield,

IL

62769-

0002

Sandy

Mollahan

[email protected]

St. John's

Hospital

800 E.

Carpenter

St.

Springfield,

IL

62769-

0002

Robert Ritz [email protected]

St. Mary's

Hospital,

Decatur

1800 E.

Lake Shore

Drive

Decatur, IL 62521-

3883

Susan

Shafter

[email protected]

St. Mary's

Hospital,

Decatur

1800 E.

Lake Shore

Drive

Decatur, IL 62521-

3883

Kevin Kast [email protected]

State of Illinois,

DHS Region 4

Director

Jordan

Litvak

[email protected]

State of Illinois,

DHS (DASA)

Joe

Lokaitis

[email protected]

State of Illinois,

DHS (DASA)

Rick Nance [email protected]

State of Illinois,

DMH

Tom Miller [email protected]

State of Illinois,

DMH

Joe

Croegaert

[email protected]

Stillmeadow

DUI

Assessment and

Remedial

Education

Center

706 S.

Grand Ave.

W.

Springfield,

IL

George

Indermark

[email protected]











58

Synergy

Consulting &

Training LLC

1305

Wabash

Ave.

Springfield, Il 62704 Cynthia

Tubbs

[email protected]

Taylorville

Memorial

Hospital

201 E.

Pleasant St.

Taylorville,

IL

62568-

1597

Daniel

Raab

[email protected]

The Wells

Center

1300

Lincoln

Ave.

Jacksonville,

IL

62650 Bruce

Carter

[email protected]

Thomas H.

Boyd Memorial

Hospital

800 School

St.

Carrollton, IL 62016-

1436

Deborah

Campbell

[email protected]

Transitions of

Western Illinois

4409 Main P.O.

Box

3646

Quincy, IL 62301 J. Michael

Rein, M.S.

[email protected]

Tri-County

Counseling

Center

P.O.

Box

381

Jerseyville,

IL

62052 Executive

Director

Wellspring

Resources

Ann Tyree [email protected]

Youth Advocate

Program

202 E.

Eldorado

St.

Decatur, IL 62523







59



Hospital Name City

Psychiatric

Licensed Beds

Staffed Psych

Beds Oct 1,

2009

A McFarland Mental Health Ctr. Springfield

Abraham Lincoln Memorial Hosp. Lincoln 0 0

Blessing Hospital Quincy 41 31

Carlinville Area Hospital Carlinville 0 0

Community Memorial Hospital Staunton 0 0

Decatur Memorial Hospital Decatur 0 0

Dr. John Warner Hospital Clinton 0 0

Hillsboro Area Hospital Hillsboro 0 0

Illini Community Hospital Pittsfield 0 0

Jersey Community Hospital Jerseyville 0 0

Kindred Hospital Springfield Springfield 0

Kirby Medical Center Monticello 0 0

Lincoln Prairie Beh. Health Ctr. Springfield 88 65

Memorial Hospital Carthage 0 0

Memorial Medical Center Springfield 44 35

Pana Community Hospital Pana 0 0

Paris Community Hospital Paris 0 0

Passavant Area Hospital Jacksonville 0 0

Sarah Bush Lincoln Health Ctr. Mattoon 20 20

Sarah D Culbertson Mem. Hosp. Rushville 0 0

Shelby Memorial Hospital Shelbyville 0 0

St Anthony's Memorial Hospital Effingham 0 0

St Francis Hospital Litchfield 0 0

St John's Hospital Springfield 40 25

St Mary's Hospital Decatur 56 42

Taylorville Memorial Hospital Taylorville 0 0

Thomas H Boyd Memorial Hospital Carrollton 0 0




Inpatient Discharges

Cumulative % Change


Statewide 1,723,215 1,714,661 1,724,116 1,715,750 1,677,926 1,651,967 -4.1%

Region 4 6,957 6,808 7,104 6,955 7,839 8,071 5.8%

Source: COMPdata

61

State Operated Inpatient Facilities Inpatient Discharges

Cases

ALOS

Average Daily Census

REGION FACILITY

SFY

2007

SFY

2008

SFY

2009

SFY

2010

SFY

2007

SFY

2008

SFY

2009

SFY

2010

SFY

2007

SFY

2008

SFY

2009

SFY

2010

1C Madden MHC* 4242 4152 3654 3,674

10 10 12 11

116 114 120 111

1N Chic-Read MHC* 1913 1789 1848 1,829

18 20 20 20

94 98 101 100

1S Tinley Park MHC* 1722 1473 1784 1,823

16 14 12 12

75 56 59 60

Region 1 TOTAL 7,877 7,414 7,286 7,326

13 13 14 13

286 268 280 271

2 Elgin MHC 1032 1031 1137 1,204

101 88 91 97

286 249 283 320

Singer MH/Dev Ctr 728 706 852 850

34 55 33 29

68 106 77 68

Treatment & Deten 4 9 9 6

619 1,096 1,665 2,038

7 27 41 34

Region 2 TOTAL 1,764 1,746 1,998 2,060

75 80 73 75

360 382 402 421

4 McFarland MHC* 719 741 636 733

57 51 64 46

112 104 112 92

Region 4 TOTAL 719 741 636 733

57 51 64 46

112 104 112 92

5 Alton MH/Dev Ctr* 232 198 191 188

92 118 139 112

58 64 73 58

Chester MHC 107 119 150 115

284 206 170 136

83 67 70 43

Choate MH and Dev* 571 514 454 298

136 102 147 134

213 144 183 109

Region 5 TOTAL 910 831 795 601

142 121 149 128

354 275 325 210

TOTAL 11,270 10,732 10,715 10,720

36 35 38 34

1,113 1,029 1,119 994

* Alton includes 1 Developmentally Disabled Patient in SFY 2008.

Chic-Read MHC includes 1 Developmentally Disabled Patient in SFY 2008.

Choate includes 33 Developmentally Disabled Patients in SFY 2007, 30 in SFY 2008, 30 in SFY 2009.

Madden MHC includes 1 Developmentally Disabled Patient in SFY 2010.

McFarland MHC includes 1 Developmentally Disabled Patient in SFY 2007.

Tinley Park MHC includes 1 Developmentally Disabled Patient in SFY 2007.




Illinois Statistics


62



63

Hospital Statistics


FY 03 FY 04 FY 05 FY 06 FY 07 FY 08 FY 09


only)

10,472 10,759 11,233 11,657 11,654 10,812 10,504


Forensics)

9,625 9,609 10,190 11,421 11,349 10,729 10,677


Civil Adult 8,870 8,844 9,462 10,770 10,668 10,063 10,045


Forensics total 634 634 610 561 602 590 574

Forensics Adult 611 614 593 546 587 573 565

Forensics Child &

Adolescents

23 20 17 15 15 17 9

Total Triage 1,482 1,784 1,653 797 907 673 401


Civil total 365 364 410 166 152 184 200

Civil Adult 365 364 410 166 152 184 200


Forensics Total 44 50 56 66 59 62 71

Forensics Adult 43 50 55 66 59 62 71

Forensics Child &

Adolescents

1 0 1 0 0 0 0

Individuals with 3+


569 536 592 639 630 585 626

Individuals with 3+


forensics

0.0632 0.0597 0.0617 0.059 0.059 0.055 0.059

FY

03

FY

04

FY

05

FY

06

FY

07

FY

08

FY

09

All Admissions/100,000 78 77 82 92 91 86 86




Admissions/100,000

4 0 4 3 2 2 2



Child & Adolescents Forensics

Admissions/100,000

1 1 1 0 0 1 0

64

FY

03

FY

04

FY

05

FY

06

FY

07

FY

08

FY

09




0.48 0.56 0.51 0.43 0.44 0.43 0.42












Average

101 120 126 113 104 112 108




23 20 26 33 25 39 22


Adolescents) Median

170 210 394 402 411 426 433


Average

678 737 841 889 926 1,005 1,077


Median

171 212 394 403 416 427 436



144 180 334 339 338 283 274


Adolescents) Median

127 127 280 353 214 150 282





Adolescents)

8 7 6 5 4 5 4



Adult)

561 588 585 582 597 590 593



9 11 15 13 10 9 6

65



Visits on 7/09/09.

1,410 1,369 1,402 1,322 1,373 1,353 1,319



799 760 791 706 762 742 709



7/09/09.

797 757 786 705 757 742 707



Visits on 7/09/09.

2 3 5 1 5 0 2



611 609 611 616 611 611 610



601 593 595 601 603 601 605




10 16 16 15 8 10 5


FY 03 FY 04 FY 05 FY 06 FY 07 FY 08 FY 09



Forensics)

9,772 9,641 10,150 11,498 11,286 10,739 10,708


Civil Adult 9,122 8,922 9,468 10,888 10,654 10,131 10,115


Forensics Total 517 589 566 517 557 528 537

Forensic Adults 502 578 553 506 538 517 525

Forensic Child &

Adolescents

15 11 13 11 19 11 12


& Forensic)

418 417 475 233 210 249 271

Civil Total 368 359 408 161 138 173 200

Civil Adult 368 359 408 161 138 173 200


Forensics Total 50 58 67 72 72 76 71

Forensics Adult 49 58 65 72 72 76 71

Forensics Child &

Adolescents

1 0 2 0 0 0 0



1



Region 5

Draft Report

2


Background 3-4

Access 4-5

Funding 5-6

Quality Improvement 6-7

Technology 7-8

Workforce 8-9

Meetings

Letter of Invitation 10-11

Agenda Nov. 21 12

Minutes Nov. 21 13-14

Small Group Responses Nov. 21 15-17

Agenda Jan. 5 18


Small Group Responses Jan. 5 21-25

Agenda Jan. 31 26


Appendices

PA 97-0381 29-32

Questionnaire 33-37


Psychiatric & Licensed Staffed Beds 56-57




ILHFB Bed Totals 60


3


For hospital, primary care, mental health, substance abuse and other community-based providers

Region 5


Association.

Background


0381, which created the Regional Integrated Behavioral Health Networks Act. The Act provides

a platform to establish 12 Regional Integrated Behavioral Health Networks. Its purpose is to

ensure and improve access to appropriate mental health and substance abuse services throughout

Illinois by: organizing systematically all relevant health, mental health, substance abuse, and

other community resources among regional providers; developing a mechanism to use regional


Under the act, each Behavioral Health Regional Network shall develop a strategic plan for its


and defines opportunities to improve access to care. The act contemplates a broad cross-section






and Division of Alcoholism and Substance Abuse, the Illinois Hospital Association and others

convened a group of behavioral health providers in the State’s DHS Region 5 to begin to identify

existing services in the region, strategies for improving the behavioral health services delivery

system including timely and appropriate access to medical and behavioral health services, and

ways in which providers can begin working together to improve access to services and patient

outcomes.


participating service providers in three Region 5 meetings. At the first meeting held at Salem

Township Hospital, Salem on November 21, 2011, providers defined their vision for behavioral

health care services and outlined priority issues and areas of focus. During the second meeting at

Centralia Recreational Complex on January 5, 2012, participants identified strategies to improve

priority areas of concern listed in this plan. In the third meeting held at Centralia Recreational

Complex on January 31, 2012, the group reviewed and provided input on the first draft of a

regional plan and provided additional feedback on data sources and trends they have experienced

over the past 12 months.



4



depend on the continued commitment of all stakeholders, state agencies, primary medical,



1. Access


for all residents of the region. Patients and consumers seeking behavioral health care

currently find long waiting lists for outpatient care, long waits in hospital emergency

departments, long waits for admission to state-operated psychiatric hospitals, and long

waits for substance abuse treatment. Providing coverage for all residents in a timely

manner through a Patient-Centered Medical Home (PCMH) model with integrated

behavioral health services provides the patient and his or her family with the consistent

health services needed for both physical and behavioral health with a holistic approach to

health care and wellness.

A PCMH model would provide connections to community mental health centers,

substance abuse treatment and prevention service providers, and other community-based

services through a care coordination program. A care coordination program will help

patients and their families navigate through health care as they move from assessment,

diagnosis, treatment, follow-up and pharmaceutical compliance. The PCMH will also

provide a foundation for the integration of physical and behavioral health services as well

as a coordinated system for patient medical records.

In addition to PCMH’s and care coordination programs, Region 5 participants would like

to explore alternative strategies to provide behavioral health services in a more

appropriate setting to stabilize patients in crisis, provide counseling to keep patients out

of crisis, assist patients with life challenges, and provide outreach to patients to improve

their quality of life through community resources, employment, housing, etc.

Notwithstanding the value of providing alternative services, providers emphasized the

need to maintain access to the full continuum of care, from acute care to rehabilitative

services.

Recommendations

Provide an alternative to the use of hospitals’ emergency departments by developing a

continuum of crisis intervention services, such as crisis stabilization centers and

home-based counseling services.

Improve assessments of emergency department (ED) patients to refer and obtain the

right level and intensity of care for them and effectively facilitate transition to this

care.

5

Coordinate care for patients and their families who navigate through the service

delivery system.

Expand access to patient-centered medical homes with integrated behavioral health

services.

Identify a centralized patient access system to ensure patients receive the right level

of care, at the right time, and in the right setting (inpatient, outpatient, treatment,

counseling, and prevention).


health agencies and others to track and monitor patients with chronic conditions to

keep them out of crisis.

Facilitate intake process and care coordination through use of electronics and

technology

Strengthen community mental health centers and bring together mental health,

behavioral health and substance abuse services.

2. Funding

Participants agreed that the funding structure should be redesigned to support flexible,

patient-centered care in the future. There was consensus among providers that funding

needs to follow the patient through the system of care. Providers would like to work with

the department and statewide organizations to plan for the use of state, federal, and

commercial insurer funds that better meet the needs of patients and their families.

Region 5 stakeholders expressed a need to decrease ED usage and create regional crisis

centers where patients can access necessary counseling, crisis interventions and

stabilization services. The creation of more outpatient services will help to reduce the

cost of care and provide more timely services for patients and their families. Members

agreed that regional providers need to work together to develop new strategies and pool

resources when necessary to meet patient needs in a more cost-efficient manner.

There is a recognition that multiple providers may need to collaborate to address common

needs. For example, multiple providers would work together to fund transportation

services in a region or to create alternative settings for service delivery. If the state

currently provides transportation for involuntary patients, can multiple providers pool

resources to provide transportation for voluntary patients?

Recommendations

6

Convene groups of providers to redesign the multiple health and human services

funding streams of providers within the region to support funding that follows the

patient through the behavioral health and health care systems.

Create behavioral health collaboratives around common needs such as transportation,

alternative service models, etc., to pool resources and implement new models for

patient services. Build these partnerships to better serve patients at lower costs.

Identify ways in which Federally Qualified Health Centers (FQHCs), Rural Health

Clinics (RHCs), and mental health providers can bill medical and behavioral health

services to Medicaid on the same day.

Explore private, state and federal funding opportunities to pilot new alternative

strategies to deliver behavioral health services in the region (crisis centers, care

coordinators, etc.). Also, make sure that we are capturing all federal matching dollars.

Explore ways to build capacity funding to keep services available in rural areas.

Review ways in which groups can collaborate to reduce the duplication and extra

paperwork.

Work with the state to enhance transportation funding for voluntary admits, mid-level

providers, and for return trips from hospitals and providers. Large geographic areas

cause great expense to patients and providers.


The group discussed the need to move towards outcomes-based care and develop a

consistent set of measures across the continuum of care. Participants agreed that

providers need to collect, analyze, and utilize data to provide more effective and efficient

services in the region. With an increasing need to identify patient needs and deliver high-

quality patient outcomes, providers need to develop quality measures that assess patient

outcomes as they move through the continuum of behavioral health services. There is a

real need to develop consistent outcome measures for patients regardless of where they

enter the system of care. Providers would like more information on evidence-based

practices that improve patient outcomes and best practice strategies to improve care.

There is also a need to eliminate the stigma associated with behavioral health issues.

Recommendations

State and local providers need to review existing mental health/behavioral

health/substance abuse core measures to ensure consistency.

Develop core measures to be used by the behavioral health care team to demonstrate

meaningful patient outcomes, not just outcome measures.

7

Cross-train providers on key patient measures needed to assess patient outcomes

across the continuum of behavioral health care service providers.

DHS and its state partners should host training sessions for behavioral health

providers to provide a consistent message on rules related to Emergency Medical

Treatment and Active Labor Act (EMTALA) and patient confidentiality.

Providers and state routinely review measures to make sure they continue to be

appropriate.

Review federal models and innovations.

View interventions, trauma issues and the community as a whole.

4. Technology


access to care and create efficiencies in the system. Participants would like the state to

use technology to improve the intake process so that patients can be directed to the right

level of care, at the right time and right place.

Providers would like to integrate behavioral health services into the patient’s electronic

medical records and have access to the patient’s complete health record when caring for

the patient. Creating an authorization form for patients to allow their behavioral health

provider to have access to their electronic medical record will assist providers in

assessing and treating the behavioral health needs of their patients.




community mental health center. There is redundancy in the process, which utilizes

resources that are unnecessary and delays access to care for the patient and their family.

Providers would like to utilize technology to record assessment information at the point

of entry and build the patient record as they move through the health care services.

Providers also would like to work with the state and its partners to expand access to

psychiatrists and other specialty providers through telemedicine services, especially

telepsychiatry in the rural parts of the region. Telepsychiatry is currently working in


services. However, the cost of equipment ($20,000) can be a barrier to implementation

especially in rural community mental health centers and substance abuse centers.

Recommendations

8

State agency leaders and providers should meet to discuss reductions in duplication

related to assessments, patient forms and provider reporting requirements through



Work with the Office of Health Information Technology and the state Health

Information Exchange (HIE) Advisory Committee to integrate behavioral health

services into the state’s HIE planning and implementation strategies and provide

technical assistance to work together.


telemedicine equipment, especially for rural providers in the region. Also, work with

providers to provide reliable and consistent delivery.

5. Workforce

The group of providers recognized a need to develop the workforce that will manage care

in the new service delivery system. There will be a need for new workers such as care

coordinators and patient navigators, information technology specialists, home health

services, and family and patient educators. Staff from the different specialty care



chronic conditions.

Providers continue to struggle with workforce shortages especially in the rural parts of

the region. Utilizing vocational and community college training programs, providers will

work to identify new members of the behavioral health workforce. However, they will

need to utilize telemedicine services to access specialty services in rural communities.

The group agreed that new information and professional skills will be needed by those in

the future workforce to address patient care such as: growing quality measures, cross-

training across specialty services, interactions with law enforcement, primary care

integration, electronic medical records, new billing and coding data, and ongoing

evidence-based practice training. Linkages with higher education will continue to be a

priority as these new members of the workforce are developed.


organization that provide quality of life services for patients and families like housing

and transportation services.

Recommendations


to fund those provider services (care coordinators, patient navigators, data, etc.).

Also, provide incentives for those to work in rural areas.

9


new system of behavioral health services. Focus on building capacity of mid-level

providers to provide care in rural regions experiencing workforce shortages.

Work with universities, community colleges, and vocational schools to recruit and

train new behavioral health service providers.

Develop a forum for a network of regional providers to share current roles and

responsibilities, share changes in regional capacity, and work together to solve

common problems.

Develop a source of consistent training for behavioral health providers to have

common understanding of language, medication, roles, and regulatory boundaries.

Also, provide training for all of those that come in contact with patients.

Disseminate a repository of evidence-based practices for providers to share.

Address reimbursement issues related to licensed clinical social workers (LCSW),

licensed clinical professional counselor (LCPC), licensed social workers, and

certified alcohol and drug counselor workers.

Create collaboration with schools and faith-based organizations.

10

October 27, 2011

Name

Title

Organization

Address

City, State Zip

Dear:

As providers, we know that persons with mental and substance use illnesses in Illinois must

navigate a complex amalgam of services that are inconsistently available and accessible. Many

seek care from us in crisis because they could not obtain more timely or appropriate care. Our

state and federal fiscal crises have translated into the loss of essential behavioral health services

particularly in rural Illinois. Yet, despite these challenging circumstances, we can also identify

opportunities to improve care. Some of these opportunities stem from health reform; others are

being generated by our own strategies to serve our patients and communities. One such

opportunity is being presented to us by the recent enactment of House Bill 2982 – Public Act 98-

031, which creates the Regional Integrated Behavioral Health Networks Act.

The bill establishes Regional Integrated Behavioral Health Networks to ensure and improve

access to appropriate mental health and substance abuse services throughout Illinois by

systematically organizing all relevant health, mental health, substance abuse, and other

community resources among regional providers, to develop a mechanism to use regional

resources efficiently and effectively.

Under the Act, each Behavioral Health Regional Network shall develop a strategic plan for its


and defines opportunities to improve access to care. The Act contemplates a broad-cross section

of the mental health, substance abuse, health, and social services community will be involved in

the development –and implementation—of the plan. Collaboration among all of the relevant

community resources will be essential to accomplish the purposes of the Act and to build


We would like to invite you to participate in the first Behavioral Health Regional Network

meeting for Region 5. The meeting will take place Monday, November 21 from 10:00 am to

1:00 pm at Salem Township Hospital in Salem, IL.

Many of you attended the Southern Illinois Behavioral Health Consortium meeting hosted by the

SIUC Center for Rural Health and Social Service Development on October 7. Not only are the

goals for the Behavioral Health Regional Network in line with the vision expressed by those in

attendance at the first Consortium meeting, but the stakeholders are almost identical. Let’s build

11

on the ideas generated by the consortium to develop our Behavioral Health Regional Network

strategic plan for Region 5.

If you have any questions or concerns, please contact IHA Staff: Lori Williams, at 217-541-

1164 or [email protected] or MaryLynn M. Clarke at 217-541-1154 or

[email protected].

To confirm your attendance, please contact Abby Radcliffe at 217-541-1178 or email your

response to [email protected].

Thank you,

MaryLynn M. Clarke

Sr. Director,

Health Policy & Regulation,


Lori Williams

V.P. Small & Rural Hospital Affairs,


Kim Sanders

Director, Center for Rural Health

& Social Service Development




12


November 21, 2011, 10:00 a.m. – 1:00 p.m.

Salem Township Hospital, 1201 Ricker Drive, Salem, IL

Agenda

I. WELCOME & INTRODUCTIONS ................10:00 ............................ Dave Allen

II. OVERVIEW OF HB 2982 (PA 97-0381) .........10:20 ....................... Lori Williams






IV. SMALL GROUP REPORTS ............................11:30 ........................ Kim Sanders

V. SETTING PRIORITIES & NEXT STEPS ....12:15 ............................ Dave Allen

VI. ADJOURNMENT & NEXT MEETING ........1:00 .............................. Dave Allen

13


November 21, 2011

Salem Township Hospital, 1201 Ricker Drive, Salem, IL 62881-6250

Sharon Adams, The H Group

Dave Allen, Richland Memorial Hospital

Vince Ashley, Harrisburg Medical Center

Dan Boehmer, Jefferson Co. Comp. Services

Georgianne Broughton, Com. Resource Center

Gary L. Buatte, Human Service Center

Robert Cole, Human Support Services

John Cooley, Touchette Regional Hospital

Lisa Crouch, SMGSMG

Randall Dauby, Hamilton Memorial Hospital

Denise Daum, Community Resource Center

Sulbrena Day, Touchette Regional Hospital

Tom Duff, United Methodist Children’s Home

Diane Duft, Bond Co. Health Department

Joann Emge, Sparta Hospital

Susan Englehardt, Perry County Counseling

Mickey Finch, The Fellowship House

Cynthia K. Flamm, Rural Health Inc.

Sharon Fradelos, JeffersonCo. Comp. Services

Amy Gibbar, Chestnut Health Systems


Angie Hampton, Egyptian Health

Joan Hartman, Chestnut Health Systems

Ruth Heitkamp, SIU

Wendy Ice, Delta Center

Beth Inman, Pinckneyville Hospital

Jeannie Johnson, Jasper Co. Health Dept.

Laurie Kellerman, Marshall Browning Hospital

Dietra Julieke, Chestnut Health Systems

John Markley, The H Group

Kate Mays, Delta Center

Mary McMahan, Union Co. Counseling Services

Gajif McNeill, IDHS/DASA

Kelly Medlin, WellSpring Resources

Donna Meyers, St. Elizabeth Hospital

Nancy Newby, Washington County Hospital

Jim Novelli, DHS/DMH

Deborah Page, The H Group

Cindy Poland, Wabash Co. Health Department


Kim Sanders, SIU

Wanda Scates, Egyptian Health

Lori Schmider, Jefferson Co. Comp. Services

Greg Sims, St. Mary’s Good Samaritan

Loretta Stevens, SMGSMG

Michele Sturm, Gateway Regional Medical Center

Sharon Szatkowski, Salem Medical Center, SIHC

Woody Thorne, Southern Illinois Healthcare

Deborah Vogel, St. Elizabeth Hospital



Art Zaitz, DHS/DMH


Dave Allen called the meeting to order at 10:00 a.m. and those in attendance introduced

themselves. An overview was given of the current state of problems. Dave noted that the

group was not here to rehash the problems, but to find solutions.


Lori Williams gave an overview of the legislation which requires the Department of

Human Services (DHS) to create Regional Behavioral Health Networks in each DHS

region to ensure and improve access to behavioral health services. The networks will

work collaboratively to develop region-specific plans. The legislation also created the

Regional Integrated Behavioral Health Networks Steering Committee comprised of state

agencies to coordinate efforts among planning regions.

14


Participants were divided into groups to discuss three questions: 1)What should the

behavioral health system look like three years from now?; 2)What would be the key

components of the new behavioral health system?; and 3)Are there immediate actions


what are they?


Kim Sanders led the small groups to report on their findings. Information from the

break-out groups is included in the attached document.





Dave noted that the next meeting will be held Dec. 14 at 10:00 a.m.

15

Nov. 21 Small Group Responses


Timely access to care, staffed adequately

Quality measured with outcomes, overall program evaluation system

Continuum of care

Funding based on cost, standard for payments, payment for uninsured and underinsured

Standardization of assessment, treatment

Electronic health records (EHRs), shared information technology, information follows

the patient

Increased reimbursement for medical, transportation and mental health centers

Integration of rules and regulations, possible waivers

Case management system for follow-up

Comprehensive Coordinated care

Crisis assessment, urgent care psych

State thorough evaluation of new ideas and get more input from providers

Streamline record keeping, reviews

Better training in schools for social workers, etc.

Laws regarding transportation, also transportation to follow-up care

Education to primary care providers and community

Cost of medicine and open access to medical formularies

Collaborative approach with government, law enforcement, and others

Funding of all evidence-based practices, modify for rural

Salaries to attract

One stop shop for patients

Free standing specialty sites

More consistent regional approach, less local

Local flexibility

Less redundancy, more fluidity

More psychiatrist availability

Alternatives to hospitalizations, ED, crisis support outside of ED

Real time information on service availability, bed, etc.

Behavioral health home

Telehealth access using advanced practice nurses (APNs), more use of telehealth

Tort immunity for psychiatrists in community mental health centers

Expand Federally Qualified Health Centers (FQHCs)

Support for physicians, to handle more psych

Education of hospital workforce, how to deal

Patient navigators

Simplify telehealth rules for patients

Community based services

Integration of behavioral health and substance abuse systems and regulations

State and private payer not consistent and federal

Alternative sites for medical clearance

16

Medical care and behavioral health/substance abuse on same day

Early identification of need for services and intervention, prevention

Screening, Assessment, and Support Services (SASS)

Impact of the Adverse Childhood Experiences (ACE) and are there resources to help

Consolidation of resources

New role of health care providers

Risk based contract

Change of rules made by payment sources


Supportive housing, less residential for young and more crisis residential

Support for indigents

Planning and communication with all players, evidence-based treatments

Attracting younger workforce in rural areas

Education, full picture for students, part-time programs, grants or loan repayment

programs

Programs in rural areas for psych services for students

Reimbursement for those not licensed and LCPC billing

Internal accounting and billing changes

Integration include schools and Department of Corrections (DOC)

Prevention, early intervention/assessment, wellness

Communication/information exchange/EHRs/HIE: system and patient

Fiscal responsibility across all stakeholders, including patients, central pot of funds

System to prevent no shows

Technology for self-assessment, data across continuum

Transportation

Connection between hospital and community particularly for heavy users-care

coordination

Integration between medical and behavioral health/substance abuse

Community services, continuity of care

Case management at community level, pull resources around individuals, consumer

friendly

Telemedicine

School system, universities, student clinics, seniors

Tax for cigarette and alcohol

Ambulance

Laws: transportation

Full assessment at each provider

Set of evaluations

Care coordination per person, patient-centered, one stop integrated behavioral health

More psychiatrists, therapists, psych nurses, mid-level capacity, new workforce roles,

innovative staffing

Stabilization

Alternative options to ED on psych beds

Ease of access

17

Change in payment system from production based to patient-centered medical home

Medication must be accessible

Children should be included instead of adult driven

Resources to make it financially viable

Robust crisis system



Coordination, communication, networking, best practices, evidence-based care

Relaxation of some requirements, redundancy, less micro management of non-Medicaid

funding

Looking outside the box, finding other referral sources, other states even

Start in crisis intervention services

Urgent care for psych patients

Money to improve access, money in the right place

Continuous Quality Improvement (CQI)

Shared list of training resources (CPI) in region, shared staff, information.

Facilitate wrap around services, family

Identify a model of care

Care coordination release form

Sharing or pooling of resources, prevent loss of services

Wellness recovery action plan ( WRAP) services, prevention, screening

Stronger legislative voice

Strategic planning across region

Coordination of data regionally, decide on metrics

Influence client choice

Better follow-up after discharge

Track patients better

Robust crisis system-build rather than reduce

Training for law enforcement

Support groups for high ED users

One set of standardized paperwork across hospitals

Telepsych

HFS waiver

18


January 5, 2012, 10:00 a.m. – 1:00 p.m.

Centralia Recreation Complex

115 E. Second Street, Centralia, IL 62801

Agenda

I. WELCOME ........................................................10:00 ........................ Kim Sanders

II. SUMMARY OF FIRST MEETING.................10:20 ...................... ..Kim Sanders


WORKFORCE:





PREVENTION:



DELIVERY SYSTEM:



TRANSPORTATION:



transportation?

PAYMENT DESIGN:




V. SETTING PRIORITIES & NEXT STEPS ....12:15 ....................... Lori Williams

VI. ADJOURNMENT & NEXT MEETING ........1:00 .......................... Kim Sanders

19


January 5, 2012

Centralia Recreation Complex, 115 E. Second Street, Centralia, IL 62801

Attendees

Kelly Medlin, WellSpring Resources

Lisa Tolbert, Delta Center

Gajif McNeill, IDHS/DASA

Mary McMahan, VCCS

Jim Novelli, DHS/DMH

Lisa Crouch, SMGSMG


Susan Engelhardt, Perry County Counseling

Dave Allen, Richland Memorial Hospital

Keith Suedmeyer, SSMHC

Virginia Telford, St. Mary’s Hospital

Wanda Scates, Egyptian Health Department

Angie Hampton, Egyptian Health

Department

Susan Grace, HMC

Bernstein, CHESI

Dan Boehmer, JCCS


Cheryl Colwell, Lawrence Co. Health Dept.

Robert J. Cole, Human Support Services

Lyn Gartke, Center for Senior Renewal



Jim Flynn, Heartland Regional

Melisa Adkins, Heartland Regional

Rachael Belford, Massac Memorial Hospital

Tom Barry, Ferrell Hospital


Beverly Vokes, SIHF

Dana Shantel Taylor, FMH


Kim Abell, Massac Memorial Hospital

Georgianne Broughton, Com. Res. Center

Donna Meyers, St. Elizabeth’s Hospital

Deborah Vogel, St. Elizabeth’s Hospital

Woody Thorne, Southern IL. Health Care

Chris Larrison, U of I

Larry Mizell, Family Counseling Center

Nancy Newby, Washington County Hospital

Sulbrena Day, Touchette Regional Hospital

Randy Dauby, Hamilton Memorial Hospital

Roger Hanna, IRC

Judy Wissel, Wabash County Health Dept.

Debby Page, The H Group


Mike McManus, Touchette Regional

Hospital

Amy Whipple, St Mary’s

Sharon Szatkowski, Southern IL HC Found.

Carole Hannan, Hardin Co. General

Hospital

Jennie Johnson, Jasper Co. Health

Department

Kim Sanders, SIU

Ruth Heitkamp, SIU

Lori Williams, IHA

Abby Radcliffe, IHA

Ann Guild, IHA


Kim Sanders called the meeting to order at 10:00 a.m. and those in attendance introduced

themselves. Kim reviewed the purpose of this series of three meetings being to outline a

plan for behavioral health services in the region and work with a state steering committee

20

to implement changes to the system. Kim outlined that in today’s meeting the group will

take the priority issues identified in the first meeting and drill down into the details in

each of the following areas: workforce, transportation, payment system redesign, service

delivery system, and prevention.

II. Regional Plan Discussion Groups

Participants were divided into groups to discuss questions in five categories:

1)Workforce; 2)Prevention; 3) Delivery System; 4)Transportation; and 5)Payment

Design. These priority issues were identified in the first meeting. The questions on these

topics will help identify provider needs in each of the areas.

III. Small Groups Reports

Kim Sanders led the small groups to report on their findings. The compiled information

from the break-out groups is included in the attached document.

IV. Next Steps

Information collected at the meeting will be used by IHA to develop a draft plan and

recommendation for a viable Behavioral Health System.

V. Adjournment & Next Meeting

IHA will communicate the next meeting date, time and place when scheduled.

21


January 5, 2012

Small Groups Report

WORKFORCE: What specific training is needed for existing workforce? What are the

new skills that are needed? What are regulatory barriers to workforce utilization? What

are the specific training needs for dual diagnosis patients?

Mental health/behavioral health/substance abuse system lacks cohesiveness with many

initiatives coming from many directions with the same goal

Difficult to plan for and educate employees due to the disarray in the mental

health/behavioral health/substance abuse system

Need for more LCSW, mid-levels, dual diagnosis practitioners, behavioral health

providers, and psychiatrists and increase use of paraprofessionals

Need evidence-based guidelines for the appropriate staff mix for care coordination - RN

vs. Social Work vs. LPN

Low pay impacts ability to retain workers, also need adequate reimbursement for

paraprofessionals

Mental health/behavioral health/substance abuse system agencies cannot afford the cost

of employing Psychiatrists

Training time, funding, consistency, and comprehensive training is an issue, need

continuing education credits as well

Need to fund an adequate workforce by redirecting/blending payment

The education system has the capacity to provide staff training but with constant changes

it must be very responsive, need best practices

Social workers do not receive training in school to attend to administrative issues they

will encounter on the job

Staff education is more assessable with use of online programs, still need networking

though

Need a dual diagnosis training program, evidence-based models, regulatory issues,

certification

Need for specialized psychiatry training - chemical and alcohol, geriatric, general

psychiatric

Need for SBIRT (Screening, Brief Intervention, Referral, Treatment) training

Mental health and substance abuse providers need training on major co-morbidities

Need for education on a good mental health assessment

Non-behavioral health providers need training on behavioral resources

Need for more training for nurses and social workers at the acute inpatient level of care

ED/hospital practitioners and providers need to be knowledgeable of psychiatric

medications (Psych 101 seminar, Touchette), crisis management training

Need for training on the patient-centered medical home model (PCMH), integrated care,

care coordination

RN, Social Work, LPN, Case Managers need to be cross-trained in mental health, mental

illness, behavioral health, and substance abuse

22

Behavioral health providers trained to team with health care providers

Need more assessment training for mid-level providers

Providers need education on roles and responsibilities, resources available, the referral

process, need for education on scope of practice/authority, system access , resident

patients, and outcome measures

Need for training on quality of life issues: housing, employment, nutrition, etc.

Need for telepsychology training, EHRs, HIE, and other data systems

Need education programs on drugs, including for law enforcement on psychiatric

medications

Need for law enforcement to be trained on mental health/mental illness/behavioral

health/substance abuse

Funding regulations must be changed to equate LCPC and LCSW and parity

Need to address scope of practice issues

Need for partnerships with SIU, U of I, or other universities for training/programs

Mid-level providers would benefit from more supervision from psychiatrists

Review mid-level regulations

Need recognition and services for domestic violence victims

PREVENTION: What are the current prevention services? What new prevention

services are needed?

Early intervention is needed for prevention, school/community partnerships important

Prevention currently provided by local mental health agencies, school and community-

based prevention, intensive outpatient programs, preventive medicine, public health

Private outreach programs are targeting prevention and working with communities

National Institute of Health (NIH) - child mental health prevention programs should

begin in the schools, need for more school based prevention program - project success

Primary care clinicians do not have time for prevention; are volunteers effective?

Current system focuses on episodic care not prevention, should also be for general

population and link to hospitals

Cycles of disparities (poverty/homelessness/low education level) limit implementation of

meaningful prevention, no mental health prevention, financial resources inadequate

SASS program cut

PCMH will strengthen prevention in primary care setting

Need for improved communication among health care providers - hospital/primary

care/community/schools for prevention

Hospitals are providing services to prevent readmissions, i.e. telephone calls

Utilize afterschool programs for prevention and DCFS parent and teen cafes

Competing needs inhibit effective preventive education in the schools

School counseling services need to be coordinated in new preventive system of care

focus, also school liability concerns limits referrals to mental health care

Use social media to promote prevention

23

Access to community mental health centers - past assessment to immediate services (four

to six-week program)

Need for more community follow-up preventive services, community awareness

Need for proactive case management, outpatient services

Need for post-partum prevention

Need links to alternative schools

Need to prevent patients from receiving drugs from multiple providers

Need to address over-the-counter designer drugs

DELIVERY SYSTEM: How would you recommend we fill the gaps in the service delivery

system? Are there new models that would be effective in this region?

Need to develop blended models for intensity of service delivery and a sustainable model

of care, regional administration of care coordination and payment design

Hospitals do not need to be the leaders for system redesign

Need community/agency support for new service delivery systems, break down silos

Need essential package of care services (housing excluded) - now directed by state vs.

federal

State needs to provide accurate, comprehensive cost/utilization data for planning delivery

system, assess bureaucratic inefficiencies in policy/procedure

Others groups must be brought into this discussion - law enforcement, FQHC, state

All entities in "new system" need to be healthy

Difficult to manage the utilization of available inpatient beds causing the supply not

meeting demand for inpatient beds, more inpatient beds in region

Models are available for alternatives to inpatient

Develop capacity for 23-48 hour hold/observation beds for patients in crisis, crisis center

Smaller hospitals must be compensated for providing the capacity for rapid access to care

for this population

Need holistic patient care: case mgmt., care coordination, timely access to behavioral

health/mental health services (esp. kids), primary care medical home, patient choice

Need for coordination among primary care and community providers

Integrate mental health within the health department

Integrate, co-locate, and change how mental health services are delivered/marketed

Need for accountable care organizations, care coordination, primary care medical home

Improved coordination with FQHC, community mental health centers and other

community primary care providers

Need to partner pharmacy and behavioral health professionals to manage dual diagnosis

patients.

Need for evaluations that align with outcomes

Explore Oklahoma, North Carolina, California, Kentucky, and Arizona telemedicine

programs

Implement new models - Recovery support model, shift of treatment, telepsych, case

management, PCMH, primary care/behavioral health integration, dental, and care

coordination

24

Explore Adams County model - groups going together to pay for services

Cherokee Health System in Knoxville, TN - model of care - system follows patient, not

funding streams, telepsych (and reimbursement), child and adolescent, assessment and

medication management

Outcome measures limit stays, resulting in too many short stays, patients discharged too

quickly, make time to get required follow-up

Disconnect between acute and community mental health/behavioral health/substance

abuse providers

Hospitals needing to provide "sitters" for acute patients

Lift Rule 132 DMH regulations - community support specialists

Need for address confidentiality laws to improve sharing of protected health information

Regulatory barriers with paperwork: private vs. public providers, assessment

requirements, H&P, state laws restricting sharing/access to mental health/behavioral

health/substance abuse information, federal regulations, accreditation process should

remove regulatory barriers, DMH - eligibility changes in mental health services,

duplicate paperwork

Need to allow hospitals to process involuntary patients

Working poor - need case management (IL Health Connect) and need to take

responsibility

Inmates released with no employment, housing, etc.; they need transition programs

Data: Population variance by provider type

TRANSPORTATION: Where are the transportation gaps (unfunded, Medicaid, others)?

What alternatives can you suggest in your community to provide transportation?

Lack of transportation providers; patients missing appointments and can’t apply for

entitlements

Transportation providers don’t want to accept Medicaid contracts; can’t build enough

volume to offer services at a fair price; want payment up front, and overcharge

Agencies looking for alternative providers - BART, sheriff department, churches, some

"pooling" funds

No payment for transit back to home

Medicaid does not reimburse for all patient transportation needs

Case managers are no longer reimbursed to provide patient's transportation

Lack of transportation prevents people from applying to entitlements

EMS won't transports patients with serious mental illness

Distance to available beds is lengthening

Burden is the paperwork and staff time to arrange transit

Regulations and liability for transportation services limits intake

Crisis - IPT works to state ops

Telemedicine would help with transportation issues

Jefferson County has a mobile detox program

Center for Rural Health and Social Service Development Rural Transportation Network

working on solutions

25

Use cell phones to help patients access transit

Needs: Case managers to assist mental health patients with transit arrangements

Need an 800 number to call and get transportation - Dial-a-ride, college

PAYMENT DESIGN: What services are not currently reimbursed that should be? How

should the payment system by redesigned to better meet the client’s needs?

Current system of reimbursement is dismantling the healthcare system, and state/grant

funding has eroded, and payment system is based on outdated models of care

Under current reimbursement system - unfunded or inadequate funding: preventive

services, medication assisted treatment, telemedicine, care management/coordination,

transportation, linkages to services, travel for case managers, consultative services,

administrative time for providing medical cards, utilization management, beds

Unable to be reimbursed for two provider visits in the same day; will only be reimbursed

for one visit and no reimbursement for mid-levels, just physicians

Does current funding reimburse for providing care in a "crisis center"?

Currently hospitals are absorbing the costs for providing direct service to the mental

illness/substance abuse population - i.e. care coordinator in emergency department,

transportation costs

Reality - reimbursement drives services offered

Providers unwilling to risk liability and use lower level of care

Hospitals/clinics etc. are hesitant to take financial risk for providing services to the

mental health/mental illness/substance abuse patient population

No health care provider will voluntarily join into an Accountable Care Organization

Utilize cost-based reimbursement

Load capacity

Need to move away from a "fee for service" model

Waivers are needed to adopt innovative models of care/delivery systems

Services bundled for reimbursement, care coordination fee is needed in addition to fee-

for-service, need for reimbursement to follow patients through new system of care

Must include reimbursement for transportation and various settings and care

coordination/case management

Reimbursement must be coordinated among organizations, allow providers to allocate

money to provide services by the patient’s needs

Provide reimbursement for quality, need for worker’s compensation

Funding differences need to be resolved – funding for FQHC, hospitals, providers needs

to look alike and community health center reimbursement must be on parity with FQHC/

Rural Health Clinics

Rule-16.6% of salary for benefits (limit) state dept. law (early 80's)

High users of mental health services are high cost; Uninsured need money to purchase

medications; as money for mental health declines, recidivism rates increase

Geriatric IOP - Senior Care Model, Medicare Part B, insurance, strictly medical fall

through cracks

26


January 31, 2012, 10:00 a.m. – 1:00 p.m.



Agenda

I. WELCOME ........................................................10:00 ........................ Kim Sanders

II. SUMMARY OF SECOND MEETING ............10:20 ...................... ..Kim Sanders

III. REVIEW OF PLAN/PRIORITIES………… ..10:25 ............................ Ann Guild


V. NEXT STEPS ....................................................12:15 ............................ Ann Guild

VI. ADJOURNMENT ..............................................1:00 .......................... Kim Sanders

27


January 31, 2012



Kevin Hutchison, St. Clair Public Health

Dana Rosenzweig, St. Clair County MHB

Orville Mercer, Chestnut Health System

Georgianne Broughton, Comm. Resource Center

Beverly Vokes, SIHF

Judy Wissel, Wabash Co. Health Dept.


Ruth Heitkamp, SIU-Center for Rural Health

Kim Sanders, SIU-Center for Rural Health

Joann Emge, Sparta Community Hospital

Lori Clinton, Sparta Community Hospital

Sharon Szatkowski, SIHF

Angie Hampton, EHD


Katheryn McWhirter, WGH

Tamara Gould, Wabash General Hospital

Lyn Gartke, Center for Senior Renewal

Carole Hannan, Hardin County General Hospital

Bob Layman, Farm Resource Center

Ann Tyree, WellSpring Resources

Lorianne Schmider, Jeff. Co. Comp. Services

Lisa Tolbert, Delta Center

Julia Holland, Salem Counseling Center

John Cooley, Touchette Regional Hospital

Michele Sturm, Gateway Regional

Dana Shantel Taylor, Fairfield Memorial Hospital

Keith Suedemyer, St. Mary’s Good Samaritan

Stacia McGuire, EHD

Fred Bernstein, CHESI



Christopher Larrison, U of I


Robert J. Cole, Human Support Services

Diane Duft, Bond Co. Health

Deborah Pape, The H Group

Patsy Jensen, Shawnee Health

Susan Grace, HMC

Jim Novelli, DMH


Woody Thorne, Southern Illinois Healthcare

Larry Mizell, Family Counseling Center

Gajef McNeill, IDHS/DASA

Rachael Belford, Massac Memorial Hospital

Kim Abell, Massac Memorial Hospital

Jeannie Johnson, Jasper Health

Ann Guild, IHA

Abby Radcliffe, IHA


Kim Sanders called the meeting to order at 10:00 a.m. and those in attendance introduced

themselves.


Kim gave an overview of the last meeting. She thanked the group and the state for





28


Ann Guild noted that today’s meeting will take the priority issues that were identified in

the first two meetings and begin to craft recommendations to be part of this region’s plan.

Comments will be recorded and added to the plan. Ann went through each section of the

draft plan and the group made recommendations for any changes.




V. Next Steps

The information collected at the meeting will be assembled by IHA. The updated draft

plan will be sent to the group for any other changes. This plan will then be submitted to

the State Steering Committee when they begin to meet.

VI. Adjournment

Kim adjourned the meeting at 1:00 p.m.

29

Appendix


Public Act 097-0381































regions.

Section 15. Goals.





30







































Committee.



31















(7) Other.





health staff.




providers.





(1) Prevention.






hospitals.









32













Public Act 097-0381

33



1. Wait Times




Available placements

No. Access is improving, as an FQHC, we are in

No, not at our facility



#5 - 1

#4 - 4

#3 - 2

#2 - 2

#1 - 5


NO - 4

YES - 6

N/A - 2


Increased number of psych patients receiving care in ED, primary care,

etc. More paying for services to assess and place patients in psych

inpatient settings.

They are documented in the ER log book (length of stay), patient charts

The ECHO group, clinician’s desktop, provides a waitlist broken out by

services needed, wait time, location, etc. We have gone to a central intake

service delivery system that has reduced wait time, but the list continues to

grow due to an inability to expand capacity for financial and other logistic

reasons.

Our problem is for psychiatry. Counseling and assessments in mental

health or substance abuse are not a problem—less than one week wait

Crisis notes, referrals




NO - 2

34

YES - 10

N/A - 2

Maintenance staff/local police

Not applicable, but safety of staff in any setting is a concern

Internal security



#5 - 2

#4 - 2

#3 - 1

#2 - 4

#1 -3


Security RTO in ED for psych-related needs

Some, completed if code called or if employee injury occurs

None

Log book, incident reports


Sitter, full-time employees in ED and or various inpatient units for those

with psych needs

Not aggregated

Use local law enforcement

3. Patient Volume



Demand has been level

Yes, response six times

Unsure, more under using bath salts

Slight

No, volume lower due to reduced staff


#5 - 1

#4 - 0

#3 - 4

#2 - 1

35

#1 - 5


State of number of patients presenting with mental health diagnosis

Significant data with ongoing dashboard to assess the need being

established and ER logs, intake and census reports, dual diagnosis tracking

Wait list

Encounter data, not sure it is correct, seems under reported. I am willing to

share this data

If there had not been such severe reduction in non-Medicaid funding, we

would have definitely seen an increase in patients served

Percent of new patients is up

Not sure how to assess it

None

4. Transportation


NO - 1

YES - 6


#5 - 2

#4 - 2

#3 - 2

#2 - 4

#1 - 4


No shows

Number of transfers related to transportation, cost of transportation to

hospitals for voluntary or involuntary psych admits

Social service/crisis staffing notes calls to public transit for after-hours

transportation is unavailable

None, starting to collect, very limited

Non-reimbursed ambulance transports

36

5. Admissions




facility?

YES - 6

NO - 1

N/A - 5

Not a big problem. Admit because not medically stable. We leave them in the

emergency department while waiting for transfer.


#5 - 0

#4 - 2

#3 - 3

#2 - 2

#1 - 1


Patient encounters, length of stay, admission records, coding

documentation

We do assist individuals who need to be hospitalized. This volume has

been stable



Lots of persons unable to get care/needs do to no funding. Referral

systems overwhelmed

No longer accept patients with no pay source, no documentation

Outpatient services are growing rapidly, more medically indigent

Medicaid reimbursement for two providers in the same day, medical and

psychiatric

As an FQHC, need to be able to bill for family practice MD/psychiatrist

same day

Patients come to the ED because they can’t afford medication, can’t find

anyone to prescribe psych medication and lack of care management. Also

lack data

Liability issue related to lack of ability to place individuals and then being

informed by mental health that it is permissible to discharge them home

Need to address co-morbidities of those with psych and medical needs

Timelines of response of mental health providers.

37


providers in your region through meetings, trainings and workshops?

YES - 11

Maybe - 1

Yes, from a community mental health center perspective

We would be happy to assist and convene parties to seek solutions




YES - 8

Please indicate which issues would be helpful to you.

Hospital ERs understanding how to treat mental illness or substance abuse

All

Patient care and coordination

System design and transportation

Regulatory, legislative



In our situation, the issue is not that the patient is in the ER or that crisis

counselors are not available because this works, but that placing patients

in appropriate facilities is very difficult and takes days sometimes.

Share successes being implemented within the region

38


Organization Address Address 2 City & State Zip Contact Email

AAA DUI Services,

Inc.

828 Klein Ave. Edwardsville,

IL

62025 Linda Khan [email protected]

ABC DUI Services 1437 W. Whittaker Salem, IL 62881 Alta M. Allen [email protected]

Accurate Evaluations 951 Fairfax St. Carlyle, IL 62231 Jessica Daab [email protected]

Adapt 727 N. 17th St. Belleville, IL 62226 Cindy Janicak

Alcoholic

Rehabilitation

Community Home

1313 21st St. Granite City, IL 62040 Cary Green [email protected]

Alton Memorial

Hospital

One Memorial Drive Alton, IL 62002-

6755

David Braasch [email protected]

Anderson Hospital 6800 State Route

#162

Maryville, IL 62062-

1000

Keith Page, FACHE [email protected]

Association of

Community Mental

Health Authorities of

IL

P.O. Box

935

Aurora, IL 60507 Maureen Mulhall [email protected]

Association of

Community Mental

Health Authorities of

IL

P.O. Box

935

Aurora, IL 60507 Phyllis Russell [email protected]

Behavioral Health

Alternatives

337 E. Ferguson Ave. Wood River, IL 62095

Bond County Health

Dept.

1520 S. Fourth St. Greenville, IL 62246 Maxine Barth, RN,

MSN

[email protected]

Bond County Health

Dept.

1520 S. Fourth St. Greenville, IL 62246 Diane Duft

Call For Help, Inc. 9400 Lebanon Road Edgemont, IL 62203 Cheryl Compton










39

Carbondale DUI and

Counseling Associates

2015 W. Main Carbondale, IL 62901 Colleen Anotnacci [email protected]

CEC/CIVIGENICS,

Inc.

3300 Honeybend

Ave.

Litchfield, IL 62056 Steven Bryant [email protected]

Center for Senior

Renewal

Lyn Gartke [email protected]

Changing Lives

Counseling Center, Inc.

307 Henry St. Alton, IL 62002 Ted Williams

Chesi Cedar Court

Clinic/Cedar Court

Specialty Clinic

1250 Cedar Court Carbondale, IL 62901-

5334

Fred Bernstein [email protected]

Chestnut Health

Systems

50 Northgate

Industrial Drive

Granite City, IL 62040 Russell J. Hagen [email protected]

Chestnut Health

Systems

50 Northgate

Industrial Drive

Granite City, IL 62040 Orville Mercer [email protected]

Chestnut Health

Systems

50 Northgate

Industrial Drive

Granite City, IL 62040 Dietra Kulicke [email protected]

Chestnut Health

Systems

50 Northgate

Industrial Drive

Granite City, IL 62040 Amy Gibbar [email protected]

Chestnut Health

Systems

50 Northgate

Industrial Drive

Granite City, IL 62040 Joan Hartman [email protected]

Children's Center for

Behavioral

Development

353 N. 88th St. Centreville, IL 62203

Choate Mental Health

& Dev Center

1000 N. Main St. Anna, IL 62906 Jim Novelli [email protected]

Christopher Rural

Health Planning

Corporation

201 Bailey Lane Benton, IL 62812

Christopher Rural

Health Planning

Corporation

4241 St. Highway 14

W.

Christopher, IL 62822











40

Christopher Rural

Health Planning

Corporation

27 Circle St. Zeigler, IL 62999

Christopher Rural

Health Planning

Corporation

Cisne, IL 62823

Christopher Rural

Health Planning

Corporation

201 E. North Ave. Flora, IL 62839

Christopher Rural

Health Planning

Corporation

3303 Logan Drive Herrin, IL 62948

Christopher Rural

Health Planning

Corporation

115 E. Franklin St. Sesser, IL 62884

Christopher Rural

Health Planning

Corporation

607 Fourth St/ Eldorado, IL 62930

Christopher Rural

Health Planning

Corporation

9525 Gold Hill Road Shawneetown,

IL

62984

Christopher Rural

Health Planning

Corporation

119 Gas Plant Road DuQuoin, IL 62832

Christopher Rural

Health Planning

Corporation

McLeansboro,

IL

62859

Christopher Rural

Health Planning

Corporation

300 S. Main Royalton, IL 62983

Christopher Rural

Health Planning

Corporation

2920 Veterans

Memorial Drive

Mount Vernon,

IL

62864

41

Christopher Rural

Health Planning

Corporation

14410 Route 37 Johnston City,

IL

62951

Clay County

Counseling Services

125 Broadway St. Louisville, IL 62858 Cara Rinehart [email protected]

Clay County Health

Department

601 E. 12th St. Flora, IL 62839

Clay County Hospital 911 Stacy Burk Drive P.O. Box

280

Flora, IL 62839-

0280

Robert Sellers [email protected]

Clinton County Health

Department

930-A Fairfax St. Carlyle, IL 62231

Community Behavioral

Healthcare Association

Sheryl Turpin [email protected]

Community Health &

Emergency Services,

Inc.

13245 Kessler Road Cairo, IL 62914-

3101

Frederick L. Bernstein [email protected]

Community Health &

Emergency Services,

Inc.

Elizabethtown,

IL

62931

Community Health &

Emergency Services,

Inc.

Pulaski, IL 62976

Community Health &

Emergency Services,

Inc.

217 S. Adams St. Golconda, IL 62938

Community Health &

Emergency Services,

Inc.

290 Railroad St. Tamms, IL 62988

Community Health &

Emergency Services,

Inc.

226 Main St. Rosiclare, IL 62982





42

Community Health &

Emergency Services,

Inc.

1340 Cedar Court Carbondale, IL 62901

Community Health &

Emergency Services,

Inc.

1250 Cedar Court Carbondale, IL 62901

Community Health &

Emergency Services,

Inc.

205 N. Main St. Harrisburg, IL 62946

Community Health &

Emergency Services,

Inc.

1400 W. Main Carmi, IL 62821

Community Resource

Center, Inc.

101 S. Locust Centralia, IL 62801 Denise Daum [email protected]

Community Resource

Center, Inc.

101 S. Locust Centralia, IL 62801 Georgianne

Broughton

[email protected]

Comprehensive

Behavioral Health

Center of St. Clair

County, Inc.

505 S. Eighth St. East St. Louis,

IL

62201 Marsha Johnson [email protected]

Crawford County

Health Department

202 N. Bline Blvd. Robinson, IL 62454

Crawford Memorial

Hospital

1000 N. Allen St. Robinson, IL 62454-

1114

Don Annis [email protected]

Crossroads Community

Hospital

#8 Doctors Park

Road

Mount Vernon,

IL

62864-

6224

M. Edward

Cunningham

[email protected]

Delta Center 1400 Commercial

Ave.

Cairo, IL 62914 Lisa Tolbert [email protected]


Ave.

Cairo, IL 62914 Kate Mays [email protected]


Ave.

Cairo, IL 62914 Wendy Ice [email protected]









43

Derouse Counseling &

DUI Services

100 W. Main St. Belleville, IL 62220 George Derousse [email protected]

om

DHS/DASA Gajef McNeill [email protected]

DHS/DMH Jim Novelli [email protected]

DHS/DMH Art Zaitz [email protected]

Egyptian Public &

Mental Health Dept.

1412 US 45 N. Eldorado, IL 62930 Angie Hamilton [email protected]

Egyptian Public &

Mental Health Dept.

1412 US 45 N. Eldorado, IL 62930 Stacia McGuire [email protected]

Egyptian Public &

Mental Health Dept.

1412 US 45 N. Eldorado, IL 62930 Wanda Scates [email protected]

Fairfield Memorial

Hospital

303 NW Eleventh St. Fairfield, IL 62837-

1298

Katherine Bunting [email protected]

Fairfield Memorial

Hospital

Dana Shantel Taylor [email protected]

Family Counseling

Center, Inc.

Washington &

Market Sts.

P.O. Box

759

Golconda, IL 62939 Larry W. Mizell [email protected]

Farm Resource Center 226 Main St. Mound City, IL 62963 Roger Hannan [email protected]

Farm Resource Center 226 Main St. Mound City, IL 62963 Bob Layman [email protected]

Fayette County Health

Department

416 W. Edwards Vandalia, IL 62471

Fayette County

Hospital

650 W. Taylor St. Vandalia, IL 62471-

1227

Lyn Gartke [email protected]

Fayette County

Hospital

650 W. Taylor St. Vandalia, IL 62471-

1227

Greg Starnes [email protected]

Ferrell Hospital 1201 Pine St. Eldorado, IL 62930-

1634

Mary Ellen Turner-

Groves

[email protected]

Ferrell Hospital 1201 Pine St. Eldorado, IL 62930-

1634

Thomas F. Barry [email protected]

First Choice DUI

Services & Evaluations

219 S. Illinois St. Belleville, IL 6220 Kevan Caliper [email protected]



















44

First Judicial

Circuit/Evaluation

Services Unit

200 W. Jefferson St. Marion, IL 62959 Merinda Nehrkorn [email protected]

First Step DUI

Evaluation &

Counseling, Inc.

504 O'Hara Drive Troy, IL 62294 Neela Williams [email protected]

Franklin Hospital 201 Bailey Lane Benton, IL 62812-

1999

Hervey Davis [email protected]

et

Franklin-Williamson

Bi-County Health

Department

8160 Express Drive Marion, IL 62959-

9808

Gateway Regional

Medical Center

2100 Madison Ave. Granite City, IL 62040-

4799

Michelle Sturm [email protected]

Gateway Regional

Medical Center

2100 Madison Ave. Granite City, IL 62040-

4799

Mark Bethell [email protected]

Good Samaritan

Regional Health Center

605 N. 12th St. Mount Vernon,

IL

62864-

2857

Mike Warren [email protected]

Greenville Regional

Hospital

200 Healthcare Drive Greenville, IL 62246-

1154

Brian Nall [email protected]

Hamilton County

Health Department

County Courthouse,

Room 5

McLeansboro,

IL

62859

Hamilton Memorial

Hospital District

611 South Marshall

Avenue

P.O. Box

429

McLeansboro,

IL

62859-

0429

Randall Dauby [email protected]

Hardin County General

Hospital

6 Ferrell Road P.O. Box

2467

Rosiclare, IL 62982-

2467

Roby Williams [email protected]

Hardin County General

Hospital & Clinic

6 Ferrell Road P.O. Box

2467

Rosiclare, IL 62982 Carole Hannan,

MSW/LSW

[email protected]

Harrisburg Medical

Center

100 Dr. Warren

Tuttle Drive

P.O. Box

428

Harrisburg, IL 62946 Rodney Smith rsmith@harrisburgmedicalcenter

.org

Harrisburg Medical

Center

100 Dr. Warren

Tuttle Drive

P.O. Box

428

Harrisburg, IL 62946 Susan Grace sgrace@harrisburgmedicalcenter

.org

Heartland Regional

Medical Center

3333 W. DeYoung Marion, IL 62959 Stephen Lunn [email protected]

















45

Heartland Regional

Medical Center

3333 W. DeYoung Marion, IL Jim Flynn [email protected]

Heartland Regional

Medical Center

3333 W. DeYoung Marion, IL Melisa Adkins [email protected]

Helm DUI Services 716 School St. Vandalia, IL 62471 Brenda Duff [email protected]

Herrin Hospital 201 S. 14th St. Herrin, IL 62948-

3631

Terence Farrell,

FACHE

[email protected]

Holbrook &

Associates, LLC

6001 Old Collinsville

Road Ste. 4b

Fairview

Heights, IL

62208-

2937

Susan Holbrook [email protected]

Human Services Center 10257 State Route 3 Red Bud, IL 62278 Gary L. Buatte [email protected]

m

Human Support

Services

988 N. Illinois Route

3

P.O. Box

146

Waterloo, IL 62298 Robert Cole [email protected]

Illinois Association of

Rehab Facilities

206 S. Sixth St. Springfield, IL 62701 Janet Stover [email protected]

Illinois Association of

Rehab Facilities

206 S. Sixth St. Springfield, IL 62701 Josh Evans [email protected]

Intensive Outpatient

Care, Inc.

2 Club Centre Court Edwardsville,

IL

62025 Jennifer Manning [email protected]

Jackson County Health

Department

415 Health

Department Road

P.O. Box

307

Murphysboro,

IL

62966

Jasper County Health

Dept.

106 E Edwards Newton, IL 62448 Debbie Clark, B.S. [email protected]

Jasper County Health

Dept.

106 E Edwards Newton, IL 62448 Jeannie Johnson [email protected]

Jefferson County

Comprehensive Svcs.,

Inc.

Route 37 N. P.O. Box

428

Mt. Vernon, IL 62864 Lori Schmider [email protected]

Jefferson County


Inc.


428

Mt. Vernon, IL 62864 Dan Boehmer















46

Jefferson County


Inc.


428

Mt. Vernon, IL 62864 Sharon Fradelos

Jefferson County

Health Department

#1 Doctors Park

Road, Suite F

Mt.

Vernon, IL

62864

Kids Hope United-

Hudelson

1400 E. McCord St. Centralia, IL 62801

Lawrence County

Health Dept.

RR #3, Box 516 Lawrenceville,

IL

62439 Cheryl Colwell, MS,

LCPC

[email protected]

Lawrence County

Memorial Hospital

2200 W. State St. Lawrenceville,

IL

62439-

1852

Douglas Florkowski [email protected]

Madison County

Health Department

101 E. Edwardsville

Road

Wood River, IL 62095

Madison County

Mental Health (708)

Board

157 N. Main Suite 380 Edwardsville,

IL

62025 Jennifer Roth [email protected]

Marion County Health

Department

1013 N. Poplar Centralia, IL 62801

Marshall Browning

Hospital

900 N. Washington

St,

P.O. Box

192

Du Quoin, IL 62832-

9788

Edwin Gast egast@marshallbrowninghospita

l.com

Marshall Browning

Hospital

900 N. Washington

St.

P.O. Box

192

Du Quoin, IL 62832-

9788

Laurie Kellerman lkellerman@marshallbrowningh

ospital.com

Massac County Mental

Health Center

206 W. Fifth St. Metropolis, IL 62960 Yvonne Rath

Massac Memorial

Hospital

28 Chick St. P.O. Box

850

Metropolis, IL 62960-

0850

Kim Abell [email protected]

Massac Memorial

Hospital

28 Chick St. P.O. Box

850


0850

David Fuqua [email protected]

Massac Memorial

Hospital

28 Chick St. P.O .Box

850


0850

Rachael Belford [email protected]

Memorial Hospital of

Carbondale

405 W. Jackson St. P.O. Box

10000

Carbondale, IL 62902-

9000

Bart Millstead [email protected]












47

Memorial Hospital,

Belleville

4500 Memorial Drive Belleville, IL 62226-

5399

Mark Turner [email protected]

Memorial Hospital,

Chester

1900 State St. Chester, IL 62233-

0609

Steven Hayes [email protected]

Monroe County Health

Department

901 Illinois Avenue Waterloo, IL 62298

PAVE P.O. Box

342

Centralia, IL 62801

Perry County

Counseling Center, Inc.

1016 S. Madison St.

Ste. A

DuQuoin, IL 62832 Susan Engelhardt [email protected]

Perry County Health

Department

907 S. Main St. P.O. Box

49

Pinckneyville,

IL

62274

Perry County Health

Department

907 S. Main St. P.O. Box

49

Pinckneyville,

IL

62274 Jodi Schoen [email protected]

Pinckneyville

Community Hospital

101 N. Walnut St. Pinckneyville,

IL

62274-

1034

Thomas Hudgins,

FACHE

[email protected]

Pinckneyville

Community Hospital


IL

62274-

1034

Nancy Keller [email protected]

Pinckneyville

Community Hospital


IL

62274-

1034

Beth Inman [email protected]

Practical Rehab

Services

3550 College Ave. Alton, IL 62002 Sharon Johnson [email protected]

Randolph County

Health Department

2515 State St. Chester, IL 62233

Red Bud Regional

Hospital

325 Spring St. Red Bud, IL 62278-

1105

Shane Watson [email protected]

Residential Options,

Inc., Fosterberg

Terrace

4617 Wonderland

Drive

Alton, IL 62002

Richland Memorial

Hospital

800 E. Locust St. Olney, IL 62450-

2553

David Allen [email protected]

Rural Health Inc. 513 N. Main St. Anna, IL 62906 Cynthia K. Flamm [email protected]












48

Rural Health Inc. 318 N. Highway 51 Dongola, IL 62926

Rural Health Inc. 803 N. First St. Vienna, IL 62995

Rural Health Inc. 608 S. Main Anna, IL 62906

Rural Health Inc. Cobden, IL 62920

Rural Health Inc. 515 N. Main St. Anna, IL 62906

Saint Anthony's Health

Center

1 Saint Anthony's

Way

P.O .Box

340

Alton, IL 62002-

0340

E.J. Kuiper, FACHE [email protected]

Salem Counseling

Center, PC

220 E. Rodgers St. Salem, IL 62881 Julie Holland [email protected]

Salem Township

Hospital

1201 Ricker Drive Salem, IL 62881-

6250

Stephanie Hilton

Siebert

[email protected]

Shawnee Health

Service

6355 Brandhorst

Drive

Carterville, IL 62918 Patsy Jensen [email protected]

Shawnee Health

Service

101 S. Wall St. Carbondale, IL 62901

Shawnee Health

Service

1006 S. Division St, Carterville, IL 62918

Shawnee Health

Service

7 S. Hospital Drive Murphysboro,

IL

62966

Shawnee Health

Service

3111 Williamson

County Parkway

Marion, IL

62959

Shawnee Health

Service

202 W. Jackson St. Carbondale, IL 62901

Shawnee Health

Service

4 South Hospital

Drive

Murphysboro,

IL

62966

Shawnee Health

Service

1301 E. Walnut St. Carbondale, IL 62901

Shawnee Health

Service

1501 S. Carbon St. Marion, IL 62959

Shawnee Health

Service

1506 Sioux Drive Marion, IL 62959





49

Shawnee Health

Service

202 W. Jackson St. Carbondale, IL 62901

Shawnee Health

Service

3115 Williamson

County Parkway

Marion, IL 62959

Shawnee Health

Service

400 S. Lewis Lane Carbondale, IL 62901

Southeastern Illinois

Counseling Center

504 Micah Drive Olney, IL 62450 Glenn Jackson

Southern 7 Health

Department

37 Rustic Campus

Drive

Ullin, IL 62992

Southern Illinois

Behavioral Services

1016 S Madison St. Suite A DuQuoin, IL 62832

Southern Illinois

Healthcare

1239 E. Main St. P.O. Box

3988


3988

Rex Budde [email protected]

Southern Illinois

Healthcare

1239 E. Main St. P.O. Box

3988


3988

Woody Thorne [email protected]

Southern Illinois

Healthcare Foundation

Sharon Szatkowski [email protected]

Southern Illinois

Healthcare Foundation,

Inc.

7210 W. Main St. Belleville, IL 62223-

3038

Beverly Vokes [email protected]

Southern Illinois


Inc.

80 Burlington Drive Collinsville, Il 62234

Southern Illinois


Inc.

815 E. Fifth St. Alton, IL 62002

Southern Illinois


Inc.

1820 Delmar Ave. Granite City, IL 62040

Southern Illinois


Inc.

304 Madison Ave. Madison, IL 62060





50

Southern Illinois


Inc.

100 N. Eighth St. East St. Louis,

IL

62202

Southern Illinois


Inc.

6000 Bond Ave. Centreville, IL 62207

Southern Illinois


Inc.


Southern Illinois


Inc.

2001 State St, East St. Louis,

IL

62205

Southern Illinois


Inc.

Belleville, IL 62223

Southern Illinois


Inc.

5540 Bunkham Road Washington

Park, IL

62204

Southern Illinois


Inc.

4901 State St. East St. Louis,

IL

62205

Southern Illinois


Inc.

800 Range Lane Cahokia, IL 62206

Southern Illinois


Inc.

550 Landmarks Blvd. Alton, IL 62002

Southern Illinois


Inc.

2 Terminal Drive East Alton, IL 62024

Southern Illinois


Inc.

Vandalia, IL 62471

51

Southern Illinois


Inc.

1275 Hawthorne

Road

Salem, IL 62881

Southern Illinois


Inc.

2100 Madison Ave. Granite City, IL 62040

Southern Illinois


Inc.

#2 Memorial Drive Alton, IL 62002

Southern Illinois


Inc.

2568 N. 41st St. Fairmont City,

IL

62201

Southern Illinois


Inc.

818 Upper Cahokia

Road

Cahokia, IL 62206

Southern Illinois


Inc.

180 S. Third St. Belleville, IL 62220

Southern Illinois


Inc.


Southern Illinois


Inc.

12 N. 64th St. Belleville, IL 62223

Southern Illinois


Inc.


IL

62201

Southern Illinois


Inc.

540 N. Sixth St. East St. Louis,

IL

62201

Southern Illinois

Regional Social Svcs.,

Inc.

604 E College St. Carbondale, IL 62901 Karen Freitag [email protected]


52

Southern Illinois

Regional Wellness

Center


IL

62201

Southern Illinois

Regional Wellness

Center

1835 Kingshighway Washington

Park, IL

62204

Southern Illinois

University, School of

Medicine

P.O. Box

19604

Springfield, IL 62794-

9604

Robert Wesley [email protected]

Southern Illinois

University-Center for

Rural Health

150 E. Pleasant Hill

Road

Suite 108 Carbondale, IL 62901 Kim Sanders [email protected]

Southern Illinois

University-Center for

Rural Health

150 E. Pleasant Hill

Road

Suite 108 Carbondale, IL 62901 Ruth Heitkamp [email protected]

Sparta Community

Hospital

818 E. Broadway P.O. Box

297

Sparta, IL 62286-

0297

Joann Emge [email protected]

Sparta Community

Hospital

818 E. Broadway P.O. box

297

Sparta, IL 62286-

0297

Lori Clinton [email protected]

SMGSMG Lisa Crouch [email protected]

SMGSMG Loretta Stevens [email protected]

SSMHC Keith Suedmeyer [email protected]

St. Clair County Health

Department

#19 Public Square-

Suite 150

Belleville, IL 62220 Kevin Hutchison [email protected]

St. Clair County

Mental Health Board

307 E. Washington

St.

Belleville, IL 62220 Dana Rosenzweig [email protected]

St. Elizabeth Hospital 211 S. Third St. Donna Meyers [email protected]

St. Elizabeth Hospital 211 S. Third St. Deborah Vogel [email protected]

St. Elizabeth's Hospital 211 S. Third St. Belleville, IL 62220-

1998

Michael Conley [email protected]

St. Elizabeth's Hospital 211 S. Third St. Belleville, IL 62220-

1998

Maryann Reese [email protected]















53

St. Joseph Memorial

Hospital

2 S. Hospital Drive Murphysboro,

IL

62966-

0580

Scott Seaborn [email protected]

St. Joseph's Hospital,

Breese

9515 Holy Cross

Lane

P.O. Box

99

Breese, IL 62230-

0099

Mark Klosterman [email protected]

St. Joseph's Hospital,

Highland

1515 Main St. Highland, IL 62249-

1698

Peggy Sebastian [email protected]

St. Mary's Hospital,

Centralia

400 N. Pleasant Ave. Centralia, IL 62801-

3091

Virginia Telford [email protected]


Centralia


3091

Amy Whipple [email protected]


Centralia


3091

Bruce Merrell [email protected]


Centralia


3091

Greg Sims [email protected]

Starting Point

Counseling Program

801 W. Main,

Columbian Complex

Collinsville, IL 62234 Robert Dellamano

Suburban Clinical, Inc. 2217 W. Main Belleville, IL 62226 Ronald Vitale [email protected]

The Fellowship House P.O. Box

682

Anna, IL 62906 Mickey Finch [email protected]

m

The H Group 902 W Main P.O. Box

637

West Frankfort,

IL

62896 John G. Markley,

MBA

[email protected]

The H Group 902 W. Main P.O. Box

637

West Frankfort,

IL

62896 Wendy Bailie [email protected]


637

West Frankfort,

IL

62896 Debby Pape [email protected]


637

West Frankfort,

IL

62896 Sharon Adams [email protected]

Thompson Counseling

Services

4230 Lincolnshire Suite E Mt. Vernon, IL 62864 Michael Thompson [email protected]

Touchette Regional

Hospital

5900 Bond Ave. Centreville, IL 62207-

2326

Sulbrena Day [email protected]

Touchette Regional

Hospital


2326

Larry McCulley [email protected]


















54

Touchette Regional

Hospital


2326

John Cooley [email protected]

Union County

Counseling Services,

Inc.

204 South St. Anna, IL 62906 Mary McMahan [email protected]

Union County Hospital 517 N. Main St. Anna, IL 62906-

1696

Jim Farris [email protected]

United Methodist

Children's Home

2023 Richview Road Mt. Vernon, IL 62864 Gary Lemmon [email protected]

United Methodist

Children's Home

2023 Richview Road Mt. Vernon, IL 62864 Dom Duff [email protected]

University of IL Chris Larrison [email protected]

Vanguard DUI

Services

44 E. Ferguson Ave. Wood River, IL 62095 [email protected]

Wabash County Health

Dept.

1001 N Market St. Mt. Carmel, IL 62863 Cynthia Poland [email protected]

Wabash County Health

Dept.

1001 N Market St. Mt. Carmel, IL 62863 Judy Wissel [email protected]

Wabash General

Hospital

1418 College Drive Mount Carmel,

IL

62863-

2698

Jay Purvis [email protected]

Wabash General

Hospital


IL

62863-

2698

Katheryn McWhirter [email protected]

m

Wabash General

Hospital


IL

62863-

2698

Tamara Gould [email protected]

Washington County

Community Counseling

781 E. Holzhauer Nashville, IL 62263 Keith Curran

Washington County

Health Department

177 S. Washington

St.

Nashville, IL 62263

Washington County

Hospital

705 S. Grand Ave. Nashville, IL 62263-

1599

Nancy Newby, PhD nnewby@washingtoncountyhosp

ital.org

Washington County

Vocational Services

781 East Holzhauer

Drive

Nashville, IL 62263
















55

Wayne County Health

Department

405 N. Basin Road Fairfield, IL 62837

WellSpring Resources 2615 E. Edwards St. Alton, IL 62002 Karen Sopronyi-

Tompkins

ksopronyi@wellspringresources.

co

WellSpring Resources 2615 E. Edwards St. Alton, IL 62002 Kelly Medlin [email protected]

o

WellSpring Resources 2615 E. Edwards St. Alton, IL 62002 Ann Tyree [email protected]






56



Hospital Name City

Psychiatric

Licensed Beds

Staffed Psych

Beds Oct 1,

2009

Alton Memorial Hospital Alton 20 5

Alton Mental Health Center Alton

Anderson Hospital Maryville 0 0

Chester Mental Health Center Chester

Choate Mental Hlth & Dev Ctr Anna

Clay County Hospital Flora 0 0

Crawford Memorial Hospital Robinson 0 0

Crossroads Community Hospital Mount Vernon 0 0

Fairfield Memorial Hospital Fairfield 0 0

Fayette County Hospital & LTC Vandalia 0 0

Ferrell Hospital Eldorado 0 0

Franklin Hospital Benton 0 0

Gateway Regional Medical Center Granite City 100 100

Good Samaritan Region Hlth Ctr Mount Vernon 0 0

Greenville Regional Hospital Greenville 10 10

Hamilton Memorial Hosp District McLeansboro 0 0

Hardin County General Hospital Rosiclare 0 0

Harrisburg Medical Center Harrisburg 27 27

Heartland Regional Medical Ctr Marion 0 0

Herrin Hospital Herrin 0 0

Lawrence County Memorial Hosp Lawrenceville 0 0

Marshall Browning Hospital Du Quoin 0 0

Massac Memorial Hospital Metropolis 0 0

Memorial Hosp of Carbondale Carbondale 0 0

Memorial Hospital Belleville 0 0

Memorial Hospital Chester 0 0

Pinckneyville Community Hosp Pinckneyville 0 0

Red Bud Regional Hospital Red Bud 0 0

Richland Memorial Hospital Olney 16 16

Saint Anthony's Health Center Alton 0 0

Salem Township Hospital Salem 0 0

Scott Medical Center Scott AFB

Sparta Community Hospital Sparta 0 0

57

St Elizabeth's Hospital Belleville 35 36

St Joseph Memorial Hospital Murphysboro 0 0

St Joseph's Hospital Breese 0 0

St Joseph's Hospital Highland 0 0

St Mary's Hospital Centralia 12 8

Touchette Regional Hospital Centreville 12 0

Union County Hospital Anna 0 0

Veterans Affairs Medical Ctr Marion

Wabash General Hospital Mount Carmel 0 0

Washington County Hospital Nashville 0 0






Statewide 1,723,215 1,714,661 1,724,116 1,715,750 1,677,926 1,651,967 -4.1%

Region 5 9,728 9,954 9,661 10,422 10,455 10,297 5.8%

Source: COMPdata

59


Peds

Adults

Total

REGION FACILITY SFY 2007

SFY 2008

SFY 2009

SFY 2010

SFY 2007

SFY 2008

SFY 2009

SFY 2010

SFY 2007

SFY 2008

SFY 2009

SFY 2010


4,242 4,151 3,654 3,674

4,242 4,151 3,654 3,674


1,913 1,788 1,848 1,829

1,913 1,788 1,848 1,829


1,721 1,473 1,784 1,823

1,721 1,473 1,784 1,823


7,876 7,412 7,286 7,326

7,876 7,412 7,286 7,326

2 Elgin MHC 0 0 0 0 1,032 1,031 1,137 1,204 1,032 1,031 1,137 1,204

Singer MH/Dev Ctr 0 0 0 0 728 706 852 850 728 706 852 850

Treatment & Deten 0 0 0 0 4 9 9 6 4 9 9 6


1,764 1,746 1,998 2,060

1,764 1,746 1,998 2,060


696 728 623 717

718 741 636 733


696 728 623 717

718 741 636 733

5

Alton MH/Dev Ctr 0 0 0 0 197 198 191 188 197 198 191 188

Chester MHC 0 0 0 0 107 119 150 115 107 119 150 115

Choate MH and Dev 78 84 60 65 460 400 364 233 538 484 424 298

Region 5 TOTAL 78 84 60 65 764 717 705 536 842 801 765 601

TOTAL

100 97 73 81

11,100 10,603 10,612 10,639

11,200 10,700 10,685 10,720




Illinois Statistics


60



61

Hospital Statistics


FY 03 FY 04 FY 05 FY 06 FY 07 FY 08 FY 09


only)

10,472 10,759 11,233 11,657 11,654 10,812 10,504


Forensics)

9,625 9,609 10,190 11,421 11,349 10,729 10,677


Civil Adult 8,870 8,844 9,462 10,770 10,668 10,063 10,045


Forensics total 634 634 610 561 602 590 574

Forensics Adult 611 614 593 546 587 573 565

Forensics Child &

Adolescents

23 20 17 15 15 17 9

Total Triage 1,482 1,784 1,653 797 907 673 401


Civil total 365 364 410 166 152 184 200

Civil Adult 365 364 410 166 152 184 200


Forensics Total 44 50 56 66 59 62 71

Forensics Adult 43 50 55 66 59 62 71

Forensics Child &

Adolescents

1 0 1 0 0 0 0

Individuals with 3+


569 536 592 639 630 585 626

Individuals with 3+


forensics

0.0632 0.0597 0.0617 0.059 0.059 0.055 0.059

FY

03

FY

04

FY

05

FY

06

FY

07

FY

08

FY

09

All Admissions/100,000 78 77 82 92 91 86 86




Admissions/100,000

4 0 4 3 2 2 2



Child & Adolescents Forensics

Admissions/100,000

1 1 1 0 0 1 0

62

FY

03

FY

04

FY

05

FY

06

FY

07

FY

08

FY

09




0.48 0.56 0.51 0.43 0.44 0.43 0.42












Average

101 120 126 113 104 112 108




23 20 26 33 25 39 22


Adolescents) Median

170 210 394 402 411 426 433


Average

678 737 841 889 926 1,005 1,077


Median

171 212 394 403 416 427 436



144 180 334 339 338 283 274


Adolescents) Median

127 127 280 353 214 150 282





Adolescents)

8 7 6 5 4 5 4



Adult)

561 588 585 582 597 590 593

63




9 11 15 13 10 9 6


Visits on 7/09/09.

1,410 1,369 1,402 1,322 1,373 1,353 1,319



799 760 791 706 762 742 709



7/09/09.

797 757 786 705 757 742 707



Visits on 7/09/09.

2 3 5 1 5 0 2



611 609 611 616 611 611 610



601 593 595 601 603 601 605




10 16 16 15 8 10 5


FY 03 FY 04 FY 05 FY 06 FY 07 FY 08 FY 09



Forensics)

9,772 9,641 10,150 11,498 11,286 10,739 10,708


Civil Adult 9,122 8,922 9,468 10,888 10,654 10,131 10,115


Forensics Total 517 589 566 517 557 528 537

Forensic Adults 502 578 553 506 538 517 525

Forensic Child &

Adolescents

15 11 13 11 19 11 12


& Forensic)

418 417 475 233 210 249 271

Civil Total 368 359 408 161 138 173 200

Civil Adult 368 359 408 161 138 173 200


Forensics Total 50 58 67 72 72 76 71

Forensics Adult 49 58 65 72 72 76 71

Forensics Child &

Adolescents

1 0 2 0 0 0 0

64



illinois regional integrated behavioral health network region reports

Documents