Draft Minutes - SRI/ASO Commitee of the Illinois Mental Health Planning and Advisory Council, 5/8/08


  • Amy Starin, DMH
  • Cassie Ayres, IARF
  • Cheryl Boyd, Franklin Williamson Human Services
  • Chris Power, DMH
  • Fred Friedman
  • Frederica Garnett, Delta Center
  • Judy King
  • Jackie Manker, DMH
  • Kathy Roberts, CBHA
  • Lora Thomas, NAMI Illinois
  • Lydia Tuck, CEO, Illinois Mental Health Collaborative for Access & Choice
  • Lynn O'Shea, Co-Chair AID
  • Mike Nance
  • Ray Connor
  • Robin Garvey, Mildred Berry Center
  • Sondra Frazier
  • Sandy Lewis, McHenry County Mental Health Board
  • Stephanie Hanko, HFS
  • Tom Troe
  • Tony Kopera, Community Counseling Centers of Chicago
  1. Introductions & Membership recruitment update

    1. Kim Miller was recommended as new consumer member
    2. We are waiting to hear from Kim Adams.
    3. Sandy does not have an ICG recipient -will defer to others.
    4. Fred Friedman has asked to join the committee.
  2. Review and approval of documents

    1. April 10 meeting minutes-accepted as presented.
    2. Committee Goals and Objectives
      1. C & A committee members questioned how to differentiate role of SRI and the C & A committees; discussion/suggestions:
        1. 1. Focus on logistic and billing issues rather than programmatic issues.
        2. 2. Modify Goals and Objectives #3 to focus on administrative/logistical issues.
        3. Share issues regarding service access with other committees.
        4. Communicate with the other committees and coordinate.
      2. The committee is spending too much time on details and not enough time with dealing with the issues.
      3. iii. Suggestion to address comments: delete the opening paragraph to Goals and Objectives #3. Robin offered to draft a revision for next meeting.
    3. DMH perspective
      1. DMH contracted with an entity that could do a number of things.
      2. The basic structure of the SRI Committee goals and objectives is good.
      3. The Division would like recommendations and guidance on system restructuring (change the system to become more recovery oriented and implement the conversion of the system to fee-for-service funding with the assistance of an ASO)
      4. DMH would also like input on what issues are priorities.
    4. Revised goals and objectives will be prepared for the next meeting.
  3. Children's Services

    1. Presentation on Children's Services: Amy Starin, LCSW, Associate Deputy Clinical Director, Child & Adolescent Services
      1. Please see the handouts for more detailed information
      2. Three influences on C & A programs
        1. DMH Mission and Vision Statement
        2. Child and Adolescent Service Systems Principles
        3. Evidence Informed Practice
      3. Child and Adolescent Service Systems Principles
        1. System should allow access to comprehensive array of services
        2. Individualized services
        3. Least restrictive, most clinically appropriate environment
        4. Family needs to be full participants
        5. Providers need to coordinate
        6. Families need access to case management
        7. Early identification
        8. Smooth transition for youths transitioning to adulthood
        9. Protection of rights and advocacy
        10. Culturally competent
      4. Evidence Informed Practice
        1. Narrowly defined
        2. Process rather than a manualized approach
      5. SASS Program
        1. Three agency partnership
        2. CARES Line
        3. 46 SASS providers
        4. 90 minute response time
        5. 23,000 SASS screens in FY '07: Amy Starin will provide unduplicated number of children served at next meeting.
        6. FRD: Family Resource Developer
          1. Parent or caregiver with experience navigating the state system
        7. Flex Dollars
          1. a. Used to support non traditional services
          2. b. There also must not be an alternative funding to cover these services
      6. ICG
        1. Designed to care for children with the most severe impairments
        2. Parents can choose residential or community based services
        3. Terminates when the child graduates high school or turns 21
        4. Four community based services
          1. Therapeutic stabilization
          2. Child Support Services
          3. Behavior Management Intervention
          4. Young Adult Support Services
        5. April 1st Collaborative began involvement
          1. Sending out application packets
          2. Answers ICG calls
          3. 1400 Quarterly reports
          4. Conducts all of the annual reviews
          5. Training and technical assistance for families and providers
          6. Monitor residential treatments facilities
          7. Billing for ICG services
          8. Family driven supports presidential new freedom commission
          9. Unique to Illinois. Other states do not have programs where families can receive this level of care
          10. Authorizations for youth entering community support services CST.
            1. Bridgeway is the only agency with CST
            2. Motion to encourage DMH to consider start up costs for CST expansion; motion passed.
              1. Need to attach a dollar amount to the request
            3. Ask the Children's Mental Health Partnership to identify where CST fits in its plan.
        6. Although all policy and program oversight will remain with DMH, some operational functions will be delegated to ASO Collaborative staff, while others will remain with the Children's Service Office of DMH, including:
          1. Community based service approvals
          2. Transition based service approvals
          3. Secretary level appeals
      7. Capacity grant funded initiatives
        1. 10 pilot programs for transitioning youth
        2. Early intervention programs
        3. Early childhood services/consultations
        4. MH Schools
        5. MH Juvenile Justice
        6. IMHPAC C & A Committee
          1. Transitions subcommittee
            1. Developing conference to educate providers and consumers on the needs of this group
            2. Developing white paper
          2. Continuity of Care subcommittee
            1. Address issues between youth moving from SASS to other programs.
            2. Surveying C & A providers about wait lists
          3.  Evidence Based Practice Subcommittee
            1. Moving C & A system toward EBP
            2. Three master level programs that have special training in EBP
            3. Web based outcome analysis system

              1. DMH purchased the system
            4. Ohio Scales

              1. 40 item scale
              2. DMH purchased a lifetime license
            5. Columbia Impairment Scale
              1. 13 item scale
              2. Youth version
              3. Available in Spanish
              4. Reports can be generated at any time.
              5. July 1st
              6. Trainings on web based system will be May 27th, May 28th, June 4th, and June 5th.
              7. Psych coordinator attend and then can train staff
              8. Is it compatible with our electronic health records?
                1. Can be downloaded/integrated
                2. IT tested
      8. Teen WRAP
      9. Family Consumer Specialists
        1. Parents employed as DMH staff in each region of the state
        2. Will be able to do consultations with agencies around family involvement
      10. Teen Advisory Council: E-mail Amy Starin for more information.
      11. System of Care: 6 year grants funding is roughly $9 million over 6 years
      12. Capacity to Care for Our Children-deferred to May meeting
      13. NCCP Report-deferred to May meeting
  4. Report from Dr. Power and Lydia Tuck, CEO

    1. Consumer issues update
      1. Second version of consumer and family handbook is being reviewed.
      2. DHS/DMH will ask Nanette Larson or Eldon Wiggett to present DMH's vision of recovery and resiliency at the next Committee meeting
      3. Bryce Goff, Director of Recovery and Resilience has responses to all of the feedback.
        1. Asked the department to share consumers' issues with recovery with Bryce Goff- Lydia offered to have Bryce address at the next meeting.
        2. Individualized choice of what recovery means/how it is defined.
    2. ROCS MIS update
      1. July 1 is still the rollout date.
      2. DMH took field file layout to IT Workgroup and received good feedback; adjusted a few things.
      3. Next week will be out to providers.
      4. Enrollment/registration field will be disseminated after DMH receives feedback.
      5. Mary Smith's presentation Q & A will be distributed either through email or posted to website.
    3. Standardized documentation update
      1. DMH has acknowledged a request to facilitate the development of standardized forms statewide. DMH has assigned staff to assess pursuing this project, but may be limited by available staff  resources and expertise within DHS/DMH.
    4. Provider payment and contract issue update
      1. 5 agencies out of 150 are billing less than 50% of their contracts
        1. Bulk of agencies billing below 50% are hospitals
        2. There are no clear trends, such as predominately rural, small, multi-disability agencies, etc., regarding agencies billing below 90%.
      2. 110 agencies are at 90% billing or more.
        1. Requested the data on how many consumers will be impacted by the billing/revenue decreases agencies experience
        2. Dr Power reported that since the fee for service system was implemented, the system is serving more people.
        3. Question asked of DMH: What will impact of providers meeting or exceeding contracts have on consumer service access?
        4. DMH stated that they have focused their efforts on addressing the extremes (providers well above or below contract levels).
      3. Will DMH share rate models?
        1. What are the assumptions in DMH rates?
        2. Providers need to know this to make informed expenditure decisions.
        3. DMH is considering the rate information request.
      4. Request was made to ensure that pass-through dollars are not included in the FFS contract amount; DMH agreed.
      5. DHS/DMH has a fixed appropriation amount available to fund providers for mental health services provided.
        1. Is there any attempt to distribute/allocate new resources to geographic areas with high growth rates?
          1. a. DMH hopes as the system moves toward FFS that it will become more family and consumer driven.
          2. DMH expects that money will not be tied to one agency but rather to consumers in need of mental health services.
      6. Requested that DMH provide an updated chart listing agencies by billing levels (% of contract), distributed at previous meeting.
    5. Other updates
      1. Accreditation costs: DMH has assigned staff to assess pursuing this project, but may be limited by available staff resources and expertise within DHS/DMH.Monitoring
        1. ACT/CST and clinical records
          1. Monitoring ACT/CST against fidelity to the model using the national SAMHSA standard
          2. CST review is primarily providing technical assistance this first year.
          3. ACT calls for a consumer interview
          4. CST encourages a consumer interview
          5. Tools should be on the Collaborative website
          6. Clinical record - DMH is reviewing 20. Reviewing to see if the needs identified in the mental health assessment walk to the treatment plan, interventions identified, and checking to see if there is a clear link between interventions and the assessment of the client.
          7. What is the follow up on findings?
            1. Division and Collaborative give a written report - 30 days post review
            2. The data will be aggregated for review by DHS/DMH. This will help DHS/DMH identify where strengths in the system as well as areas for improvement.
        2. Provide DMH Regional staff or other DHS/DMH staff with any feedback on the monitoring process.
        3. Collaborative staff and DMH are trying to be consistent.
          1. Reviewers conducting ongoing meetings to evaluate themselves and determine improvements
        4. Timeline for BALC portion of monitoring?
          1. Still a separate review.
          2. DMH is starting to train Collaborative staff on postpayment review.
          3. Post payment piece will begin July 1st.
          4. BALC is still doing three year certification reviews.
          5. The Collaborative will join BALC on years when BALC is doing review at the same time as DMH.
      2. May 12th ACT /CST leader meeting is scheduled to review issues and foster the development of these services
      3. Provider data verification :DMH has all of the info and is finalizing
        1. The Collaborative should submit data verification reports back to providers and ask them what number they want to use for the crisis contact.
          1. Will the handbook list service providers by region
            1. No, because this information is outdated so quickly; thus, plan to have it available online.
          2. Now collecting similar data from all of the ICG providers.
          3. DMH wants input on 800 number: Urgent call protocol
            1. DMH will bring call report to next meeting.
            2. Can 800 call in number use the main number of an agency to link urgent calls?
            3. Important to be clear about what you expect from this main number.
      4. SASSAR Update-nothing to report.
  5. System Restructuring Initiative

    1. a. Service Access Discussion
      1. Sandy Lewis provided an overview of Standards of Care Matrix, levels of care Matrix/Grid and other handouts provided to committee
        1. Requested feedback/response from ASO.
        2. Check and see if the Collaborative already has comparable data
        3. Lydia will review this for the next meeting
      2. Discussion of how much of this is already a part of the MH/Collaborative data system.
        1. What is Collaborative already doing/collecting?
        2. Requested ASO's feedback on the document- an assessment of the document versus industry standards
        3. Requested a list of reports that Value Options produces in other states.
        4. Collaborative response: IT workgroup already has established priorities (Billing/payment changes); will not be able to get to it until after July 1.
        5. In relation to access, geo-mapping process is under way.
          1. Very instructive to get baseline data that was not previously available
          2. It will give us a picture of what services are available and where they are located
            1. This is key to the access issue.
            2. DMH is working on geo-mapping and hope to have it by December.
    2. Model Rates-defer to next meeting
    3. Unresolved SRI Issues-defer to next meeting
  6. Draft May Meeting Agenda

    1. Membership Update
    2. Approval of Minutes
    3. Goals and Objectives revisions
    4. Children's Services
      1. Questions on C & A presentation-Amy Starin
      2. A Capacity to Care for Our Children-Terry
      3. NCCP Report Discussion-Sandy
    5. DMH/Collaborative Update
      1. Consumer Issues: Bryce Goff-Recovery & Resiliency definitions
      2. Provider Issues: Billing report update
      3. Lydia Tuck-Service Access reports update
      4. MIS/IT update
      5. Community Support Teams update
    6. System Restructuring Initiative
      1. Model Rates
      2. Unresolved Issues