The Division of Mental Health (DMH) and its private sector administrative service organization (ASO), ValueOptions, have partnered to form the Illinois Mental Health Collaborative for Access and Choice. Using consumer empowerment principles this public-private association is advancing the state's mental health care delivery service system. The alliance, formally begun in December 2007, follows on the heels of the multi-year System Restructuring Initiative (SRI) undertaken by the Division, consumer-representatives and selected members of the state's mental health provider network.
"As the Collaborative's senior partner, DMH is committed to making it easier for persons with mental illnesses to get the right care, at the right time, and in the right amount," states Division Director Lorrie Rickman Jones. "We 're here to facilitate recovery and resilience. The Collaborative is a big step forward in making that commitment a reality."
As Director Jones noted, the Collaborative successfully addressed several longer-term SRI objectives that included transitioning to a consumer/family-centered recovery and resilience-oriented service system and converting funding to community providers from pre-payment (grant-in-aid) financing to a post-payment/fee-for-service (FFS) arrangement. In combination, these two accomplishments promote consumer empowerment through significantly improved access and choice opportunities.
Still another key DMH objective being implemented is enhanced information resources and accountability mechanisms for our network of mental health providers. Achieving this critical goal gives providers an efficient way to check on authorizations for priority services for consumers in addition to developing a reliable claims processing/payment process. DMH Associate Director for Community Services Jackie Manker observes that achieving these aims will reduce confusion or errors over contracted services. Just as important, the new state-of-the-art electronic system means that mental health consumer needs will be the driving force in determining the ultimate shape of the delivery system. Moreover, during this time of limited state resources, she advises that strengthening DMH's electronic capabilities through the Collaborative is as necessary as it is beneficial.
Collaborative Team Accomplishments Lead to Increased Consumer Access
The Collaborative's successful launch represents the tireless effort of a number of health care specialists including the nationally recognized Parker Dennison and Associates. The actual implementation process began with workgroups comprised from DMH and ASO management staffs who developed new approaches to create consumer and provider relations, information technology (IT), clinical, and quality assurance. In addition to executing the necessary strategies for the Collaborative's operation, these teams generated its staffing, recruitment and hiring strategies.
One of the most visible achievements is the organization's consumer and family handbook in both English and Spanish versions available in hard copy and online. The manual provides a step-by-step guide for those seeking help through the Collaborative. Live consumer assistance is available through the Collaborative's toll free consumer and family care line (866-359-7953; 866-880-4459, TTY ). The Collaborative website (www.IllinoisMentalHealthCollaborative.com) functions as a welcome resource through its mental health community news, activities and links.
As Director Jones indicated, a key DMH aim through the Collaborative is the assurance that intensive mental health services are offered in the appropriate amount and duration to those most in need. These services are sometimes better known by their acronyms: ACT (Assertive Community Treatment), CST (Community Support/Team), and ICG (Individual Care Grants). Because each service is contingent upon the individual consumer obtaining authorization prior to getting treatment, numerous technical assistance teleconferences have been held with providers to ensure their detailed familiarity with the preauthorization process.
Bolstering the Illinois Provider Network
DHS/DMH delivers community (outpatient) mental health services through its more than 150 provider-partners statewide. As the purchaser of and payer for these services, the Division must promote opportunities for its provider-partners to better serve consumers while maximizing the overall capacity of the service delivery system. Specific Division duties include ensuring that services are targeted to those most in need and working with the DHS Bureau of Accreditation, Licensure and Certification (BALC) to ensure that members of the provider network adhere to applicable federal and state statutes and regulations. However, as already indicated, DMH has contracted with its ASO through the Collaborative to assist providers in this endeavor by putting efficient and effective mechanisms for claims processing and payment, post-payment review, provider technical assistance/training and provider network information management in place. This effort includes and requires implementing a computer hardware and software infrastructure that is "state-of-the-art" to replace an information infrastructure designed nearly fifty years ago. It is pivotal to the ultimate success of the project.
In Step with Progress
According to Associate Director Manker, "From its very beginning, the Collaborative has never characterized itself as a finished product. Instead, it's better to think of it as a dynamic process created to meet the needs, preferences and options of mental health consumers and their families. We expect it to serve as an outstanding resource for fostering strong partnerships among consumers, providers and DMH." Her insight means that the Collaborative's success requires the general public's recognition of its "evergreen" role, that is, an always evolving, flexible organization committed to ensuring consumer access and choice in an efficient, easily understood and transparent manner to any eligible consumer whether looking for help for the first time or already familiar with the Division's transforming service delivery system. With that in mind, every stakeholder should take comfort in knowing that the Collaborative contributes to Illinois' mental health community-wide partnership.
The Collaborative has offices in Chicago and Springfield. Business hours are from 8:00 AM to 5:00 PM Monday through Friday except federal and state holidays. Live consumer assistance is available through the toll free consumer and family care line (866.359.7953; 866.880.4459, TTY). The Collaborative website address is www.IllinoisMentalHealthCollaborative.com