DMH Director Confers with Providers over FY10 Budget

Helping Families. Supporting Communities. Empowering Individuals.

Praising the continued patience, commitment and hard work of the Illinois mental health provider community, Division of Mental Health Director Dr. Lorrie Jones conferred with state providers over FY10 budget implications in a statewide mid-August conference call. Among other cutbacks, Illinois' current fiscal year budget calls for DMH to absorb a $42.5 million or 8% reduction from its community services budget line.

Although the cut is far less painful than the one proposed under the initial "Doomsday budget", Dr. Jones observed that the state's current economic woes along with its constitutional requirement forbidding annual budget deficits leaves the Governor's Office with hard choices and even harder circumstances. As a result, the state's spending allocations must be based largely on keeping all court-ordered, statutorily required and federally mandated and/or reimbursable programs and services functioning at optimal levels.

On the other hand, preserving the basic health, life, and safety needs of citizens and investing in less-costly prevention and intervention services also have been deemed priorities. With those goals setting the standard, DMH is making every effort to retain clinically appropriate services for Illinois residents, including those without Medicaid. Director Jones also made clear her resolve to protect funding for early intervention and prevention services, services that top health experts are increasingly promoting as the answer for averting the chronic progression that can lead to harmful outcomes in a number of mental and co-occurring medical disorders if treated too late.

FFS, CHIPS, ICG, Capacity Grants

Reflecting FY09 provider billings, Fee-For-Service (FFS) budget lines were reduced by approximately $20.8 million. Nonetheless, the conversion from a grant to FFS system is proceeding although inopportune budget, training and technical concerns have slowed its implementation. Even so, 80% of providers are billing in excess of their individual FFS contract while nearly 62% are billing in excess of 90% of their respective contracts. With those and other relevant data in mind, instead of simply enacting an across the board cut, the Division is making provider funding calculations on a case-by-case basis. In that way, its purchase of provider services can more accurately parallel the varying needs of Illinois consumers and their communities throughout the state.

Until further review, Community Hospital Inpatient Psychiatric Services (CHIPS) funding has been eliminated. The $9.4 million program allowed the Division to fund the same acute care services in local community hospitals as is available in state mental health facilities. This has been particularly beneficial in areas where state operated hospitals have been closed.

Despite a $4 million "cut" in the ICG or Individual Care Grant program the news is more encouraging. ICG provides financial support for Illinois families with children and adolescents who either need residential placement or intensive community-based support services. Dr. Jones advises that it is actually best to consider it a realignment as the decrease will, at most, have only a marginal impact because the program's annual expenditures thus far have not exceeded a level where such a reduction would come into play. Lastly, most capacity grants also have been maintained though attention is being given to ensuring that they can better assist providers in meeting the Division's and provider network's common mission of recovery.

Budget Realities

Director Jones and her administrative staff answered a number of provider budget questions and concerns ranging from the highly technical such as submission of claims procedures and Medicaid contract amounts to the more general such as emergency room wait times and the state's cash flow problems. Even though providers expression their appreciation of the detailed responses and clarifications, Director Jones observed that much remains to be accomplished. Accordingly, she looked forward to DMH's and the provider community's continued cooperation as co-experts in finding and implementing creative solutions. The patience, commitment and hard work of the Illinois mental health provider community will continue to be instrumental in overcoming the present and future challenges of these uncertain times in the Illinois mental health community.