I. Context

A. Background

In the fall of 2011, a shortfall in the fiscal year 2012 budget made it necessary to begin actions to close several State of Illinois facilities by June 30, 2012. Local meetings were initiated to engage stakeholders who would be impacted by these closures. Subsequent action by the Illinois State Legislature provided the needed funding flexibility to keep all facilities open for the entire fiscal year. This extension has allowed the IDHS to work with community stakeholders to refine the plan for the transition of acute care services to local community providers.

This RFI is for the purchase of community-based inpatient and outpatient alternatives to services provided at Tinley Park Mental Health Center (TPMHC), which is now scheduled for closure as of June 30, 2012. It reflects community stakeholder input garnered from "Active Community Care Transition" (ACCT) planning process, which began on January 19, 2012, and continued through the issuance of this document. The ACCT design was detailed in a presentation to the Commission on Governmental Forecasting and Accountability (COGFA) on February 6, 2012, which can be found at:

Commission on Government Forecasting and Accountability 

(http://www.ilga.gov/commission/cgfa2006/home.aspx)

Some highlights from that presentation include the steps taken by the DMH to restart the TPMHC closure process. Important steps included:

  1. An analysis of the clinical needs of persons served at TPMHC;
  2. An analysis of the existing and potential community service capacity in the area served by TPMHC (Region 1 South);
  3. Drafting a description of the core service elements identified by the community stakeholders in the fall of 2011; and,
  4. Preparing a "Plan Evolution" for moving the work with the community stakeholders forward.

Plan Evolution. Immediately following the COGFA hearing, DMH conducted a series of clinical focus groups to gather expert opinion on the most appropriate service interventions for the new Crisis Care System in Region 1 South. On February 17, 2012 an expert panel of community hospital emergency department and inpatient psychiatric unit managers was assembled, and on March 20 and 26, a panel of state hospital clinical administrators, supervisors, and managers were convened. These groups reviewed clinical vignettes based on typical presentations for admission at TPMHC, and also reviewed a sample of actual admission records (with names and identifying information redacted).

The focus groups were asked to:

  1. determine what services would have been needed to avert SOH admission, and
  2. to make recommendations for community stabilization service package. The list of the participants in this process can be found at Appendix 1 titled Rebalancing Mental Health Focus Group Agenda.

Simultaneous with this activity, the Governor's Office and DHS began the formal ACCT process. Six strategic ACCT Committees were formed and empanelled. The committees and their mission/function are as follows:

  1. Hospital Engagement - Mission: Assist the state in determining the scope, types, amounts, locations and rates for hospital based care.
  2. Service Models & Innovations - Mission: Assist the state in determining the appropriate scope, types, amounts and locations of services for enhancement in the region. In addition, assist the state in developing and planning for the implementation of innovative service interventions.
  3. Community Education & Support - Mission: Assist the state in planning for the education of consumers and providers as the system changes, and to identify and plan for workforce development needs.
  4. Service Financing & Payment Methodology - Mission: Assist the state in defining new payment models for financing the community service enhancements and innovations recommended by Committees 1 & 2.
  5. System Performance & Outcomes Assessment - Mission: Assist the state in determining the most appropriate methodology and metrics for evaluating effectiveness of system reforms and restructuring efforts.
  6. Messaging, Media & Legislative Liaison - Mission: Assist the state in developing appropriate messages, and interface with the members of the General Assembly on restructuring issues.

Co-Chairs for each of the above ACCT Committees were appointed. For all except the System Performance & Outcomes Assessment Committee, the co-chairs are leaders in the community stakeholder realm. Top executives from the Governor's Office, DMH, and the Division of Alcohol and Substance Abuse (DASA) were appointed to be state liaisons and to provide support to the committee co-chairs.

A list of the Committee members is attached to this RFI is contained at Appendix 2 titled ACCT Committee List.

Significant work by five (5) of the ACCT Committees has contributed to this RFI. The Hospital Engagement and Service Models & Innovations Committees have recommended the community crisis system enhancements contained in this RFI. The Service Financing & Payment Methodology and the System Performance & Outcomes Assessment Committees have explored approaches to financing enhancements and measuring their impact respectively. Work by the Community Education & Support Committee and the Messaging Media & Legislative Liaison Committee is underway and will play an important role once the system enhancements move forward. All committees are seen as essential to guiding the continued refinement of the new Region 1 South Crisis Care System in the future.

A record of to-date ACCT Committee Meetings is attached to this RFI is provided at Appendix 3 titled Master Schedule and Brief Status of ACCT Committee Meetings.