Choate Transformation and Recommendation Review

Recommendation SIU E4E Process- Research, in development, ongoing, not applicable Steps taken
Clinical Operations
Build Community Capacity SIU E4E Ongoing efforts
Build a system of care- step down homes SIU Phase 2 or 3 Cottages for stepdown homes to prepare for or demonstrate community readiness to include sprinklers
Training to enhance skills in serving individuals with co-occurring SIU E4E Ongoing/in development Assessing nationally used de-escalation programs, Enhance training programs with SIU for staffing, Enhanced training on active treatment (objectives, engagement, etc.) in September and October 2023 for all SODCs.
DHS-DMH expand inpatient forensics and civil mental health services SIU Ongoing DMH is preparing an additional area for increased bed capacity
All certified units SIU Re-establishment/Research Choate was in the process prior to the transformation process and is resuming efforts for all units to meet certification.
Increase specialized services SIU Ongoing Review of CMS 104 of clinicians to focus on specialized services such as substance abuse, trauma, psychotherapy, etc.)
Stereotypes SIU Rebranding SIU and others have stereotyped individuals in SODC as needing a higher level of care which is not accurate. There is a statewide misconception that the State operated ICF/IDD are different from the private ICF/IDDs which is inaccurate and are all under the same requirements and considered institutional care.
Relocate non-clinical out of the cottages SIU Not needed The small cottages need more renovation than cost effective to make resident appropriate. Renovation of the larger 4 to 5 bed cottages will be more beneficial.
Separate the budget, leadership, and oversight of SODC and SOPH services with increased delivery of psychiatric services SIU Increased collaboration SOPH Director is now attending the SODC large meeting due to shared services and to enhance services back and forth to build off each strength. SOPH to those on DD with SMI with SODC brining their knowledge of DD to those on the MI side.
Admission and Discharge process /planning SIU Review/ongoing Discharge begins at admission with a strength-based focus and skill development during the stay. Choate is only admitting when court ordered.
Transition coordination SIU Ongoing Transition coordinators and ISCs work together to identify and address needs. Follow up for a year after transition is in place.
Utilization review committee SIU Needs development The recommendation for a robust UR process outside of the treatment team should be in place to assist the team in identifying barriers and providing recommendations to overcome barriers to community placement. This group should be made up of the DDD med dir, Dep. Direct of SOC, Dep Director of Community placement, guardian and advocate representative, etc.
Dual Diagnosis or Co-occurring units SIU Needs rebranding In the general population 30-35% of the ID/DD population has co-occurring mental illness. At Choate it is between 55-60% of the population of co-occurring due to others SODC and the Community placing individual's that are difficult to serve at this campus but overall they have no different needs than others at the facilities.
Outpatient clinic SIU Need development A variety of hard to get services in the community including substance abuse, therapy, OT, PT, etc.
Expansion of Telepsych SIU Ongoing/Limitations This is in place and continues to have its limitation in both SODC and SOPH programs due to the high level of need.
Culture of Safety
Electronic medical record SIU Ongoing Review of vendors currently occurring
Systematic Culture of Safety /safety program SIU E4E Ongoing Safety review, Safety Summit, Camera installation internal and external, increased safety officers and ISI, safety champions in place and plans of action
Streamline process for medication changes SIU
Evidenced based training for staff SIU E4E In development with SIU Active treatment seminar at Choate/SODC occurring in September.
DDD/SIU/E4E are in collaboration to develop enhanced training
Improved communications SIU Ongoing Review of current process for updating families/guardians on Individual life plans, behavior plans, etc.
Workforce needs
Retraining of staff to work on remaining units SIU Ongoing Overall training enhancement on mental health concerns
Review staffing assignments to ensure staff are working at top of their licensure SIU Review Review and modify CMS 104 of social workers for more therapeutic purposes. Reviewing and revising CMS 104 to enhance expectations of those working in our clinical roles and clinical leadership.
Onsite workers compensation SIU CMS process SODC and SOPH many years ago had a health services department for work comp.
OIG/ISP expedite investigation process to return employees that are not substantiated SIU Ongoing Efforts by OIG to reduce the time for investigations and determinations
Establish workforce development programs that bring learners to camps for clinical rotations, pathways to hire SIU E4E Development DDD/SIU/E4E in collaboration to develop training to include rotations from students
Explore post-graduate programs SIU Ongoing DDD/DMH are working to expand professional training programs and recruitments of licensed staff such as psychiatrist
Rural resident and fellowship programs SIU Need to explore Tuition reimbursement, K1 visa's, etc. to increase licensed professionals in rural area
Relationships Choate leadership and people of Anna, IL SIU Ongoing New Center Director has reach out to the Chamber of Commerce to re-establish community relations.
Streamlined processes for hiring SIU Ongoing Continued efforts to increase the rate of hiring.
Statewide training program for DSP SIU EfE In process Working with SIU and EfE on the development of a training program for MHTs. Legislation passed for community DSP training.
Build community partners SIU In progress New Center Director is re-establishing relationships with the Anna Chamber of Commerce. Residents are returning to activities in the community such as community Day program (Rave), attended local activities including farmers market, craft sales, fair, etc. Volunteers are returning with religious services being re-established.