SRI TASK GROUP MEETING MINUTES

May 17, 2006

Noon - 3:00 pm

Via Video and Teleconference

Present

Brian Allen, Mike Bach (representing Frank Anselmo), Mary Lynn Clarke, Carroll Cradock, Linda Denson, Janet Stover, Frederica Garnett, Doug Kolasinski, Frank Kopel, Sandy Lewis, Cheryl Lietz, Viviana Ploper, Chris Power, Lora Thomas, Frank Ware, Tony Zipple

Absent

Salim Al-Nurridin, Mike Boyle, Luberta Connor, Kurt Deweese, Tony Kopera, Nanette Larson, Marina Martinez, Orville Mercer, Lena Raimondo, Cynthia Riseman, Angie Sidles, Hayward Suggs, Donald Wells

Guests

Heather Eagleton

DMH Staff

Brittan Harris, Randy Pletcher, Mary Smith, Mike Pelletier, Jackie Manker, Bob Vyverberg

Consultants

Susan Parker, Parker Dennison & Associates

Handouts

Agenda

SRI Task Group Draft Minutes 4/19/06

Services Workgroup Update 5/17/06 (Jackie Manker)

C&A Report 5/17/06 (Viviana Ploper)

Access and Eligibility Workgroup Minutes 4/21/06 (Sandy Lewis)

Minutes

The minutes of the April meeting were accepted without modifications.

Administrative Services Organization (Aso) Discussion

In response to questions about the new service definitions and an ASO RFP, Chris Power stressed that service definitions would continue to be adjusted even after DMH contracts with an ASO. Several pending DMH policy decisions will need to be finalized regardless of the status of an ASO contract.

As recommended at the last meeting, a small workgroup met to draft a suggested list of benchmarks / policy decisions that must be made before DMH begins coordination with an ASO and implements FFS. Chris Power thanked the group for drafting the document. He agreed with several of the suggested benchmarks but disagreed with some assumptions underpinning the draft. The document appeared to assume: 1) The status quo is OK, for example, that the consumers being served now are in the target group and are receiving appropriate services; and

2) Conversion to FFS is a one?time event; i.e., you "flip the switch" and there is a total conversion, rather than an incremental or evolutionary process.

All services that are happening now should not necessarily be continued in the same manner. We have seen examples of clients receiving inappropriate levels of service (for example, active ACT clients that are able to maintain full time employment) - providers should strive to maintain services at the appropriate level for those who still need it and create transition plans for those whose services should change. DMH recognizes that the new services will require transition plans for consumers, providers and state agencies. In addition, the conversion to FFS is an incremental or evolutionary process that can permit adjustments as the process proceeds and the system is monitored. The Service Implementation Teams will address many of these concerns. There is room to improve the system.

Frank Ware underlined that the population providers now serve will be impacted by the conversion. MaryLynn Clarke was interested in how DMH would monitor ASO activities and evaluate outcomes. Jan Stover suggested that future Workgroup reports address the pertinent benchmark areas.

Provider TA Status

Upon request for any trends Parker Dennison was seeing in their technical assistance efforts, Susan Parker confirmed that they have observed commonalities and trends that they will share at the June 13/14 provider trainings. DMH and Parker Dennison are currently working on the technical assistance plan for FY07. Linda Denson was curious if Parker Dennison had noticed and responded to any disparities in services received by different ethnic groups. Since low billing and FFS conversion issues have been the FY06 TA focus, the consultants have not been looking at ethnic group disparities.

ACT

Tony Zipple inquired if anyone had been researching the financing of evidence-based services like ACT. Cheryl Lietz was interested in procedures to transition from current non-evidence-based ACT to the new Community Support Teams. Freddy Garnett expressed concerns that rural providers could not provide strict fidelity to the ACT model.

Susan Parker confirmed that evidence-based practices are financially more risky than other services. Evidence-based services are not more prestigious - responding to client need should be our priority and agencies must respond to this need the best they can with the resources they have available. Many providers are calling some services they provide "ACT" without fidelity to the model - it is not fair to pay them and agencies with rigorous fidelity the same rate for these different services. In the absence of a "rural" ACT model, the Services Workgroup worked hard to ensure Community Support definitions included those services. Rusty Dennison and Cheryl Lietz will review the Community Support definitions with the SRI Task Group in a teleconference scheduled for May 24th at 10:30 am. Randy Pletcher confirmed he is working on cost models with the Services Workgroup though HFS must set the payment rates. Frank Kopel confirmed that HFS had solicited public input into their most recent rate increase. Jackie Manker will email the current ACT and PSR definitions to this group.

C/A Issues & Sass

Viviana Ploper referred members to her written report, which included the following issues: the issue of physician services for non-Medicaid children is still pending; the interface between SASS and an ASO needs to be addressed; there is no resolution as to the completed Medicaid application requirement for SASS payment to providers; there is no resolution as to the additional cost and labor for SASS providers due to web-based reporting requirements. The SASS Medicaid workgroup will meet on June 2.

Update on Workgroups

Services Workgroup (Chair: Cheryl Lietz)

Community Support Community Support Individual, Group, Residential and Team definitions were reviewed and approved by the Services Workgroup on April 28th. The Workgroup moved that Case Management be maintained unique from Community Support to ensure providers could bill for the services appropriately. These definitions will be reviewed with SRI Task Group by teleconference on May 24th.

Residential Subgroup DMH is working to contract with a consultant to create a Residential Vision. The Residential Subgroup will wait for input from this consultant before beginning a Supported Housing residential survey.

The Pilot Project of the LOCUS (Level of Care Utilization Scale) continues. Twenty-nine (29) agencies volunteered and many have already begun submitting data collection forms. The pilot runs from May 1 through June 30 and a report will be compiled on the results at the end of July.

Consumer Focus Groups Results of these groups are still being analyzed.

Interdepartmental Implementation Plan Staff from DHS DMH, DCFS, HFS, DOC, IPI and DHS BALC have started meetings to develop an implementation plan for the new services.

State Plan Amendment and Rule 132 Revision The Interdepartmental Medicaid Group submitted the State Plan Amendment language to HFS. It is anticipated that the Amendment will be sent to Federal CMS by June 1st.

Access and Eligibility Workgroup (Chair: Sandy Lewis)

Sandy referred the group to her written minutes. The group is working with Parker Dennison to complete a survey of eligibility requirements in other states. The other states were chosen on the basis of their administrative similarity to Illinois (not county-based) and similar Medicaid procedures. The Workgroup added the term "community-based" to their definition of Access. They will meet again on May 19th to draft input to DMH regional staff on their planned geographic needs survey.

Financial Workgroup (Chair: Doug Kolasinski, reported by Randy Pletcher)

This group has not met since the last SRI Task Group meeting.

Adult Psychiatric Hospital Diversion Program

The group requested information about reports they had heard about a potential adult psychiatric hospital diversion program in Illinois. Mike Pelletier indicated that what the Secretary presented in her House FFS testimony still applies: that the Departments are engaged in discussions about this as well as other programs. DMH recognizes the importance of stakeholder involvement and recommends an approach of soliciting input into such planning at the appropriate time, similar to what is occurring in the SRI/FFS conversion.

Mh Planning Council

At the last Planning Council meeting Mary Smith answered questions from the group on ASO issues. There were discussions regarding Mental Health Juvenile Justice and Medicaid billing. Mary Smith shared a report with the group on admissions to state hospitals. This report demonstrated a disproportionate admission rate for African-American males over other groups. Mary indicated the need for further follow up on these data. The group expressed their appreciation for the change in the 718 Fund policy.

Future Meetings

SRI TASK GROUP - Community Support Definitions Discussion

Wed. May 24th, 10:30am, by teleconference.

SRI TASK GROUP

Wed. June 21st, 12 pm - 4 pm, by teleconference.