Response to Inquiries #1 - As received April 6, 2012 COB

  1. Inquiry #1:
    Haymarket Center has worked closely with DMH over many months to develop solutions to some of DMH's needs related to the closure of Tinley Park.
    It is disconcerting, then, to receive an 85-page RFI requesting extensive detail, including data, in just over one week.
    Would DMH consider extending the due date, or providing a Chicago delivery address so that we would have an additional, non-holiday, weekend to prepare a quality response? Note that since the services requested are in the Chicago area, a Springfield submission location effectively makes the due date Friday, April 13 in order to allow for delivery time.

    Jeffrey Collord
    Director of Development and External Affairs
    Haymarket Center
    312-226-7984 ext 331

    The RFI is the formal process to receive in bids for services. The requirements of the RFI, as specified, allow DMH to compare all provider proposals using the same standards.
    An extension has been provided for electronic submission of your proposal to be received in by COB Friday, April 20th and hard copy to the Springfield address by Monday April 23rd COB. More Information. 
  2. Inquiry #2:
    Thank you for responding to our questions about the proposed CHIPS program, which will be a purchase of care agreement between the DHS Division of Mental Health and hospitals for inpatient psychiatric services. In your response, you clarified many of our questions. Some of our issues and concerns remain outstanding, however. They are as follows:
    1. Lack of funding for the indigent patient/consumer with mental illness, in general, but particularly as it applies to community providers. Although the CHIPS agreement is executed between a hospital and the DHS Division of Mental Health for acute, inpatient services, it is designed to deliver such services within the context of a continuum of care. The CHIPS patient likely will also benefit from case management, access to medication, outpatient therapy, and a variety of support or wrap-around services. Recognizing this, coordination between the hospital and community provider is built into the CHIPs contract. However, community providers in recent years have been and continue to be at risk of losing funding for unfunded patients-the patient population covered under the CHIPS program. If community providers lack the resources to provide services, the CHIPS program will fail. Moreover, CHIPS patients unable to obtain medication or follow-up appointments will continue to present in hospital emergency departments, compromising the hospital's performance under CHIPS as well as other Medicaid programs aimed at reducing readmissions.
    2. Narrowly defined financial eligibility criteria compromising access to care. The CHIPs contract applies to persons whose income is at or below 200% of Federal Poverty levels and who do not meet Medicaid eligibility criteria. By narrowly defining financial eligibility criteria for CHIPS, it is very likely persons who otherwise would access the Tinley Park Mental Health Center or other SOHs will not be eligible for CHIPs services. How will the system of care provide for those individuals who will slip between the cracks of Medicaid, CHIPs, and community funding categories? We must anticipate these persons will need treatment and plan for it. Hospital EDs will serve these persons, but what other services will be available?
      Will community providers have funding that exceeds 200% of poverty levels? What are the financial criteria for crisis services and other mental health and substance abuse services?
    3. Lack of identified, adequate, and sustainable resources to support the CHIPs program. The CHIPS program was originally developed as a patient safety net program when Zeller Mental Health Center was closed and when inpatient, civil bed capacity was reduced at the Elgin and Alton Mental health Centers. The program involved approximately 30 hospitals and served persons with mental illness until the program funding was abruptly ended in 2009. Because there was no separate line item for CHIPS, the DMH had discretion whether to eliminate CHIPs funding. CHIPs -eligible patients were left to their own devices and surely became some of those among the growing numbers of persons presenting in crisis to hospital EDs and community providers. As we again consider providing a safety net for inpatient hospital and other services, we should specifically identify a funding stream for this program.
    4. Lack of clearly identified services for substance abuse patients. You have indicated that CHIPS clinical criteria will be driven by a patient's functional status, not a diagnosis. This alleviated some of our concerns that the substance abusing patient be eligible for and be able to obtain appropriate services for his or her condition, either under CHIPs or another venue. Many patients currently using state psychiatric hospitals have co-morbid substance abuse disorders. And, many patients presenting to hospital EDs have substance abuse disorders that, upon presentation, may or may not be accompanied by psychiatric conditions. The system requires sufficient flexibility and resilience to accommodate patients with multiple conditions that may not be fully apparent at presentation. We suggest the CHIPS and alternative services programs include a component for patients at the point of crisis or admission. Do not penalize a hospital or crisis provider if the patient is later identified as having a primary substance abuse disorder. Further, identify substance abuse services for which the person in the ED can be referred. Funding and clinical criteria for substance abuse services should recognize the need for such services for persons who may currently be using Tinley Park or other SOHs.
      We believe it is absolutely essential to develop a continuum of care for the unfunded person who has a serious mental illness that ensures access to those services that are necessary to treat his or her presenting symptoms, stabilize him or her, and support his or her continued recovery. We can accomplish these goals by centering the services constellation around the patient and funding accordingly. As we design a system of care to replace in part and complement in part the fragments of a system that currently exist, we have the opportunity to align clinical and financial criteria. We look forward to working with you and our community partners in doing this.

      MaryLynn McGuire Clarke
      Sr. Director, Health Policy & Regulation
      Illinois Hospital Association
      700 South 2nd Street
      Springfield, IL 62704
      P 217.541.1150
      F 217.541.1166


      1. Several of the services identified in the RFI specifically, access to Psychiatry, medications, and Rule 132 services are intended for consumer access post discharge from a SOH, CHIPs, or other alternative residential services. DMH concurs that coordination of care between inpatient, residential and subsequent outpatient providers is an essential component for the seamless transition of services that would better ensure overall stability and reduce re-admissions.
      2. The 200% FPL is the historical financial criteria for previous CHIPs contracting. The financial eligibility requirement for consumer access to community based, non-Medicaid services is covered in Attachment B and outlines the DMH responsibility for payment at various FPL levels.
      3. The funding stream for this rebalancing project is included within the Governor's proposed FY13 Budget as a lump sum General Revenue Fund appropriation. This appropriated line item would cover "costs associated with Mental Health Community Transitions or State Operated Facilities" as specified in the introduced appropriations bill. The GRF line item is proposed at $36,320,000 and would be subject to final authorization by the General Assembly.
      4. The RFI targets the pool of persons who would have been served by an admission to Tinley Park MHC after July 1, 2012. The intents of the RFI identifies persons being served in Emergency Departments that continue to meet that standard, i.e. at risk for an admission to a SOH, would be afforded the opportunity to access a full range of MH and Substance abuse services. It is the intent of the RFI that providing enhancements in the assessment and triaging of person presently at the ED that the most appropriate level of care can be better determined at that entry point.
  3. Inquiry #3:
    We are an hour plus from Chicago. We only offer outpatient services with no medication given to our clients. If you think that Adult Education Associates, Dixon IL can be of assistance then I will fill out the RFI but I am unsure that we offer what is needed.


    The RFI was published broadly to DMH and DASA contracted providers. Your actions in response to the RFI is only required should you wish to provide services to the target population as identified in the RFI.  

  4. Inquiry #4:
    On page 26 asks for program information, I cannot type inside this document, you are requesting an electronic reply and paper reply, the document is 85 pages long. Should I copy the entire document, full in the information and mail it to you or just certain pages. What exactly is the electronic part. Thank you.

    Millie Hernandez
    CADC/MISA I Adult Counseling Center, Director

    See the attachments can be download for completion.
  5. Inquiry #5:
    Community Education Centers is strictly a provider of In-prison treatment in Illinois. We are not a Community Provider. Do you still need a response for us? Thanks.

    The RFI was published broadly to DMH and DASA contracted providers. Your actions in response to the RFI is only required should you wish to provide identified services to the target population as identified in the RFI.
  6. Inquiry #6:
    My CEO received the attached RFI - and we're a tad confused. Is this for providers that want to become a mental health provider??
    Please advise

    Maureen Drumm R.N. MHA
    Director Case Management/Social Services
    Adventist Bolingbrook Hospital
    500 Remington Blvd
    Bolingbrook, IL 60440
    office: 630-312-6088
    pager: 630-512-2260
    fax: 630-312-6830

    The RFI was published broadly to DMH and DASA contracted providers. Your hospital was identified as within the Region 1 South area and with a history of your Emergency Department referring patients to the Tinley Park MHC for admission. Your actions in response to the RFI is only required should you wish to provide identified services to the target population as outlined in the RFI.
  7. Inquiry #7:
    Can providers outside of the South region apply for the proposal? We are in Region 1 north.

    The RFI was published broadly to DMH and DASA contracted providers. Your actions in response to the RFI is only required should you wish to provide services to the target population as identified in the RFI within the Region 1South area and /or to persons as DMH identifies presenting to the MADDEN MHC from the Region 1South area.
  8. Inquiry #8:
    As our agency is located in rural Central Illinois we have never served any clients from the counties/communities served by Tinley Park Mental Health Center and have no useful information/input to offer.

    Deborah Nelson

    The RFI was published broadly to DMH and DASA contracted providers. Your actions in response to the RFI is only required should you wish to provide services to the target population as identified in the RFI.