Transcript Tinley Park Rebalancing Crisis Care System

Northwest Crisis Care System
(NCCS)
Illinois Department of Human Services
Division of Mental Health
September 10, 2012
1
Northwest Crisis Care System
Guiding Principles
Services
are Recovery-Oriented
Services
are Trauma-Informed
Services
and system must be outcome-validated
Individuals
can recover more fully in their communities
Region
2W and 3N providers are best informed to plan the
system of care for its residents
State
hospital has a continuing role in the continuum of care
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Northwest Crisis Care System
Planning Approach and Method
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Extensive data review and analysis
Community and stakeholder engagement
Clinical Focus groups
Requests for Information
Implementation protocol
Systems monitoring protocol
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Northwest Crisis Care System
Community & Stakeholder Engagement was directed by DMH,
the Governor’s office and:
The Mental Health Rebalancing Advisory Workgroup
Hospital
Engagement
Service Models
&
Innovation
Dan Neal
(formerly FHN)
&
David Deopere
(Trinity Medical
Center)
Jim Sarver
(Sinnissippi)
&
Don Miskowiec
(North Central
Behavioral Health
Services)
Michael Pelletier
(DMH)
Dennis Beedle, MD
(DMH)
Dan Wasmer
(DMH)
Amparo Lopez
(DMH)
Jordan Litvak
(DMH)
Community
Education &
Support
John Shustitzky
(The Chgo School of
Psychology)
Lora Thomas
(NAMI)
Gustavo Espinosa
(DMH)
Amparo Lopez
(DMH)
Patricia Reedy
(DMH)
Service Financing
& Payment
Methodology
Ben Stortz
(Cornerstones
Services, Inc)
&
Lynn O’Shea
(AID)
Brock Dunlap
(DMH)
Systems
Performance
& Outcomes
Assessment
Mary E. Smith
(DMH)
Messaging Media
& Legislative
Liaison
Janet Stover
(IARF)
Pat Knepler
(DMH)
Debra Ferguson
(DMH)
4
Northwest Crisis Care System
FY
Budgeted Adms Homeless Adms. Unfunded Adms. First Time Adm
Beds
to State Hosp.
%
%
Unduplicated
Served
%
%
Patient Days/ Avg Daily
Census
Days
ADC
ALOS
%
2006
76
869
167
19.2%
554
63.8%
330
38.0%
640
73.6% 29,434
80.59 106.0%
29.9
2007
76
734
125
17.0%
515
70.2%
301
41.0%
584
79.6% 26,739
73.21
96.3%
37.4
2008
76
724
137
18.9%
478
66.0%
298
41.2%
577
79.7% 26,815
73.42
96.6%
55.4
2009
76
858
155
18.1%
598
69.7%
381
44.4%
682
79.5% 26,432
72.37
95.2%
34.0
2010
76
861
122
14.2%
615
71.4%
438
50.9%
708
82.2% 26,892
73.63
96.9%
30.0
2011
76
845
118
14.0%
557
65.9%
430
50.9%
788
93.3% 25,910
70.99
93.4%
25.2
2012
76
396
82
20.7%
257
64.9%
183
46.2%
368
92.9% 20,263
55.52
73.0%
31.3
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Northwest Crisis Care System
Governor’s Rebalancing Advisory Workgroups
Six strategic Committees were formed and empanelled. The committees and
their mission/function are as follows:
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Hospital Engagement - Mission: Assist the state in determining the scope, types,
amounts, locations and rates for hospital based care.
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.
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.
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.
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.
Messaging, Media & Legislative Liaison - Mission: Assist the state in developing
appropriate messages, and interface with the members of the General Assembly on
restructuring issues.
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Northwest Crisis Care System
Workgroups informed plan elements
required for rebalancing
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Community-based hospital inpatient psychiatric services (CHIPs);
Enhanced Crisis Response Services
Centralized 800 line for authorization and utilization management;
Intensive Mental Health Crisis Residential services;
Enhanced Community treatment services (Rule 132);
Community Support Team (CST) services;
Transportation;
Safety Net State-operated inpatient services.
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Northwest Crisis Care System
Expert Clinical Focus Groups: Method
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Convened multidisciplinary team of experts in
community mental health and substance abuse
treatment;
Identified top 10 diagnostic groupings and
presented clinical case studies of each;
Team of experts identified optimal service array for
each grouping.
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Northwest Crisis Care System
Expert Clinical Focus Group
Results:

Approximately 65 % of the individuals represented by the
clinical typologies used for the clinical review team service
projections met admission criteria for inpatient level of care.


Of these, approximately 40%
would require longer term
community based inpatient care which was defined as 30 or
more days.
Approximately 71% of the individuals represented by the
typologies who were not projected to require inpatient care
would require observation (up to 48 hours); and the majority
of these individuals would require crisis residential services
followed by an intensive level of outpatient ambulatory care
(within the rule 132 array).
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Northwest Crisis Care System
Requests for Information (RFI)
Published on July 26, 2012 with purpose of purchasing communitybased inpatient and outpatient alternatives to services provided at
Singer Mental Health Center.
Responses were due August 13, 2012.
16 proposals received
 6 Hospital providers (two both CMHC & Hospital)
 9 DMH community mental health providers (two both CMHC & Hospital)
 1 Transportation provider
14 proposals accepted
 8 DMH community mental health providers
 5Hospital providers
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Northwest Crisis Care System
Hospital Providers for CHIPs

Swedish American Hospital, Rockford
 Rockford Memorial Hospital Rockford
 OSF St. Elizabeth’s, Ottawa
 Trinity Medical Center, Moline
 Provena Mercy Center, Aurora
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Northwest Crisis Care System
Awarded Mental Health Providers for :
Enhanced Crisis response (EDAs)
&
Acute Community Service Providers (ACS)
 Ben Gordon Center, DeKalb
 North Central Behavioral
Health, LaSalle
 Bridgeway, Inc, Galesburg
 Robert Young Center, Rock
Island
 FHN- FCC, Freeport
 Stepping Stones, Rockford Awarded for special services
 Rosecrance, Rockford
 Sinnissippi Center Inc., Dixon
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A Team Approach to Recovery
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Northwest Crisis Care System
Goals: Develop a crisis system to engage individuals
presenting at all Northwest Crisis Care Systems Emergency
Departments (EDs) and select community sites

Provide timely and accessible assessment –
Enhanced Crisis Response (aka EDAs) to EDs and utilizing mobile teams
for in-community evaluations MHCs;
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Provide community treatment alternatives to the consumers
Leverage and/or purchase access to MH Crisis residential, Community
based Inpatient care (CHIPs), community based mental health services
Acute Community Services (ACS), entry to state operated hospital;
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Rapidly triage and transport consumers to appropriate levels of care.
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Northwest Crisis Care System
Authorization Protocol
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After evaluation and consultation, Evaluator contacts authorizing agent (ACCESS line)
Evaluator describes clinical condition and makes level of care recommendation
Level of care determination is made based on medical necessity ;
If there is concurrence with ACCESS on LOC determination, ACCESS authorizes service and
transportation as appropriate;
If there is a denial by ACCESS, the Evaluator and the ED re-assess options;
If Evaluator and ED appeal the denial, ACCESS has @1 hour to arrange for MD final review.
Levels of care: service definitions:
CHIPS
Crisis Residential
Enhanced Community Supports
Access to
Community Crisis
Full access to Rule 132 services
Inpatient beds;
stabilization;
Post ED care w/in 24 hours;
For acute psychiatric
MD/RN supervised;
Post discharge care w/in 72 hours;
conditions;
24/7/365;
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Region 2W 3N;
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Northwest Crisis Care System
Behavioral health consultative expertise to EDs
Collaboration by Community Providers to ED’s and select community sites:
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Evaluate and recommend the appropriate level of care;
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Assist in crisis intervention and case management;
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Determine eligibility for Northwest Crisis Care System (NCCS) program;
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Facilitate authorization to appropriate level of care as purchased for the Northwest Crisis Care
System (NCCS);
Facilitate safe transportation to next level of care as purchased by DMH;
Facilitate registration and enrollment into Northwest Crisis Care System (NCCS) to insure Acute
Community Services (ACS) package.
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Northwest Crisis Care System
Acute Community Services - ACS
All enrolled and authorized persons discharged from Inpatient or
Residential services are eligible to receive ACS.
Persons may be determined eligible for ACS as a diversion
service from the ED or community site.
ACS provides:
 Grant Payment structure
 Allows agency to directly provide or subcontract services to most
appropriate treatment agency
 Full provider flexibility to deliver clinically indicated treatment
service which could include: any 132 service, any 2060 service,
medications, transitional services, as determined by agency MHA
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Northwest Crisis Care System
Role of State Hospitals
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SOH admissions for significant targeted population groups
◦
◦
persons with extended acute care needs.
persons with readmission profiles.
◦
persons who are experiencing homelessness.
as examples
Access to purchased inpatient, residential levels of care and ACS;
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Northwest Crisis Care System
Implementation Protocol
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Reorganized internal project management structures
corollary to Advisory Group structure (SPRINT)
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Implementation Committees
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Contracts
Policy
Workforce Development
Roll out (Communications)
Hospitals and Operations
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Northwest Crisis Care System
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Implementation:
Singer Mental Health Center closure
Admissions close October 1, 2012;
Purchased Community Services will commence;
Recent Medical records will move to Elgin MHC;
Finalization of securing inventory and buildings.
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Northwest Crisis Care System

Systems Monitoring Protocol
DMH to
1.
2.
3.
4.
5.
6.
take “snapshot” of systems performance currently measuring:
Admission rates
Readmission rates
Consumer Perception of Care
Emergency Department wait times
Deflection Rate
Transportation response times
DMH will track these and other indicators at 6, 12, 18 months.
Advisory group structure will transition to DMH Systems ReBalancing Quality Improvement Committee
Provider issues phone line and email established
312-814-0930
[email protected]
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Training Opportunities
MEETING TITLE: Region 2 West Crisis Care System Consumer & Family Education

DATE:
Tuesday September 11, 2012
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TIME:
1:00pm-2:30pm.
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DIAL-IN NUMBER: (866) 871-4877
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CONFIRMATION NUMBER: 259493
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INTENDED AUDIENCE: CONSUMERS and FAMILIES

Please dial in no earlier than 12:45pm
The purpose of this call is to provide individuals who might previously have been served
by Singer Mental Health Center in a time of psychiatric crisis with information on the
new Northwest Crisis Care System. This will include a description of services available
as well as instructions on how to access those services.
Training Opportunities
All providers, persons served, and other stakeholders are invited.
Registration is required (see below).
Wednesday September 12, 2012
10AM – 12PM

System of Care Overview/Policies and Procedures

For everyone who delivers, uses, administers, or supervises services in NCCS..

Location: Rosecrance Griffith Williams Center 1601 N. University Rockford, IL
Wednesday September 12, 2012
1PM - 5PM

Evaluation/Disposition Assessments LOCUS/USARF
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Location: Rosecrance Griffith Williams Center 1601 N. University Rockford, IL
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Training Opportunities
All providers, persons served, and other stakeholders are invited.
Registration is required.
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Friday September 14, 2012
10AM – 12PM
System of Care Overview/ Policies and Procedures
For everyone who delivers, uses, administers, or supervises services in NCCS.
Location: Bridgeway, Inc. 2323 Windish Dr. Galesburg, IL
Friday September 14, 2012
1PM- 5PM
Evaluation/Disposition Assessments LOCUS/USARF
Location: Bridgeway, Inc. 2323 Windish Dr. Galesburg, IL
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Training Opportunities
All providers, persons served, and other stakeholders are invited.
Registration is required.
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Wednesday September 19, 2012
10AM – 3PM
Recovery Training
For everyone who delivers, uses, administers, or supervises services in NCCS.
Location: Rosecrance Griffith Williams Center 1601 N. University Rockford, IL
Friday September 21, 2012
10AM – 3PM
Recovery Training
For everyone who delivers, administers, or supervises services in NCCS, and for persons
served.
Location: Bridgeway, Inc. 2323 Windish Dr. Galesburg, IL
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Registration Information
For
Training Opportunities
All providers, persons served, and other stakeholders are invited.
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To Register: Please call Kelly Dee (847) 742-1040, Ext. 2002, or e-mail
[email protected]
If you require certain accommodations, please inform Kelly when you register. Please be
as specific as possible.
CEUs available for LCSW and LSWs. These are transferable to LCPC staff. Certificates of
attendance are also available. If you would like to get CEUs or Certificates of Attendance
for your participation, please inform Kelly when you register.
Lunch: Rockford Trainings: Lunch will be provided at $5 per person. If interested,
please inform Kelly.
Galesburg Trainings: Lunch on your own; a listing of fast food/restaurants will be
provided.
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Thank you
Questions?
http://www.dhs.state.il.us/page.aspx?item=61113