Community Mental Health Board Monthly Meeting

WHEN: MONDAY, SEPTEMBER 21, 2015

TIME: 11:00  AM  TO  1:00  PM

WHERE: THE DePAUL CENTER, 333 S. STATE STREET
CDPH BOARD ROOM, 2nd FLOOR

Proposed Meeting Agenda​:​
Clinic Director’s Report​
​[​Perspective of persons served​]​
Administrative Reports:
Service Quality Monitoring (as per Dr. Morita on 9/3/15) ​
Department Quality Monitoring and Improvement Activities and Outcomes
Outreach and Follow up {“identifying and engaging vulnerable populations who are out of care”}

​Response of Department to Recently Published Post-Payment Review Findings​/​Plans of Correction​​
[​Quality ​Perspective/Re​commendations​ ​from persons served​]​

2015 and 2016 CDPH Mental Health Centers Budget ​
Review of Appropriations, Expenditure​s​, Revenues by Funding Source – Line Item by Mental Health Center and Central Office​
​[Plans to provide services under contract?]
Update on status of enrollment in Medicaid managed care plans
Update on health center psychiatry coverage​ – recruitment activities
​Updated ​health center statistics
Other concerns
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Elimination of Psychiatric Leadership Funding in SFY 2016- Dollar Amounts Lost by IDHS Contracted Community Mental Health Service Providers

One of the major line item cuts in Governor Rauner’s FY 2016 Illinois Department of Human Services (IDHS) Community Mental Health Program budget is the elimination of $27 million in Psychiatric Leadership Capacity Grants.[1]  These program funds have been used by many mental health service vendors to help cover the cost of psychiatry services[2] – psychiatrist salaries, support programs, etc. The scope of service provided under this program is described in the attachment.

Psychiatric Leadership funds are not covered under any consent decree or mandated by any federal law. Without a budget approving the expenditure of these funds, vendors will not have this money to help pay for their psychiatry programs.

How many mental health service providers are directly affected by the elimination of these funds and how much did each receive in SFY 2015?[3]

109 Illinois vendors were identified that received psychiatric leadership awards in 2015. They are listed in the attached spreadsheet (two received awards under two different contract numbers).[4] The total FY 2015 expenditure for these 109 vendor programs was $26.5M ($27M). [5]

Two agencies received more than $1 million each in FY 2015 (Chestnut Health Systems, Inc $1,145,846 and Rosecrance, Inc.$1,217,237).

27 Chicago area community mental health service providers have received annual Psychiatric Leadership awards in the range of $28,507 (Children’s Home & Aid Society) to $860,904 (Community Counseling Centers of Chicago C4).[6]

The total amount of psychiatric leadership program funds awarded to Chicago-based vendors in FY 2015 was $8,155,949.

The City of Chicago Department of Public Health received $53,560.

The Senate Bill 2046 (Senate Amendment 1) that passed in the Illinois Senate last week would restore some IDHS mental health funding but it’s not clear exactly how much funding would go towards Psychiatric Leadership or whether the legislation, if ratified by the House, will survive the Governor’s veto.[7] Perhaps you know more about this.

Calls for the city to turn over management of city mental health services to vendors have become more aggressive perhaps as a result of the current state budget mess. Sustained loss of Psychiatric Leadership funding may cause significant financial strain on several city and state vendors and impact their ability to provide services.

Some vendors would like the city to replace lost state funding with city funds.

*****

For several years IDHS has attached performance measures to its community mental health service contracts. For your review, a copy of the psychiatric services performance measures and deliverables from the FY 2014 CDPH contract are attached. The same measures and deliverables were required of other vendors and in previous fiscal years. Advocates should ask IDHS for the outcomes of this data collection.

jk

[1] See IDHS 2016 Budget Presentation online here http://www.dhs.state.il.us/page.aspx?item=76664

[2] Also known as 350-Psychiatrist Services in Mental Health Center/ SM00-350-0000/ Cost Center 350

[3] Just about all these 107 vendors received the same award in SFY 2014 and before.

[4] The source for this list comes from IDHS and Illinois Comptroller’s Awards Database.

[5] It is unknown whether there were others. Still the total adds up to just about $27M so the list is pretty complete.

[6] The Chicago provider organizational locations are mapped here https://chicagomentalhealth.wordpress.com/2015/07/18/idhs-funded-chicago-cmh-agencies-with-sfy-15-psychiatric-leadership-awards/

[7] Senate Bill 2046 (Senate Amendment 1) can be found here http://www.ilga.gov/legislation/99/SB/PDF/09900SB2046eng.pdf

CDPH should promote smoking cessation in city mental health centers

According to the Centers for Disease Control and Prevention (CDC), “cigarette smoking is the leading preventable cause of disease, disability, and death in the US.” [CDC, Vital Signs, February2013]

Whether you receive mental health services or not– cigarette smoking can cause “disease, disability, and death.”

The prevalence of smoking is higher in persons with a mental illness. The CDC reports that 36% of adults with a mental illness smoke compared to 21% of adults without a mental illness. The report includes the following stats:

31% of all cigarettes are smoked by adults with mental illness
40% of men and 34% of women with mental illness smoke
48% of people with a mental illness who live below the poverty level smoke, compared with 33% of those with mental illness who live above the poverty level

Chicago Department of Public Health (CDPH) administrators should tell us how they are promoting smoking cessation to the at risk population that comes directly through their mental health center doors.

Studies have shown that persons with *serious* mental illness diagnoses die on *average* 20-25 years before their peers without a diagnosis of serious mental illness and that they die earlier from preventable or modifiable chronic medical conditions *including smoking related conditions* such as heart and lung disease.

Former commissioner Terry Mason and the Board of Health discussed this several years ago (circa 2007). But CDPH has provided little evidence that it is doing anything systematically (or un) with this knowledge to improve the care of the people it serves –including making sure that mental health center participants have primary care physicians (PCPs) and are following up with there PCPs, targeting smoking cessation, obesity prevention, immunizations, and chronic disease prevention efforts to person served by CDPH mental health centers and addressing other determinants such as housing, transportation, and employment. [This was CMHBC CDBG recommendation #7, a year ago]
jk