Report to the community regarding Family Service

7/31/2019 Report to the community regarding Family Service

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A Report to the Community Regarding Services at

Family Service,

Division of North Central Behavioral HealthMay 29, 2012

Sandy W. Lewis, Ed.D., Executive Director

Background:For the past two years, the McHenry County Mental Health Board has been assisting the Board

and staff of Family Service and Community Mental Health Center to continue its long legacy of

providing substance abuse and mental health services to the residents of McHenry County

through consultation, direct funding of services and administrative support, and most recently,

cash flow loans and advances. At its peak, Family Service reported serving 6,000 clients per

year. Their recent FY11 report indicates that individuals were served primarily through

psychiatric and outpatient mental health services. Their building houses not only the operations

of their staff, but a pharmacy and offices for the Greater Elgin Community Health Center, which

provides primary health services to clients. Together, this model represents the most innovative

and integrated model of care this community offers. However, reduced state funding, reductions

to services to those not covered by Medicaid, additional costs to maintain electronic

health/service records and financial reporting infrastructure continued to take tolls on thesustainability of Family Service. Additionally, their building was heavily financed and their debt

structure through their bank further weakened Family Service.

In order to continue to make services accessible at the same location, a unique collaboration

emerged between Family Service and North Central Behavioral Health (NCBHS), which

provides similar services in seven other central and western Illinois locations. In early 2012,

Family Service and NCBHS announced the intention to transition Family Service systems and

programs to North Central effective May 1stthrough a Transition of Services agreement. This

was not a traditional merger but an effort to sustain services through a seamless delivery model

where North Central would hire Family Service staff and use their building to deliver services.The agreement was contingent on several conditions, including continued access to the Family

Service building and unencumbered use of equipment and furnishings; the transfer of current

contracts from State and local funding sources; and the ability to sustain operations at a break

even financial position so as to not jeopardize current NCBHS services. Based on verbal

commitments from these parties, North Central moved ahead on good faith to stabilize services

on May 1st. Recent events affecting these conditions in all three areas (contracts/licensure


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assignments; facility; and revenue targets) make it impossible for North Central to continue

moving forward on the agreement, despite their dedicated efforts to do so. Due to

relinquishment of current contracts and employees, and the lack of sufficient infrastructure, it is

also not possible for Family Service to reinstate employment and continue services. Therefore, a

May 25, 2012 announcement by NCBHS was released announcing the closure of services and

employment of staff effective June 30, 2012 or sooner.

Leadership staff of the Mental Health Board was informed of the potential for this action earlier

in the week and committed to assist the North Central and Family Service staff and Board

members in helping with communication with the State Department of Human Services,

Division of Mental Health; the Department of Alcohol and Substance Abuse; and the community

agencies funded by the MHB.

ImpactService Demand: Noting that transition of services to North Central had just begun in May, thenumber of active clients seen in the last 90 days is estimated at 2,000, and the first months

formal registration of clients to North Central acknowledged by the Division of Mental Health is

approximately 600 clients. To base the impact solely on these numbers is faulty because, due to

the announcement of the transition of services this past spring, and the reduction in force that

Family Service had to implement over the last two years, some clients have been seen on an

emergency response basis only, and others have chosen not to formally register or have not had

the opportunity to re-register with North Central. Therefore, the Mental Health Boards

assessment is that the impact will continue over the next months, and it is preparing to target the

incidence of crisis calls and assessments, and the increased number of potential incidents with

law enforcement resulting in arrest or, for the youth population, the increased truancy and/or

drop out and expulsion rate as indicators of impact.There is no single agency in McHenry County that possesses the appropriate licensures and

contracts to serve all the substance abuse and mental health services provided by Family Service.

Therefore, the obligation and responsibility for identifying service transition plans for clients is

complex.Clients seeking mental health services at Family Service and North Central were primarily

funded by Medicaid or recently discharged from state operated facilities. These clients are

therefore the responsibility of the Division of Mental Health through their Medicaid Rule 132funding; limited funding for non-Medicaid (target population); or through the Department of

Alcohol and Substance Abuse Services. Based on recent discussions with the Division of Mental

Health, it is their intention to reach out to their certified Medicaid providers to determine which

providers have the capacity to accept new clients and will ensure that clients have at least two

alternative sources of services. We have agreed to assist in helping the Division of Mental

Health in coordinating questions from clients who are seeking to remain in treatment with other


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McHenry County providers. These providers are Pioneer Center/YSB, Family Alliance and

Thresholds. The Mental Health Board is also a certified Medicaid provider and subcontracts

with the Crisis Team (Centegra) for additional services.

Clients seeking substance abuse outpatient services must be referred to providers licensed with

the Department of Alcohol and Substance Abuse for specific populations. While The AdvantageGroup and YSB have licensure for services to youth, the community has no adult service

provider licensed for outpatient substance abuse services. To respond to critical needs,

Centegras Behavioral Health Program has an intensive outpatient program. The Mathers Group

and other private providers may have licensed clinicians, but they are not certified as Medicaid

providers. They could, however, apply to be Medicaid providers.

Those clients without a payer source (such as Medicaid and Medicare) and residents of McHenry

County have been provided services through funding from the Mental Health Board. Because

the MHB could not replace all services lost by state funding reductions, service funding was

prioritized and limited to funding certain positions such as psychiatry and nursing or funding forgroup activities as a means of stabilizing the highest prioritized needs in substance use and

mental health services. Additionally the Mental Health Board also funded specific positions to

assist with evidence based care (Co-Occurring Integrated Treatment, Wraparound, Traumatic

Brain Injury) or positions to help other projects such as the Mental Health Court Social Worker

and nurse and Drug Court Clinician. Additionally, the MHB had responsibility for the

children/adolescent crisis response program, SASS in which Family Service and YSB were both

contracted providers. Clients and services affected by these areas will be the responsibility of the

Mental Health Board. The Mental Health Board has also supported the recruitment of

psychiatrists and advanced practice nurses to increase and maintain access to psychiatry and

medication. This is one of our highest prioritized areas to stabilize. Psychiatric services

represent almost 50% of the client services provided by Family Services.Facility Impact: Family Services owns the main building at Veterans Parkway (approximately

34,000 square feet) and their original facility on Elm Street, both in McHenry. The Elm Street

facility was renovated during a time when the MHB occupied their building temporarily with our

staff. It is now fully occupied through leases with Home of the Sparrow, Transitional Living

Services, and Prairie State Legal Services. The Veterans Parkway building was to have housed

North Central staff as part of the Transition of Service plan, which would have occupied the

second floor. The building is partially leased by a pharmacy and the Greater Elgin Community

Health Clinic. The facility has space available for additional tenants. However, due to the end

of the North Central transition, the building will be vacated except for the pharmacy and the few

exam rooms used by the Greater Elgin Health Clinic. The future of both facilities is in question

and the Family Service Board will need to resolve their dispositions and current lease

arrangements. Both facilities are financed by separate banking institutions. The facility may be

needed by providers (current or new) that may want to expand their capacity to respond to the

client demand but have no existing space.


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Community Impact: Understanding that no single existing McHenry County provider has the

capacity or licensure status to assume responsibility for all the clients in a seamless transition, the

dissemination of services to a variety of local and regional providers is expected. This will cause

confusion for clients, delays in treatment, lack of coordination and demand for additional

supports such as transportation, emergency medications assistance, and emergency housing

needs. Due to the delay in securing stable outpatient services, we can predict increases in crisis

demand and inpatient care. Inpatient care at Centegra is already strained in responding to the

current demand without expanding bed capacity, securing additional psychiatric leadership and

relying on additional Mental Health Board financial resources. Our community has no inpatient

child/adolescent psychiatric beds, nor any residential treatment or detox facility for substance

use. Therefore, individuals and families will travel outside the county for these services.

Regional providers will need to be contacted to assist with the demand for services. United Way

and Mental Health Board resources may be needed for emergency medications, transportation,

and housing.Mental Health Board Action Steps:Understanding that nearly half of the impacted clients are covered by Medicaid, the MHB will

continue to assist the Division of Mental Health and Department of Alcohol and Substance

Abuse to respond these needs. Focusing on the urgent needs of community safety net services

(crisis, psychiatry, medications, integrated care) for those without a payer source and to stabilize

services, the Mental Health Board will hold emergency public meetings to seek input from

consumers and providers to stabilize service and further coordinate communication among all

parties. These meetings begin on Wednesday, May 30 at 6:00 pm at the Mental Health Board,

620 Dakota Street Crystal Lake. Additionally, the Mental Health Board will meet with funded

agencies prior to the Board meeting.

In order to stabilize the SASS contract services to adolescents/children, and transition

employment for positions that support TBI, Mental Health and Drug Court and

psychiatric/nursing services, the leadership staff is engaged in discussions with key partner

agencies to encourage those agencies to offer employment to Family Service staff. The Mental

Health Board staff will identify specific recommendations to the MH Board at the May 30th

and

subsequent meetings.We will work with the Family Service /North Central staff to assist with communication to

clients and to make MHB and crisis staff available to assist with coordination and crisis

response. This includes helping those without other public funding to seek services through the

MHBs warrant of need referrals to other private providers, such as Horizons, Mathers,

Professional Consultations group.Finally, the MHB will explore how redirected resources can improve the communitys crisis

response with alternative and new program approaches with input from providers and


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consumers. The MHB may also need to stabilize services using their location for temporary

delivery of services.

Additional action steps will be taken once the publicly funded clients (Medicaid) begin to seek

services and are registered at the various other McHenry county provider agencies. At that time,

we will continue to assess the most appropriate and available assistance as longer termresponses. It is important to remember that without adequate and timely payments from the State

to respond to the Medicaid population, providers will be challenged with this responsibility and

it may further weaken the sustainability of other organizations.

The Mental Health Board acknowledges the diligent work of the Board and staff at Family

Service and North Central Behavioral Health. Their efforts to ensure an innovative and seamless

delivery system were heroic in the face of significant challenges and barriers. For more

information on the MHBs response to this announcement, contact Sandy Lewis 815-455-2828

or Lori Nelson, Director of Family Services Division of North Central Behavioral Health at 815-

669-2500.

Report to the community regarding Family Service

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