State-Operated Psychiatric Hospital Diversion Payments - Feb. 3

February 3, 2022

Memorandum

On Jan. 25, the Illinois Dept. of Human Services – Division of Mental Health (DHS-DMH) announced an extension of time-limited payments to Illinois community hospitals for treating eligible, uninsured patients in hospital inpatient psychiatric units who are diverted from State-Operated Psychiatric Hospitals (SOPHs) due to a temporary COVID-19 outbreak status requiring a pause in admissions.

DHS-DMH has retroactively extended the community hospital diversion contract program’s applicability to Sep. 1 through Oct. 31, 2021, due to funding availability for Calendar Year 2021. Further, DHS-DMH has committed to continue the program through Feb. 28, 2022, given the recent impact of the Omicron variant of COVID-19. Previously, DHS-DMH agreed to temporarily reinstate the community hospital diversion contract program from Nov. 1 through Dec. 31.

Eligibility standards and reimbursement mirror the standards detailed in the Nov. 4 IHA Memo. Hospitals will continue to be reimbursed for eligible patients at a rate of $880 per diem.

The new program extensions amount to a six-month continuous approval for the community hospital diversion contract program. This program was successfully implemented through the collaborative efforts of the agency, IHA, and member hospitals three times previously during the COVID-19 pandemic due to case spikes. DHS-DMH will continue to consider extending this program in 2022, depending on the status of SOPH bed availability during the COVID-19 pandemic.

IHA’s weekly SOPH admission status report memo will be edited to incorporate cumulative quarantine status data backdated to Sep. 1, 2021 in order to determine patient eligibility for SOPH diversion payments. The cumulative data will continue to be updated to incorporate all program-eligible dates for hospitals to easily determine patient eligibility.

If you have questions about patient eligibility, please reach out to the admissions unit in the SOPH where you would normally have sent the referral, or contact Teresa Glaze, PhD at Teresa.Glaze@illinois.gov. If you have contractual questions after eligibility is approved, please contact Jason Buckhold at Jason.buckhold@illinois.gov.

Contact us with any questions or comments.