The Department of Mental Health Inpatient Study Commission
Scope & Mission
May 2009

Background

The Department of Mental Health (“Department”) is committed to fulfilling its vision to provide a most responsive mental health delivery system that embraces the values of recovery, choice and self-determination.  The guiding principles for this vision are:

1.	Empower individuals with mental illness to live with dignity and independence in the community;
2.	Provide access to a full range of quality services and supports to meet their mental health needs;
3.	Enable individuals to live, work and participate in their communities; and 
4.	Implement a consumer-centered, recovery-oriented system of mental health care.

To achieve its vision successfully, the Department has made the Community First plan its priority for all adult consumers and will:

1.	Create flexible, recovery-based and person-centered services supporting consumer choice;
2.	Serve individuals transitioning from institutional settings to the community in the most appropriate manner; and 
3.	Manage limited resources effectively.

In recent years, the Department has made major investments in developing the community system of care through directing the savings achieved by closing facilities to expand community services.  The current economic downturn and resulting fiscal realities has created a set of challenges for the Department that presents the opportunity to accelerate the reconfiguration of mental health services in Massachusetts.  Specifically these are:

1.	An immediate structural deficit of $24 million that will require significant service reductions.  
2.	An already significant reduction to DMH community services with the elimination of day and employment services and a reduced case management work force. 
3.	At any point in time, more than 200 of 788 adult patients in DMH continuing care facilities are ready for discharge but appropriate community services are not available.

Purpose and Scope

The purpose of the Department of Mental Health Inpatient Study Commission (“Commission”) is to assist the Executive Office of Health and Human Services (EOHHS) and Department of Mental Health with recommendations that achieve balance, independence and objectivity.  The Commission shall evaluate the Department of Mental Health inpatient system; determine an appropriate inpatient capacity for the Department; and recommend a plan to the Secretary of EOHHS for her consideration.  The Commission shall assure a public, comprehensive, independent and timely process.

The Commission shall:

1.	Evaluate the Department’s state-operated inpatient system;
2.	Determine an appropriate level of state-operated inpatient capacity; and
3.	Support the balance of inpatient bed capacity need with the needs for Community First and the Department’s budget. 

From its review, the Commission will recommend a plan to the Secretary of the Executive Office of Health and Human Services for consideration.  The Commission’s recommendations should support the vision of the Department and provide a blueprint for: 

1.	Implementation of the DMH Community First plan for adult consumers; 
2.	Transition and consolidation of existing inpatient facility capacity to support the opening of the new state-of-the-art psychiatric facility in central Massachusetts in the spring of 2012;
3.	Continuation of the highest quality of care in accredited state operated facilities, providing services based in evaluation, rehabilitation and a safe environment for individuals in need of continuing inpatient care and/or forensic evaluation and services; 
4.	Maintenance of the continuum of care in which psychiatric units in acute and private psychiatric facilities have timely access to transfer of consumers requiring continuing care and patients ready for discharge receive timely community placement;
5.	Development of community services that assure sustained flow of the Department’s continuum of care; and
6.	Acknowledgement of the Department’s fiscal realities and responsibly implementing a plan that continues the Department’s fulfillment of its responsibilities to the Commonwealth and the citizens for which it is responsible.

To complete its work, the Commission may:

1.	Review clinical, operational and financial data for each Department operated, contracted or funded inpatient unit/hospital, including the capital costs of maintaining and/or upgrading the physical plant infrastructures of said facilities;
2.	Review programmatic, operational and financial data for each Department operated, contracted or funded community-based program;
3.	Review utilization trends for general and acute psychiatric units and private psychiatric hospitals, including trends for transfer of clients from general and acute psychiatric units and private psychiatric hospitals to Department continuing care inpatient units;
4.	Review Department inpatient bed capacity and projected utilization, including forensic admissions;
5.	Review the impact of previous Department inpatient bed closings;
6.	Review current treatment practices in behavioral health, including evidence-based practices; 
7.	Review any other material that is deemed necessary for the commission’s work; and
8.	Hold public hearings and create other avenues to elicit comments from the public.