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1 | HOUSE RESOLUTION
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2 | WHEREAS, The Illinois Department of Corrections | ||||||
3 | (Department) has approximately 47,000 inmates at its 27 | ||||||
4 | correctional centers; and
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5 | WHEREAS, In 2011, the Department of Healthcare and Family | ||||||
6 | Services awarded a 10-year, $1.36 billion contract to Wexford | ||||||
7 | Health Sources, Inc. (Vendor) to "provide comprehensive | ||||||
8 | medical and mental health services to offenders [in the custody | ||||||
9 | of the Department]... in order to maintain their health status, | ||||||
10 | establish innovative and cost effective medical and | ||||||
11 | administrative programs, improve the quality of care, provide | ||||||
12 | acceptable, cost effective levels of staffing, [and] | ||||||
13 | positively impact purchasing of pharmaceutical and/or medical | ||||||
14 | supplies"; and
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15 | WHEREAS, Pursuant to the solicitation for the contract | ||||||
16 | awarded to the Vendor, the Vendor is required to provide | ||||||
17 | services at targeted performance levels (including compliance | ||||||
18 | with staffing schedules, administrative directives, and | ||||||
19 | treatment protocols) with any failure to meet the target levels | ||||||
20 | of performance subjecting the Vendor to payment adjustments; | ||||||
21 | and
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22 | WHEREAS, Also pursuant to the solicitation, the Department |
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1 | is required to "[c]onduct audits to confirm the validity of the | ||||||
2 | performance guarantee results reported and enforce penalties | ||||||
3 | as appropriate"; and | ||||||
4 | WHEREAS, The Department has indicated that it would | ||||||
5 | "contract with a vendor outside the comprehensive medical | ||||||
6 | contract to audit activities of the comprehensive medical | ||||||
7 | provider"; and
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8 | WHEREAS, The Vendor is required to submit monthly | ||||||
9 | utilization reports detailing inpatient hospitalization | ||||||
10 | referrals, outpatient referrals, emergency services referrals, | ||||||
11 | primary healthcare services utilization data, and | ||||||
12 | pharmaceutical usage; and
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13 | WHEREAS, At the time the solicitation was issued, the | ||||||
14 | Department was pursuing accreditation from the American | ||||||
15 | Correctional Association for its facilities and projected that | ||||||
16 | the accreditation would occur within 3 years; and
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17 | WHEREAS, At the time the solicitation was issued, the | ||||||
18 | Department identified approximately 250 pending inmate | ||||||
19 | healthcare lawsuits in which the State, its employees, or | ||||||
20 | agents were named parties; and
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21 | WHEREAS, A Department administrative directive requires |
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1 | each correctional center to "develop a comprehensive Quality | ||||||
2 | Improvement Program that provides for the systematic, | ||||||
3 | on-going, objective monitoring and evaluation of the quality | ||||||
4 | and appropriateness of offender care", including an internal | ||||||
5 | audit of the directive to be conducted at least semi-annually; | ||||||
6 | therefore, be it
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7 | RESOLVED, BY THE HOUSE OF REPRESENTATIVES OF THE | ||||||
8 | NINETY-EIGHTH GENERAL ASSEMBLY OF THE STATE OF ILLINOIS, that | ||||||
9 | the Auditor General is directed to conduct a management audit | ||||||
10 | of the Department of Corrections' implementation of a | ||||||
11 | comprehensive medical and mental health services program for | ||||||
12 | adult offenders; and be it further
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13 | RESOLVED, That the audit include, but not be limited to, | ||||||
14 | the following determinations: | ||||||
15 | (1) whether the Department adequately monitors the | ||||||
16 | Vendor's performance and compliance with contractual | ||||||
17 | requirements, including the timeliness of services, scope | ||||||
18 | of services, recordkeeping, periodic reporting, staff | ||||||
19 | qualifications, and staffing levels; | ||||||
20 | (2) whether the Department takes appropriate action in | ||||||
21 | response to instances where the Vendor is noncompliant or | ||||||
22 | where Vendor performance issues are identified; | ||||||
23 | (3) whether the Department has in place an audit | ||||||
24 | program to confirm the validity of performance guarantee |
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1 | results and to audit the activities of the comprehensive | ||||||
2 | medical provider; | ||||||
3 | (4) whether the Vendor's and the Department's | ||||||
4 | processes for tracking, reviewing and recording inmate | ||||||
5 | complaints, grievances, and requests pertaining to medical | ||||||
6 | and mental health services are adequate; | ||||||
7 | (5) whether the billings submitted by the Vendor are | ||||||
8 | adequately reviewed by the Department, and are supported | ||||||
9 | and allowable under the terms of the contract; | ||||||
10 | (6) whether each correctional center has in place a | ||||||
11 | Quality Improvement Program as required by
Department | ||||||
12 | administrative directives and whether required internal | ||||||
13 | audits are being performed; and | ||||||
14 | (7) the status of the Department's pursuit of | ||||||
15 | accreditation from the American Correctional
Association; | ||||||
16 | and be it further | ||||||
17 | RESOLVED, That any State agencies, the Vendor, and any | ||||||
18 | other entity having information relevant to this audit | ||||||
19 | cooperate fully and promptly with the Auditor General's Office | ||||||
20 | in the conducting of this audit; and be it further | ||||||
21 | RESOLVED, That the Auditor General commence this audit as | ||||||
22 | soon as possible and report any findings and recommendations | ||||||
23 | upon completion in accordance with the provisions of Section | ||||||
24 | 3-14 of the Illinois State Auditing Act.
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