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PELLETIER RESUME 112216

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PELLETIER RESUME 112216

  1. 1. Michael S. Pelletier, M.A. SKILLS: Mission/value driven Policy development Sound fiscal focus Revenue generation Cost analysis expertise Program development Clinical Background Assertive business manager Diversity Sensitivity Team builder/Team leader Community relations focus Marketing savvy Contract management Performance management RFP development Video Production oversight Consumer focused Recovery oriented Accreditation maintained CON development Downsize/closure management Public and Private sector exposure Professional Experience Independent Contractor, State of Illinois Division of Mental Health November 2016 - Present Provide expert guidance on the development of contracts for outpatient providers to manage alternative ambulatory services for persons with significant history of mental illnesses who might otherwise be candidates for long term care or for those persons involved with the criminal justice system. Hospital Administrator, State of Illinois Division of Mental Health April 2016- November 2016 Under contract to provide complete operational authority for a 124 bed state operated psychiatric hospital. Direct reports included Medical Director, Chief Nursing officer, Quality Manager, Chief Engineer, Security Chief, Business Manager, Safety Officer upon others. Lead team through CMMS and TJC surveys, resolving all outstanding issues for successful final reports. Oriented and trained (3 months) incoming Hospital Administrator Interim Program Director Acadia Healthcare Psychiatric Resources Partners (PRP) April 2015 – May 2015 (2 months) Easton Pennsylvania Served in an interim capacity at a CHS Pennsylvania hospital to assist in the startup and opening of a 16 bed inpatient older adult behavioral Health unit. Senior Public Service Administrator, State of Illinois, Department of Human Services (DHS) Division of Mental Health (DMH) January 2004 – January 2015 (retired) SUMMARY: During employed tenure and since 2004 I acted continuously as a member of the Senior management team of the Division of Mental Health, reporting directly to the Director of the Division of Mental Health (DMH) / Director of the Division of Alcoholism and Substance Abuse (DASA). DMH has an annual budget of $800+ million and is the state of Illinois’ Mental Health authority, operating 7 state operated psychiatric hospitals, an inpatient Treatment and Detention Center and contracts, funds and monitors mental health services to over 160 community agencies throughout the state. As the Special Assistant to the Director I had multiple high level executive, operational, policy, legislative projects assigned to me for my actions. Provided executive leadership during transition of closing two state operated hospitals within a 6 month period. Wrote and provided expertise in all areas of legislative matters relating to closure. Developed and contracted for outpatient replacement services in two distinct areas of the state with over 30 inpatient and outpatient providers for over $18,000,000 in alternative care programming.
  2. 2. MAJOR PROJECTS: Served as Interim Hospital Administrator (9-29-14 to 1-31-15) for the Elgin Mental Health Center (EMHC), a 419 bed mixed civil and forensic state operated psychiatric hospital. Provided leadership to correct deficiencies noted in The Joint Commission (TJC) and especially Center for Medicare and Medicare (CMS) services site surveys that threatened de-certification of the EMHC. Provided comprehensive assessment and development of policies, procedures for clinical, life safety and major capital issues that when put into place secured re-certification. Provided day to day operations management of the EMHC as well as focusing on an intensive hiring initiative and project to reduce overtime costs. Developed and analyzed bed-need analysis and review of operational capacity for state-operated psychiatric hospitals. Provided to leadership a comprehensive assessment of needs and recommendation for downsizing and right sizing existing State operated beds based on utilization patterns, trending in BH admissions and length of stay data, projection of impact of ACA onto the current state operated inpatient system of care and other statutory and regulatory considerations. Provided in-depth research, policy analysis and strategic planning in review of managed care practices specific to services to persons with mental illnesses using Medicaid and indigent funding sources. Included assistance in preparation and interactions with senior level staff in Governor’s and Management and Budget offices and recommendations to the Department of Healthcare and Family Services (HFS) and DMH executive staff on contracting with Medicaid and MMAI managed care organizations for state operated services. Modified draft Administrative Rule for community based Residential services capacity (Crisis, Supervised and Supported level) within the structure of the existing capacity grant programs for DMH with planned progression into Fee for Service funding. Analyzed pricing methodologies along with clinical care requirements to develop a comprehensive proposed rule. Negotiated with statewide trade organizations on philosophy, concept detail and rate methodology in proposed rule. Developed policy recommendation for the management of and monitoring of grants with state funded community agencies providing Community Mental Health Center services - outpatient behavioral health – as well as community residential and other related BH services on behalf of the Department of Human Services Division of Mental Health. Developed and assisted to maintain strategic, fiscal & operational goals for both segments - Inpatient and Outpatient - of the state operated or state (DMH) supported care delivery network. Maintained intimate understanding of actions necessary to maintain compliance to federal, state regulatory and accreditation agencies standards. Analyzed, assessed, developed and monitored actions that supported the division’s actions for restructuring the mental health services delivery structure in the Region 2W area (aka Northwest Crisis Care System) specifically related to evaluating, determining and acting upon the recommendation to replace Psychiatric hospital services with community based alternative care to respond to the closure of the Singer MHC, (accomplished on 9-1-12). This included the assessment of the need for a replacement inpatient capacity and considered utilization and cost projections for community based treatment alternatives; developed a Request for Information (RFI) process in addition assessed all responses to the RFI and the development of contracts for all alternative treatment programs and models for the provision of inpatient and outpatient care ($7.3 million to 8 CMHCs and 5 hospitals). Actions also included complete preparation of the discontinuation application (CON) for the Singer MHC to the Health Facilities Services Review Board (HFSRB), preparation for self and other DHS executives and multiple personal testimonies before the HFSRB and in front of legislative committees, the Commission On Governmental Fiscal Accountability (CGFA), community based public hearings, legislative commissions and other state regulatory bodies as well as provided continuing updates and reports to Governor’s Office of Management and Budget and DHS Executive staff. Wrote extensive executive summary for DHS leadership and
  3. 3. Governor’s office related to the implementation and results of the Crisis Care systems as developed to support the closure of the Tinley Park MHC and the Singer MHC. Analyzed, assessed, monitored actions that supported the division’s actions for restructuring the mental health services delivery structure in the Region 1 South area (Region 1 South Crisis Care System) specifically related to evaluating, determining and acting upon the recommendation to replace Psychiatric hospital services with community based alternative care for the Tinley Park MHC closed on 7-1-12. This included the assessment of the need for a replacement inpatient capacity and considered utilization and cost projections for community based treatment alternatives; developed a Request for Information (RFI) process and additionally assessed all responses to the RFI and developed contracts for all alternative models for the provision of inpatient and outpatient care ($11.0 million to 11 CMHCs and 9 hospitals). Actions included preparation and shared testimony in front of legislative committees- Commission on Governmental Fiscal Accountability (CGFA)-, public hearings, legislative commissions and other state regulatory bodies with continuing updates and reports to Governor’s offices and Management and Budget offices. Actions included complete preparation of the reports to the Health Facilities Services Review Board (HFSRB) to facilitate the closure of the Tinley Park MHC under current HFSRB standards and rules. Preparation of all materials for distribution to HFSRB. Wrote extensive executive summary for DHS leadership and Governor’s office related to the implementation and results of the Crisis Care systems as developed to support the closure of the Tinley Park MHC and the Singer MHC. Developed initial policy analysis, programmatic, operational and contractual terms as well as financial structuring and continued monitoring of the CHIPS project (Community Hospitals Inpatient Psychiatric Services) while assisting regional staff in maintaining local contracts in both the Northwest (NCCS) and the Region 1 South Crisis Care Systems (R1SCCS). These contracts were privatization contracts for access to inpatient psychiatric beds days in community hospitals. Responsibilities included policy development, adherence monitoring, contract writing and revisions, provider relations, utilization oversight and claims processing and technical assistance. Original Program was discontinued in FY10 but re-initiated with FY12 state hospital rebalancing efforts for R1SCCS and NCCS. Acted as Permanent representative from Department of Human Services as ex-officio member to the Illinois Health Facilities Services Review Board (HFSRB-formerly Health Facilities Planning Board). Advised the Director in my preparation for and analysis of all materials presented before the Board for consideration related to Behavioral Health services. Acted as permanent designee representative for Department of Human Services on the State of Illinois, Hospital Licensing Board predominantly representing the interests of Behavioral Health service delivery. Was the primary contact for DMH to Illinois Department of Public Health for purposes Hospital survey questionnaires, EMTALA actions as well as other BH subject matter expertise and functions. Provided full project management for a two day state-wide conference related to the integration of Behavioral Health and Medical health systems of care. Interfaced with state agency directors in Public Health (IDPH), Children and Family Services (DCFS), Healthcare and Family Service (DHFS), Department of Human Services (DHS) and DHS, Division of Substance Abuse (DASA), FQHCs and Rural Health Centers. Recruited all program participants; coordinated all programmatic material, provided review of all participant’s presentations. Coordinated contract with vendor for site conference management. Provided in-depth research, policy analysis and strategic planning in review of managed care practices specific to services to persons with mental illnesses using Medicaid and indigent funding sources. Included assistance in preparation and interactions with senior level staff in Governor’s and Management and Budget offices.
  4. 4. Provided policy analysis and strategic planning for the provision of acute care BH services using alternative programmatic and financing structures, based on research and analysis of patterns of publicly and private funded programs in other states. Maintained as technical expert to DMH on the HFS development, implementation and contracting for Accountable Care Entities (ACEs) and Care Coordination Entities (CCEs). Maintained understanding of the implementation of both projects including full roll out and analysis of possible new policy standards for DMH and an impact analysis to the existing DMH funded services. Acted as DMH technical expert and operational interface representative to Healthcare Family Services (HFS) on the Integrated Care Project (ICP) which placed @ 36,000 Medicaid Disabled persons residing in the five collar counties and suburban Cook County into a managed care arrangement. Insured appropriate interface with awarded contractees to insure a smooth transition of care delivery and imparted onto Contractees a full understanding of DMH operations, contracting and financing mechanisms, reimbursement structures and mission imperatives. Reviewed contract management for Inpatient state operated services. Maintained as technical expert to HFS in the development and implementation of the Integrated Care Project (managed care) as well as the precursor Primary Care Case Management (PCCM) project. Implementation of both projects include full roll out inclusive of policy and development of BH specific performance measure development and implementation of the enrollment processes through a HFS contracted enrollment broker. Serviced as division’s technical expert on policy, the opportunities available and actions required under the Accountable Care Act (Healthcare Reform bill). Maintained operational control over the division’s “SAY IT OUT LOUD” campaign, an information awareness multi-media campaign targeted towards educating and empowering a broad base of persons, including consumer, family members, advocates, non-traditional support personnel and providers, to better identify their needs and assist in their ability to access MH services. Managed the Request for Proposal (RFP) process for, contracted, managed and monitored a vendor engaged to develop, produce and launch a statewide multimedia public awareness campaign targeting the reduction of stigma towards persons with mental illnesses. Budget of $500,000, annually. Website and promotional activities are still operational and occurring, see SIOL above. Assisted in the overall public relations and communications functions of the Division of Mental Health. Assists Director, as requested, in preparations for lectures, workshops, invited conferences with speech or presentation development. Analyzed and developed programs and services on behalf of the Division for accessing funds from the American Recovery and Reinvestment Act (ARRA). Managed a major project with consultants to analyze the bed capacity needs and cost projections for Metro South (Chicago) area in preparation for possible closure of Tinley Park MHC. The project also reviewed the community services available and needed in order to respond to inpatient and ambulatory service demands. The project was built using models that were to be used for a bed needs analysis for other state- operated psychiatric hospitals. Assembled workgroups and complied their reports for the Governor’s Campus Security Task Force. This was an initiative that advised colleges and university with recommendations to assist them in developing or augmenting their counseling or crisis services capacity, as well as policies and emergency management plans in anticipation or response to any acts of violence on campus.
  5. 5. Acted as Divisional onsite representative at Northern Illinois University (NIU) assisting in the state’s overall response and assistance to the university subsequent to the tragic shooting incident of 2008. Managed a project in collaboration with Healthcare and Family Services (HFS) that reviewed how to set up programs, policy, financing and all programmatic developments necessary for the implementation of pre- screening services for inpatient psychiatric admissions for adult indigent and public aid recipients (aka Adult SASS). Provided extensive budgetary modeling and significant project management work with contractors and community representatives. Project management in collaboration with Healthcare and Family Services (HFS) for the assessment and tracking of medical costs, policy formulation and contract negotiations for medical services to all state operated hospitals; developed and maintained a formal relationship with other state agencies concerning this maintenance of effort. Developed and monitored processes to assist DMH grant funded agencies in identifying and the re- submission of billing errors on MRO (Medicaid Rehab Option) claims and identifying retrospective billing opportunities for MRO billing (MAXX initiative). $5 million new federal dollars secured. Develop and trained hospital and provider agency staff statewide on the processes necessary to assist consumers to access Disability determinations and other Public Aid benefits in more expedited fashion. Job Title: Facility Director (CEO ) / Network Manager March 2001 – March 2004 State of Illinois/Department of Human Services/Division of Mental Health/Elgin Mental Health Center Served as Facility Director-CEO/Network Manager, Metro Suburban Comprehensive Community Network, Division of Mental Health Region 2. Assumed full statutory authority for the management of the Elgin Mental Health Center, a 390-bed inpatient psychiatric state operated hospital (SOH) with 860 employees. This is mixed use civil and forensic hospital. Acted as Governing Body and CEO for the Elgin Mental Health Center. Maintained through subordinate personnel, compliance to clinical standards of care. Maintained budgetary control over annual budget of @$100 million. Supervised and maintained the compliance to federal, state and accreditation agencies standards. Maintained, monitored and negotiated grants with 19 distinct state funded community agencies providing Community Mental Health Center services -outpatient behavioral health - services on behalf of the Department of Human Services Division of Mental Health (now Region 2). Developed and maintained standards, policy & procedures, strategic, fiscal & operational goals for both segments - Inpatient and Outpatient - of the care delivery network. Job Title: Assistant Administrator, Behavioral Health 1997-2001 Saint Mary of Nazareth Hospital Center, Chicago, Illinois Employed 1975-2001 Assumed full administrative control as senior manager for 63 bed inpatient Psychiatric program and full Comprehensive Community Mental Health Center. Included inpatient units for adults (2) and Adolescent and Pediatric populations; Outpatient services for Adults and Child / Adolescent consumers. Services in outpatient included state of Illinois grant funded programs for Outpatient, Crisis Intervention, Partial Hospital and Psycho-Social Rehabilitation programs. Monitored and maintained compliance to all federal, state and accreditation agencies standards; monitored compliance to secure state grant funds; Opened new Pediatric, Adult Medical-Surgical units; supervised remodeling of new Pediatric and two Adult care units; monitored business and clinical practices of all subordinate staff; represented Hospital at all state DHS/DMH meetings; represented Hospital as a managing director at ACCORD Inc., a carve out managed care organization with 160,000 covered lives for behavioral health services. Job Title: Administrative Director, Mental Health Center 1986- 1997 Saint Mary of Nazareth Hospital Center, Chicago, Illinois
  6. 6. Responsible for day-to-day operations of the outpatient and inpatient programs and services at a community general not-for-profit hospital. Also provided budgetary, policy procedural oversight of these programs. Developed strategic goals planned marketing activities and community relations promotions. Maintained federal and state and JCAHO accreditation Job Title: Clinical Therapist. Outpatient Mental Health Center 1975- 1986 Saint Mary of Nazareth Hospital Center, Chicago, Illinois Performed Psychological services / testing for child and adult populations; performed clinical assessments; performed individual, group and family psychotherapy. Review qualitative and quantitative business and clinical practices for senior administrative staff.. Education: Degree: Master of Arts in Psychology, 1975 Roosevelt University, Chicago, Illinois Degree: Bachelor of Arts in Psychology, 1972 Benedictine University, formerly Illinois Benedictine College and St. Procopius College, Lisle Illinois PERSONAL CONTACT information: 847-337-8167 email: micste011@hotmail.com REFERENCES: On request OBJECTIVE: Increasing levels of responsibility in terms of management, administrative and policy formulation within the Healthcare industry particularly within the Behavioral Health field, both public and private sector.
  7. 7. Responsible for day-to-day operations of the outpatient and inpatient programs and services at a community general not-for-profit hospital. Also provided budgetary, policy procedural oversight of these programs. Developed strategic goals planned marketing activities and community relations promotions. Maintained federal and state and JCAHO accreditation Job Title: Clinical Therapist. Outpatient Mental Health Center 1975- 1986 Saint Mary of Nazareth Hospital Center, Chicago, Illinois Performed Psychological services / testing for child and adult populations; performed clinical assessments; performed individual, group and family psychotherapy. Review qualitative and quantitative business and clinical practices for senior administrative staff.. Education: Degree: Master of Arts in Psychology, 1975 Roosevelt University, Chicago, Illinois Degree: Bachelor of Arts in Psychology, 1972 Benedictine University, formerly Illinois Benedictine College and St. Procopius College, Lisle Illinois PERSONAL CONTACT information: 847-337-8167 email: micste011@hotmail.com REFERENCES: On request OBJECTIVE: Increasing levels of responsibility in terms of management, administrative and policy formulation within the Healthcare industry particularly within the Behavioral Health field, both public and private sector.

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