Illinois General Assembly - Full Text of HR1248
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Full Text of HR1248  97th General Assembly




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2    WHEREAS, The Illinois Department of Corrections
3(Department) has approximately 47,000 inmates at its 27
4correctional centers; and
5    WHEREAS, In 2011, the Department of Healthcare and Family
6Services awarded a 10-year, $1.36 billion contract to Wexford
7Health Sources, Inc. (Vendor) to "provide comprehensive
8medical and mental health services to offenders [in the custody
9of the Department]... in order to maintain their health status,
10establish innovative and cost effective medical and
11administrative programs, improve the quality of care, provide
12acceptable, cost effective levels of staffing, [and]
13positively impact purchasing of pharmaceutical and/or medical
14supplies"; and
15    WHEREAS, Pursuant to the solicitation for the contract
16awarded to the Vendor, the Vendor is required to provide
17services at targeted performance levels (including compliance
18with staffing schedules, administrative directives, and
19treatment protocols) with any failure to meet the target levels
20of performance subjecting the Vendor to payment adjustments;
22    WHEREAS, Also pursuant to the solicitation, the Department



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1is required to "[c]onduct audits to confirm the validity of the
2performance guarantee results reported and enforce penalties
3as appropriate"; and
4    WHEREAS, The Department has indicated that it would
5"contract with a vendor outside the comprehensive medical
6contract to audit activities of the comprehensive medical
7provider"; and
8    WHEREAS, The Vendor is required to submit monthly
9utilization reports detailing inpatient hospitalization
10referrals, outpatient referrals, emergency services referrals,
11primary healthcare services utilization data, and
12pharmaceutical usage; and
13    WHEREAS, At the time the solicitation was issued, the
14Department was pursuing accreditation from the American
15Correctional Association for its facilities and projected that
16the accreditation would occur within 3 years; and
17    WHEREAS, At the time the solicitation was issued, the
18Department identified approximately 250 pending inmate
19healthcare lawsuits in which the State, its employees, or
20agents were named parties; and
21    WHEREAS, A Department administrative directive requires



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1each correctional center to "develop a comprehensive Quality
2Improvement Program that provides for the systematic,
3on-going, objective monitoring and evaluation of the quality
4and appropriateness of offender care", including an internal
5audit of the directive to be conducted at least semi-annually;
6therefore, be it
9the Auditor General is directed to conduct a management audit
10of the Department of Corrections' implementation of a
11comprehensive medical and mental health services program for
12adult offenders; and be it further
13    RESOLVED, That the audit include, but not be limited to,
14the 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 is 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
18other entity having information relevant to this audit
19cooperate fully and promptly with the Auditor General's Office
20in the conducting of this audit; and be it further
21    RESOLVED, That the Auditor General commence this audit as
22soon as possible and report any findings and recommendations
23upon completion in accordance with the provisions of Section
243-14 of the Illinois State Auditing Act.