FY13 DHS/DMH Community Mental Health Provider Manual

Table of Contents

I. INTRODUCTION

  1. DHS/DMH Mission/Vision Statement
  2. Philosophy of Recovery
  3. Illinois Mental Health Collaborative: Consumer and Family Handbook
  4. FY 13 Provider Manual - Definitions (pdf) 
  5. Description of Role: Background, History, and Goals of the Illinois Mental Health Collaborative

II. PROVIDER ELIGIBILITY

  1. DMH Community Services Contract-Attachment B 
  2. Medicaid Enrollment
    1. Provider Enrollment 
    2. Chapter CMH-100 
    3. Chapter CMH-200 Children's Mental Health (SASS) (pdf)
    4. Appendix (pdf)
  3. Certification
    1. Medicaid Community Mental Health Tool (MMH)
  4. Forms to make Changes to Provider Database 
  5. Accreditation Standards/Requirements
    1. Commission on Accreditation of Rehabilitative facilities (CARF) 
    2. Joint Commission on Accreditation of Healthcare Organization 
    3. Council on Quality and Leadership (The Council) 
    4. Council on Accreditation of Services for Families and Children (COA)
    5. Healthcare Facilities Accreditation Program (HFAP) 

III. CONSUMER ELIGIBILITY AND ENROLLMENT

  1. Consumer Eligibility, Enrollment/Registration and Benefit Groups (pdf)
  2. Functional Standardized Assessments of Consumers Overview (pdf) 
    1. Level of Care Utilization System (LOCUS) 
    2. Columbia Impairment Scale 
    3. Ohio Scales 
    4. Devereux Scale  
  3. Estimating MH spending for individuals on Medicaid Spend-down Status (HFS Form 2653) (pdf)

IV. MENTAL HEALTH SERVICES

  1. Service Definitions and Requirements
    1. 59 ILAC 132, Revised 07.01.2008
    2. Community Mental Health Provider's Reimbursement Guide
    3. Revised Rule 132 Training Presentation (ppt)
    4. Rule 132 Questions and Answers
  2. Utilization Management Program
    1. Overview of Utilization Management Program (pdf) 
    2. Medical Necessity Criteria and Guidance Manual
  3. Capacity Grants,
    1. DMH Community Services Contract-Attachment B
  4. Forensic Services
    1. Training Manual for Unfit to Stand Trial (UST) (pdf) 
    2. Revised Forensic Handbook (pdf)
  5. Child Mental Health Services (SASS)
    1. Chapter CMH-200 (Children's Mental Health/SASS) (pdf)
      1. Appendix (pdf) 
  6. Pre-Admission Screening/Mental Health (PAS/MH)
    1. PAS/MH Contractor's Procedure Manual (pdf) 
  7. Title XX/ Donated Funds Initiative Program Manual
  8. Williams Consent Decree 
  9. Region I South Crisis Care System 
    1. Policy and Procedures 
  10. Region 2 Crisis Care System 


V. PROVIDER MONITORING

  1. FY 13 Provider Monitoring
    1. Provider Monitoring External Protocols (doc)
    2. Post Payment Review Tool (doc)
    3. Post Payment Review Interpretive Guidelines (doc)
    4. CST Review Tool (pdf)
    5. CST Interpretive Guidelines (pdf)
    6. ACT Review Tool (pdf)
    7. ACT Instructions (pdf) 
    8. Plan of Improvement Template (doc)
    9. ICG Documentation Review Tool (doc)
  2. Provider Complaints and Appeals
    1. Medicaid-59 ILAC 132.44 

VI. CLAIMS SUBMISSION FOR COMMUNITY SERVICES 

  1. DHS/DMH Registration 
  2. HFS Claims Submission Information  
  3. PAS Mental Health
    1. PAS/MH Contractor's Procedure Manual (pdf)
  4. SASS claims (direct submission to HFS)
    1. Chapter CMH-100, DHFS Handbook
    2. Chapter CMH-200, DHFS Handbook
    3. Chapter CMH-300, DHFS Handbook

VII. ICG

  1. ICG Services Manual (pdf) 
  2. ICG Claims (refer to claims section)
  3. 59 ILAC 135
  4. Eligibility Criteria for the Individual Care Grant
  5. Frequently Asked Questions - ICG 

VIII. IMPORTANT REFERENCE AND RESOURCE DOCUMENTS

  1. Illinois Statutes
    1. Mental Health and Developmental Disabilities Confidentiality Act
    2. Mental Health and Developmental Disabilities Code
    3. Children's Mental Health Act of 2003 (pdf) 
    4. Public Act 097 - 0515, Disclosure for Treatment and Coordination of Care 
  2. Important Federal Policies, Regulations, and Reports
    1. Code of Federal Regulations (CFR) 
    2. United States Code (USC) 
    3. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) 
    4. Surgeon General's Report on Mental Health, 1999 
    5. President's New Freedom Commission's Report on Mental Health, 2003 
  3. Illinois Provider Tools and Resources
    1. Management Information System Resources Tool (pdf)
  4. Evidence Based Practices:
    1. Dartmouth IPS Supported Employment Center 
    2. SAMHSA Registry of Evidence Based Practices 
  5. Continuity of Care
    1. Continuity of Care Strategic Planning Guidelines (pdf)
    2. USARF for Adolescents (pdf)
    3. USARF for Adults (pdf)
  6. Coordination of Benefits, Provider Requirements (pdf) 
  7. Performance Measures (pdf)


NOTE: For accessible versions of any of these documents, please contact

  • Richard Jones
  • 217/ 785-3298 (voice)
  • 217/ 785-3066 (fax)