FY14 DHS/DMH Community Mental Health Provider Manual

FY14 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 14 Provider Manual - Definitions  
  5. Illinois Mental Health Collaborative for Access and Choice 

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. Community Based Service (Rule 132) - Medicaid Community Mental Health Tool (MMH)
  4. Provider Forms 
  5. Accreditation Standards/Requirements
    1. CARF International
    2. The Joint Commission
    3. CQL The Council on Quality and Leadership
    4. COA Council on Accreditation
    5. HFAP Healthcare Facilities Accreditation Program

III. CONSUMER ELIGIBILITY AND ENROLLMENT

  1. Consumer Eligibility, Enrollment/Registration and Benefit Groups
  2. Functional Standardized Assessments of Consumers Overview
    1. Level of Care Utilization System (LOCUS) 
    2. Columbia Impairment Scale 
    3. Ohio Department of Mental Health - Ohio Scales 
    4. Devereux Center for Resillient Children - DevereuxScale 
  3. Notice of DHS Community - Based Service - Estimating MH Medicaid Spend-down Status (pdf)

IV. MENTAL HEALTH SERVICES

  1. Service Definitions and Requirements
    1. Rule 132 59 ILAC, effective December 13, 2012
    2. Community Mental Health Providers (CMHP) Reimbursement-Service Definition and Reimbursement Guide (SDRG) 
    3. Community Based Services (Rule 132) - Training Presentations
    4. Rule 132 Questions and Answers
  2. Utilization Management Program
    1. Utilization Management Program
    2. Medical Necessity Criteria and Guidance Manual
  3. Capacity Grant Definitions and Requirements
    1. DMH Community Services Contract-Attachment B
  4. Forensic Services
    1. Training Manual for Unfit to Stand Trial (UST) (pdf)
    2. Revised Forensic Handbook (doc) 
  5. Child Mental Health Services (SASS)
    1.  Chapter CMH-200 (Children's Mental Health/SASS) (pdf)
    2. 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. Region I South Crisis Care System
    1. Policy and Procedures 
  9. Northwest Crisis Care System

V. PROVIDER MONITORING

  1. FY 14 Provider Monitoring
    1. Provider Monitoring External Protocols
    2. Post-Payment Review Tool
    3. Post-Payment Review Interpretive Guidelines
    4. CST Review Tool
    5. CST Interpretive Guidelines
    6. ACT Review Tool
    7. ACT Instructions
    8. Plan of Improvement Template
    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
    1. Illinois Mental Health Collaborative for Access and Choice - Provider Information - Batch Registration
    2. Illinois Mental Health Collaborative for Access and Choice - Provider Information - ProviderConnect Registration 
  2. HFS Claims Submission Information 
     
  3.  PAS Mental Health 
    1. PAS/MH Contractor's Procedure Manual
  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. WILLIAMS CONSENT DECREE 

  1. Williams Vs. Quinn 
  2. Resource Directory and Guide (RDG) for Williams Transition Coordinators 
  3. Individualized Comprehensive Service Plan Guide

IX.  Specialized Mental Health Rehabilitation Facilities (SMHRF) Comparable Services Provider Manual

X. Important Reference and Resource Documents

  1. Illinois Statutes
    1. Mental Health and Developmental Disabilities Confidentiality Act 
    2. Mental Health and Developmental Disabilities
    3. Children's Mental Health Act of 2003 
    4. Public Act 097 - 0515, Disclosure for Treatment and Coordination of Care
    5. Public Act 097-0689 (SMART) Act 
    6. Illinois Mental Health Community Services Act (405 ILCS 30)
    7. Mental Health and Developmental Disabilities Administrative Act (20 ILCS 1705) 
    8. Title 59 Mental Health 
  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
    2. USARF for Adults (pdf) 
  6. Coordination of Benefits, Provider Requirements (pdf)
  7. Performance Measures

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

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