Scope of Service

The Provider will provide the services of a Quality Administrator (QA) staff position(s). The QA(s) will function as part of the community agency's quality improvement or quality assurance department with strong oversight for community service delivery to Williams Class Members. The Quality Administrator serves as the conduit for information and reporting between the Department of Human Services/Division of Mental Health (DMH) and the contracted Williams agency. DMH funds this position to be independent of direct care service delivery to Class Members, but responsible for all information on the interface of services and coordination of care outcomes to the Department. The provider will ensure that the QA(s):

  1. Participates in DHS/DMH training (including training on the duties and responsibilities of the QA staff position(s)), quality initiatives, Quality Improvement Committee meetings, and any other related DHS/DMH quality initiatives deemed necessary by DHS/DMH
  2. Serves as the single point of contact with DHS/DMH regarding assigned Class Members and transition related issues.
  3. Receives referrals on Class Member case assignments from DHS/DMH
  4. Assures assignment of Class Member cases to the provider's direct care team services or appropriate staff
  5. Provides oversight of all Williams related processes and policies
  6. Provides direction to clinical staff serving Class Members with significant oversight into job performance and productivity
  7. Is responsible for the provision of reports and data to DHS/DMH in prescribed formats to facilitate DHS/DMH tracking and monitoring.
  8. Monitors multiple aspects of the transition and services being received by Class Members, such completion of the Comprehensive Service Plans, development of the Treatment Plan and the actual services provided, post transition, as well as the consumers stability, wellness in the community (housing management, medication management, eating, socialization, etc.) and ongoing mental health services provided. Documentation is via review of the actual Treatment Plan and ongoing progress notes, as well as participation in daily team meetings.
  9. Is responsible for monitoring the Comprehensive Service Plan and documenting Service Plan quality indicators.
  10. Is responsible for monitoring the Risk Assessment and Mitigation Strategies for individuals who have transitioned to the community.
  11. Conducts quality visits to Class Members for the first twelve months, post transition.

Deliverables

The QA(s) is/are responsible for services and the provision of reports and data to DHS/DMH. Reports and data shall be separated by consent decree and/or program. Services and reporting to DHS/DMH will include (but not be limited to):

  1. Routine quality reports, including a completed Transition Checklist for each client placed in the community, documentation of completed Comprehensive Service Plans and Risk Assessment and Mitigation Strategies for Individuals Transitioning into the Community, completed prior to transition.
  2. Sentinel indicator completed upon notification of a Critical Incident, within 24 hours, resulting in a Root Cause Analysis to be completed within 72 hours.
  3. Notification to DHS/DMH when barriers or other problems or issues arise in assuring that clients can access and continue to receive needed services and supports
  4. Monitoring the multiple aspects of the transition, services and supports as detailed and planned in the individual's Comprehensive Service Plan (inclusive of services and supports beyond just mental health services) for assigned clients, with a minimum monitoring schedule of:
    1. at least weekly from initial assignment to the provider through the first four weeks following the client's move into their community placement
    2. at least every other week for the second four weeks following the client's move into their community placement
    3. at least monthly for the remaining twelve months following the client's move into their community placement
  5. Documentation of the QA's monitoring of the transition, services and supports received by clients, as well as the quality of the services. Monitoring is to be conducted by:
    1. Attendance at service planning meetings, including service team meetings
    2. Review of clinical record documentation
    3. Through direct interview and observation of the client in their current living situation or other location

Reporting Requirements:

  1. Financial Report in accordance with Exhibit C.
  2. Performance Report in accordance with Exhibit E.

Payment

Payment will be issued monthly and reconciled on the basis of reported allowable expenses per the Grant Funds Recovery Act [30ILCS 705/7 and 8].

The Provider shall report quarterly allowable grant expenses on the appropriate DMH reporting template to the DMH program contact no later than November 1, February 1, May 1, and August 1, and reported expenses should be consistent with the submitted annual grant budget. If any budget variances are noted, the DMH program contact may request that the provider submit a revised grant budget before subsequent monthly payments will be made. DMH program contacts and reporting templates can be found in the Provider section of the DHS website.

Performance Measures

The Provider shall report quarterly performance on the appropriate DMH reporting template to the DMH program contact no later than November 1, February 1, May 1, and August 1. DMH program contacts and reporting templates can be found in the Provider section of the DHS website.

The following are included in the reporting template:

  1. Completes routine quality reports, including a completed Transition Checklist for each client placed in the community, documentation of completed Comprehensive Service Plans and Risk Assessment and Mitigation Strategies for Individuals Transitioning into the Community, completed prior to transition.
  2. Receives case assignments from DMH and timely process assignments to clinical teams, accordingly.
  3. Prepares sentinel indicators completed upon notification of a Reportable Incidents, within 24 hours, resulting in a Root Cause Analysis to be completed within 72 hours.
  4. Monitors the multiple aspects of the transition, services and supports as detailed and planned in the individual's Comprehensive Service Plan (inclusive of services and supports beyond just mental health services) for assigned Class Members, with a minimum monitoring schedule of:
    1. at least weekly from initial assignment to the provider through the first four weeks following the Class Member's move to community settlement
    2. at least every other week for the second four weeks following the Class Member's move to community settlement
    3. At least monthly for the remaining twelve months following the Class Member's move to community settlement.
  5. Provides documentation of the QA's monitoring of the transition, service and support activities received by the Class Members, as well as the quality of the services. Monitoring is to be conducted by:
    1. Review of clinical record documentation
    2. Through direct interview and observation of the Class Member in their current living situation or other location.

Performance Standards

  1. 100% of quality reports and supporting documentation requested will be submitted to DMH within the designated time frames.
  2. 100% of cases assigned by DMH to the agency will be expeditiously processed to appropriate clinical teams.
  3. 100% of sentinel events reports, including Critical Incidents and Root Cause Analyses will be submitted to DMH within 24 hours and 72 hours, respectively, of the incident
  4. 100% of the Class Members' Comprehensive Service Plans will be monitored in accordance to DMH policies and expectations.
    1. 100% of Class Members will have a weekly monitoring visit during the first month of transition.
    2. 100% of Class Members will have a bi-weekly monitoring visit during the second month, post transition.
    3. 100% of Class Members will have a monthly visit for the remaining months, post transition.
  5. 100% of quality monitoring visits and documentation will be contained in the Class Members service file, including review of clinical records and direct observation and interviews.