Scope of Service

This funding will be used for the enhancement of integrating physical and behavioral health care by building local community-based infrastructures that will allow the Colbert and Williams community mental health providers better access and information to evaluate and coordinate total physical health care and behavioral health care. This infrastructure will assist individuals to maintain optimal wellness in the community setting. Persons with mental illnesses have a higher predominance of health care challenges. Attention to their mental illnesses cannot be separated from attention to their physical health. An integrated approach will assure that both critical needs to wellness are addressed at the same time, through a coordinated effort.

Deliverables

The provider will be required to submit, to DHS/DMH regional contract manager for approval, a description of their plan to integrate health care with ongoing mental health service delivery.

The plan must specify:

  1. Number of medical staff positions to be employed
  2. Job descriptions and qualifications for each identified position
  3. Identification of key health care indicators to be collected, such as percentages of Class Members with complex co-morbid medical conditions, including, cardiology, Chronic Obstructive Pulmonary Disease (COPD), brittle diabetes, hypertension, obesity, etc.
  4. Time frames for monitoring and follow-up visits
  5. Track measures for unscheduled Emergency Room (ER) visits, hospitalizations, deaths

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. Number of health care positions employed
  2. Number of completed job descriptions with qualifications on file
  3. Number of unduplicated Class Members seen by Integrated Health Care staff services during the first 30 days post transition from the NF/IMD
  4. Number of Class Members with high risk health challenges seen weekly by RN for vital checks (blood pressure checks, blood sugar, weight)
  5. Number of Class Members scheduled for routine annual medical evaluation visits
  6. Number of Class Members scheduled for specialty health care visits
  7. Number of Class Members who had an unscheduled ER visits
  8. Number of Class Members in which the ER visit resulted in a medical hospitalization
  9. Number of Class Members who had medical consultations
  10. Number of Reportable Incidents due to health care complications
  11. Number of Reportable Incidents due to death that occurred during the quarter

Performance Standards

  1. 100% of positions identified for employment will be filled
  2. 100% of job descriptions with staff qualifications will be on file
  3. 100% of Class Members referred to Integrated Health Care staff will be seen during the first 30 days post transition.
  4. 100% of Class Members who have high risk health challenges will be seen weekly by the RN
  5. 100% scheduled with Integrated Health Care will have a routine annual medical evaluation visit
  6. 100% of Class Members scheduled for a specialty health care visit will be seen in the scheduled month.
  7. 100% of Class Members who had an unscheduled ER visit will have a follow up visit by the RN within three days.
  8. 100% of Class Members who had a medical hospitalization will be seen by the RN within three days post discharge.
  9. 100% medical consultations will be attempted for any Class Member who did not consent to a RN visit after hospitalization or ER visit
  10. 100% Reportable Incident forms will be submitted for all incidents due to health care complications
  11. 100% Reportable Incident forms will be submitted on all deaths.