Scope of Service

Provider will facilitate the completion of a professional clinical, functional, strength- based assessments for each consenting Consent Decree Class Member referral, to determine his or her capability to transition from the respective nursing facilities' Institutions for Mental Disease/Specialized Mental health Rehabilitation Facility and Skilled Nursing Facilities (NF/IMD/SMHRF and SNF) to a self-contained lease-held rental apartment (Permanent Supportive Housing) or appropriate community housing alternative. This assessment is to recommend the most appropriate level of care setting and, if transition is the outcome, the array of mental health support services (Assertive Community Treatment or Community Support Team or case management, etc.) in the mental health service taxonomy and other ancillary State Plan services, necessary to move individuals from the NF/IMDs /SMHRF and SNF as part of the Williams and Colbert Consent Decrees.

The Williams and Colbert Consent Decrees require strength based assessments, those that consider goals, interests and desires, as well as explore other indicators such as risks (medical, behavioral and physical), criminal histories, functional capability and cognitive abilities, are conducted on all remaining, consenting residents of the NF/IMDs/SMHRFs and SNFs. In addition, Consent Decree Class Members' assessments that do not result in a transition will have a scheduled annual re-review. Consent Decree Class Members, who are not recommended to transition, may request a review up to four times (once per quarter) within a twelve month period.

Deliverables

Provider will hire a full complement of licensed, clinical professionals to conduct a designated target number of Resident Review assessments, annual reassessments and quarterly assessments upon request.

Reports and data shall be separated by the respective Consent Decree. The provider will:

  1. Maintain a full array of licensed (LPHA, LCSW, RNs (with a concentration in psychiatry), clinically trained staff with expertise in mental health and or behavioral health.
  2. Complete record review of Williams Class Members to be seen for a Resident Review assessment
  3. Approach Williams Class Members to obtain consent to conduct a Resident Review assessment
  4. Conduct and complete Resident Review assessments on consenting Class Members (initially, annually or upon request every four months)
  5. Submit full completed Resident Review assessments to DMH for data input within 7 business days post completion
  6. Submit Invoices to DMH, by Class Member's name, on activities initiated to complete a Resident Review assessment
  7. Assure that staff participates in hosted/scheduled training sessions, webinars or teleconferences.

Resident Review assessments will include:

  1. Preparation time to review the clinical record
  2. Phone or face-to-face discussions with collateral contacts (family, friends or guardians) as well as key IMD staff (Director of Nursing, Social Services and IMD administrator, etc.)
  3. Face-to-face interviews with the Class Member, using established Resident Review assessment tool.
  4. Completion of a full clinical write-up assessment with recommendations. Each reviewer is expected to produce (at a minimum) one completed, full assessment, per day.

Reporting Requirements:

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

Payment

Payment will be issued in response to Provider submitted monthly invoices on the appropriate DMH invoice template at the established rate(s) (if applicable). Invoices shall be submitted to the DMH program contact by the 15th day of the month following service, and will be reconciled on the basis of reported allowable expenses per the Grant Funds Recovery Act [30 ILCS 705/7 and 8]. (The Grant Funds Recovery Act is not applicable to Fixed-Rate Grants.) All invoices shall be HIPPA compliant and encrypted utilizing DHS approved encryption software.

Rates:

  1. $550: Full Review.
  2. $475: Partial Review. This is a Face to Face Resident Review initiated, but not completed due to one of the following reasons. Documentation of the reason(s) for non-completion must be contained in the Resident Review Summary section:
    1. Consent Decree Class Member referral refused to complete the process or changed his/her mind about continuing the process;
    2. Consent Decree Class Member referral's cognitive or functional capability to complete the process was limited or compromised;
    3. Consent Decree Class Member referral was hospitalized before completion and did not return to the facility;
    4. Consent Decree Class Member referral left the facility Against Medical Advice before completion;
    5. Consent Decree Class Member referral died before completion.
    6. Other (to be explained)
  3. $375: Intake Only. This includes Resident Review preparation activities, such as reviewing IMD/SMHRF/NF records; obtaining Consent Decree Class Member referral's consent to be assessed; contacting collaterals or significant others to obtain more information with written consent of the Consent Decree Class Member referral; pursuing the guardian (if applicable) for his/her written consent (phone contact, letters, etc.) to conduct the assessment; and/or other related activities which do not lead to a completed Resident Review.
  4. $100: Minimum Activity. These are encounters that include all activities that do not constitute conversation or contact with a Consent Decree Class Member referral, a family member, guardian or collateral, a chart review, staffing on behalf of a Consent Decree Class Member referral and/or actions that are not preparation activities to conduct a Resident Review.

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 full/part-time staff in employment, meeting credentials as a Resident Reviewer
  2. Number of unduplicated records reviewed in preparation for completing a Resident Review assessment
  3. Number of Class Members approached for consent to be assessed
  4. Number of Class Members approached/initiated for a Resident Review assessment, but refused to be assessed
  5. Number of unduplicated Class Members for whom a full Resident Review assessment is completed
  6. Number of duplicated Class Members for whom a full Resident Review assessment is completed
  7. Number of unduplicated Class Members who abort the Resident Review assessment before completion
  8. Number of unduplicated Class Members assessed and recommended for transition
  9. Number of unduplicated Class Members assessed and not recommended for transition
  10. Number of Resident Review outcomes submitted to DMH
  11. Number of staff participating in DMH hosted trainings or webinars

Performance Standards

  1. 90% of credentialed staff will be in full/part-time employment, per contract agreement, at all times.
  2. 100% of records assigned for assessment will be reviewed in preparation for the assessment
  3. 100% of Class Members scheduled will be approached for consent to complete the Resident Review assessment
  4. 100% of Class Members approached, but who subsequently refuse to be assessed will be documented in the Resident Review paperwork
  5. 80% of consenting, unduplicated, Class Members will have a Resident Review assessment completed
  6. 80% of consenting, duplicated, Class Members will have a Resident Review assessment completed
  7. 20% of unduplicated Class Members abort the Resident Review assessment before completion
  8. 70% of unduplicated Class Members assessed are recommended for transition
  9. 30% of unduplicated Class Members assessed are not recommended for transition
  10. 100% of Resident Review outcomes are submitted to DMH