Scope of Service

The Provider will facilitate completion of neuropsychological assessments/evaluations on identified Williams Class Members when there is a suspicion of dementia or other organic brain syndrome and, if such, to determine if the disease is so severe or persistent to the extent that it adversely affects the individual's ability and capability to transition from a nursing home setting to independent living (Permanent Supportive Housing (PSH)) or other appropriate community-based housing alternatives. The outcome of this clinical battery/assessment will recommend the most appropriate level of care setting and, if transition is the outcome, the individual's capability to maintain wellness in the community.

The Williams Consent Decree requires that a strength based assessment, one that considers individual goals, interests and desires, as well as explores other indicators such as risks (medical, behavioral and physical), criminal histories, functional capability and cognitive abilities, is conducted on consenting residents of the nursing facilities/Institutions for Mental Disease/Specialized Mental Health Rehabilitation Facility (NF/IMDs/SMHRFs). Class Members who have not been recommended for transition due to the suspicion of dementia, Alzheimer's or other organic brain syndrome may have a secondary, specialized assessment conducted by a Board Certified neuropsychologist to determine the severity of the disease.

Deliverables

Each assessment is estimated at an average of nine hours to complete.

Provider will:

  1. Accept referrals from DMH on behalf of Williams Class Members who require a specialized neuropsychological assessment
  2. Schedule time slots for each Class Member referred
  3. Review medical, clinical charts and/or other pertinent documents made available by the nursing facility (NF/IMD) and documentation from the community mental health center, as appropriate
  4. Conduct interviews with family members, guardians or significant others, as appropriate, about the Class Member's past and present functional levels, capabilities and performances.
  5. Conduct a face-to-face interview with the Class Member using state-of-the art batteries or appropriate assessment tool.
  6. Complete narrative reports on assessment outcomes with recommendations.

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 quarterly invoices on the appropriate DMH invoice template at the established rate(s) (if applicable). Invoices shall be submitted to the DMH program contact no later than November 1, February 1, May 1, and August 1, 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.

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.

Rate: $252 per hour

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.

The following are included in the reporting template:

  1. Number of Class Members referred for a neuropsychological assessment
  2. Number of neuropsychological assessments scheduled
  3. Number of neuropsychological assessments initiated.
  4. Number of neuropsychological assessments completed
  5. Number of Class Members who self-aborted the assessment
  6. Number of Class Members whose assessment was aborted by the clinician due to distress or other symptoms
  7. Number of Class Members assessed and recommended for transition
  8. Number of Class Members assessed and not recommended for transition

Performance Standards

  1. 15 Class Members referred by DMH will receive a neuropsychological assessment, annually
  2. 100% of referrals will be scheduled for an assessment
  3. 100% of referrals scheduled will be initiated
  4. 70% of assessments initiated will be completed
  5. Less than 10% of Class Members' scheduled will self-abort the assessment
  6. Less than 10% of Class Members' scheduled will have the assessment session aborted by the clinician
  7. 40% of Class Members assessed will be recommended for transition, based on clinical appropriateness
  8. 60% of Class Members assessed will not be recommended for transition, if based on clinical appropriateness