Scope of Service

Provider will facilitate completion of Occupational Therapy (OT) assessments on identified Williams Class Members, to determine if cognitive impairments or performance delays exist and if such impairments are severe or persistent to the extent that it adversely affects the individual's ability and capability to transition from a nursing home setting to Permanent Supportive Housing (PSH) or the most appropriate community-based alternative. The outcome of this skill based/performance 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 ongoing strength based assessments, one that considers goals, interests and desires, as well as explores 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 nursing facilities/Institutions for Mental Disease or Specialized Mental Health Rehabilitation Facilities (NF/IMD or SMHRFs). Class Members who have not been recommended for transition due to the suspicion of cognitive impairment/mental retardation (MR) or delay will have a secondary specialized assessment conducted by a licensed Occupational Therapist to determine the existence and/or severity of the impairment.

Deliverables

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.

Rates:

$75.00 per hour for 5 hours, per Class Member (on-site assimilation)

$75.00 additional per hour for 3 hours (off-site natural environments), if necessary.

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 an OT assessment
  2. Number of OT assessments scheduled
  3. Number of interviews scheduled with family and significant others
  4. Number of OT assessments initiated
  5. Number of Class Members with OT assessments conducted on site
  6. Number of Class Members with OT assessments conducted off-site (natural environments)
  7. Number of Class Members who self-abort completion of the assessment
  8. Number of Class Members whose assessment was aborted by the clinician due to distress or other symptoms
  9. Number of Class Members assessed and recommended for community transition
  10. Number of Class Members assessed and not recommended for community transition

Performance Standards

  1. 100% of the OT assessments referred for an assessment must be scheduled.
  2. 90% of OT assessments initiated will be completed.
  3. 50% of family or significant others will be contacted for interviews
  4. 100% of OT assessments scheduled will be completed on-site
  5. 50% of OT assessments scheduled will be completed in the natural environment
  6. No more than 20% of OT assessments initiated will be aborted by Class Members
  7. No more than 5% of OT assessments initiated will be aborted by the clinician
  8. 70% of Class Members assessed will be recommended for community transition, if clinically appropriate.
  9. Less than 30% of Class Members assessed will not be recommended for community transition, if clinically appropriate