Mental Health Program Manual

Helping Families. Supporting Communities. Empowering Individuals.

Table of Contents

  1. I. Introduction/Definition
  2. II. Policies & Procedures
  3. III. Contract and Amendment Process
  4. IV. Deliverables/Costs/Rates/Payments
  5. V. Provider Responsibilities
  6. VI. Department Responsibilities
  7. VII. Support Services
  8. VIII. Billing Instructions
  9. IX. Program Monitoring
  10. X. Appendix - State Authoritative Sources

I. Introduction/Definition

The Department of Human Services/Division of Mental Health (DHS/DMH) Program Manual is a resource for funded providers to obtain more detail about procedures or requirements contained in the Attachment B to the Community Services Agreement and the DHS/DMH Provider Manual.

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II. Policies & Procedures

DHS/DMH has the following detailed policies and procedures in certain program areas:

  1. It is the policy of DHS/DMH that Medicaid eligible individuals in the target or first presentation of psychosis populations must be given priority for services.
  2. Medicaid Enrollment

    All community mental health providers with contracts to provide services defined in 59 IL. Admin. 132 must be certified and enrolled as Medicaid providers for each of their DHS/DMH funded sites. The Division will act as a liaison between the Department of Healthcare and Family Services (DHFS) and community mental health providers to assist providers who qualify to enroll as Medicaid providers.

  3. Preadmission Screen/Mental Health (PAS/MH) Contractor's Procedure Manual is available at:
    PreAdmissionScreen-MH-Manual (pdf)
  4. Forensic Training Manual for Fitness Restoration of Individuals found Unfit to Stand Trial (UST):
    Forensic Training Manual (UST) (pdf)
  5. DMH Community Mental Health Provider Manual is available at:
    http://www.dhs.state.il.us/page.aspx?item=95166

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III. Contract and Amendment Process

  1. The DHS Community Services Agreement between the Department and the Provider is generally referred to as the Agreement and consists of several parts:
    1. DHS Uniform Grant Agreement containing the standard contract language for all Department agreements.
    2. Contract Attachment B containing specific agreement requirements related to programs funded by the DMH.
    3. Community Services Agreement Exhibits A - F showing the contract scope, the deliverables, the method of payment and payment reconciliation, contact information, performance measures, and performance standards. The Department will initiate the Agreement, send it to the Provider for review and signature, obtain the Secretary's signature and return a copy of the executed Agreement to the Provider. The Agreement is not effective until signed by the Secretary of DHS.
  2. Amendment Procedures DHS: Mental Health Program Manual http://www.dhs.state.il.us/page.aspx?item=92857 [3/21/2017 12:45:49 PM].  The Department will initiate a two-party signed amendment to the contract when changes are made to the contract that are beyond the scope shown in Exhibit A.

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IV. Deliverables/Costs/Rates/Payments

  1. Deliverables

    DMH contract deliverables are specified in DMH Attachment B and the Community Services Agreement Exhibit B for each provider. DMH Attachment B & Program Manual may be obtained at the following internet address listed under (Mental Health):
    http://www.dhs.state.il.us/page.aspx?item=29741

  2. Payment and Rates
    1. The maximum payment during a fiscal year to Providers under a contract with DHS/DMH is the total contract amount displayed on the Uniform Grant Agreement- Article I, Paragraph 1.2. Payment for Medicaid services to Medicaid eligible individuals is not part of the total contract amount.
    2. Provisions for payment are described in Section IV of the DMH Attachment B.
  3. Pre-Admission Screening for Mental Health (PAS/MH)
    1. Contracted PAS/MH agencies will perform Pre-Admission Screening and Resident Review as assigned by DHS/DMH. Contracted PAS/MH agencies will perform Pre-Admission Screening, Resident Review and Targeted Case Management as assigned by DHS/DMH.
    2. Service requirements, rates, payment limits and conditions are described in the PASRR manual available at: PreAdmissionScreen-MH-Manual (pdf)
    3. PASRR contractors will report and bill Pre-Admission Screening and Resident Review using the information and billing system prescribed by DHS/DMH to receive payment for approved services.
    4. Targeted Case Management services may only be provided with prior authorization from DMH Central Office. These services will be provided in accordance with Administrative Rule 132. With prior approval services will be billed directly to the Illinois Department of Healthcare and Family Services through the web-based PASRR reporting system.

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V. Provider Responsibilities

Funded providers are expected to be in full compliance with all laws, rules, policies, procedures and mandates specified in the Uniform Grant Agreement, DHS/DMH Attachment B, as well as other applicable administrative rules and all other referenced documents. It is the responsibility of the Provider to notify their DHS/DMH Program Contact of any difficulties in meeting any contractual obligation.

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VI. Department Responsibilities

DMH is responsible for activities including, but not limited to:

  1. Executing the Uniform Grant Agreement according to the provisions contained therein including the DMH Attachment B and applicable federal, state and local laws and rules as enumerated in that Attachment;
  2. On-going monitoring of Provider services and funding;
  3. Notifying Providers of changes or additions made to documents referenced in this manual.

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VII. Support Services

Providers may request technical assistance by contacting their DHS/DMH Program Contact.

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VIII. Billing Instructions

Billing instructions for mental health Medicaid, and PAS/MH (Pre-admission Screening/Mental Health) can be obtained by contacting the DHS/DMH Program Contact.

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IX. Program Monitoring

  1. The Provider shall allow the Department or its agent access to its facilities, records and employees for the purposes of monitoring this Agreement.  The Department will monitor compliance with the conditions specified herein. Monitoring will be conducted by staff within various offices of the Department, including but not limited to the:
    1. Division of Mental Health
    2. Bureau of Accreditation, Licensure, and Certification
    3. Office of Contract Administration,
    4. Office of the Inspector General
    5. The Illinois Mental Health Collaborative for Access and Choice
  2. The Department or its agent will share any findings arising from its monitoring activities of the Provider for review and corrective action to the Provider. The Provider shall submit corrective action plans to DHS as requested, and shall comply with plans of correction approved or imposed by the Department. Monitoring may consist of, but is not limited to, the following:
    1. Reviews of all required licenses and certifications;
    2. Reviews of all provider service and funding plans;
    3. Reviews of direct service provision;
    4. Reviews of substantiated cases of abuse and neglect;
    5. On-site reviews of client records, personnel files, agency and program policies and procedures, and financial records;
    6. On-site observations and interviews of clients, guardians, and agency staff (including, but not limited to, program supervisory and direct care staff);
    7. Reviews of electronic data submissions and verification of data submissions or data accepted in lieu of electronic submission;
    8. Reviews of utilization patterns; and
    9. Reviews of training records.

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X. Appendix - State Authoritative Sources

As the Provider, in addition to State and Federal rules and regulations governing the programs you deliver you are responsible for complying with all of the State sources below, if applicable:

  1. Illinois Charitable Trust Act(760ILCS55):
    (http://www.ilga.gov/legislation/ilcs/ilcs3.asp?ActID=2127&ChapterID=61)
  2. Business Corporation Act (805 ILCS 5):
    (http://www.ilga.gov/legislation/ilcs/ilcs3.asp?ActID=2273&ChapterID=65)
  3. Executive Orders:
    https://www.illinois.gov/Government/ExecOrders/Pages/default.aspx#ExecOrder
  4. Administrative Orders

    Administrative Order #1:
    (http://www.illinois.gov/publicincludes/statehome/gov/documents/AO-2010-1.pdf)

  5. Illinois Emergency Budget Act of Fiscal Year 2011 SB3660 Enrolled:
    (http://www.ilga.gov/legislation/96/SB/09600SB3660enr.htm)
  6. Illinois Administrative Code:
    (http://www.ilga.gov/commission/jcar/admincode/titles.html)
  7. Contractual Services defined State Finance Act (30 ILCS 105/15a):
    (http://www.ilga.gov/legislation/ilcs/documents/003001050K15a.htm)
  8. Professional and Artistic Services defined Illinois Procurement Code (30 ILCS 500/1-15.60):
    (http://www.ilga.gov/legislation/ilcs/documents/003005000K1-15.60.htm)
  9. Purchasing, Contracting and Leasing Illinois Procurement Code (30 ILCS 500/1-1 et seq.):
    (http://www.ilga.gov/legislation/ilcs/ilcs5.asp?ActID=532&ChapterID=7)
  10. 44 Ill. Adm. Code Part 1:
    (http://www.ilga.gov/commission/jcar/admincode/044/04400001sections.htm)
  11. Contract filing and late filing affidavits

    Illinois Procurement Code (30 ILCS 500/20-80):
    (http://www.ilga.gov/legislation/ilcs/documents/003005000K20-80.htm)

  12. Lease of office and storage space and facilities

    Civil Administrative Code of Illinois (20 ILCS 405/405-300):
    (http://www.ilga.gov/legislation/ilcs/documents/002004050K405-300.htm)

  13. Fair Employment Practices Ill. Const. (1970) art. 1, sec. 17:
    (http://www.ilga.gov/commission/lrb/con1.htm)
  14. Governmental Ethics:
    Illinois Governmental Ethics Act (5 ILCS 420/1-101 et seq.)
  15. DHS Mental Health Program Manual:
    http://www.dhs.state.il.us/page.aspx?item=92857  [3/21/2017 12:45:49 PM]
  16. State Officials and Employees Ethics Act (5 ILCS 430 et seq.):
    (http://www.ilga.gov/legislation/ilcs/ilcs5.asp?ActID=2529&ChapterID=2)
  17. Expenditure Authority

    SAMS (Section 11):
    (http://www.apps.ioc.state.il.us/ioc-pdf/SAMSManualMaster.pdf) (pg. 392)

  18. Contract Signatures

    SAMS procedure 15.20.95:
    (http://www.apps.ioc.state.il.us/ioc-pdf/SAMSManualMaster.pdf) (pg. 665)

  19. Payment for Goods and Services

    State Prompt Payment Act (30 ILCS 540/1 et seq.):
    (http://www.ilga.gov/legislation/ilcs/ilcs3.asp?ActID=539&ChapterID=7)

  20. State Contracts

    Business Enterprise for Minorities, Females, and Persons with Disabilities Act (30 ILCS 575/0.01 et seq.):
    (http://www.ilga.gov/legislation/ilcs/ilcs3.asp?ActID=550&ChapterID=7)

  21. Human Services Provider Contracts

    Human Services Provider Bond Reserve Payment Act (30 ILCS 435/15):
    (http://www.ilga.gov/legislation/ilcs/documents/003004350K15.htm)

  22. Requirement to Purchase from Department of Corrections Unified Code of Corrections (730 ILCS 5/3-12-7):
    (http://www.ilga.gov/legislation/ilcs/documents/073000050K3-12-7.htm)
  23. Child Care Service Contracts (Only Applicable to Child Care Contracts)

    State Agency Employees Child Care Services Act (30 ILCS 590/1 et seq.):
    (http://www.ilga.gov/legislation/ilcs/ilcs3.asp?ActID=554&ChapterID=7)

  24. Purchase of Recyclable Products or Supplies

    Illinois Solid Waste Management Act (415 ILCS 20/3):
    (http://www.ilga.gov/legislation/ilcs/documents/041500200K3.htm)

  25. Change Orders in Public Contracts

    Criminal Code (720 ILCS 5/33E-9):
    (http://www.ilga.gov/legislation/ilcs/documents/072000050K33E-9.htm)

  26. Invoice Voucher Certification Clause

    State Finance Act (30 ILCS 105/9.04):
    (http://www.ilga.gov/legislation/ilcs/documents/003001050K9.04.htm)

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