Comprehensive Pilot Program FAQs

September 24, 2020

In light of COVID, how should we categorize a Class Member who is on a ventilator and cannot talk and therefore cannot be engaged in outreach? Similarly, for Class Members who are identified by the NF as having dementia or are on a dementia unit? In light of COVID restrictions, how should they be categorized as unable to engage at this time?
1. Staff should select "Inability to engage the member due to health status barrier" on the 1.2 Outreach Outcome form.
Can you provide definitions for the housing types referenced on multiple CCMTP forms? I am clear on PSH, private home, and senior housing, but could use some guidance on supported living vs. supervised residential and assisted living.
1. Supportive living programs are funded by a Medicaid waiver and provide additional support and monitoring to individuals with physical/medical needs.
2. Supervised residential programs are funded by DMH and provide support and monitoring for individuals with serious mental illness.
3. Assisted living establishments provide individual housing units in a shared homelike setting that includes community-based residential care for persons who need assistance with ADLs.
Can a Class Member sign their name on a tablet/electronically to satisfy the signature requirement for documents?
1. Yes, we will accept electronic signatures. The associated policy is currently being updated.
Does a CM have to be a resident/citizen to participate in Colbert/Williams? If a CM's green card was revoked (not expired) due to their criminal activity/background, how would we proceed? Are they still eligible? The CM is currently receiving Medicaid benefits but was receiving them prior to the green card being revoked. The CM's work permit is also revoked.
1. CCMTP does not directly have a citizenship requirement.
2. However, Medicaid benefits are contingent upon legal status in the United States, with the exception of some emergency situations. In addition, members need to have a source of income in order to transition. The member described here has no authorization to work in the United States, and individuals who do not have legal status in the United States are ineligible for SSI/SSDI benefits. It is unlikely that an individual with the limitations described in this question would be able to successfully transition.
In regard to Comprehensive Service Plans, are prime agencies able to bill for these? For example, could it be billed as an assessment or case management?
1. Per Comprehensive Program contracts, care managers, who are funded by the Comprehensive Program grant, are responsible for completing the Service Plan. Therefore, they cannot bill Medicaid for those efforts.
2. If other staff are involved in the preparation of the Service Plan, they may be eligible to bill Medicaid for some of this work.
Previously, when in the housing search phase for a Class Member, if they declined 3 reasonable units they were shown, there needed to be a call/consultation with the state regarding next steps for the member. Is there still such a "rule" in place? We have a Class Member to whom we've shown a total of four reasonable apartments (of his own choosing) and he was denied from one and declined the other three. What would be the next steps in terms of his housing search and his expectations?
1. While the 3 units "rule" is not set in stone, Prime Agencies may request a staffing with DHS if a Class Member is refusing multiple reasonable units that meet their housing preferences. Prime Agencies should also attempt to resolve these situations internally where possible.
Regarding the PRTP, there is a performance standard that states "100% of OT assessments completed on-site" --can it be clarified what this means? What counts as on-site? (At the NF? at the Class Member's home?)
1. For the purposes of the PRTP, "On-Site" is defined as at the agency's premises or at an agency-designated location.

September 10, 2020

Our agency does not have an ACT program and will have to refer any class members requiring said services to another agency. Is there an established policy that says we can only refer class members to another Prime agency for those services, or can those class members be referred to a CMHC that is not a Prime?
1. Prime Agencies can refer class members to Community Mental Health Centers for ACT or CST services when those are necessary. These service providers do not have to be Prime Agencies. Primes are expected to meet the need of any Class Member who needs ACT level of care in order to safely transition and live in the community.
2. The Prime Agency can establish and deliver ACT/CST services on their own, or the Prime Agency can subcontract or establish an agreement with any CMHC for ACT or CST services, as long as the Prime Agency can refer the Class Member and there is no unreasonable delay in transitioning (i.e. ACT/CST waitlist), and the Class Member can be served in the location of his/her choosing.
Which form is completed if a member was not recommended and passes away due to COVID before their SPU?
1. On form 2.8 6-Month Service Plan Update, there is a checkbox for indicating that the class member is deceased.
When will all these changes be updated in PRTP850? What is the deadline to complete Quarterly Report 1?
1. The PRTP 850 form is updated.
2. Quarter 1 reports are due November 1; all quarterly reports are due 30 days after the end of the reporting period.
Are housing case reviews for Quadrant III/IV, or all clients in the housing phase?
1. During the COVID-19 pandemic, all clients who are actively in housing search must be referred for a case review.
What is the state's progress to target goals for FY20 and FY21? Is that information readily available somewhere?
1. FY20 numbers are being finalized currently for the semi-annual report. FY21 statewide targets are included in the implementation plan, and individual Prime Agency targets are included in contracts.
What does 'Planning' refer to on this Housing Phase form?
1. 'Planning' should be indicated when the class member has completed intake, and the class member is engaging in completing tasks related to initial service plan development needed before starting housing search.
Could you clarify when we use the new Transition Notice form versus the Housing Status form? Do we have to go back and do a housing status form for all of our clients who are just in the planning process, or is this form just moving forward?
1. The transition notice form is used to notify CCMTP of a transition to the community, where the class member will be continuing to receive care management services from the Prime Agency.
2. The housing status form should be submitted at least once a month for all class members who are in the housing search process.
When will the training on the new forms be scheduled?
1. Updated forms were reviewed during the TA webinar on 8/27/2020; this recording is available on the UIC CON website. Additional questions can be directed to your OMSU liaison.
What is the role of the MCO relative to the service authorization packet? When might we receive the documents referenced in this training? For waiver services for individuals under the age of 60, the MCO works with the lead agency to develop and authorize the service plan. Is there a reason this is approached differently for waiver services for individuals over the age of 60?
1. The processes for obtaining waiver services are developed by IDoA for individuals over 60, and by DRS for individuals under the age of 60; Comprehensive Program staff are not involved in the development of these processes.
2. IDoA waiver packets were distributed to Prime Agencies' clinical leadership on 9/1/2020.
If we are waiting on a signature for the Not Recommended Letter, do you want us to delay submitting the assessment until the signature is received?
1. Delays in obtaining a signature should not delay the submission of an assessment, particularly during COVID-19.
Is the "recommended outcome" date the date of the assessment or the date of the recommended letter? Additionally, is it intended that the assessment and the letter be submitted together? How will these changes affect the data needed for the quarterly report?
1. Yes, they are intended to be submitted together; the form date does not need to be identical.
2. There are no changes to the data needed for the quarterly report at this time.
There is a lot of confusion on how we know what to include in the service plan. How do we know how many hours, etc. that the client should receive? what if we don't have any packets? How will we be notified when these additional trainings from IDOA and DHS are scheduled?
1. Additional training from IDoA is tentatively scheduled for 9/24/2020.
2. IDoA waiver packets were distributed to Prime Agencies' clinical leadership on 9/1/2020.

August 27, 2020

Someone who discharges without recommended status agrees to transition services and is not in stable housing yet-if they are hospitalized, do they need a reportable incident even if we can't yet count them as a transition?
1. If a class member is not residing in a nursing facility or SMHRF and experiences a critical incident (such as a hospitalization), a Reportable Incident document should be completed and submitted.
If a CM is assessed as recommended but does not begin the housing search immediately due to extenuating circumstances (repeated hospitalizations, difficulty locating etc), when does the timeline for completing the initial CSP begin?
1. Service Plans must be completed within 45 days of the recommended outcome of the assessment.
2. Service plans cannot be completed without input from the class member. In this situation, the care manager should make every effort to contact the class member to obtain their input into the service plan. If this is impossible, the service plan should be submitted late if necessary, once the class member's input is included. The reasons for a delay should be clearly documented.
The P&P that states that primes may accept verbal consent with 2 documented witnesses.Prior to this updated addendum, the P&P indicated that the witnesses should be from the prime or nursing home.Our subcontractors who are doing the outreach are signing as witnesses.Would the Prime need to be present during each of these outreach attempts?
1. Subcontractors can sign as witnesses.
If a Class Member had a guardian (in this case, his spouse), but the guardian passes away, can the Class Member proceed with being assessed or would a new guardian need to be appointed?
1. If the previous guardian provided consent to the assessment, the assessment could proceed. However, the court will need to determine if the class member still requires a guardian, and if so, appoint that individual. Check to see if a standby guardian was appointed; the nursing facility or SMHRF should be able to provide information on this process.
In regard to the previous question: If a new guardian needs to be appointed by a judge, would this be a decline at this point, in regard to the individual's assessment?
1. No, this is not considered a decline.
In regard to outreach, if a Class Member is almost completely deaf and has visual impairments, what tools are available to conduct outreach? This Class Member is supposed to be outreached to tomorrow and I am hopeful I can provide my outreach team with the necessary tools.
1. Consult with the nursing facility or SMHRF to understand their process for communicating with this class member, and coordinate outreach with the facility. You can also reach out to UIC ATU for assistance in providing ongoing services to the class member.
Is the timeframe for assessment submission from the last interview with the class member or when they receive documents needed to complete the assessment, or is it from the completion of the writing of the assessment?
1. Assessments must be submitted within 7 days of completion. Prime Agencies should have internal processes to determine when an assessment is considered "complete," but the expectation is that this takes place as soon as possible. Completed assessments should include a thorough interview, a review of the member's records, and follow-up with collateral contacts.
Is CAST review the new protocol only for CMs who were originally recommended, but were then reassessed and found not recommended? Or, should new/initial assessments who are determined not recommended also proceed with a CAST review?
1. The CAST review would only apply to individuals who have been recommended for transition and who are then Not Recommended following an annual reassessment. The process for initial assessments has not changed; not recommended outcomes are still being reviewed by the UIC CON quality team to ensure the rationale provided is clear.

August 13, 2020

PRTP: Assessments Since the language surrounding "declined assessments" has been removed, should this be notated as a "refusal"?
1. Yes
PRTP: Transition Coordination For 8 a, b, and c: This set of questions asks about class members engaged in a housing search within two weeks of initial contact and more than four months after initial contact. Is this asking about all members who are still pre-transition or only members that were referred this quarter?
1. These questions are referring to class members who begin the housing search process within this reporting period.
PRTP: Integrated Health Care What entails a health assessment? If I call a CM and ask about their blood pressure readings and blood pressure related symptoms, does that count as a health assessment? If I call a member who requests a walking cane and I assess their mobility concerns/impairments either in person or over the phone, does that count as an assessment? If I review someone's medical history and current symptoms either in-person or over the phone, does that count as a health assessment?
1. We are referring to direct individual contact with the class member, either in-person or via telehealth protocols established during COVID-19. Please refer to your internal policy for what is included in a health assessment. (Please refer to the PRTP Training Day 2.)
PRTP: Integrated Health Care Please clarify whether #1 is asking for the number of assessments or the number of class members who have had assessments. The item asks for the number of assessments but the clarifying statement asks for the number of class members.
1. This should reflect the number of assessments scheduled, not necessarily the number of assessments completed.
PRTP: Integrated Health Care Based on how health assessment is defined, many class members may have multiple assessments done within a quarter. If that's the case, how do we document assessment refusals for unduplicated class members in 2a and 2b? If they refuse one assessment, do we count that in this category? Or do they have to refuse all health assessments to be counted in this category?
1. If the class member completes a health assessment within the reporting period, that should be counted; only document as a refusal if the class member declines all assessments during the reporting period.
PRTP: Integrated Health Care Similarly, #3 asks for UNDUPLICATED class members but asks for assessments which include family involvement. Is this counted if ANY of the assessments for that class member included family involvement?
1. Yes
PRTP: Integrated Health Care Similar type questions for ER & hospitalizations? We are counting unduplicated class members who had ER visits/hospitalizations. How do we document #15 -#16 if they refused post-hospital visits for some but not all hospitalizations?
1. If a class member has refused any post-hospital visit during the reporting period, they should be counted as refused under measures 15 & 16.
PRTP: Integrated Health Care For #20, do the telehealth protocols also apply here?
1. This measure can include both in-person and telehealth visits when appropriate.
Are there any resources for Spanish interpreter services?It is for a Resident Review which is a much more lengthy process.
1. Prime Agencies are responsible for securing and utilizing interpreting services when necessary, including when conducting assessments.
2. (Resident Reviews are now called Assessments; the older terminology is no longer in use.)
If a CM had a Resident Review approved through the prior program, and that Resident Review is about to expire and the CM was inherited by new agency in the Housing stage, does the class member need to go back to the Assessment phase and initially start over or can the new agencies continue on with the housing stage, even with an expired Resident Review?
1. Transition coordination services should not stop because the class member is due for an updated assessment, but the assessment should be conducted when it is due. A delay in completing the annual reassessment should not delay the member's transition.
2. If a class member who has been recommended for transition receives an annual reassessment and is not recommended for transition, the Prime Agency should request a CAST review of the member. A service plan with goals for future transition will be required following the completion of the CAST process.
Who handles DON assessment referrals? How? What about for class members who currently reside in SNFs/SMHRFs?
1. Training was conducted in June on the process for requesting Aging waiver services; a recording and resources are available on the UIC Colbert-Williams website. A refresher will be held on Thursday, August 27during the TA webinar.
2. Training on the process for requesting DRS waiver services will be held on the afternoon of Tuesday, August 25.
Who fills out the Quality of Life survey and when? Where is it available on the website?
1. UIC CON completes the Quality of Life (QoL) survey with class members at baseline and at one year post-transition. Completed QoL surveys are not posted on the website, as the surveys contain confidential class member information and responses.
Can the decline statement come from a facility's worker? I experienced a time where client seemed to be not interested to talk to me but rather have a SW to let me know she is not interested.
1. No. If you are unable to speak with a class member directly while providing outreach via telehealth, that outcome should be documented as "Class member unavailable."
We have a newer client on our caseload that has been hospitalized multiple times since opening her to services so have not been able to reach her to complete the CSP within the 45 days. I was hoping to receive information on how we should handle this as now the CSP would be considered late due to it being after 45 days. Should we just submit the document with as much info as we have from the assessment/records and indicate that it was not done with the client, or should the initial CSP just be sent in when we are able to make contact, etc.?
1. Service plans cannot be completed without input from the class member. In this situation, the care manager should make every effort to contact the class member to obtain their input into the service plan. If this is impossible, the service plan should be submitted late if necessary, once the class member's input is included. The reasons for a delay should be clearly documented.
Are physical assessments by the RN required or completed on an as needed/requested basis?Are physical assessments by the RN required or completed on an as needed/requested basis for complex medical cases?
1. Assessments by an RN are required for all class members and should also be provided on an as needed basis.
How can a Prime obtain monthly facility resident census information for all of their assigned facilities?
1. DMH is working with IDPH as part of the FY21 Implementation Plan to obtain census on a monthly basis. Use the most accurate data that you have, whether from the facility or from HFS census.

July 23, 2020

When will appointments for neuropsych assessment resume at UIC? Will referrals submitted before COVID-19 shutdown be prioritized? If so, what will be the criteria be, or will a new referral be required?
1. UIC Department of Psychiatry will be available to see Class Members beginning the first week of August. Previously submitted referrals will be prioritized according to the date the referral was received by DHS. If Primes require prioritization of an individual case due to severity of need, please reach out to your Quality Liaison at DHS.
When will training for the Program 850 Quarterly Report take place?
1. DHS fiscal is currently finalizing the Quarterly Report. As soon as it is finalized, DHS will schedule a training. We have asked for, and received an approval, of an extension for the Prime Agencies to submit the PRTP to Friday August 14, 2020.
2. Please note: Please submit the PFR report on or before August 1, 2020. Although the PFR and the PRTP documents are usually submitted together, delay in the submission of the PFR could impeded DHS' ability to make payments to the Prime Agencies for the months of May and June.
If during FY 20 3rd Quarter CCMTP was billed for services rendered, should the current Program 850 Quarterly Report form be used when 3rd Q reports are due in August?
1. The Program 850 Quarterly PRTP Report currently posted should not be used. A new template is under development, and will be posted shortly for use for both 3rd Quarter and 4th Quarter CCMTP Program 850.
Is it possible for DHS to reconsider some sort of weekly/ monthly (on a set time table) meeting with the agencies to specifically address housing issues (including inspections status, possible evictions, etc …)
1. DHS is currently deciding the best way to communicate Class Member specific housing information with the Prime Agencies. We would like to have Class Member specific housing information available to the OMSU team, who could communicate that information to the Prime during your regularly scheduled meetings, and are exploring processes to make this happen.
Is it expected that a nurse and OT be involved during Resident Review determination to "Recommend" or "Not Recommend" transition? Or, is it expected that those staff be involved in subsequent assessment of readiness to transition? Currently, the Quarterly Report asks about involvement of those staff during "Assessment."
1. RNs are expected to provide input into the Class Member's Assessment (Resident Review), and are required to be involved in the overall assessment continuum, which is always ongoing.
2. Occupational Therapists should be involved where the Assessment determines that an OT evaluation is appropriate.
3. If a Prime Agency has completed the Class Member's Assessment, but the Prime's RN has not completed his/her review of the Class Member's status, the Prime Agency should submit the completed Assessment and continue to consult with the RN throughout the Class Member's movement towards transition.

July 9, 2020

If a Class Member wants to move more than 1 year after transitioning: - How does this affect their subsidy?
1. An approved move from one home to another does not affect a Class Member's subsidy. The Class Member must follow the same protocol regarding the new unit, including passing an inspection prior to signing the lease.
If a Class Member wants to move more than 1 year after transitioning: - Does anybody help them identify new housing? If so, who?
1. The Prime Agency should help the Class Member identify new housing. The Prime Agency should pay close attention to the Fair Market Rent (FMR) per zip code, as provided by Hud.gov.
If a Class Member wants to move more than 1 year after transitioning: - Is there financial assistance through the Consent Decrees for this secondary move if they used their all $4,000 for the initial move?
1. Prime Agencies receive flex funding (an average of $1,000 per Class Member) to meet unanticipated expenses related to community living. Flex funds can be used to assist with the secondary move.
Can flex funds be used to purchase smart devices for Class Members in the facilities?
1. Flex Funds should be used to meet expenses related to community living. If a Class Member is living in a facility but it is anticipated that the Class Member will be transitioning soon, the flex funds can be used to purchase smart devices.

June 25, 2020

During this period of non-access to NFs, Primes are experiencing difficulty contacting CMs by phone. How should Prime staff complete and submit to UIC-CON the Outreach Outcome form 1.2? Should Primes document each failed attempt? Providers report that often it takes multiple contacts (as many as 5) before CM contact is achieved.
1. Primes should use the Outreach Outcome Form 1.2 to document the ultimate outcome of the aggregate outreach attempts. In other words, at the end of the outreach period for New Class Members or Existing Class Members, or when the outreach has ended (either successfully or unsucessfully), Primes should document the final outcome of the outreach for that period. Form 1.2 should be filled out once per outreach period.
2. Primes should not use Form 1.2 to document every failed attempt or phone call. However, Primes should internally track those efforts, and in the comments section of form 1.2, can document the multiple attempts and contacts.
When will UIC resume neuropsych evaluations?
1. UIC plans to begin scheduling neuropsychevaluations for the end of July.This is of course dependent on the assumption that it will be safe for high risk residents to leave the facilities.
Even though UIC's contract for OT evaluations is ending, will UIC honor OT evaluation requests made before COVID-19 restrictions caused a halt to these services?
1. Even though UIC's contract for OT evaluations is ending, will UIC honor OT evaluation requests made before COVID-19 restrictions caused a halt to these services?
What is the current rule regarding CM that need to move to a different apartment getting an inspection? Inspections were halted related to COVID-19 restrictions.
1. A Class Member cannot move until lease contract expires. There are mitigating circumstances where CM may be enduring unforeseen hardship hindering their recovery and remaining in unit would only exacerbate or debilitate their condition. In those cases, an advance notice to vacate letter to landlord would be required.
2. For Class Members that choose to move after their lease expires and have identified a new unit, care managers would need to submit an inspection request form. Once the new unit passes inspection the tenant can sign the lease.
What is the current status of inspections?
1. Catholic Charities is now cautiously conducting inspections for all moves. Statewide inspections are allowed.
2. IACCAwill resume inspections in the Kankakee/Bourbonnais area on July 1st.
3. HACCstates that inspections will proceed during the COVID-19 crisis without interruption.
When will the final quarterly report be available? Or is the currently posted 850 quarterly report the end product?
1. The currently posted quarterly report is not final. We are making minor changes to the report in an effort to make it easier to understand and complete. The final report should be available very soon.
Some agencies have sent comments/concerns/requests for clarifications regarding the 850 quarterly report. Is anyone reading those and taking those comments into consideration?
1. Yes. These comments are being read, discussed, and helping to inform decisions regarding the report.
When is the training rescheduled for?
1. The training has not been rescheduled yet, but will be scheduled in the coming weeks. We will publicize the date in advance to ensure those Prime employees who need to attend will be able to do so.
What is the new due date for 3rd quarter reporting? (Concern that the agencies will not have adequate time to pull together accurate data while time is passing closer to a due date.)
1. Third quarter reporting is due August 1, 2020.
If a Prime agency has a Class Member who wants to move outside of the typical service area and the current Prime identifies an alternate prime agency who can provide the supports and transition services for the CM, and the CM agrees to work with this alternative Prime agency, is this acceptable? If so, what actions would the current Prime need to take in order to effectuate the transfer of the CM to the new Prime?
1. The original Prime Agency must continue to serve the Class Member in the facility through transition. After transition, the original Prime can transfer the case to the new Prime Agency. The original Prime Agency would need to fill out the Post-Transition change Form (5.1), and ensure that all documentation is shared with the new Prime Agency.
DHS noted that the Bridge Subsidy can be applied outside of Cook County. However, the Bridge Subsidy is through HACC, which is part of Cook County, so are there additional steps/forms/agencies for the current Prime to be aware of when a Class Member wants to live in another county?
1. We are working through a process with HACC for this situation. If this is currently an issue, please reach out to your OMSU auditor and the IDHS housing coordinators and the specific case can be addressed.
If a Class Member wants to move outside of Illinois, are they still eligible for the benefits of the Comprehensive Program as a Class Member? Or would the be ineligible for transitional services if they are planning to move out of state?
1. No. An individual must be a resident of Illinois to be eligible for the benefits and services of the Comprehensive Program. If a Class Member wants to move outside of Illinois, the Prime Agency can provide links and referrals to services, but not the transitional services themselves.
In regard to a Class Member whose family member moved them out of the NF and into a SLF in the beginning of March 2020 (not COVID-19 related), would this Class Member still be eligible for the Colbert Program? If so, would the current prime be required to transition them or to provide community-based services only?
1. A move from Nursing Facility to a SLF is considered a transition. Whether the Prime can count this move towards its transition target, and whether the individual can receive Comprehensive Program services depends on several factors, including whether the Class Member had been assessed and recommended for transition prior to moving out of the Nursing Facility. Prime Agencies should refer to the Self-Move policy, the Unexpected Discharge guidance, and the associated matrix (new).

June 18, 2020

Is there a policy about income requirements for class members?
1. The Comprehensive Program does not have a policy regarding Class Member income. There is an inherent expectation that Prime Agencies will ensure that when a Class Member transitions, he or she will have an income stream that is sustainable to support success in the community. Prime Agencies must work with the Class Member prior to transition to identify sustainable income sources and amounts (for example, SOAR and DRS), and develop budgets and strategies to succeed in the community.
If a class member is transitioning a second time, will they still be eligible for the Bridge Subsidy if they gave it up in their last transition?
1. Yes
You may be aware that during this period of non-access to NFs, Primes are experiencing difficulty contacting CMs by phone. My question is how should Prime staff complete and submit the Outreach Outcome form 1.2 for each failed attempt? Providers report that often it takes multiple contacts (as many as 5) before contact is achieved.
1. Question received and being reviewed - the answer will have many downstream impacts on Prime workload (paperwork) and DHS data. DHS wants to ensure we only request Primes to report and capture data that is beneficial for program analysis and reporting.
Self-Moves and Unexpected Discharge Questions
1. DHS has received several follow-up questions to the Self-Move Policy and Unexpected Discharge guidance issued in May of 2020. We are developing answers to the questions posed and other issues related to these policies and will communicate further guidance this month.

June 11, 2020

Last week a Prime Agency asked whether Class Members must be "Medicaid recipients" or "Medicaid eligible."
1. In order for a NF resident to be a Colbert Class Member, the Decree specifically requires they must be Medicaid eligible. Additionally, the Decree requires Class Members transitioning to a community-based setting be provided community-based services under the Illinois Medicaid State Plan, therefore a Class Member must be a Medicaid recipient in order to transition and receive those services.
2. In order for a SMHRF resident to be a Williams Class Member, the Decree requires only that they must be residing in the SMHRF and have a mental illness. Therefore, an individual SMHRF resident may be a Class Member even without Medicaid. However, the Decree requires Class Members transitioning to a community-based setting be provided community-based services under the Illinois Medicaid State Plan, therefore a Class Member must be a Medicaid recipient in order to transition and receive those services.
Is the Bridge subsidy able to be applied outside of Cook County? If there is a Class Member who wants to move to another county, would they be able to use this specific subsidy?
1. Yes, bridge subsidies are available outside of Cook County for both Colbert and Williams Class Members. If a Colbert Class Member is seeking to secure housing outside of Cook County, please work with the Housing Coordinators (Raul (Ivan) Lopez, Donna O'Connor, and Peter Nicholson) to assist with the housing inspection and other aspects of securing the apartment and subsidy. IDHS is working on guidance to assist with this process that should be published next week.
2. Please note: Prime Agencies are expected to serve Class Members who transition from an assigned facility into the community, regardless of whether that Class Member transitions into the Prime's service area. The Prime Agency must continue to service the Class Member in the community with the full array of supports, or find another Prime that can do so.
Regarding a class member who previously transitioned with our agency a few years ago, is it at our agency's discretion to administer a full set of transition funds for him, as he is recommended to transition a second time? Do we need to provide DHS with previous information about how many transition funds he previously used?
1. Any time a Class Member transitions, the Prime Agency should use only those funds needed to aid in a successful transition to the community. This may require use of the full amount, or this may require less, depending on what already existing resources the Class Member has available. For Class Members who are transitioning for a second (or more) time, the Prime Agency does not need to provide DHS with information regarding previous funds used.
We had about 45 class members transferred to our agency, as we are their new prime. In regard to their eventual transition funds: I am aware that the grant provided each prime with a certain amount of money, based on the projected number of transitions. Are all of these transferred class members accounted for, within that budgeted amount?
1. Yes, Class Members in facilities that were assigned to the Prime Agencies, even if transferred, are accounted for in the budgeted transition funds.
In regard to the 45 class members who were transferred, I have made the state aware that several were transferred without documentation. Many of the assessments that were sent by Illinicare or were recovered from UIC included assessments that were over a year old. Will these class members require a new assessment as opposed to picking up their process in the housing search phase? If they do need a new assessment, do they first need to be outreached to, starting their entire process over?
1. Prime Agencies should not "start over" with Class Members who were transitioned from a previous provider. Under the Comprehensive Program protocol, assessments are required annually until the Class Member is transitioned, so a Class Member that was transferred from a previous provider whose assessment is over a year old would require a new assessment. Outreach is not required prior to the assessment.
Can a Prime Agency develop a brief video about the program that can be shown to Class Members in facilities during COVID-19, to assist in outreach and education efforts?
1. Yes. However, IDHS needs to review and approve the video prior to use with Class Members.
How should a Prime Agency handle the following scenario: A Class Member in the community was transferred from IlliniCare to the Prime Agency. When the Prime Agency called to initiate intake, the Class Member stated he was not interested in services. How should the Prime Agency document the Class Members' declination of services?
1. The Prime Agency should complete and submit forms 5.1 "Post Transition Change" and 2.9 "Decline Letter." The Decline Letter requires the Class Member's signature - during COVID, 2 witness signatures can be used to document the declination. Once it is safe to do so, the Prime Agency must follow-up with the Class Member and obtain his/her written signature.
IDHS has received several questions regarding when SNFs and SMHRFs will reopen to visitors or employees of the Prime Agencies.
1. IDHS does not have information regarding when the COVID restrictions will be lifted at SNFs and SMHRFs and the Prime Agencies will be allowed into the facilities.

June 4, 2020

Would it be possible to have a sample of a service plan that is considered a model comprehensive service plan, along with the assessment tool on which it was based? If there are trends noted in service plans that are being reviewed and found lacking in some way, that would also be very helpful.
1. IDHS and UIC-CON will provide the Prime Agencies with a sample service plan, assessment tool, and the scoring rubric used to evaluate the service plans. There are also trainings posted on UIC's website that provide detailed explanations of how to complete service plans and what IDHS and UIC CON look for when reviewing completed service plans. Additionally, individualized feedback is provided to each Prime Agency in monthly reports from UIC CON.
2. IDHS and UIC-CON will provide the Prime Agencies with a sample service plan, assessment tool, and the scoring rubric used to evaluate the service plans. There are also trainings posted on UIC's website that provide detailed explanations of how to complete service plans and what IDHS and UIC CON look for when reviewing completed service plans. Additionally, individualized feedback is provided to each Prime Agency in monthly reports from UIC CON.
Is there a plan to develop a policy relative to Post-Transition Visits, as well as a corresponding Post Transition Visit Form? We used to enter monthly home visits into CTS, but since that is no longer, how should monthly care manager home visits be recorded?
1. IDHS distributed guidance to the Prime Agencies regarding Post-Transition contact expectations on May 12, 2020 (email titled "Community Engagement Guidance"). IDHS is currently discussing the need to develop a universal form or reporting system to record Prime Agency care manager contacts. However, the current expectation is that all Prime Agencies have internal processes and procedures to record these home visits and contacts.
What is process by which a Prime Agency closes out a class member's case after 18 months in the community? In the past, a final service plan was reviewed with the managed care coordinator.
1. IDHS does not have a written policy and procedure regarding closing Class Member cases after the Class Member has successfully lived in the community for 18 months. IDHS expects that Prime Agencies conduct a final service plan review and ensure that a handoff in services and care is coordinated with all essential providers on the Class Member's "team," such as the Rule 140 providers, MCO care coordinator, and waiver providers.
Regarding the Class Members in the community weekly contact list, is there a guideline for how to designate "service levels" in the drop down for Class Members residing in SLF's or group homes? Is It necessary to have weekly phone contact when they are in a group home or SLF?
1. For Class Members residing in group homes or SLFs, the Prime Agencies can select "other" from choices in the service level drop down. Prime Agencies should engage these Class Members residing in group homes or SLFs a minimum of once per week.
Regarding the Class Members in the community weekly contact list, is there a guideline for how to designate "service levels" in the drop down for Class Members residing in SLF's or group homes? Is It necessary to have weekly phone contact when they are in a group home or SLF?
1. For Class Members residing in group homes or SLFs, the Prime Agencies can select "other" from choices in the service level drop down. Prime Agencies should engage these Class Members residing in group homes or SLFs a minimum of once per week.
Since the IDHS Consent Form is not a UIC document, are we still able to obtain verbal consent from the Class Member with two witness signatures? Also, would you be able to confirm when we should be using the UIC signature page?
1. Whether the IDHS Consent Form will be accepted with two witnesses signatures and verbal consent from the Class Member is determined by the policy of the entity receiving the document (and therefore potentially disclosing the Class Member's personal information). We are currently asking if the UIC Psychiatry department will accept verbal consent with two witness signatures.
2. The UIC Signature page is intended to be used when the Prime Agency cannot get the underlying document (for example, the Outreach Outcome document) signed by the Class Member directly.
Translation of client-facing documents into Spanish and Polish
1. IDHS is following up on this issue. We do not currently have an estimated completion date, but will update the Prime Agencies regularly until completed.
New FCRC for Class Members
1. FCRC #238 for both Williams and Colbert Class Members who transitioned on or after February 1, 2019 will go live on June 8, 2020. A flyer with contact information for this office will be sent out this week to all Prime Agencies.
Document Completion
1. All Comprehensive Program forms must be typed and submitted electronically. Handwritten forms will not be accepted by UIC CON and IDHS.

May 28, 2020

Is it expected that agencies submit staff change forms when staff leave and are hired?
1. Yes, Prime agencies are expected to submit the Staff Change form for both exiting and incoming employees.
Is it permissible to conduct and complete an assessment over the phone? Previous Q&As have stated that assessments may be completed only by those Prime Agencies involved in the Teleservices pilot, but our understanding is that the Pilot involves video transmissions only.
1. While it is not permissible to complete the entire Comprehensive Program assessment by telephone, some portions can be done over the phone (for example collecting demographic information), but other portions (for example, assessing Class Member's functional status) must be done "in-person" (which includes by video transmission).
When class members are in post-transition and have begun receiving their full SSA income amount, which new CCMTP form would be appropriate to use; if we want to report this information to their Subsidy Administrator so that the CM's Rent amount can be adjusted?
1. When post-transition Class Members have a change in income amount, please use form 5.1 "Post-Transition Change Form." Under "Change Details: Member remaining active in the community with the program," select "Other" and include new income amount.
2. Please use this form when any other changes occur with a Class Member in the community - for example, if the Class Member has a new phone number.
3. Update the Subsidy Administrator following the income verification requirements in the Subsidy Packet.
While our outreach team is able to make contact with class members over the phone and through video communication, our assessment team cannot do so because our agency is not a part of the pilot program. This is going to cause a large backlog of members who will potentially have to wait until the new fiscal year to be assessed, since assessments cannot presently be conducted over the phone or via video communication. What is the state's recommendation in regard to this issue? The inability to conduct assessments via phone or video delays class members' processes and causes disruption in regard to our targeted outcomes, which could ultimately impact our funding.
1. For those Prime Agencies not participating in the Tele-Service Pilot program, we recommend taking the following steps so that you are prepared to conduct assessments when the pilot is over: (1) assess whether your current supply of technology will be sufficient to serve all assigned Class Members living in facilities; (2) conduct those portions of assessments that can be done over the phone (for example, document collection and demographic data); and (3) begin discussions with your assigned facilities regarding the details (the who, what, when, where, and how) of working together to complete video assessments.
2. If interested in joining the pilot, please contact Beth Festa.
3. DHS has sent out prior communication (on March 16, 2020), stating that providers will not be financially penalized if services are slowed or stopped during this pandemic.
Comprehensive Transition Program deliverables state that "transition staff are to show residents no less than three units" when in housing search and that "class members must be accompanied to purchase household items". Are these really requirements? If the class member likes the first unit shown is it necessary to show three? Can class members inform the list of household items but not physically participate if the class member is in agreement?
1. The Prime agencies are expected to adhere to the Comprehensive Transition Program deliverables. Training on these deliverables is scheduled for June 11. If a Class Member wishes to pursue and secures the first housing option, additional showings are not necessary. It is expected that the Prime Agency show Class Members no less than three units when they choose not to pursue one of the options or is not accepted for the unit. If it is the Class Member's choice, it is acceptable that they not physically participate in the shopping for household items. This could be a good opportunity to build the Class Member's skills for online shopping.
Is it expected that agencies follow up with legacy class members recommended to transition over 6 months ago with outreach outcomes, informed consents and new assessments?
1. DHS expects Prime Agencies to follow-up with legacy Class Members according to the Comprehensive Program contract deliverables and policies and procedures. Outreach is expected quarterly for all Class Members. Informed Consent is required annually; however, we are asking Prime Agencies to obtain Informed Consent on the new Comprehensive Program Informed Consent document as soon as possible. Assessments are required annually.
What is expected for service plan updates for legacy class members when agencies are not provided assessments or service plans?
1. Regarding Class Members in the community who were assigned to your Prime Agency post-transition, if your agency has not received the legacy assessment or service plan, the Prime Agency is expected to review the clinical needs of the Class Member and develop a new service plan.

May 21, 2020

Subsidy providers from Catholic Charities are now in Entrust however they are requesting that faxes are still the primary way of providing documents. Wondering if we should be communicating to subsidies that Entrust was how we were directed to communicate?
1. IDHS has followed up with Catholic Charities to reinforce the requirement to communicate Class Member information using Entrust.
Would it be possible to have a training specific to the new PRTP quarterly reporting form (there are over 300 items to report on) so clarify what some of the items are asking for and to become familiar with the document?
1. Yes. IDHS is developing a training on the PRTP quarterly report in conjunction with DHS DMH Fiscal. This training will take place during this TA webinar on June 11.
There is a reference to batching documents when submitting encrypted forms to UIC-CON/DHS in the Document Submission training video. How is this done?
1. Documents like the assessment require supporting documentation (like laboratory reports, nursing facility records, etc.) to be submitted at the same time in a single PDF file.
2. This can be done using Adobe® Acrobat Pro or other PDF software. You may need to work with your agency's IT staff in order to determine the best software for your system.
Pamela Glenn is now the listed contact for HACC but is still not in Entrust. Could this also be discussed? Thanks!
1. The State is working with HACC to resolve Pam Glenn's Entrust issues. Until the issue is resolved and Pam can receive documents via Entrust, correspondence should be encrypted and sent to: Guadalupe Marquez, Supervisor (gmarquez@thehacc.org).
Will the data we submit to UIC/IDHS be provided to Prime agencies in advance of the quarterly report due dates?
1. IDHS and UIC are developing a process to share data Prime agencies submit according to the Comprehensive Class Member Transition Program document submission protocol. This process should be complete before the quarterly report is due at the end of July. Please note, however, that data UIC/IDHS can provide to the Prime Agency is contingent upon the Prime Agency submitting complete documentation in a timely manner.

May 7, 2020

The schedule as we know it for post-transition wellness checks is initially weekly, then bi-weekly, then monthly, as the class member progresses in number of months in community. For the roster of post-transition class members we received (the people previously transitioned by MCO or another agency): is the schedule the same? Or is there a different expectation?
1. During the COVID-19 pandemic, DHS has issued guidance requiring, at a minimum, weekly contact with Class Members in the community to ensure their safety and support. Due to the numerous ways in which our society has quickly altered, DHS wants to ensure that Class Members have the ability to connect with Prime Agencies to ask question, get information, and access help if needed. Some Class Members may require more frequent contact (for example, those requiring ACT level of service). The Prime Agency's Care Manager is ultimately responsible for ensuring the expected number of contacts is occurring, whether through the care management team or through clinical services.
Does anyone know how SSA is handling the switching of payee ship services right now? If we want to proceed with transitions, this is a potential barrier.
1. The best way to initiate 'changing payee' is still by phone. The class member should call the local SSA office. (If you don't know which office serves a particular zip code, use this link: https://secure.ssa.gov/ICON/main.jsp). They'll make a phone appointment with the class member.
2. 1) Almost all SSA representatives are working remotely. The necessity to leave a message (rather than getting a live person right away) is routine. They will call you back. Call early unless you want a call-back after regular business hours.
3. 2) Third-party inquiries: The only third-party inquiries that are being honored during the COVID crisis are to current representative payees or to SSA FORMAL representatives.
4. 3) Start the process well in advance of the customer moving out. Remember that SSA guidelines require a letter from SSA to the prior representative payee. The prior payee has 15 days to respond before SSA changes the payee. We recommend that this process be started a month before the class member moves out.
5. If you have other questions about COVID-19 changes at SSA, here's a helpful link: https://www.ssa.gov/coronavirus/. You can also get Social Security and SOAR information here https://www.ssa.gov/and here https://soarworks.prainc.com/
6. If you have other questions about this, call Patricia Reedy at 312-639-4777.
When referring Class Members for homemaker services, the website asks if the person is a Class Member and then asks for a "decree ID." What is a Decree ID and how do we find/obtain it?
1. DHS DMH has provided DRS with the names and contacts of all the Primes so they can establish Consent Decree ID's for each Prime agency. In the interim, you can send DRS the referral request to DHS.HSPColbert@illinois.gov and they will process your request.

April 30, 2020

When will the 850 Excel be available, and will there be training on this document?
1. Please report this issue according to the Policy P6.2 - Facility Concern. DHS is also actively working on addressing this issue.
How can an agency picking up a new Class Member already in the community determine the Medicaid redetermination date, so the agency is prepared and the Class Member does not experience a lapse in coverage?
1. There are a few ways to determine a Class Member's Medicaid Redetermination date:
2. Re-De dates are usually in Medical Electronic Data Interchange (MEDI);
3. We encourage the Prime agencies to talk to Class Members about assigning a Prime employee (a case manager, for example) to be his or her "approved representative." (This is different from representative payee, in which the agency receives benefit funds.)
4. Once your agency's case manager staff is approved representative for a class member, the representative will receive any correspondence-including requests for information for re-determination-that is sent to the class member.
5. Here is the link to the form: https://intranet.dhs.illinois.gov/oneweb/page.aspx?item=86633
What is DHS's position on Prime Agencies being required to find people who have moved from nursing facilities on their own with help from the nursing facility staff, but not Colbert/Williams services, and then being required to follow that person for 18 months post-transition even though the person is not using Colbert/Williams services?
1. DHS had a meeting on 4/28/2020 to develop guidance for the Prime Agencies regarding this issue.
2. We understand that due to COVID-19, some Class Members are moving out on their own, and some nursing facilities are involuntarily discharging members.
3. We are developing guidance that should cover all of these situations and clarify expectations.
Assessors will need the HFS claims to complete the Assessments. In the past we worked with Elizabeth Weiss and she was very helpful/cooperative through this process (we also CC'd Mindy Bristle from UIC). Will we be able to continue with this process?
1. Primes do not need claims data to complete an assessment.
2. You will receive claims data on those Class Members recommended for transition to use as a planning tool; these claims are requested by UIC CON and sent to Prime agencies.
Currently neither HACC nor Catholic Charities staff use Entrust; will CCMTP require subsidy administrators to use Entrust? If so, when will that change occur? During this period of not having access to office equipment, the subsidy administrators' preference for faxed documents is a challenge.
1. Catholic Charities and IACCA now have Entrust. We are actively working with HACC to secure Entrust.
Where in the contract or other document is it stated that post-transition follow-up is to occur for 18 months, and where is the follow-up schedule/frequency stated?
1. The requirement to follow Class Members for at least 18 months is in both the Reportable Incident Policy (P5.2) and the Mortality Review Policy (P5.3).
2. Please note the Prime Agency is to continue support as indicated by Class Member status, which may go beyond 18 months. In addition, a Class Member can refuse services at any point, including after transition.
3. The follow-up frequency is determined by the Class Member's need. Service plan updates are required every 180 days; transition plans are required to be completed in the 14 days before transition. Therefore, a Class Member would have a Service Plan at the time of transition, one at 6 months post-transition, one at 12 months post-transition, and again at 18 months post-transition (which may be a termination plan based on above).
My understanding is we are not to pursue confirmation of exclusionary conditions by a 3rd party medical provider unless the CM is able to provide informed consent for assessment. Thus, if a CM is approached at outreach phase, has symptoms of an exclusionary condition and is unable to sign or provide consent to proceed to the assessment phase, are these CMs still to be approached every 3 months?
1. Prime Agencies are expected to outreach and assess Class Members that provide Informed Consent. If a Prime Agency encounters a Class Member who appears unable to provide Informed Consent, the Prime Agency should gather as much information from the facility staff on the status of the Class Member's cognitive functioning and ability to consent for assessment. These cases should be presented to their DHS OMSU designee, and consultations can be requested from the UIC CON clinical team as needed.
We're being told by Catholic Charities that they will not accept an unsigned participation agreement along with household composition and income packet for any new clients. They are accepting unsigned paperwork for all renewals, but not for anyone in the process of moving out of a nursing home. […] Is there any room for workaround with this issue given the extreme situation we are currently in?
1. DHS sent the following communication to Catholic Charities (and the other two subsidy administrators): "Please note that effective immediately DMH will authorize (temporarily) IACAA and CC to accept class members' verbal agreement and two (2) witnesses' signatures (provider care managers and their respective supervisors), in lieu of class member's signatures normally submitted with client agreement and SA referral forms. This will be authorized until the pandemic restriction is lifted."

April 23, 2020

Is IDPH sharing/releasing any information regarding what nursing facilities have active COVID-19 cases? The agencies are hearing rumblings from CMs and facility staff about active cases within their facility.
1. Yes, IDPH is releasing weekly data regarding facilities have had confirmed COVID-19 cases. The link to this data was shared with Prime Agencies on 4/20/2020: https://www.dph.illinois.gov/covid19/long-term-care-facility-outbreaks-covid-19
Is the COVID incident reporting and tracking to follow the same guidelines in that this is only for those within their 18-month post transition? Does this include those living in a facility? Or just community members?
1. For Class Members in the Community 18 months or less, Prime Agencies should use the Reportable Incident form to report COVID incidents. The form should be submitted according to the Document Submission Guidelines posted on UIC's website, and in addition should be emailed (encrypted) to Rebecca Paz, Ryan Rollinson, and Elizabeth Festa.
2. For Class Members living in a facility, Prime Agencies should report COVID incidents using the excel spreadsheet and protocol sent to you on April 8, 2020.
3. Please note: If a Class Member passes away (including due to COVID) while living in a facility, there is pre-transition status change form that must be completed and submitted.
Is the COVID incident reporting and tracking to follow the same guidelines in that this is only for those within their 18-month post transition?
1. For Class Members in the Community 18 months or less, Prime Agencies should use the updated Reportable Incident form to report COVID incidents.
2. The form should be submitted according to the Document Submission Guidelines posted on UIC's website, and in addition should be emailed (encrypted) to Rebecca Paz, Ryan Rollinson, and Elizabeth Festa.
(continued from previous question) Does this include those living in a facility? Or just community members?
1. For Class Members living in a facility, Prime Agencies should report COVID incidents using the Excel spreadsheet and protocol sent to you on April 8, 2020.
2. Please note: If a Class Member passes away (including due to COVID) while living in a facility, there is pre-transition status change form that must be completed and submitted.
We are going to get our housing locator person certified to do HQS inspections and while I have done a little research it seems there are a number of companies out there that provide this training. Do you have any recommendations or know who other agencies have used?
1. IDHS does not allow providers to administer their own inspections at this time. Inspections must be conducted by the subsidy administrators through the approved housing process and procedures.
Follow-up to last week's question on documenting witnesses for verbal consents: Is an actual physical signature required or is an electronic signature permitted?
1. IDHS will accept electronic signatures during the COVID-19 pandemic.
On the Colbert & Williams Training site, Medicaid waiver Home and Community Based Services processes and forms are Colbert-specific. Do the processes and forms apply to Williams Class Members also?
1. IDHS and UIC are updating these trainings.
2. However, the processes and forms apply to both Colbert and Williams Class Members.
Will there be a training or webinar on all policies and processes on the Colbert & Williams Training website? Specific interest in the CAST and Appeals/Grievances.
1. Yes, there will be trainings on the policies and processes posted on the Colbert and Williams Training website. These trainings are being finalized and will be available very soon.

April 16, 2020

How do we document witnesses for verbal consents?
1. Please have both witnesses sign and date, along with a statement that you were unable to obtain the Class Member's signature due to COVID-19.
2. One acceptable example:
  1. Unable to obtain Class Member signature due to COVID-19 restrictions. Witness signature 1: [Signature] Printed Name, Date Witness signature 2: [Signature] Printed Name, Date
What credentials are qualified to complete the Quadrant Placement form?
1. Assessment credentials are needed:
2. Master's Degree in counseling, social work, psychology or other highly-related field, supervised by an LPHA, RN or OT with oversight of the assessor's work.
Will scheduled neuropsychological exams canceled due to COVID-19 restrictions be rescheduled? If so, how will new appointments be communicated to CMs, NF staff and Prime?
1. The class members, facility staff, and Prime agencies will be notified once exams are ready to be scheduled. Imani and Valencia will notify all parties involved when this occurs.
What's the process, including required documentation, for closing a case and notifying DHS/DMH? Examples: - When an assigned CM is discharged from NF? - A CM transferred from sunsetting provider is no longer interested in receiving services? - A post-transition CM cannot be located?
1. The Pre-Transition Change form should be completed for class members who are discharged from facilities, or when a member/guardian is not interested in continuing to receive services. Additional specific guidance regarding closing members after transition is forthcoming.
2. Please follow instructions in guidance distributed on 4/8/2020 if you are unable to contact a Class Member in the community.

April 9, 2020

Is there no longer a window of time clients have to be living in a facility prior to doing the assessment?
1. Primes must wait 60 days after admission to engage in Class Member-specific outreach. This applies to both Colbert and Williams Class Members.
2. Class Member-specific outreach must be attempted between day 60 and 70 after admission. The Prime Agencies can engage in general outreach activity (that is not Class Member specific) at any time.
Can you clarify if there are any positions covered by the grant which can bill any services to Medicaid Rule 132?
1. Any positions that are eligible to bill under Rule 140 may do so at this time.
2. The Comprehensive Program is a pilot program; we will be evaluating all aspects of the Comprehensive Program, including the cost of delivering services.
Are you able to help us get informed consents that were previously summitted by the prior agency? We are having trouble getting them from the old agencies.
1. IDHS will assist in obtaining any legacy files in our possession or control. Please notify your IDHS OMSU Compliance Auditor of the records you need or are missing. If we do not have these records, the Prime Agency will have to engage the Class Member to obtain updated forms.
Can we use UIC as a resource for missing evaluations and service plans?
1. Please notify your IDHS OMSU Compliance Auditor of the records you need or are missing. If we do not have these records, the Prime Agency will have to engage the Class Member to obtain updated forms.
Will subsidy providers be using Entrust to receive documents (inspection requests/housing forms)?
1. Any document containing Class Member PHI should use Entrust. We are working with the subsidy providers to ensure they are using Entrust.
MCOs have been sending records for class members that were not assigned to us on the master list sent by the state for post-transition members. Were Illinicare and Aetna sent the same lists that were sent to the Primes?
1. Pending
Outreach Outcome form: do we need to submit all 3 pages when either page 2 or page 3 will always be not applicable?
1. Yes, Prime Agencies need to submit all 3 pages. Please check N/A and initial those pages that are not applicable, to clearly communicate that the page is intentionally left blank and the form is complete.
Informed Consent form: There is no place for a guardian to decline if they do not want the class member to be assessed.
1. The forms are under review and these comments will be taken into consideration.

April 2, 2020

For Aetna and IlliniCare members, when will the geographical location change in these assignments take place?
1. The final assignments of Colbert Class Members living in the community who were transitioned by agencies not involved in the Comprehensive Program were sent out on or around March 20th.
Can Prime agencies use flex funds if a class member transitioned by another agency needs something in the community?
1. Yes. Prime Agencies can use flex funds to serve Class Members previously transitioned and living in the community.
2. If, over the course of the contract, the Prime Agency begins to run low on flex funds due to these previously transitioned Class Members' needs, please contact Consent Decree staff to discuss.
Several questions were asked about Critical Alert Incidents and the roles of the DHS Quality Monitors.
1. The processes and procedures surrounding issues that Class Members present to the DHS Quality Monitors are being finalized. Answers will be presented next week (April 9).
Are Primes allowed to conduct assessments over the phone with the intent to later follow-up/verify with the class member physically once nursing facility restrictions are lifted?
1. Prime Agencies participating in the telehealth pilot can conduct assessments under the terms of that pilot program. All other Prime Agencies should not conduct assessments via phone or video while the NF/SMHRF restrictions are in place, unless and until IDHS develops a standardized process for phone/video assessments.
If a Class Member's post-transition case was closed at the 12-month mark (under the former program), but the Class Member is still within the 18-month monitoring timeframe, should the Prime reopen the closed case and continue to monitor the Class Member until the 18 month mark?
1. For Williams Class Members, there is no change. Williams class members always have always been and will continue to be monitored in the community for 18 months post-transition.
2. For those Colbert Class Members whose case was closed at the 12-month mark prior to February 1, 2020, those cases should remain closed. All other Class Members who are receiving Care Management services in the community as of February 1, 2020 should remain open for 18 months.
We have heard that all neuropsych evaluations and OT assessments have been postponed until further notice. Should we continue to send the referrals over for a waiting list? Or should we discontinue sending them at all?
1. Please continue to send referrals for neuropsych evaluations and OT assessments so that these can be conducted once services are able to resume.
In a quality review of the Comprehensive Service Plan, what is being reviewed and how will it be rated?
1. UIC CON will review its process for quality review of CSPs on Thursday, April 9, 2020. The process will be the same as UIC has historically conducted under the Colbert consent decree.

March 26, 2020

For Class Members who have transitioned, which agency is responsible for monitoring the Class Member during the 18-month post-transition period?
1. This is the assigned Prime agency. For Williams members, this is the CMHC that was responsible for the member's transition. For Colbert members, it is the Prime to which the class member was assigned by IDHS.
Does the Informed Consent allow sunsetting providers and Prime agencies legal permission to exchange class member information without violating HIPAA?
1. Yes, the informed consent does allow exchange of information between the sunsetting provider and the new Prime.
Should Primes be instructed to have the Informed Consent signed by all class members that are assigned to them prior to their provider-to-provider meeting and the exchange of records?
1. Yes, the informed consent should be signed by all class members who are working with Prime agencies. However, IDHS is investigating whether the current federal 1135 waiver may allow relaxation of this physical signature requirement due to the relaxation of HIPAA regulations during the COVID-19 outbreak. Informed consents should be submitted to IDHS and UIC CON.
Can a class member request to be assigned to a specific Prime of their choice, rather than being assigned to a Prime based on their nursing facility/SMHRF? What is the process for this?
1. Members can request to work with a specific Prime agency; members should request this by filing a grievance with their initially assigned Prime, who should immediately forward this request to IDHS.
2. In addition, regardless of Prime agency, members can also elect to receive Rule 132 community mental health services from any provider.
For class members who are recommended for CAST by the sunsetting agency, should the new Prime move forward with closing the class member's case?
1. New Prime agencies should follow the CAST process if they feel that the class member is unsafe to transition at this time. The class member's case should not be "closed."
For class members who were recommended for transition and moved from a nursing facility/SMHRF to a SLF, does that count as a transition?
1. YES
Our understanding was that Comprehensive Service Plans could be completed by a minimum bachelor's level staff, as long as a credentialed care manager reviewed and signed off on them. Is this accurate?
1. No. CSPs are required to be completed by Care Management staff. Care Management requires a Master's Degree in counseling, social work, psychology or other highly-related field, supervised by an LPHA, RN, or OT with oversight of the care managers.
Can we "count" class members transitioning from nursing facility to residential, and then again when they move from residential to an apartment? Or just when they move from the facility to residential?
1. No, class member transitions should only be counted once, i.e., from the SNF/SMHRF to the residential facility. The transition from residential facility to the apartment does not "count."
We have previously moved some class members from the nursing facility into RSSI. Is RSSI still a contracted provider, or should we interface with them as we would any non-contracted housing provider?
1. The Prime agency is ultimately responsible for all aspects of the Class Member's transition. The Prime agency should interface with RSSI as it would any other housing provider.
You previously confirmed that class members who have already moved, had a lease signed, or application approved, would stay with their sunsetting agency, but all other referrals would be the Prime's responsibility. If we run into scenarios where the sunsetting agency is pushing back, to whom should we refer them?
1. Any questions regarding class member assignments or information sharing should be directed to Sandra Brand (Sandra.Brand@Illinois.gov)
Will class members with exclusionary diagnoses need to be outreached again? Will the exclusionary diagnosis need to be re-confirmed by an MD independent from the LTC facility if it hasn't been already?
1. Answer is pending.
Will DMH be forwarding the Decatur Resident Reviews from January to Heritage, or would they like us to send and ROI to CMS at Decatur Manor so we can forward the Resident Reviews directly?
1. Upon request, DMH can forward these to Heritage.
Can Williams Class Members be approached for outreach at any time?
1. Members should be able to access outreach at any time, although that may be limited at this time given the current public health situation.
If a class member is not recommended for transition, do they need to be re-approached by outreach for another evaluation, or by the assessor?
1. Once a member has been not recommended for transition, they should have a service plan update at the 6-month mark, and an annual assessment at 12 months. They do not require additional outreach.
2. However, Prime agency staff are expected to maintain engagement with the member throughout this period in order to enable the member to work towards the goals established in their service plan.
Is there an exact time frame that a Prime has to respond to a Critical Alert Incident once they are notified by the OMSU Compliance Auditor? What is the time frame for reporting the outcome of the investigation to the OMSU Compliance Auditor?
1. DMH is in the process of developing timeframes for responding to issues discovered by home visits. Critical follow-up issues are an internal process designed to seek a resolution, identified by the consent decree monitors. Written guidance is pending.
What does the Quality Monitor look for during a class member home visit that would trigger a Critical Alert Incident?
1. Answer is pending.
How frequently will Class Members be visited in the community by a state Quality Monitor under the Comprehensive Program?
1. The Quality Monitors will be conducting home visits at the following intervals once the class member transitions to the community: 30 days, 90 days, 6 months, 12 months, and 18 months.
Will there be a formal Critical Alert Incident training for the Primes and information about the Role of the State Quality Monitor?
1. There will be a written protocol to address follow-up to critical issues.
Can a new Prime agency who "inherited" a member currently in the community use flex funds if that member needs something?
1. YES
Do DON score requests still go through the member's Medicaid MCO?
1. Any provider can initiate a waiver application by working with the member to submit an application with either the Department on Aging or the Division of Rehabilitation Services in IDHS. The MCO will assure waiver services are implemented once the member has been approved for the waiver. The provider may coordinate this work with the MCO care manager.