1529 Q&A - Front Door Diversion (800)

TA Session Presentation:  Pgm800FDDTA3-22-21 (pdf)

ACT/CST Start-up Policy Program 800:  ACTCSTStart-UpPolicy800 (pdf)

Questions from the TA Session held 3/22/21

  1.  Q:  Are out of state applicants able to apply? 

    A:  Yes.

  2. Q:  Can you provide any insight into the volume applicants can expect to see to inform a proposed staffing model?

    A: There are attachments within the NOFO.  See Attachment A, B and E in regard to this.

  3. Q:  How quickly would an awarded provider be expected to begin diversion?  What is the start-up time?

    A:  We would expect diversion for providers to begin operating on July 1, 2021.  This NOFO closes April 15, 2021, so DMH will work quickly to review the proposals and issue the Notice of Award and begin negotiating so that everyone who is chosen can begin providing services on July 1, 2021.

  4. Q:  Regarding milestone payments and psychiatric admission, how will this be tracked/reported?

    A:  We have not definitively worked all of the tracking and reporting out.  We would expect the front door grantees to track and report their activities.  Currently it is being done by Excel Spreadsheet and then DMH does verification.  In the future we hope to roll out a web-based system but that is not definitive yet.

  5. Q: 
  6. Q:  Are ACT services covered by this NOFO or is there an expectation to contract with Medicaid MCOs?

    A:  There is an expectation that the grantee contract with Medicaid MCOs.  Services that are reimbursable by Medicaid are not funded through this grant.  This grant will fund performance milestones and will fund expenses that are not reimbursable by Medicaid such as emergency support, temporary residential housing and staffing and administrative support costs that are not Medicaid billable.

  7. Q:  Should the budget reflect proposed milestone payments?

    A:  Yes.

  8. Q:  Do grantees have to be able to provide ACT/CST services or do they just have to secure those services?

    A:  Grantees have two choices.  They can provide ACT/CST services themselves or they can secure those services for their clients through another provider.  The arrangement for ACT/CST services would be approved by DMH.  Include in your proposal whether you will be providing ACT/CST services or if you will use a third party and let us know the details of who that third party is and how you can ensure access to those services.

  9. Q:  Is it realistic for an out of state provider to hire staff, start diversion operations and contract with MCOs in the timeline you have provided? 

    A:  We don't want to discourage out of state providers to apply.  If you don't think you can have it in place by July 1st, please submit an application and outline when you can begin providing services in your proposal. 

  10.  Q:  Can DMH support expedited credentialing with the MCOs and cover costs while the contracting process is under way.

    A:  Credentialing is handled exclusively by the Illinois Department of Healthcare and Family Services (HFS) through its IMPACT provider enrollment system. Once credentialed by HFS, providers must contract with those MCOs with whom it would like to partner and complete the universal provider roster (which can be found here (Illinois Association of Medicaid Health Plans (IAMHP) - Providers). IDHS cannot cover costs while the Medicaid contracting process is underway. If the applicant anticipates that it cannot complete all steps necessary to become an Illinois Medicaid provider by July 1, 2021, the applicant can still submit an application and specify the date on which it believes it can begin providing Front Door Diversion services. However, the applicant can partner with Community Mental Health Centers in Illinois to provide Medicaid services to its diversion clients.

  11. Q:  Can projected budgets include one-time start-up costs of operations that would normally be part of an indirect cost rate for the first year?

    A:  You cannot claim start-up costs as well as indirect costs both at the same time.

  12. Q:  Are direct start-up costs allowable? 

    A:  If it is not part of your indirect base that you apply your indirect cost rate to, to avoid double charges and it is strictly a direct cost, in the past we have allowed start-up costs for ACT and CST teams until a full complement of a team is in place in order to bill Medicaid for ACT and CST services to be reimbursed.  We have a policy for how many months we will pay.  It is paid over a 3-month period but it is equivalent to two full months of salary.  We will provide a better explanation of this in writing that explains the percentages and declining scale for those three months from 100 percent down to 66 percent, down to 33 percent, which is why we say it is equivalent to two months of salaries of staff you are bringing on board with the expectation that in the fourth month the compliment of the team would be in place and you could begin billing for Medicaid for those services. 

  13. Q: Are ACT rates publicly available?

    A:  Yes, they can be found here:  https://www.illinois.gov/hfs/SiteCollectionDocuments/11092020CommunityBasedBehavioralHealthFeeScheduleEff07012020Final.pdf

  14. Q:  Can you provide formula/rules for budgeting line item start-up costs?

    A:  If you are referring to what is allowable you need to refer to 2 CFR 200 in the section for allowable costs.  We do not pay for capital expenditures.  The threshold is set by your cost policy and everyone's cost policy is different.  If you have any type of capital expenditure it gets depreciated and it is applied according to your individual cost policy.  We do not pay an outlay of cash for any type of capital expenditures . 

  15. Q: Re: the allowable costs under 2 CFR 200 what are the percent of salary expenses you allow while waiting for MA agreement covered in the first three months.

    A:  See document above.  We would pay for salaries and fringes on a declining scale.

Other Questions

  1. Q:  Does this require agencies have both ACT and CST or would an ACT team meet this requirement?

    A:  Agencies need to have capacity in BOTH ACT and CS-T programs to meet consumer needs. Should capacity be exhausted in existing teams, the agency should be prepared to add services to meet new demand.

  2. Q:  Are agencies required to be identified in the PASRR volumes historical data to be eligible (attachment B)?

    A:  Attachment A shows "ALL state/county-operated psychiatric hospitals and all community hospitals with a HFSRB authorized inpatient psychiatric (AMI) unit are allowable as participant hospitals." Attachment B identifies "Historical data on completed Level 2 screens which could result in referrals for Front Door services." A hospital could be identified on Attachment A as "allowable as participant hospitals" and not show Level 2 activity as in Attachment B. Agencies in their program proposal response should clearly identify those hospitals from Attachment A which they plan to serve.

  3. Q:  In the definition of diversion, subpart e, states that "the person is housed into safe, stable housing/residential setting." Are motels or SROs considered safe, stable housing for the purposes of this grant?

    A:  While motels or SROs may be used for the purposes of diversion if no other options are immediately available, motels and SROs are not the preferred safe and stable housing.

  4. Q:  Will supports offered to Williams and Colbert Class Members, such as Durable Medical Equipment and access to Assistive Technology through UICs Assistive Technology Unit be available for participants in this program?

    A:  Most DME is available and funded through the individual's Medicaid MCO. Access to Assistive Technology through UIC's ATU will be available to Front Door Diversion participants in FY22.

  5.  Q:  Will financial supports such as those offered to Williams and Colbert class members be offered to participants in this program? For instance, will these clients be able to access bridge subsidy?

    A:  Front Door participants will be eligible for Bridge subsidies which will include one-time transition funding allotments up to $2,800.

  6. Q:  Regarding the Milestone 4 requirement, what does the "negotiated diversion target number" represent? Is this a set number that already exists?

    A:  See "Service Program details 7", "Grantee shall clearly advise in narrative and budget sections their projected numbers of Offers and Diversions. Target numbers for offers and diversions will be negotiated upon contract execution".  "Milestone 4 Outcome Payment:  Grantee can invoice and will be reimbursed $1,000 for each person diverted in excess of their negotiated diversion target number.  Determined and Reimbursed ANNUALLY on attainment".