Program Description
Scope of Services:
Front Door Diversion Program (FDDP) services are to be provided to an eligible person who, without such services, might be referred and/or admitted to a Specialized Mental Health Rehabilitation Facility (SMHRF), and who have been assessed as appropriate for community-based services. Services are provided to maintain individuals in the most integrated community-based setting. Persons eligible for FDDP services are defined as:
- Medicaid eligible or Dual-eligible (Medicaid/Medicare-eligible) (Note: This eligibility criteria is subject to potential expansion. If expanded, grants will be amended to reflect the same.) and
- Persons who have received a Level 2 Screening by a PASRR agent as contracted with DHS/DMH or HFS and/or have a current completed PASRR screen completed within the last 90 days 1 and
- The PASRR screen must contain a Level 2 Determination and Disposition of "Eligible for Nursing Facility - Diverted to Community Option."2
Engagement into the FDDP:
Engagement may be initiated at different "intercept points" and as determined by PASRR with focused action to include, but not be limited to, the following:
- Community Hospital inpatient psychiatric units and/or emergency departments;
- State-operated and county-operated hospital inpatient psychiatric units;
- Community hospital behavioral health crisis stabilization units;
- IDHS-sponsored Crisis Residential (Program 860) sites as described below;
- IDHS-sponsored CILA (620), Supported (820) or Supervised Residential (830, 832) sites as described below;
- Other community-based settings, as approved by DMH.
Rapid Re-Integration:
Grantee shall provide, upon direction and referral from DHS/DMH or HFS PASRR vendor, evaluative, transition case management and treatment services which the person agrees to participate in for those persons admitted to Specialized Mental Health Rehabilitation Facilities (SMHRFs) known as Rapid Re-Integration and/or
Transition from short-term residential programs:
Grantee shall provide evaluative, transition case management and treatment services which the person agrees to participate in for those persons either admitted to any DMH funded short-term crisis residential (860) or a DMH funded residential treatment program (820,830,832,620) as part of the diversion plan.
Grantee shall assume primary responsibility for discharge planning from both of these short-term services.
Service Program Details:
- Grantee shall within twenty-four (24) clock hours of receipt of the referral complete an assessment of need, then recommend and offer a discharge/ treatment plan which provides for alternative community-based treatment care options, housing opportunities, as needed, and support services, as needed, for the referred person to secure a diversion. This program shall fund Grantees in the manner displayed in Payment Method section below.
- Grantee shall directly provide or secure, through an affirmative letter of agreement or contract with another provider agency, as is acceptable to DHS/DMH, each referred person with access to the full array of all Rule 140 behavioral health services to address the individual needs, including without limitation case management and team-based services of Community Support, Team (CS-T) and Assertive Community Treatment (ACT), Peer Recovery services, and SOAR and employment services for persons that have accepted diversion.
- Grantee staff must be fully and appropriately trained and credentialed to provide all services, including to meet the assessment and service needs of those with serious mental illness or /with serious mental illness and other co-occurring disorders with distinct team-based services (CS-T, ACT), and other support services as needed to effectively support participants in community-based clinical care.
- Grantee shall have the capacity to provide continuing outreach and treatment contacts with participants following diversion, in the community or other settings, to maintain engagements with the participants to support them in the community, including the provision of supportive services for the participant(s) as provided in their agreed to treatment plan and completing subsequent re-evaluations or re-assessments after the initial diversion.
- Grantee shall offer and make fully available to potential and existing Front Door participants access to ALL of their agency's DHS and DMH funded services or programs. Proposals shall fully detail the full array of these agency-based services. Agencies which provide an affirmative contract or letter of agreement with another provider, as acceptable to DHS/DMH, shall also guarantee admission/access to ALL of that sub-contractor's DHS and DMH funded services or programs.
- Grantee shall be expected to provide an offer for diversion to all consenting referrals received from PASRR as the default action. Likewise, it is the predominant purpose of the program to secure diversions into community-based services so that participants can live successfully in the most integrated community-based setting appropriate to their needs.
Diversion is defined as: A person who has received and accepted an offer from the grantee which provides:
- the full array of treatment services needed and to be provided by the grantee and/or secured for the participant AND
- the full array of housing site/services needed and to be provided by the grantee and/or secured for the participant AND
- the full array of supportive services as defined below, including SOAR or employment services, needed and to be provided by the grantee and/or secured for the participant AND
- the grantee has accomplished one (1) case management encounter with the participant within 24 hours of discharge or diversion start date AND
- the person is housed into a safe, stable housing/residential setting.
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.
8. Grantee shall establish and maintain capacity to also serve each of the below referenced populations with serious mental illness, including:
- persons with co-occurring SUD AND
- DHS/DMH-identified forensically involved persons (serving this specialty population includes provision of all mandated court reporting requirements, and the further requirements set forth below at part C 5 AND
- court involved persons AND
- persons registered as sexual offender status AND
- persons aging out the care and custody of DCFS AND
- persons who are homeless AND
- persons with co-occurring physical disabilities AND
- persons without verifiable income such as access to SSI/SSDI, or other federal or state Income subsidies.
9. Grantee will assist participants with all applications for state and/or federal medical benefits, including re-determinations and appeals.
Housing Service details:
Grantees shall create immediate housing capacity using grant funds as per the approved contract budget. This housing shall be used to provide access to safe community housing immediately upon acceptance of an offer for diversion, either by
a. A comprehensive HOUSING FIRST proposal whose services are all directly provided by applicant or with an affirmative letter of agreement/subcontract with another provider, as acceptable to DHS/DMH. Proposals shall advise:
i. admission, exclusion and discharge criteria, if applicable;.
ii. how the grantee will maintain occupancy management and secure new housing stock;
iii. how the grantee will ensure and maintain participant's access, linkage and engagement to all treatment services;
iv. These programs must provide in the narrative and budget how they will comply with all other requirements in this NOFO specifically how the proposed model ensures engagement to all treatment services, as identified in the participant's treatment plan.
AND/OR
b. The leasing of a transitional studio or one (1) bedroom furnished apartment(s) or other such units as accepted by DHS/DMH which a participant may use temporarily to support their stabilization. The participant and the agency must actively attempt to secure mid to longer term permanent housing using all options. These transitional units will be expected to be re-used with subsequent participants.
Length of stay in such immediate transitional housing should be 90 calendar days or less. Extensions can be approved by the FDDP Program Contact if it facilitates the desired outcome of securing safe, affordable housing of choice for the participant(s).
2. Grantee shall register participant(s), including those needing housing at any time during their participation, into the SRN/PAIRS database for potential access to the SRN, 811 housing waitlists and matching processes. Grantee shall assist participants with all applications, tenancy services and housing search activities as well as all possible housing program options to progress towards independent Permanent Supportive Housing (PSH), including use of FDDP Bridge Subsidy Program, PAIRS, State Referral Network, 811 Vouchers, any and all federal, state or local subsidized housing opportunities etc. Grantee shall educate participants on all program requirements.
3. Grantee shall advise how they propose to use, if any existing, DMH funded residential programs, - 860, 830, 832, 820, 620 - under their direct agency control or as secured through sub-contract or an affirmative letter of agreement with another provider, as acceptable to DHS/DMH. Proposals shall include written admission, exclusion and discharge criteria (policies) for each level of care proposed
Support Service:
1. Grantees may use contract funds to provide for the emergent support needs of participants. Those allowable supports may include transportation vouchers/cards, emergency clothing, emergency food, emergency medications, and emergency communication (cell phones). Grantees will first utilize any available governmental or community resources for these needs, and transition participants to these other support options as soon as is possible.
2. Other support needs may be requested for approval from the FDDP Program Contact person on an as needed basis
Staffing details:
1. Grantees may incur and be reimbursed for budgeted approved costs (payroll and fringes) for only those staff who assist with all levels of housing services, SOAR activities, employment service, recovery services, or provide supervision or administrative management solely for their non-billable (Rule 140 or other payor) services/time as distinctly identified in the proposal narrative and budget.
2. Grantees may incur and be reimbursed for administrative support costs that may be needed to administer the emergency support, housing, SOAR activities, employment services.
1 This requirement is subject to change based on the Illinois Department of Healthcare and Family Services Request for Proposal for Pre-Admission Screening and Resident Review System, 2021-23-008. See https://www.bidbuy.illinois.gov/bso/external/bidDetail.sdo?bidId=21-478HFS-MEDPR-B-18523&parentUrl=activeBids
2 This requirement is subject to change based on the Illinois Department of Healthcare and Family Services Request for Proposal for Pre-Admission Screening and Resident Review System, 2021-23-008. See https://www.bidbuy.illinois.gov/bso/external/bidDetail.sdo?bidId=21-478HFS-MEDPR-B-18523&parentUrl=activeBids
Deliverables:
- Responding to Referrals from identified Settings:
- Grantee shall have the capacity available with appropriately trained and credentialed staff to meet the assessment and service needs of those with serious mental illness or with serious mental illness and other co-occurring disorders to respond to referrals made by PASRR agents at identified local community hospitals or state/county hospitals or approved sites as indicated #A Engagement into FDDP 1,2.3 above.
- Grantee shall perform within 24 clock hours of receipt of the referral, a review of PASRR referral materials, including online reports, a face-to-face assessment by an MHP (with immediate 24/7/365 access to a QMHP) or QMHP. (The state reserves the right to modify the face-to-face requirement to conform with Illinois Department of Public Health standards, directives or requirements); and then recommend and offer a treatment plan which provides for alternative community-based treatment care options, housing or residential placement, as needed, and support services, as needed.
- Grantee shall provide continuing care management for persons accepting diversion (alternative care options) until a hard hand-off is accomplished at the next level of community-based care, as identified in the participant's agreed to discharge/treatment plan with their agency or other psychiatric service providers or by another DMH/SUPR agency.
- Grantee shall provide continuing care management for participants (alternative care options) with their agency utilizing all clinically appropriate Rule 140 services as defined in the agreed to discharge, master treatment plan (or as amended) until the participant terminates care.
- Grantee shall provide first outreach/engagement within 24 hours, via telephone or face-to-face, following the participant's exit (discharge date) from the hospital unit or other approved site as indicated or the diversion start date.
- Grantee shall register all participants using the unique Front Door Diversion Program identifier in accordance with the requirements of the Provider Manual and shall report participants served through the submission of billing claims according to requirements prescribed by the HFS Rule 140 or other payor standards.
- Grantee shall exhaust all other resources, including but not limited to Medicaid, MCO, Medicare or other insurance, to ensure that DHS/DMH is the funder of last resort for these levels of care/services. Grantee shall comply with all other requirements of the Provider Manual, including but not limited to Grantee monitoring and utilization management.
- Grantee shall submit registration data and Rule 140, FFS or MCO, billing claims information on a weekly basis.
Payment
Reference the Uniform Grant Agreement, Article IV Payment, Section 4.3 Cash Management Improvement Act of 1990 and Section 4.7 Timely Billing Required. Grantee shall submit allowable grant expenses on the appropriate DMH invoice template to the email address indicated on the template no later than the 30th day of the month following the end of the service month. Invoiced expenses should be consistent with the approved annual grant budget. Any expenditure variances require prior Grantor approval in accordance with Article VI of the grant agreement to be reimbursable. All invoices shall be HIPPA compliant Invoices shall serve as the request for reimbursement as well as the Periodic Financial Report (PFR, 4002).
The FDDP invoice template can be found in the Provider section of the DHS website.
a. Rate-based services (PAY for PERFORMANCE) will be reimbursed as follows:
Milestone 1 Outcome Payment.
Grantee can invoice and will be reimbursed $3,000 for each person diverted (see definition A Service Program Details 6 above). The date of hospital discharge or diversion start date is equal to day one (1). Reimbursed once in the attainment month.
Milestone 2 Outcome Payment.
Grantee can invoice and will be reimbursed $3,000 for each diverted person who remains in community placement at day 90 who is also engaged in treatment services from the diversion start date with no intervening behavioral health (psychiatric) inpatient admissions nor any admission to any type of long-term care facility. Reimbursed once in the attainment month.
Milestone 3 Outcome Payment.
Grantee can invoice and will be reimbursed $1500 for each person diverted and who was placed into a Permanent Supportive Housing (PSH) unit, defined as a leased unit in the person's name. Reimbursed once in the attainment month.
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.
NOTE: The date of hospital discharge or diversion start date is equal to day one (1).
b. Expense based services will be reimbursed as:
Emergency Support Needs: Grantee will submit monthly invoices utilizing the DMH invoice template and delineating allowable expenses during the month as described in Exhibit A Scope of Services.
Temporary Residential Housing Option(s): Grantee will submit monthly invoices outlining allowable costs for the proposed unit(s) by utilizing the DMH invoice template and delineating allowable expenses during the month as described in Exhibit A Scope of Services.
Staffing and Administrative Support Costs: Grantee will submit monthly invoices utilizing the DMH invoice template and delineating allowable expenses during the month as described in Exhibit A Scope of Services.
Performance Measures:
1. Engagement/linkage at identified Hospital Psychiatric Inpatient Units or approved sites as indicated above:
a. Number of persons referred from PASRR to establish baseline.
b. Number of first contacts performed by an MHP (with immediate 24/7/365 access to a QMHP) or QMHP within twenty-four (24) clock hours after receipt of the referral.
c. Number of referrals resulting in consent to the program.
d. Number of consenting referrals resulting in an offer for recommended diversion.
e. Number of persons who were diverted after receiving an offer for diversion
2. Rapid Re-Integration: Engaging persons at Specialized Mental Health Rehabilitation Facilities (SMHRFS) for active enrollment in Front Door Diversion Program:
- Number of persons referred either by DMH or HFS PASRR and admitted to a SMHRF to establish baseline.
- Number of persons who were contacted at the SMHRF within 3 calendar days after admission to the SMHRF.
- Number of persons who consent to the program.
- Number of consenting persons who received an offer for diversion to community-based services within 10 business days after admission to the SMHRF.
- Number of persons who were diverted after being contacted at a SMHRF and receiving an offer for diversion.
3. Supportive Services for securing safe, affordable housing:
- Number of persons accepting diversion and who were homeless or deemed to have unstable housing at the time of the Level 2, as noted by PASRR, to establish baseline.
- Number of persons accepting diversion who were registered into PAIRS within 30 calendar days of the diversion start date and who were homeless or deemed to have unstable housing at the time of the Level 2, as noted by PASRR
4. Supportive Services for transition from short term crisis stabilization programs:
- Number of diverted persons who were admitted to any DMH funded short-term crisis (860) stabilization or residential treatment (820, 830,832,620) program(s) for short-term stabilization as part of their diversion plan, to establish baseline.
- Number of persons who were contacted at that facility to which they were transferred or discharged to within 3 business days after admission to that program.
- Number of persons who were discharged to community-based services within 180 calendar days after the admission date.
- Number of persons who were provided transition case management services by the Front Door provider during the entire length of stay.
5. The Division of Mental Health (DMH) will require additional monthly reporting requirements which will identify participants at all levels of engagement and their statuses at those stages; costs of services which may be proposed as in Sections above.
Performance Standards:
1. Engagement/linkage at Hospital Psychiatric Inpatient Units or approved sites as indicated above.
- 95% of PASRR referrals result in a face-to-face first contact, performed by an MHP (with immediate 24/7/365 access to a QMHP) or QMHP within twenty-four (24) clock hours after receipt of the referral.
- 90% of PASRR referrals for consenting participants receive an offer for diversions to community-based services.
2. Rapid Re-Integration: Engaging persons at Specialized Mental Health Rehabilitation Facilities (SMHRFS) for active enrollment in Front Door Diversion Project.
- 100% of referred persons are contacted at the SMHRF within 3 calendar days after admission to the SMHRF.
- 90% of referred persons who consent to participate in Rapid Re-Integration receive an offer for diversion to community-based services within ten (10) business days after admission to the SMHRF.
- 75% of persons were diverted after receiving an offer for diversion to community-based services.
3. Supportive Services for securing safe, affordable housing
a. 100% of persons were registered into PAIRS within 30 calendar days after the diversion start date after accepting diversion and who were homeless or who were deemed to have unstable housing at the time of the Level 2, as noted by PASRR.
4. Supportive Services for transition from short term crisis stabilization or other residential programs as part of the diversion discharge treatment plan.
- 100% of persons are contacted within 3 business days after admission to any DMH funded short-term crisis (860) stabilization or residential treatment (820, 830,832) program(s) for short- term stabilization as part of their diversion plan.
- 65% of persons were discharged to community-based services within 180 days after admission date and who were evaluated for diversion who were admitted to any DMH funded short-term crisis stabilization or residential treatment (820, 830,832) program(s) for short-term stabilization as part of their diversion plan.
- 90% of persons were provided transition case management services by the Front Door provider during the entire length of stay and who were admitted to any DMH funded short-term crisis stabilization or residential treatment program(s) for short-term stabilization
5. The Division of Mental Health (DMH) will require additional monthly reporting requirements which will identify participants at all levels of engagement and their statuses at those stages; costs of services which may be proposed as in Sections above.
Application Review Information
All applicants must demonstrate that the NOFO requirements are met as identified in Section C: Eligibility Information.
The maximum possible score is 100 points. All submissions will be reviewed, evaluated and based on the following criteria.
| CRITERIA |
PURPOSE |
POINTS |
| Executive Summary |
The purpose of this section is for the applicant to present the agency description, history, achievements, service description, financial overview and any future plans. |
5 |
| Capacity - Agency Qualifications/Organizational Capacity |
The purpose of this section is for the applicant to present an accurate picture of the agency's ability to meet the program requirements.
Applicant must include the ability of an entity to execute the grant project according to project requirements.
|
5 |
| Need - Description of Need |
The purpose of this section is for the applicant to 1) Clearly identify which hospital(s) the Grantee proposes to serve, at a minimum of five (5) hospitals, 2) Clearly identify which SMHRFs the Grantee proposes to serve, and 3) Clearly detail how they will achieve and maintain collaborative relationships with identified hospitals, other sites, as approved and PASRR.
Identify stakeholders, fact and evidence that demonstrate the proposal supports the grant program purpose
|
20 |
| Quality - Description of Program Services |
The purpose of this section is for the applicant to provide a detailed, clear and accurate picture of its intended program design which will address the anticipated clinical, housing and support service needs and to effectively evaluate and support participants in community-based clinical care.
Applicant must include totality of features and characteristics of a service, project or product that indicated its ability to satisfy the requirements of the grant program
|
20 |
| Special Populations |
How does applicant address each of the populations identified within the Service Program Details section: 1) persons with co-occurring SUD; 2) DHS/DMH identified Forensically involved persons; 3) court involved persons; 4) Persons with sexual offender status; 5) persons aging out of the care and custody of DCFS; 6) persons who are experiencing homelessness; 7) persons with co-occurring physical disabilities; and 8) persons without verifiable income such as SSI/SSDI, other federal or state income subsidies, or employment. |
8 |
| Data Collection, Evaluation and Reporting |
To ensure accountability at all levels of service provision, IDHS is implementing the practice of performance-based contracting with its Grantee agencies. Applicant shall advise how they will meet and collect data to support the achievement of measurable outcomes to ensure that we are carrying out the most effective programming possible. At a minimum, Grantees will be expected to collect, and report data indicators and measures as described in this NOFO. |
10 |
| Resource Availability |
Describe what resources and other knowledge, skill and abilities in addition to those specific to the duration of the funding cycle the applicant possesses or will budget for in order to support the objectives of this program. These may include, but not limited to the availability of space like meeting rooms, space to carry out this program, etc. |
2 |
| Housing First proposal |
Preference points will be scored for applicants who propose Housing First models which are fully compliant to a fidelity model. Applicant should reference the fidelity model proposed and indicate any areas of deviations from the model's fidelity standards. |
10 |
| Provision of ACT and CS-T services |
Preference points will be scored for applicants who propose that they will directly provide ACT and CS-T services. |
5 |
| Budget |
The purpose of this section is to evaluate the budget for Narrative Inclusion, Fiscal Soundness and Programmatic Soundness.
Describe the budget details in relation to rate-based services and expense-based costs.
|
15 |
Proposals will be reviewed by IDHS/DMH staff familiar with the requirements of the program including services to be performed in specified geographic location, if applicable. Review team members will have no conflicts of interest and will read and evaluate proposals independently.
Merit-Based Evaluation Appeal Process
Competitive program grant appeals are limited to the merit-based evaluation process only. Evaluation scores cannot be protested. Only the evaluation process is subject to appeal
An appeal must be submitted electronically, in accordance with the grant application document.
An appeal must be received within 14 calendar days after the date that the grant award notice has been published.
Appeals are to be submitted to the following address: DHS.DMHGrantApp@illinois.gov.
The written appeal shall include at a minimum the following:
- the name and address of the appealing party.
- identification of the grant.
- a statement of reasons for the appeal
Response to appeal: The appealing party must supply any additional information requested by DHS/DMH within a reasonable time period.
Anticipated Announcement and State Award Dates
It is anticipated that Notices of State Award (NOSA) will be made in June 2021.
NOSA: Applicants recommended for funding under this NOFO following the above review and selection process will receive a Notice of State Award (NOSA) via the Grantee Portal. It is important to keep contact information in the Grantee Portal updated since the main contact is the person notification is sent to.
The NOSA shall include:
- The terms and conditions of the award.
- Specific conditions assigned to the grantee based on the potential grantee answers on the Fiscal and Administrative Risk Assessment (ICQ), the Programmatic Risk Assessment and the Merit-Based Reviews.
The NOSA is not an authorization to begin performance or incur costs. The NOSA is a notice of the State's intention to make an award but should not be construed as a guarantee of award. A grant award is not considered to be fully executed until both parties have signed the grant agreement.
After acceptance of the NOSA, announcement of the grant award shall be published by the awarding agency at www.grants.Illinois.gov. The grant agreement will also be published in the CSA Tracking System for signature.
A Notice of Non-Selection shall be sent via email to the applicants not receiving awards.
