FY 2023 Mental Health Program Manual

Table of Contents

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

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I. Introduction/Definition

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

II. Policies & Procedures

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

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

   All community mental health providers with contracts to provide services defined in 59 Ill Admin 132 and 140 must be certified and enrolled as Medicaid providers for each of their DHS/DMH funded sites. The Division will act as a liaison between the Department of Healthcare and Family Services (DHFS) and community mental health providers to assist providers who qualify to enroll as Medicaid providers.

3. Forensic Training Manual for Fitness Restoration of Individuals found Unfit to Stand Trial (UST): Forensic Training Manual (UST) (pdf)
4. DMH Mental Health Provider Manual

III. Contract and Amendment Process

1. The DHS Uniform Grant Agreement between the Department and the Provider is generally referred to as the Agreement and consists of several parts:
   1. DHS Uniform Grant Agreement containing the standard contract language for all Department agreements.
   2. Grant Agreement Attachment B containing specific agreement requirements related to programs funded by the DMH.
   3. Uniform Grant Agreement Exhibits A - F showing the contract scope, the deliverables, the method of payment and payment reconciliation, contact information, performance measures, and performance standards. The Department will initiate the Agreement, send it to the Provider for review and signature, obtain the Secretary's signature and return a copy of the executed Agreement to the Provider. The Agreement is not effective until signed by the Secretary of DHS.
   4. The Department will initiate a two-party signed amendment to the Grant Agreement when changes are made to the Grant Agreement that are beyond the scope shown in Exhibit A.

IV. Deliverables/Costs/Rates/Payment 

DMH Grant Agreement deliverables are specified in DMH Attachment B.

Payment and Rates

1. The maximum payment during a fiscal year to Providers under a Grant Agreement with DHS/DMH is the total Grant Agreement amount displayed on the Uniform Grant Agreement- Article I, Paragraph 1.2. Payment for Medicaid services to Medicaid eligible individuals is not part of the total Grant Agreement amount.
2. Provisions for payment are described in Section IV of the DMH Attachment B.

V. Provider Responsibilities

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

VI. Department Responsibilities

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

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

VII. Support Services

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

VIII. Billing Instructions

Billing instructions for mental health Medicaid can be obtained by contacting the DHS/DMH Program Contact.

IX. Program Monitoring

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

X. Appendix - State Authoritative Sources 

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

1. Illinois Charitable Trust Act (760ILCS55)
2. Business Corporation Act (805 ILCS 5)
3. Executive Orders
4. Illinois Administrative Code
5. Contractual Services defined State Finance Act (30 ILCS 105/15a)
6. Professional and Artistic Services defined Illinois Procurement Code (30 ILCS 500/1-15.60)
7. Purchasing, Contracting and Leasing Illinois Procurement Code (30 ILCS 500/1-1 et seq.)
8. 44 Ill. Adm. Code Part 1
9. Contract filing and late filing affidavits - Illinois Procurement Code (30 ILCS 500/20-80)
10. Lease of office and storage space and facilities - Civil Administrative Code of Illinois (20 ILCS 405/405-300)
11. Fair Employment Practices Illinois Constitution (1970) art. 1, sec. 17
12. Governmental Ethics Act
13. DMH Mental Health Provider Manual
14. State Officials and Employees Ethics Act (5 ILCS 430 et seq.)
15. Expenditure Authority SAMS Manual - Illinois Comptroller (Section 11)
16. Grant Agreement Signatures - SAMS - Illinois Comptroller's Office
17. Payment for Goods and Services - State Prompt Payment Act (30 ILCS 540/1 et seq.)
18. State Grant Agreements - Business Enterprise for Minorities, Females, and Persons with Disabilities Act (30 ILCS 575/0.01 et seq.)
19. Human Services Provider Grant Agreements - Human Services Provider Bond Reserve Payment Act (30 ILCS 435/15)
20. Requirement to Purchase from Department of Corrections Unified Code of Corrections (30 ILCS 5/3-12-7)
21. Child Care Service Contracts (Only Applicable to Child Care Contracts) - State Agency Employees Child Care Services Act (30 ILCS 590/1 et seq.)
22. Purchase of Recyclable Products or Supplies - Illinois Solid Waste Management Act (415 ILCS 20/3)
23. Change Orders in Public Contracts - Criminal Code (720 ILCS 5/33E-9)
24. Invoice Voucher Certification Clause - State Finance Act (30 ILCS 105/9.04)