The following are the steps a provisionally or fully certified CMHC organization must take when wanting to provide additional specialty/subspecialty services at a servicing location. The organization must work with the Illinois Department of Healthcare and Family Services (HFS) to complete the requirements to have the additional service(s) added.
"Outpatient-No Subspecialty" and/or "Residential Services-No Subspecialty" must be listed as specialty/subspecialty combinations on the Specialties step upon initial application in the Illinois Medicaid Program Advanced Cloud Technology (IMPACT) System. This section shall outline the steps a certified CMHC site shall need to follow when wanting to add additional specialty/subspecialty combinations which are outside of the initial combination(s) selected.
1. CMHC Contacts HFS
It is recommended that the CMHC organization reach out to HFS or their representative to inquire about adding the specialties of "Day Treatment", "Team Based Services", "Crisis Response", and any of their associated subspecialties, to a site's IMPACT enrollment due to additional HFS program requirements. Inquiries should be forwarded to the Office of Medicaid Innovation at omi.impact@uillinois.edu .
Program requirements may be referenced in the:
| Enrollment Type |
Provider Type |
Specialty |
Subspecialty |
| Facility Agency Organization (FAO) |
Community Mental Health Center (CMHC) |
Outpatient |
None |
| Facility Agency Organization (FAO) |
Community Mental Health Center (CMHC) |
Residential Services |
None |
| Facility Agency Organization (FAO) |
Community Mental Health Center (CMHC) |
Day Treatment |
Intensive Outpatient |
| Facility Agency Organization (FAO) |
Community Mental Health Center (CMHC) |
Day Treatment |
Psychosocial Rehabilitation |
| Facility Agency Organization (FAO) |
Community Mental Health Center (CMHC) |
Team Based Services |
Assertive Community Treatment |
| Facility Agency Organization (FAO) |
Community Mental Health Center (CMHC) |
Team Based Services |
Community Support Team |
| Facility Agency Organization (FAO) |
Community Mental Health Center (CMHC) |
Team Based Services |
Violence Prevention Community Support Team |
| Facility Agency Organization (FAO) |
Community Mental Health Center (CMHC) |
Crisis Response |
Mobile Crisis Response |
| Facility Agency Organization (FAO) |
Community Mental Health Center (CMHC) |
Crisis Response |
Crisis Stabilization |
2. IMPACT Modified
The certified site's IMPACT enrollment, in which an added specialty/subspecialty combination is being added, must be modified to reflect the additional service(s). This is completed by adding the new specialty/subspecialty combination(s) on the Specialties/Taxonomy step. In addition, the Complete Modification Checklist step shall need to be completed.
Other modifications to the enrollment may be made at this time, such as updating contact information or email addresses, changing a managing employee, or changing a correspondence address. The modified enrollment should be submitted to HFS once completed.
The following link accesses the IMPACT System: https://impact.illinois.gov
Organizations having questions about IMPACT may contact the:
For difficulties experienced in logging into the IMPACT System, contact:
The IMPACT System serves as the SYSTEM OF RECORD for the receipt of Federal Medicaid funding, therefore, all CMHC organizations are responsible for maintaining their IMPACT enrollment(s) with up-to-date and accurate information at all times.
3. HFS Confirms Program Requirements
HFS or their representative shall work with the CMHC organization in confirming compliance with HFS program requirements for any of the additional specialty/subspecialty combinations selected. Compliance with HFS Rule 140 program requirements shall be validated through attestations and/or site visits and/or program plan, policy, procedure, and staffing reviews.
4. IMPACT Modification Processed
HFS or their representative shall approve the IMPACT modification after confirming compliance with HFS program requirements. The organization shall receive a systematically generated email from the IMPACT System signifying the approval. If HFS or their representative is unable to approve the IMPACT modification for any reason, such as due to a background screening result, the designated Certifying State Agency (CSA), DHS-DMH-PACE or DCFS-IPI, shall be notified so further steps may be discussed and action taken.
5. Form 2 Updated
Form 2 (Request for Change to DHS/DMH Provider Record - Site Location Information) shall be updated by the CMHC for the site in which additional services were added, and submitted to the designated CSA, DHS-DMH-PACE at DHS.DMHProviderAssist@illinois.gov or DCFS-IPI at DCFS.Medicaid@illinois.gov .
Form 2 serves to notify the Administrative Service Organization (ASO), the Illinois Mental Health Collaborative (Carelon), of data that is necessary for Federal reporting requirements.
Form 2 is located on the DHS Rule 132 website or may be obtained by contacting the designated CSA at the email address above. Please see Instructions for Completing Form 1 and 2 for details on completing and submitting the forms.
If DCFS-IPI is the designated CSA, DCFS-IPI shall forward Form 2 to DHS-DMH PACE.
6. Bureau of Community Programs Notified (applies when DHS is the designated CSA)
When DHS is the designated CSA, DHS-DMH-PACE shall notify the respective Program Manager of the additional service(s) being provided by forwarding a copy of Form 2.
7. Illinois Mental Health Collaborative Notified
DHS-DMH-PACE shall notify the Illinois Mental Health Collaborative of the additional service(s) being provided by forwarding a copy of Form 2.
