Juvenile Inpatient Forensic Services (515-JIFS)
CSFA Number: 444-22-1183
Agency Name
Department Of Human Services (444)
Agency Identification
DMH
Agency Contact
Barb Roberson
(217) 557-5876
barb.roberson@illinois.gov
Short Description
Scope of Services
Program Description
The Grantee will operate an Inpatient Forensic Unit by licensed mental health professionals who will provide statewide forensic services for juveniles adjudicated Unfit to Stand Trial (UST) and Not Guilty by Reason of Insanity (NGRI) and are remanded to the Department of Human Services for treatment on an inpatient basis. These services shall include, but are not limited to, psychiatric, mental health, substance abuse and dually diagnosed intellectual disability treatment services, as well as, legal education, case management, transportation, court reporting and court testimony.
There are to be twelve inpatient beds available for UST and NGRI juveniles. The Inpatient Forensic Unit is designed to:
1. Provide services to juveniles who are remanded by court order to DHS for forensic services on an inpatient basis.
2. Increase the prompt access to clinically appropriate inpatient forensic services for individuals adjudicated UST and NGRI who require the restrictiveness of a hospital setting.
The Grantee must bill Medicaid/Managed Care Organization (MCO) or other billing source for payment for eligible juveniles. DMH will pay for vacant beds and non-covered juveniles. The Grantee agrees to admit all juveniles remanded (up to twelve) to DMH by the courts for inpatient forensic services.

2.Deliverables/Milestones
REPORTING REQUIREMENTS:

A. Time Period for Required Periodic Financial Reports. N/A Grantee will be paid via invoice.

B. Time Period for Close-out Reports. Grantee shall submit a Close-out Report pursuant to Paragraph 13.2 and no later than 60 days after this Agreement’s end of the period of performance or termination.

C. Time Period for Required Periodic Performance Reports. Unless a different reporting requirement is specified in Exhibit G, Grantee shall submit Performance Reports to Grantor pursuant to Paragraph 14.1 and such reports must be submitted no later than 30 days after the quarter ends.

D. Time Period for Close-out Performance Reports. Grantee agrees to submit a Close-out Performance Report, pursuant to Paragraph 14.2 and no later than 60 days after this Agreement’s end of the period of performance or termination.


The Grantee shall submit quarterly Periodic Performance Report (GOMBGATU-4001 (N-08-17)) and the Periodic Performance Report Template by Program (PRTP) to the appropriate email address below. Reporting templates and instructions for submitting reports can be found in the Provider section of the DHS website.

PPR and PPRT Email Address for All Grants:
DHS.DMHQuarterlyReports@illinois.gov


DMH reporting templates and detailed instructions for submitting reports can be found in the Provider section of the DHS website.


PERFORMANCE REQUIREMENTS:
The Grantee will:
1. Ensure that the inpatient forensic services meet the statutory requirements of Illinois statutes 725 ILCS 5/104-17 (or its successor).
2. Ensure twelve inpatient beds are available for juveniles adjudicated as Unfit to Stand Trial and Not Guilty by Reason of Insanity.
3. Bill Medicaid/MCO or other billing source for payment first.
4. Recruit, train, and maintain qualified staff, including a Board-Certified Psychiatrist, who is to provide psychiatric services to funded and unfunded clients; other licensed professionals to provide assessment, fitness restoration services and work as a liaison between the contractor and the criminal justice system; and to coordinate discharge planning and linkage.
5. Ensure prompt access to clinically appropriate psychiatric/pharmacological, psychological, treatment planning and linkage services.
6. Ensure prompt access to legal education using DHS/DMH-approved curricula as needed.
7. Provide transportation for patients to court and to other necessary and approved off-grounds locations
8. Provide face to face individual and group fitness restoration and treatment services for individuals served in the Program to ensure participation and promote adherence.
9. Develop, maintain and follow written procedures and court reporting to establish individuals progress toward fitness restoration, readiness for return to court and conditional release.
10. Provide thorough continuity of care for individuals being released to the community and back to court or who are determined not to be restorable.
11. Ensure the provision of medication, as needed. Discharge shall be in accordance with 725 ILCS 5/104-20(b) and should ensure the following are in place: Facilitate ongoing services with the appropriate community mental health agency before final discharge from the Program if individuals are released to the community; provide Psychiatric consultation for case review and clinical input (e.g., diagnostic, risk assessment, psychopharmacology) to other DHS/DMH programs which serve MHJJ youth or other youth served by the Department.
12. Ensure individuals remanded by the court for inpatient services are admitted within the statutory time frame (725 ILCS 5/104-17).
13. Complete the 30-day admission reports, individual treatment plan and progress reports per statute (725 ILCS 5/104-17; 5/104-18).

Exhibit C – 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 and encrypted utilizing DHS approved encryption software if so indicated on the invoice template. Invoices shall serve as the request for reimbursement as well as the Periodic Financial Report.

DMH invoice templates can be found in the Provider section of the DHS website.

Rate: DMH will pay for occupied beds for non-Medicaid individuals at the Healthcare and Family Services (HFS) Medicaid rate. Bed hold rate will be determined via Grantee submitted and DMH approved budget. In the event the total combined revenue between SASS Payments, other payment sources, and Bed Hold payments is less than $3,172,890, Grantee may submit a supplemental invoice for the difference between the total amount billed and $3,172,890. In the event the combined revenue between SASS Payments, other payment sources, and Bed Hold Payments is more than $3,172,890 no supplemental invoice will be paid. The supplemental payment is only available if the Grantee performs services under this contract for the full fiscal year. The amount of $3,172,890 may be reviewed for sufficiency at the end of the first quarter.

Performance Measures
1. Number of beds available for Juvenile Forensic patients at any time.
2. Number of Medicaid/MCO eligible client.
3. Number of eligible clients billed to Medicaid/MCO.
4. Number of clients with access to clinically appropriate psychiatric/pharmacological, psychological, treatment planning and linkage services.
5. Number of clients with access to legal education using DHS/DMH-approved curricula, as needed.
6. Number of clients needing transportation to court and to other necessary and approved off-grounds locations.
7. Number of clients provided transportation to court and to other necessary and approved off-grounds locations.
8. Number of clients provided face-to-face, individual and group fitness restoration and treatment services.
9. Number of clients who show progress toward fitness restoration, readiness for return to court and conditional release.
10. Number of clients provided thorough continuity of care for individuals being released to the community and back to court or who are determined not to be restorable.
11. Number of clients discharged in accordance with 725 ILCS 5/104-20(b).
12. Number of clients remanded by the court for inpatient services.
13. Number of clients remanded by the court for inpatient services within the statutory time frame (725 ILCS 5/104-17).
15. Number of clients with admission reports, individual treatment plan and progress reports submitted per statute (725 ILCS 5/104-17; 5/104-18).

Performance Standards
1. 12 or more beds available for Juvenile forensic patients at any time.
2. 100% of eligible clients billed to Medicaid/MCO.
3. 100% of clients with access to clinically appropriate psychiatric/pharmacological, psychological, treatment planning and linkage services.
4. 100% of clients have access to legal education using DHS/DMH-approved curricula, as needed.
5. 100% of clients were provided transportation to court and other necessary and approved off-grounds locations.
6. 100% of clients provided face-to-face, individual and group fitness restoration and treatment services.
7. 100% of clients show progress toward fitness restoration, readiness for return to court and conditional release.
8. 100% of clients provided thorough continuity of care for individuals being released to the community and back to court or who are determined not to be restorable
9. 100% of clients discharged in accordance with 725 ILCS 5/104-20(b).
10. 100% of clients remanded by the court for inpatient services within the statutory time frame (725 ILCS 5/104-17).
11. 100% of clients’ admission reports, individual treatment plans and progress reports submitted per statute (725 ILCS 5/104-17; 5/104-18).
Subject Area
Human Services
Program Function
Health
Enabling Legislation
Mental Health Community Services Act (405 ILCS 30/)

Objectives and Goals
DELIVERABLES

REPORTING REQUIREMENTS:

A. Time Period for Required Periodic Financial Reports. N/A Grantee will be paid via invoice.

B. Time Period for Close-out Reports. Grantee shall submit a Close-out Report pursuant to Paragraph 13.2 and no later than 60 days after this Agreement’s end of the period of performance or termination.

C. Time Period for Required Periodic Performance Reports. Unless a different reporting requirement is specified in Exhibit G, Grantee shall submit Performance Reports to Grantor pursuant to Paragraph 14.1 and such reports must be submitted no later than 30 days after the quarter ends.

D. Time Period for Close-out Performance Reports. Grantee agrees to submit a Close-out Performance Report, pursuant to Paragraph 14.2 and no later than 60 days after this Agreement’s end of the period of performance or termination.


The Grantee shall submit quarterly Periodic Performance Report (GOMBGATU-4001 (N-08-17)) and the Periodic Performance Report Template by Program (PRTP) to the appropriate email address below. Reporting templates and instructions for submitting reports can be found in the Provider section of the DHS website.

PPR and PPRT Email Address for All Grants:
DHS.DMHQuarterlyReports@illinois.gov


DMH reporting templates and detailed instructions for submitting reports can be found in the Provider section of the DHS website.


PERFORMANCE REQUIREMENTS:
The Grantee will:
1. Ensure that the inpatient forensic services meet the statutory requirements of Illinois statutes 725 ILCS 5/104-17 (or its successor).
2. Ensure twelve inpatient beds are available for juveniles adjudicated as Unfit to Stand Trial and Not Guilty by Reason of Insanity.
3. Bill Medicaid/MCO or other billing source for payment first.
4. Recruit, train, and maintain qualified staff, including a Board-Certified Psychiatrist, who is to provide psychiatric services to funded and unfunded clients; other licensed professionals to provide assessment, fitness restoration services and work as a liaison between the contractor and the criminal justice system; and to coordinate discharge planning and linkage.
5. Ensure prompt access to clinically appropriate psychiatric/pharmacological, psychological, treatment planning and linkage services.
6. Ensure prompt access to legal education using DHS/DMH-approved curricula as needed.
7. Provide transportation for patients to court and to other necessary and approved off-grounds locations
8. Provide face to face individual and group fitness restoration and treatment services for individuals served in the Program to ensure participation and promote adherence.
9. Develop, maintain and follow written procedures and court reporting to establish individuals progress toward fitness restoration, readiness for return to court and conditional release.
10. Provide thorough continuity of care for individuals being released to the community and back to court or who are determined not to be restorable.
11. Ensure the provision of medication, as needed. Discharge shall be in accordance with 725 ILCS 5/104-20(b) and should ensure the following are in place: Facilitate ongoing services with the appropriate community mental health agency before final discharge from the Program if individuals are released to the community; provide Psychiatric consultation for case review and clinical input (e.g., diagnostic, risk assessment, psychopharmacology) to other DHS/DMH programs which serve MHJJ youth or other youth served by the Department.
12. Ensure individuals remanded by the court for inpatient services are admitted within the statutory time frame (725 ILCS 5/104-17).
13. Complete the 30-day admission reports, individual treatment plan and progress reports per statute (725 ILCS 5/104-17; 5/104-18).
Types of Assistance
Direct Payments for Specific Use
Uses and Restrictions
Funding for this award will come from the State's General Revenue Fund and does NOT have a match or cost sharing requirement.

Funding Restrictions
DHS/DMH is not obligated to reimburse applicants for expenses or services incurred prior to the complete and final execution of the grant agreement and filing with the Illinois Office of the Comptroller.

Allowable Costs
Allowable costs are those that are necessary, and reasonable and permissible under the law and can be found in 2 CFR 200 - Subpart E - Cost Principles.

Unallowable Costs
Please refer to 2 CFR 200 - Subpart E - Cost Principles to see a collection of unallowable costs.

Indirect Cost Rate Requirements
Please refer to 2 CFR 200.414 regarding Indirect (F&A) Costs.

In order to charge indirect costs to a grant, agencies must have an annually negotiated indirect cost rate agreement (NICRA). There are three types of NICRAs: a. Federally Negotiated Rate; b. State Negotiated Rate and c. De Minimis Rate

5. Renewals
This program is a 12 month contract with 2, one-year renewal options. Renewals are at the discretion of the DHS/DMH and are contingent on the meeting the following criteria:
a. Applicant has performed satisfactorily during the past six months; b. All required reports have been submitted on time, unless a written exception has been provided by the Division; and c. No outstanding issues are present (i.e. in good standing with all pre-qualification requirements and no outstanding corrective action, etc.)

This program was competitively bid through the Notice of Funding Opportunity (NOFO) process in FY 2018 with 2 one-year extensions. FY 2021 will be considered competitive opportunity.
Eligibility Requirements
Eligibility Information 1.Eligible Applicants
This funding opportunity is not limited to those who currently have an award from the IDHS; however, applicants must:
a.Be in good standing with the Illinois Secretary of State (not applicable to governmental entities)
b.Not be on the Federal Excluded Parties List;
c.Not be on the Illinois Stop Payment list;
d.Not be on the Department of Healthcare and Family Services Provider Sanctions List;
e.Complete one Fiscal and Administrative Risk Assessment (ICQ);
f.Complete a Programmatic Risk Assessment for each grant at the following link: http://www.dhs.state.il.us/page.aspx?item=121872;
g.Register and access both the IDHS Community Service Agreement (CSA) tracking system and the Centralized Repository Vault (CRV);
h.Obtain a Dun and Bradstreet Universal Numbering System (DUNS) number. The DUNS number does not replace an Employer Identification Number. DUNS numbers may be obtained at no cost by calling the DUNS number request line at (866) 705-5711 or by applying online: https://www.dandb.com/. It is recommended that service providers register as soon as possible before the application due date.
i.Register with the System for Award Management (SAM) and maintain an active SAM registration until the application process is complete, and if a grant is awarded, throughout the life of the award. SAM registration must be renewed annually. It is recommended that service providers finalize a new registration or renew an existing one at least two weeks before the application deadline to allow time to resolve any issues that may arise. Applicants must use their SAM-registered legal name and address on all grant applications to IDHS.

Applicants that do not comply with these requirements are not eligible to receive an award.



2.Cost Sharing or Matching: Not applicable.
3.Indirect Cost Rate: See Section B Funding Information, #4 Indirect Cost Rate Requirements.

Other Information 1.IDHS reserves the right to request additional information that could assist with its award decision. Applicants are expected to provide the additional information within a reasonable time period. Failure to provide the information could result in the rejection of the proposal.
2.The release of this Notice of Funding Opportunity does not compel IDHS to make an award.
3.This funding opportunity is considered a new application.

Mandatory Submissions -- Required for All Agencies A.Uniform State Grant Application
B.Program Proposal
C.Budget prepared in the CSA Tracking System
D.Budget Narrative within the Budget in the CSA Tracking System
E.ICQ
F.PRA

Eligible Applicants
Nonprofit Organizations;
Application and Award Processing
Application and Award Processing: Enter Section E and F from the NOFO
a. Application Packet
Each applicant must have access to the internet. Applicants may obtain this application form at the Division's Grant Information website http://www.dhs.state.il.us/page.aspx?item=120031. Questions and DMH Responses will also be posted on this website. It is the responsibility of each applicant to monitor that website and comply with any instructions or requirements relating to the NOFO.
b. Application Procedure/Content and Form of Application Submission
i. Each applicant is required to submit a Uniform Application for State Grant Assistance. This is a 3-page document with the first page already completed by the Division of Mental Health. This document must be signed and dated.

e. Award Procedure
i. Applicants will receive a Notice of State Award (NOSA). The NOSA shall include:
1) The terms and conditions of the award.
2) Specific conditions assigned to the grantee based on the potential grantee answers on the Fiscal and Administrative Risk Assessment (ICQ), the Programmatic Risk Assessment. The NOSA is not an authorization to begin services or incur costs.
iii. Once grantee accepts the NOSA, announcement of the grant award shall be published by IDHS/DMH at www.grants.Illinois.gov. The grant agreement will also be published in the CSA Tracking System for signature.

f. Renewals
i. Renewals are at the sole discretion of the IDHS and are contingent on meeting the following criteria:
ii. Applicant has performed satisfactorily during the most recent past-funding period;
iii. All required reports have been submitted on time, unless a written exception has been provided by the Division;
iv. No outstanding issues are present (i.e. in good standing with all pre-qualification requirements); and
v. Funding for the budget year has been appropriated in the state's approved fiscal year budget.
g. Administrative and National Policy Requirements
i. Applicants awarded these funds shall provide services as set forth in the IDHS grant agreement and shall act in accordance with all state and federal statutes and administrative rules applicable to the provision of the services including indirect cost rate requirements in Section B: Funding Information, #4 Indirect Cost Rate Requirements.
ii. The legal agreement between IDHS and the successful applicant(s) will be the standard IDHS Uniform Grant Agreement. If selected for funding, the applicant will be provided an IDHS grant agreement for signature and return. A sample of the agreement may be found at http://www.dhs.state.il.us/page.aspx?item=29741.
Assistance Consideration
Serves as Maintenance of Effort to the Federal Substance Abuse and Mental Health Services Administration Community Mental Health Block Grant
Post Assistance Requirements
Reporting
Reporting requirements for the grant agreement shall be in accordance with the requirements set forth in the Short Description, Payment Terms and Performance Measures.

IDHS reserves the right to request additional information that could assist with its award decision. Applicants are expected to provide the additional information within a reasonable time period. Failure to provide the information could result in the rejection of the proposal.
The release of this Notice of Funding Opportunity does not compel IDHS to make an award.
This funding opportunity is considered a new application.

Audits In accordance with the provisions of 2 CFR 200, Subpart F - Audit Requirements, non-Federal entities that expend financial assistance of $750,000 or more in Federal awards will have a single or a program-specific audit conducted for that year. Non-Federal entities that expend less than $750,000 a year in Federal awards are exempt from Federal audit requirements for that year, except as noted in 2 CFR 200.503. Records Each Applicant must maintain records which are consistent with their State laws and requirements.
Regulations, Guidelines, Literature
Title 59: Mental Health of the Administrative Code

DHS/DMH Attachment B
DHS/DMH Program Manual
Federal Funding
None
Notice of Funding Opportunities
Agency IDAward RangeApplication Range
Details18-444-22-1183-01$3193750 - $319375003/20/2017 - 05/01/2017 : 12:00 pm
Details18-444-22-1183-01$3193750 - $319375005/05/2017 - 05/22/2017 : 12:00 PM
Agency IDGrantee NameStart DateEnd DateAmount
45CYB03470-45CYB03470BHC STREAMWOOD HOSPITAL INC07/01/201906/30/20202,000,000