Transition Coordination Non-Billable (780)
CSFA Number: 444-22-0628
Agency Name
Department Of Human Services (444)
Agency Identification
DMH
Agency Contact
Barb Roberson
217-557-5876
Barb.roberson@illinois.gov
Short Description
Exhibit A – Scope of Services
There is an array of non-billable services/activities and supports that are essential to timely and efficiently facilitating a client’s move from the Skilled Nursing Facilities (SNF) or Specialized Mental Health Rehabilitation Facilities (SMHRFs)/Institutions for Mental Disease (IMD) to the community. These transitional activities complement the treatment supports and mental health services that clients will have to move toward individual recovery and to live successfully in the community. The coordination of care needs such as assuring continuity of necessary medical interface and doctors’ appointments, timely transfer of benefits/entitlements, accompanying clients to Social Security Administration (SSA) to change payee status and Local Offices to activate Medicaid is critical to support self-sufficiency; the ability to interface with landlords or property management entities, who may have potential rental properties available, then conduct preliminary visits across vast geographic areas as a means of scouting appropriate rental units is essential if timely execution of a move from the SNFs or SMHRFs/IMDs to the community is to occur. The availability to travel to a SNF or SMHRF/IMD and to transport clients as they navigate housing searches; to accompany them as they make decisions to purchase household needs and the ability to facilitate in moving furniture and setting up the household are all necessary and functional resource requirements to make the transition from the SNFs or SMHRFs/IMDs possible. Transition Coordination is the means to assure that all efforts to make the transitions to the community occur and that they occur under a vision of coordinated attention.

Exhibit B – Deliverables
Each Grantee will hire or assign transition coordination staff who will facilitate full activities of transition coordination for the agency as a supplement to the job duties of direct care clinicians. Such activities include:
1. Coordinate the transfer of benefits and entitlements through Social Security Administration initiated prior to transfer and completed within 5 days of transition into the community.
2. Transition staff to work with Class Members (CM) in applying for Supplemental Nutrition Assistance Program (SNAP) within 7 days of transitioning into the community
3. Transition staff will assist CMs in applying for transportation assistance within 7 days of transitioning into the community.
4. Coordinate transfer of medications and linkages with primary healthcare and ancillary services/supports, as appropriate.
5. Coordinate service planning with the class member and key stakeholders and transfer the service plan of care to the post-transition team.
6. Arrange for durable medical equipment and home and community-based waiver services with Medicaid Managed Care health plan support, as appropriate
7. Coordinate discharge planning with the class member, the staff of the SNF/SMHRF and others as appropriate
8. Identify and navigate affordable housing stock through relationship building with landlords and property management companies.
9. Maintain and update an active dossier of property listings.
10. Identify appropriate housing options in the area of CM's geographical preference.
11. Accompany Class Members on housing searches for a potential apartment. Transition staff are required to show CMs no less than 3 separate units to choose from during the housing search process.
12. Assist with the purchase of household items to facilitate independent living in the community.
13. Assist Class Members actual move from the SNFs or SMHRFs/IMDs to the community.
14. Complete other related activities associated with securing independent housing.
Reporting Requirements:
1. Financial Report in accordance with Exhibit C.
2. Performance Report in accordance with Exhibit E.


Exhibit C – Payment

Reference the Uniform Grant Agreement, Article IV Payment, Section 4.2 Return of Grant Funds and 4.3 Cash Management Improvement Act of 1990. Payment will be issued quarterly and reconciled with reported allowable expenses. Grantee shall submit a quarterly Periodic Financial Report (GOMBGATU-4002 (N-08-17)) to the appropriate email address below no later than November 1, February 1, May 1, and August 1. Reported expenses should be consistent with the approved annual grant budget. Any expenditure variances require prior Grantor approval in accordance with Article VI of the Uniform Grant Agreement to be reimbursable.

PFR Email Address for General Grants:
DHS.DMHQuarterlyReports@illinois.gov

PFR Email Address for Williams Consent Decree: DHS.DMHWilliamsInvoices@Illinois.gov

PFR Email Address for Colbert Consent Decree:
DHS.DMHColbertInvoices@illinois.gov


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

If more transitions occur during the reporting quarter, the grantee will receive additional payment for each additional transition. If less transitions occur during the reporting quarter, reconciliation will occur against the advance payment amount.
For Williams Transition Only grantees (grantees contracted by DMH to provide services to Williams Class Members, which have neither ACT or CST services; existing array of available services is in accordance with grantee’s Medicaid certification as established by the Bureau of Accreditation and Licensure) payment will be issued based on Grantee submitted quarterly invoices and applicable rates. Invoice template can be found in the Provider section of the DHS website.
Rate Structure for both the Williams and Colbert Consent Decrees:
Initial Transition - Rate $2,562.50
Application:
1. Original transition of Class Member
2. Repeat transition of Class Member by another grantee
3. Repeat transition of Class Member across both Williams and Colbert Consent Decrees
Repeat transition - Rate $1,397.08
Application:
1. Repeat transition of Class Member by same grantee
Non-transition - Rate $ 512.50
Application:
1. Transition activities defined as engagement, pre-discharge or discharge staffing, service plan development, skills building, housing search, coordination of care benefits and medical, etc., with a Class Member and transition does not occur
Note: All rates also apply to transitions by Williams Transition Only Grantees as defined above

Exhibit E – Performance Measures
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 no later than November 1, February 1, May 1, and August 1. 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

The following are included in the reporting template:
1. Number of unduplicated Class Members assigned to the agency for transition coordination.
2. Number of unduplicated Class Members’ assignments received by Transition Coordination.
3. Number of Class Members first contact occurring within 7 business days after receipt of the assignment.
4. Number of Class Members who refuse transition coordination activities.
5. Number of Class Members who refused transition coordination activities documented and identified to the Consent Decrees’ designated contact.
6. Number of consenting Class Members engaged in a housing search within:
a. Two weeks or less after initial contact
b. Two week and two months after initial contact
c. Two months and four months after the contact
d. Four months or greater after the initial contact
7. Number of Class Members assisted with transferring benefits/entitlements from the SNF or SMHRF prior to transition.
8. Number of Class Members assisted with linkages to primary health care.
9. Number of Class Members accompanied to purchase basic household items/supplies.
10. Number of Class Members assisted with moving from the SNF or SMHRF to the community.
11. Number of the Class Members Comprehensive Service Plans of Care which include the findings and recommendations of the resident review assessment.

Exhibit F – Performance Standards
1. 100% of unduplicated Class Members’ assignments received by Transition Coordination.
2. 100% of Class Members contacted within 7 business days after receipt of the case assignment.
3. 100% of Class Members who refuse transition coordination activities are documented and identified to the Consent Decrees’ designated contact.
4. 100% of consenting Class Members are engaged in a housing search.
5. 100% of consenting Class Members have their benefits/entitlements transferred from the facility prior to transition.
6. 100% of Class Members are assisted in linkage to primary health care.
7. 100% of Class Members are accompanied to purchase basic household items.
8. 100% of Class Members are assisted in relocation from the SNF or SMHRF to the community.
9. 100% of the Class Members Comprehensive Service Plans of Care will include the findings and recommendations of the resident review assessment.
Subject Area
Human Services
Program Function
Health
Enabling Legislation
Mental Health Community Services Act (405 ILCS 30/)

20 ILCS 1705 Sect. 73(a)
Objectives and Goals
Each Grantee will hire or assign transition coordination staff who will facilitate full activities of transition coordination for the agency as a supplement to the job duties of direct care clinicians. Such activities include:
1. Coordinate the transfer of benefits and entitlements through Social Security Administration initiated prior to transfer and completed within 5 days of transition into the community.
2. Transition staff to work with Class Members (CM) in applying for Supplemental Nutrition Assistance Program (SNAP) within 7 days of transitioning into the community
3. Transition staff will assist CMs in applying for transportation assistance within 7 days of transitioning into the community.
4. Coordinate transfer of medications and linkages with primary healthcare and ancillary services/supports, as appropriate.
5. Coordinate service planning with the class member and key stakeholders and transfer the service plan of care to the post-transition team.
6. Arrange for durable medical equipment and home and community-based waiver services with Medicaid Managed Care health plan support, as appropriate
7. Coordinate discharge planning with the class member, the staff of the SNF/SMHRF and others as appropriate
8. Identify and navigate affordable housing stock through relationship building with landlords and property management companies.
9. Maintain and update an active dossier of property listings.
10. Identify appropriate housing options in the area of CM's geographical preference.
11. Accompany Class Members on housing searches for a potential apartment. Transition staff are required to show CMs no less than 3 separate units to choose from during the housing search process.
12. Assist with the purchase of household items to facilitate independent living in the community.
13. Assist Class Members actual move from the SNFs or SMHRFs/IMDs to the community.
14. Complete other related activities associated with securing independent housing.
Reporting Requirements:
1. Financial Report in accordance with Exhibit C.
2. Performance Report in accordance with Exhibit E.

Population to be Served (e.g., children, youth, adults, families, etc.)
Adults with a Serious Mental Illness (SMI)

Program Eligibility Requirements
Adults with Serious Mental Illness (SMI)


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 2019 with 2 one-year extensions. FY 2022 will be considered competitive opportunity.
Eligibility Requirements
11. Be certified by IDHS as a Community Mental Health Provider or a Community Mental Health Center;
2. Be in good-standing with the Illinois Secretary of State (not applicable to governmental entities)
3. Not be on the Federal Excluded Parties List;
4. Not be on the Illinois Stop Payment list;
5. Not be on the Department of Healthcare and Family Services Provider Sanctions List;
6. Complete one Fiscal and Administrative Risk Assessment (ICQ);
7. Complete a Programmatic Risk Assessment for each competitive program;
8. Register and access both the Illinois Department of Human Services Community Service Agreement (CSA) tracking system and the Centralized Repository Vault (CRV);
9. Obtain a Dun and Bradstreet University 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: DUNS Request Service. It is recommended that service providers register at least 30 days before the application due date.
10. 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 DHS/DMH.
Eligible Applicants
Government Organizations; Nonprofit Organizations;
Application and Award Processing
1. 3 page Uniform Application for State Grant Assistance completed, signed and dated.
2. Uniform Grant Budget completed and submitted in the CSA tracking system
3. Notice of State Award to be accepted or declined. The NOSA shall include:
a. The terms and conditions of the award.
b. Specific conditions assigned to the grantee based on the fiscal and administrative, programmatic risk assessments and merit-based review conditions.
c. The NOSA is not an authorization to begin performance or incur costs.
d. Upon acceptance of the NOSA, announcement of the grant award shall be published by the awarding agency to www.Grants.Illinois.gov
4. Grant Agreement prepared in CSA Tracking system
5. Grant Agreement signed by Grantee and returned to DHS
6. Grant Agreement signed by DHS
7. Grant Agreement obligated at Comptroller Office

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
a) Reporting
The Grantee shall submit quarterly Periodic Performance Report (GOMBGATU-4001 (N-08-17)) on the Periodic Performance Report Template by Program to the appropriate email address below no later than November 1, February 1, May 1, and August 1. Reporting templates and instructions for submitting reports can be found in the Provider section of the DHS website.

b) Audits
Grantee shall be subject to the audit requirements contained in the Single Audit Act Amendments of 1996 (31 USC 7501-7507) and subpart F of 2 CFR Part 200, and the audit rules set forth by the Governor’s Office of Management and Budget. See 30 ILCS 708/65(c).

c) Records
Grantee shall maintain for three (3) years from the date of submission of the final expenditure report, adequate books, all financial records and, supporting documents, statistical records, and all other records pertinent to this Award, adequate to comply with 2 CFR 200.333, unless a different retention period is specified in 2 CFR 200.333. If any litigation, claim or audit is started before the expiration of the retention period, the records must be retained until all litigation, claims or audit exceptions involving the records have been resolved and final action taken.
Regulations, Guidelines, Literature
Title 59: Mental Health of the Administrative Code

2 CFR 200/45 CFR Part 75 Uniform Administrative Requirements, Cost Principles, and Audit Requirements

DHS/DMH Attachment B
DHS/DMH Program Manual
Federal Funding
None
Notice of Funding Opportunities
Agency IDAward RangeApplication Range
Details19-444-22-0628-01$4089 - $10904002/02/2018 - 03/19/2018 : 5:00 pm
Details19-444-22-0628-02$4089 - $10904004/26/2018 - 05/02/2018 : 5:00 pm
Agency IDGrantee NameStart DateEnd DateAmount
45CYB00837-45CYB00837THE THRESHOLDS07/01/201906/30/2020866,000
45CYB04015-45CYB04015THE THRESHOLDS07/01/201906/30/2020857,750
45CYB04016-45CYB04016TRILOGY, INC.07/01/201906/30/2020741,126
45CYB03208-45CYB03208SERTOMA CENTRE INC07/01/201906/30/2020489,125
45CYB00838-45CYB00838TRILOGY, INC.07/01/201906/30/2020432,650