Eligibility and Disposition Assessment (420)
CSFA Number: 444-22-0797
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
The Grantee will provide Eligibility and Disposition Assessment (EDA) services with availability on a 24 hour/seven day per week basis using staff at or above the level of a Qualified Mental Health Professional (as defined 59 Ill. Adm. Code 132) (Rule 132) (or its successor). Rule 132 is available at: http://www.dhs.state.il.us/page.aspx?item=56754.
Eligibility and Disposition Assessments (EDA) are defined as: Actions that ensure the qualified professional (evaluator) completes the face-to-face evaluation of the individual presenting, as in a mental health crisis in need of services, to determine the individual's eligibility for needed crisis services with a disposition to the next level of care.
1. The Grantee receiving funding for Eligibility and Disposition Assessments (EDAs) are to assist in the evaluation of an unfunded individual(s) and determine and facilitate the placement into the needed level of care. OR
2. Expand mobile crisis level services by receiving calls requesting an Eligibility and Disposition Assessment from the below noted sites and document the response time.
a. Hospital Emergency departments - Ensure priority responses are provided to the Emergency Departments of community hospitals. (see below Performance Measure #1).
b. CIT teams
c. Schools: elementary, high school and college/university
d. Other, as necessary


Exhibit B - Deliverables:

The Grantee receiving funding for Eligibility and Disposition Assessments (EDAs) is to do the following:
1) Ensures qualified staff uses all DMH prescribed assessment elements when determining the eligibility of the individual.
2) Ensure that each assessment includes the prescribed clinical evaluation of the individual similar to MH Assessment, Mobile Crisis Assessment or other applicable services, as in Rule 132/140.
3) Determines the most appropriate and available level of care and secures referral and placement for same based on the determination of eligibility and clinical evaluation.
4) Ensures firm linkage (hard hand-off) of the individual with the recommended level of care.
5) Ensures documentation of the evaluation, recommendations and disposition outcome for the individual.
6) Submits required registrations and encounters per DHS/DMH policy.

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 monthly 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.


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

1. The number of evaluations completed and maintain them in a clinical record for the individual.
2. The number of individuals registered with the designated identifier in the DHS/DMH consumer registration/enrollment system.
3. Number of staff working in their EDA program who have the Certified Recovery Support Specialist (CRSS) designation.
4. The following are included in the reporting template and i through viii below, respond for each category a, b, c, d below, as applicable:
a. Hospital Emergency departments
b. CIT teams
c. Schools: elementary, high school and college/university
d. Other, as necessary

i) Numbers of unfunded persons referred (calls) each in a, b, c, d in reporting period.
ii) Numbers of those unfunded persons referred (in #1) each in a, b, c, d who were served in the reporting period.
iii) Total number of unduplicated individuals served in contract period each in a, b, c, d as of the end of the reporting period.
iv) Number of completed evaluations each in a, b, c, d during the reporting period.
v) Number of completed evaluations each in a, b, c, d documented and completed as a clinical record for individuals prior to linkage to service.
vi) Number of calls for evaluation of individuals (‘referred persons’) each in a, b, c, d with successful linkages to any recommended level of services.
vii) Number of completed evaluations of individuals each in a, b, c, d with successful linkages to any recommended level of services (hard hand-off).
viii) Numbers of calls for evaluation of individuals (‘referred persons’) each in a, b, c, d with successful linkages to any recommended level of services which are completed as a (in the) clinical record

ix) Number of referred cases (calls) each in a, b, c, d responded to on-site in community hospital emergency departments within one hour/60 minutes and documented as such.


Exhibit F – Performance Standards
Standards are calculated for each category, in a, b, c, and, d as applicable:

1. 80% of persons referred shall be evaluated (served).
2. 100% of evaluations in a, b, c, and, d were completed for persons referred in reporting period.
3. 100% of evaluations in a, b, c, and, d are completed as a clinical record prior to the linkage to service.
4. 100% of calls for evaluation in a, b, c, and, d of an individual are responded to on-site (at the community hospital emergency department or other community location) within one hour/60 minutes and documented as such.
5. 100% of successful linkages in a, b, c, and, d to the recommended level of service are completed as a clinical record.
Subject Area
Human Services
Program Function
Health
Enabling Legislation
Mental Health Community Services Act (405 ILCS 30/) (from Ch. 91 ½, par. 901) Section 2, "(f)
Objectives and Goals
The Grantee receiving funding for Eligibility and Disposition Assessments (EDAs) is to do the following:
1) Ensures qualified staff uses all DMH prescribed assessment elements when determining the eligibility of the individual.
2) Ensure that each assessment includes the prescribed clinical evaluation of the individual similar to MH Assessment, Mobile Crisis Assessment or other applicable services, as in Rule 132/140.
3) Determines the most appropriate and available level of care and secures referral and placement for same based on the determination of eligibility and clinical evaluation.
4) Ensures firm linkage (hard hand-off) of the individual with the recommended level of care.
5) Ensures documentation of the evaluation, recommendations and disposition outcome for the individual.
6) Submits required registrations and encounters per DHS/DMH policy.

Types of Assistance
Direct Payments for Specific Use
Eligible Applicants
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
Post Assistance Requirements
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.
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
Details19-444-22-0797-01Not Applicable08/21/2018 - 09/10/2018 : 5:00 pm
Agency IDGrantee NameStart DateEnd DateAmount
45CYB03993-45CYB03993Chestnut Health Systems, Inc.07/01/201906/30/2020200,000
45CYB03991-45CYB03991Heritage Behavioral Health Center, Inc.07/01/201906/30/2020200,000
45CYB03990-45CYB03990Sinnissippi Centers, Inc.07/01/201906/30/2020200,000
45CYB03995-45CYB03995Transitions of Western Illinois07/01/201906/30/2020200,000
45CYB03997-45CYB03997CENTERSTONE OF ILLINOIS INC07/01/201906/30/2020133,333