Date: July 11, 2018
To: Community Mental Health Centers (CMHCs)
Behavioral Health Clinics (BHCs)
Re: Update to Community Mental Health Service Array
This notice provides updates regarding the provision of community-based mental health services under the Illinois Medical Assistance Program.
Healthcare and Family Services (HFS) will introduce an updated Handbook for Providers of Community-Based Behavioral Health Services (Handbook), the successor to the Service Definition and Reimbursement Guide (SDRG). This update will include new and updated services as detailed below, effective for dates of service on or after August 1, 2018.
Integrated Assessment and Treatment Planning (IATP)
Beginning August 1, 2018, HFS will introduce IATP as a billable service that links identified needs and strengths to specific treatment recommendations. IATP will replace the two services of Mental Health Assessment and Treatment Plan Development, Review and Modification. IATP requires usage of the HFS-approved IATP instrument, as detailed in the Handbook. Future communication will include the final guidelines related to the approved IATP instrument, including dates for required implementation.
Expanded Crisis Service Array
The crisis service array has been updated to include the services described below:
Crisis Intervention – Crisis Intervention includes short-term treatment services and referral for individuals that, through the course of treatment or intervention, appear to need immediate, intensive intervention to achieve symptom reduction and stabilization.
Mobile Crisis Response (MCR) – MCR is a mobile, focused, and time-limited service designed to achieve crisis symptom reduction, stabilization, and restoration of the client to the previous level of functioning. MCR services require face-to-face screening using the HFS-approved crisis screening instrument, and may include: short-term intervention, crisis safety planning, brief counseling, consultation with other qualified providers related to the individual’s crisis, and referral and linkage to other mental health community services. MCR service delivery requires program-based Crisis Certification from HFS.
Crisis Stabilization – Crisis Stabilization services are time-limited intensive supports available following a MCR event, designed to target and mitigate the symptoms and causes of crisis. Crisis Stabilization requires a demonstrated need for ongoing stabilization supports as documented in the individual’s crisis safety plan and authorized by a Licensed Practitioner of the Healing Arts (LPHA). Crisis Stabilization provides strengths-based, individualized support on a one-to-one basis to individuals in the home or community setting and requires program-based Crisis Certification from HFS.
Providers seeking to be certified as MCR providers must meet HFS’ established requirements. HFS will be granting Crisis Certification for all existing Screening, Assessment and Support Services (SASS) providers. Additional information regarding Crisis Certification can be found in the Handbook.
HFS will also introduce an updated Handbook for Providers of Mobile Crisis Response Services, which will replace the current Handbook for Providers of SASS, and will be in effect for services provided on or after August 1, 2018.
Centralized Intake of Crisis Services
To ensure a consistent response protocol and timeline, HFS will expand access to MCR services through the state’s centralized crisis intake line, the Crisis and Referral Entry Service (CARES), effective August 1, 2018. This expansion will allow CARES to accept crisis referrals from any professional for Medicaid-eligible adults experiencing a behavioral health crisis. Any Crisis Certified provider may offer MCR services; however, only referrals processed through CARES may result in level of care changes (e.g., admission to a hospital for youth) or authorization for the provision of Crisis Stabilization services.
Impacts upon the Screening, Assessment, and Support Services (SASS) Program
By expanding referrals of adults to the CARES line, the number of referrals issued to SASS providers will increase in volume over time. SASS providers will continue to receive referrals from the CARES line and will be expected to meet the full terms of their provider agreement, including responding to referrals from the CARES line on a no-decline basis.
Updated rate structure
The rate associated with MCR is event-based and equates to four (4) units of crisis intervention, which is consistent with historical data gathered from SASS providers regarding crisis screening activities. Once a provider has completed the MCR event, the provider may transition to billing Crisis Intervention until they have resolved the crisis situation. This methodology ensures a base reimbursement level for all MCR events, while also allowing providers to access additional reimbursement for time spent resolving the crisis beyond the required screening and assessment activities of MCR.
Questions regarding this notice may be directed to the Bureau of Behavioral Health via telephone at 217-557-1000 or via email at HFS.CBH@illinois.gov.
Patricia R. Bellock