INDIVIDUAL CARE GRANT PROGRAM CHANGES: OVERVIEW Seth Harkins, EdD Director, ICG Program Department of Human Services Div

1. INDIVIDUAL CARE GRANT PROGRAM CHANGES: OVERVIEWSeth Harkins, EdDDirector, ICG ProgramDepartment of Human ServicesDivision of Mental Health

2. Why the Changes to the Individual Care Grant (ICG) Program ? • The Department of Human Services (DHS) / Division of Mental Health (DMH) objectives for the changes in ICG services include: • Enhancement of recovery and resiliency focus • Increase family participation • Focus on least restrictive environment • Outcomes • Enhanced clinical care management • Fee for service reimbursement • Resume Medicaid billing

3. What Are the Changes to the ICG Program? • The Illinois Mental Health Collaborative for Access and Choice (the Collaborative) provides administrative and clinical services for sending and receiving applications, reviewing applications, making initial eligibility determinations, and making continuing eligibility determinations • There is authorization of residential ICG nights of stay services approximately every ninety days. • There is an increased emphasis on the Quarterly Report.

4. What Are the Changes? • There is an increased role of the Collaborative Clinical Care Managers in partnering with parents, ICG/SASS providers, and residential providers. • Eligibility and levels of care are based on medical necessity. • Medicaid eligibility for residential ICG clients will increase after 90 days of residential care.

5. The Same application process & requirements ICG eligibility criteria and determination process Quarterly and annual reviews under Rule 135 Rates for services except for application assistance and case coordination Payments to providers by DHS/DMH Case coordination role of ICG.SASS worker Active parent and family role in treatment planning Providers required to assist with Medicaid applications Different Claims submitted to the Collaborative Service billed using DMH Service Matrix and the old ICG codes are no longer valid Residential nights of care require authorization for claim payment Residential providers required to submit encounters for treatment services provided during the residential day - encounters equal to at least 40% of the per diem rate required Consumer registrations into DHS/DMH ROCS system not required for consumers receiving services on/after 4/1/09 What’s the Same? What’s Different?

6. Different Collaborative Clinical Care Manager in placement decisions and treatment planning Human Capital Development (HCD) field offices aware of ICG program and exclusion of family income for Medicaid eligibility at 90th day of treatment Behavior Intervention Management 97 M and Child Support Services 72M require authorization at $1570 and $3500 respectively, per child in place of case-by-case reviews. Medical necessity reviews for additional services All providers and sites required to be certified for Rule 132 services. What’s the Same? What’s Different?