reglab/statecodes huggingface dataset:
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart C - HOMEMAKER SERVICES › Section 686.250 - Financial Reporting of Homemaker Service Providers

Current through Register Vol. 48, No. 28, July 12, 2024
a) Homemaker Service Providers shall be
				required to:
1) complete and submit a
				Homemaker Cost Certification report that is based upon actual, documented
				expenditures.
A) The report must be submitted
				annually, within 60 days after the end of the reporting period, and may be
				prepared as a part of the Homemaker Service Provider's annual audit.
B) The report may be based on a calendar year
				or on the Homemaker Service Provider's fiscal year; however, once it is
				determined which time period is to be used, written approval from HSP shall be
				required for a change in that determination.
C) The report must demonstrate that the
				Homemaker Service Provider has expended a minimum of 77% of the total revenues
				due from HSP, including the customer incurred expense, for Homemaker costs as
				enumerated in Section
				686.280.
				For purposes of this report, the phrase "total revenues due from HSP" does not
				include any amount received as an enhanced rate under Section
				686.235
				by a qualifying Homemaker Service Provider.
D) The report shall identify the Homemaker
				Service Provider's expenditures for Homemaker costs of Program support costs,
				and administrative costs as enumerated in Section 686.280.
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart C - HOMEMAKER SERVICES › Section 686.260 - Unallowable Expenses for Homemaker Service Providers

Current through Register Vol. 48, No. 28, July 12, 2024
The following Homemaker Service Provider expenses shall not
				  be considered by HSP:
a) expenses
				resulting from transactions with related parties or parent organizations that
				are greater than the going market cost of the transactions to the Homemaker
				Service Provider;
b)
				non-straightline depreciation;
c)
				bad debts;
d) special benefits to
				owners, including owner and key-man life insurance;
e) compensation to non-working owners and
				officers;
f) discounts, rebates,
				allowances and charity grants offered by the Homemaker Service
				Provider;
g) entertainment
				expenses;
h) fundraising;
i) legal fees for litigation with
				governmental agencies;
j) awards,
				grants and gifts to individuals;
k)
				fines and penalties;
l) contingency
				funds;
m) losses on other grants
				and contracts; and
n) health
				coverage costs as described under Section
				686.250(e)(2).
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart C - HOMEMAKER SERVICES › Section 686.270 - Minimum Homemaker Costs for Homemaker Service Providers

Current through Register Vol. 48, No. 28, July 12, 2024
a) As provided
				under Section
				686.250(a)(1)(C),
				Homemaker Service Providers are required to expend a minimum of 77% of the
				total revenues due from the HSP, to include the customer incurred expense, for
				Homemaker costs, as enumerated in Section
				686.280,
				during a reporting year.
1) This percentage is
				to be adhered to on a statewide basis.
2) The remaining 23% of the total revenues
				may be spent by the Homemaker Service Providers at their discretion on
				administrative or Program support costs, also delineated in Section
				686.280.
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart C - HOMEMAKER SERVICES › Section 686.280 - Cost Categories for Homemaker Services

Current through Register Vol. 48, No. 28, July 12, 2024
Homemaker Service Providers will provide for cost reporting
				  based on the following categories:
a)
				Homemaker costs (costs paid to or on behalf of Homemakers) that may include:
1) wages, time paid on behalf of the worker
				(i.e., vacation, sick leave, holiday and personal leave);
2) health coverage for any Homemaker Service
				Provider that does not qualify for the enhanced rate for health insurance costs
				from the HSP or the amount of the cost incurred in excess of the enhanced rate
				paid to the Homemaker Service Provider during a reporting period, life
				insurance and disability insurance;
3) retirement coverage;
4) Federal Insurance Contributions Act (FICA)
				(
				26
				USC 21 );
5) uniforms;
6) worker's compensation;
7) Federal Unemployment Tax Act (FUTA) (
				26 USC 23
				);
8) travel time and travel
				reimbursement;
9) unemployment
				insurance; and
10) other costs
				approved, in advance, as Homemaker costs by HSP.
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart D - ELECTRONIC HOME RESPONSE SERVICES › Section 686.300 - Electronic Home Response Services (EHRS) Provider Requirements

Current through Register Vol. 48, No. 28, July 12, 2024
In order for a specific EHRS Provider to be approved for use
				  by DHS in obtaining services for individuals served through HSP, the EHRS
				  Provider must:
a) have, and make
				available on request:
1) articles of
				incorporation; or
2) if
				unincorporated, a statement of purpose and function; and
3) a list of the owners and/or the EHRS
				Provider's owners and/or directors/officers;
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart D - ELECTRONIC HOME RESPONSE SERVICES › Section 686.310 - Services Which Must Be Provided by EHRS Providers

Current through Register Vol. 48, No. 28, July 12, 2024
In order to be a DHS approved EHRS Provider, the EHRS
				  Provider must:
a) have trained
				employees or volunteers that install the EHRS units in the individual's home.
				This service may not be sub-contracted;
b) be able to install the EHRS unit in the
				individual's home within 48 hours upon referral of an individual by DHS to the
				EHRS provider;
c) assist the
				individual in arranging several appropriate responders and provide training to
				those responders;
d) provide
				24-hour monitoring;
e) provide
				instruction to the individual receiving EHRS services on the proper use of the
				EHRS unit at the time the unit is installed. The instruction must include:
1) provisions for monthly testing of the unit
				and its transmission by the individual receiving the EHRS services;
				and
2) general care of the home
				unit; and
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart D - ELECTRONIC HOME RESPONSE SERVICES › Section 686.320 - Minimum Specifications for EHRS Equipment

Current through Register Vol. 48, No. 28, July 12, 2024
a) All home units, at a minimum, must meet
				the requirements of this subsection (a).
1)
				Home units must be able to be activated from:
A) a wireless remote; and
B) from the telephone, using a predetermined
				number;
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart D - ELECTRONIC HOME RESPONSE SERVICES › Section 686.330 - Compliance Review of EHRS Providers

Current through Register Vol. 48, No. 28, July 12, 2024
a) DHS-ORS shall conduct a compliance review
				of any EHRS Provider seeking an approval from DHS-ORS and at least every two
				years shall conduct a review of all EHRS Providers that have current approval
				of DHS-ORS for the purpose of determining compliance or continued compliance
				with the criteria for approval set forth in this Subpart.
b) DHS-ORS shall, when contacted by an EHRS
				Provider, or when notified by staff of the need to access the services of a
				specific EHRS Provider, conduct the review within a period of 60 calendar
				days.
c) DHS-ORS shall notify all
				currently approved EHRS Providers, in writing, at least 10 working days prior
				to the date of the review to determine continued compliance.
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart D - ELECTRONIC HOME RESPONSE SERVICES › Section 686.340 - Appeal of Compliance Review for EHRS Providers

Current through Register Vol. 48, No. 28, July 12, 2024
a) EHRS Providers determined not to be in
				compliance with DHS-ORS requirements as a result of the review may appeal the
				decision to the Chief of the Bureau of Home Services. The Bureau Chief shall
				conduct a review of the facts related to the rating and shall, within 15
				working days, provide a written decision to the EHRS Provider.
b) If the EHRS Provider is not satisfied with
				the decision of the Bureau Chief, the EHRS provider may request review of the
				Bureau Chief's decision by DHS-ORS Associate Director. The request must be in
				writing and received by DHS-ORS Associate Director within 10 working days after
				the date the decision was rendered by the Bureau Chief. The decision of DHS-ORS
				Associate Director shall be final.
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart D - ELECTRONIC HOME RESPONSE SERVICES › Section 686.350 - Rate of Payment for EHRS Services

Current through Register Vol. 48, No. 28, July 12, 2024
a) Installation
DHS-ORS shall pay up to the rate negotiated as a one time
				  installation fee for the installation of the EHRS unit, plus the charge of the
				  local telephone company for telephone service hook up for those customers who
				  do not have local telephone service at the time EHRS services are
				  initiated.
b) Monthly
				Service Fees
DHS-ORS shall pay no more than the rate negotiated for EHRS
				  services, including all fees and charges. DHS-ORS will not pay the cost of the
				  monthly local telephone services required to have EHRS.
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart E - MAINTENANCE HOME HEALTH SERVICE › Section 686.400 - Maintenance Home Health Provider Requirements

Current through Register Vol. 48, No. 28, July 12, 2024
DHS shall use Maintenance Home Health Providers which are
				  approved Medicaid providers or licensed by the Illinois Department of Public
				  Health pursuant to the Home Health Agency Licensing Act [210 ILCS 55
				  ].
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart E - MAINTENANCE HOME HEALTH SERVICE › Section 686.410 - Rate of Payment for Maintenance Home Health Services

Current through Register Vol. 48, No. 28, July 12, 2024
DHS shall pay Maintenance Home Health Providers the rate
				  established by the Illinois Department of Public Aid through the Medicaid
				  Program for the same service.
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart F - HOME DELIVERED MEALS › Section 686.500 - Home Delivered Meals Provider Requirements

Current through Register Vol. 48, No. 28, July 12, 2024
Any entity providing Home Delivered Meals must be certified
				  by the health department in the county in which the program or facility is
				  located and must meet the approval of the customer and
				  counselor.
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart F - HOME DELIVERED MEALS › Section 686.510 - Rate of Payment for Home Delivered Meals

Current through Register Vol. 48, No. 28, July 12, 2024
Providers of Home Delivered Meals may be paid up to the
				  amount that would be paid a PA to prepare meals for the
				  customer.
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart G - ENVIRONMENTAL MODIFICATION › Section 686.600 - Description

Current through Register Vol. 48, No. 28, July 12, 2024
Environmental Modification - Services to physically modify
				  the customer's home to accommodate the customer's loss of function in the
				  completion of his/her Activities of Daily Living (ADLs).
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart G - ENVIRONMENTAL MODIFICATION › Section 686.605 - Criteria for the Provision of Environmental Modifications

Current through Register Vol. 48, No. 28, July 12, 2024
Environmental modifications may be provided to a customer
				  if:
a) the modification will enable
				the customer to independently perform his/her ADLs,
will result in a decreased need for assistance from another
				  individual in the completion of his/her ADLs, will prevent an anticipated
				  increase in service costs, or will improve the safety of the customer during
				  the completion of his/her ADLs;
b) there are no other resources, public or
				private, that will provide the modification; and
c) the HSP total cost for purchase of all
				environmental modifications and assistive equipment purchases, rentals, and
				repairs (89 Ill. Adm. Code
				686.705(d)
				) does not exceed $25,000 over 5 years.
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart G - ENVIRONMENTAL MODIFICATION › Section 686.608 - Environmental Modification Provider Requirements

Current through Register Vol. 48, No. 28, July 12, 2024
All Environmental Modification providers must:
a) meet the approval of the customer and
				counselor;
b) submit a completed
				1413 A - Waiver Program Provider Agreement for Participation in the Illinois
				Medical Assistance Program form;
c)
				submit a completed W-9 Request for Taxpayer Identification Number and
				Certificate;
d) carry a minimum of
				$500,000 in liability insurance, and provide DHS-DRS with a copy of the
				Certificate of Insurance verifying current coverage;
e) provide proof of appropriate current
				contractor licenses, as applicable;
f) perform all modifications so that they
				meet the standards established by the Environmental Barriers Act, the Illinois
				Accessibility Code [71 ILCS 400 ] and local zoning ordinances and codes;
				and
g) obtain proper building
				permits as required by local municipalities.
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart G - ENVIRONMENTAL MODIFICATION › Section 686.615 - Environmental Modification Bidding Procedures and Requirements

Current through Register Vol. 48, No. 28, July 12, 2024
a) For
				environmental modification purchases costing $1,500 or less, bids are not
				required.
b) For environmental
				modification purchases costing more than $1,500, 3 bids must be obtained using
				an Invitation to Bid form (IL 488-0293);
1)
				If an item is available from fewer than 3 sources, the maximum number of bids
				possible shall be obtained.
2) The
				lowest bid received from an eligible provider will be accepted.
3) All exceptions must have supervisory
				approval.
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart G - ENVIRONMENTAL MODIFICATION › Section 686.620 - Permanency of Environmental Modification

Current through Register Vol. 48, No. 28, July 12, 2024
For environmental modifications that cannot be detached from
				  the dwelling, the home must be owned or mortgage held by the customer. If the
				  home is not owned by the customer, the customer, with the assistance of the
				  counselor, must obtain written permission of the homeowner/property owner to
				  make the modifications and to ensure that the homeowner/property owner
				  understands the permanency of the modifications and DHS-DRS' inability to
				  return the building to its previous condition. A Homeowner/Lessor Agreement
				  form (IL 488-0040) must be completed and signed by the homeowner/lessor,
				  customer/lessee, and the counselor prior to the installation of any
				  environmental modifications.
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart G - ENVIRONMENTAL MODIFICATION › Section 686.630 - Reason for Denial of Environmental Modification

Current through Register Vol. 48, No. 28, July 12, 2024
Environmental modifications shall be denied when:
a) the cost of the modifications does not
				comply with the provisions of Section
				686.605(c);
b) the customer has a poor history as a
				tenant, or is otherwise not expected to remain in the home to be modified for a
				period of at least 1 year;
c) the
				past practices or reputation of the landlord is unfavorable; or
d) the modifications are for "value added" or
				cosmetic purposes.
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart G - ENVIRONMENTAL MODIFICATION › Section 686.640 - Verification of Environmental Modification

Current through Register Vol. 48, No. 28, July 12, 2024
Within 30 days of the date of completion of the environmental
				  modifications, the counselor must make a home visit to inspect the
				  modifications and to ensure customer satisfaction with the modifications. A
				  signed Receipt for Appliances, Merchandise and Supplies form (IL 488-1694) from
				  the customer shall be required to verify receipt and satisfaction with the
				  modifications.
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart H - ASSISTIVE EQUIPMENT › Section 686.700 - Description

Current through Register Vol. 48, No. 28, July 12, 2024
Assistive Equipment - Items necessary to accommodate the
				  customer's loss of function in the completion of his/her Activities of Daily
				  Living (ADLs). This does not include medical supplies, disposable personal
				  hygiene items, or items necessary for medical treatment.
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart H - ASSISTIVE EQUIPMENT › Section 686.705 - Criteria for the Purchase, Rental, or Repair of Assistive Equipment

Current through Register Vol. 48, No. 28, July 12, 2024
Assistive equipment may be provided to a customer if:
a) the equipment will enable the customer to
				independently perform his/her ADLs, will result in a decreased need for
				assistance from another individual in the completion of his/her ADLs, will
				prevent an anticipated increase in service costs, or will improve the safety of
				the customer during the completion of his/her ADLs;
b) there is an official
				communication/documentation in the file of Medicaid denial by the Department of
				Healthcare and Family Services (HFS) for the requested assistive
				equipment;
c) there are no other
				resources, public or private, that will provide the equipment; and
d) the HSP total cost for purchases, rentals,
				and repairs of all assistive equipment and environmental modifications (89 Ill.
				Adm. Code
				686.605(c)
				) does not exceed $25,000 over 5 years.
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart H - ASSISTIVE EQUIPMENT › Section 686.708 - Purchase, Rental, or Repair of Assistive Equipment

Current through Register Vol. 48, No. 28, July 12, 2024
A prescription from a physician or licensed therapist is
				  required for all purchases or rentals of medically-oriented assistive
				  equipment.
a) Assistive equipment may
				be purchased when:
1) the customer is
				expected to need the equipment for a period to exceed 1 year;
2) the cost of renting the equipment exceeds
				the purchase price of the equipment; or
3) the equipment is not available for
				rental.
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart H - ASSISTIVE EQUIPMENT › Section 686.715 - Assistive Equipment Provider Requirements

Current through Register Vol. 48, No. 28, July 12, 2024
All assistive equipment providers must:
a) meet the approval of the customer and
				counselor;
b) submit a completed
				1413A - Waiver Program Provider Agreement for Participation in the Illinois
				Medical Assistance Program form; and
c) submit a completed W-9 Request for
				Taxpayer Identification Number and Certificate.
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart H - ASSISTIVE EQUIPMENT › Section 686.722 - Assistive Equipment Bidding Procedures and Requirements

Current through Register Vol. 48, No. 28, July 12, 2024
Section
				  686.722
				  Assistive Equipment Bidding Procedures and Requirements
a) For assistive equipment purchases costing
				$1,500 or less, bids are not required.
b) For assistive equipment purchases costing
				more than $1,500, 3 bids must be obtained using an Invitation to Bid form (IL
				488-0293);
1) If an item is available from
				fewer than 3 sources, the maximum number of bids possible shall be
				obtained.
2) The lowest bid
				received from an eligible provider will be accepted.
3) All exceptions must have supervisory
				approval.
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart H - ASSISTIVE EQUIPMENT › Section 686.730 - Verification of Receipt of, and Customer Satisfaction with, Assistive Equipment

Current through Register Vol. 48, No. 28, July 12, 2024
Assistive equipment that is purchased, rented or repaired
				  requires customer contact for verification of equipment/services provided. A
				  Receipt for Appliances, Merchandise and Supplies form (IL 488-1694) must be
				  completed and signed by the customer within 60 days after the equipment
				  delivery, installation, or repair.
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart I - RESPITE CARE › Section 686.800 - Respite Care Provider Requirements

Current through Register Vol. 48, No. 28, July 12, 2024
Any individual or agency providing respite services to an
				  individual through HSP must meet the standards set forth in the appropriate
				  Subpart for that service as listed in this Part.
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart J - CASE MANAGEMENT SERVICES TO PERSONS WITH AIDS › Section 686.900 - Program Overview

Current through Register Vol. 48, No. 28, July 12, 2024
The Department of Human Services Division of Rehabilitation
				  Services (DHS-DRS) shall enter into agreements with agencies to provide case
				  management services to persons diagnosed with AIDS, which includes persons with
				  human immunodeficiency virus (HIV) infection, who are eligible for services
				  provided by the AIDS Medicaid Waiver. For geographical areas in Illinois in
				  which case management agencies are not located, case management shall be
				  provided by DHS-DRS Home Services counselors, utilizing licensed home health
				  nurses, as needed, to comply with the services offered and the requirements
				  contained in Section 686.910(b), (c),
				  (d), and (e).
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart J - CASE MANAGEMENT SERVICES TO PERSONS WITH AIDS › Section 686.910 - Case Management Provider Responsibilities

Current through Register Vol. 48, No. 28, July 12, 2024
a) Case Management
1) The case management agency shall receive
				Customer referrals from hospitals, the Illinois Department of Public Health's
				AIDS Hotline, HSP Ashburn Unit, other State and local agencies, and other
				referral services (e.g., doctors and individuals). The provider shall assign a
				case manager to each Customer.
2)
				There shall be two levels of case managers: provisional case managers and case
				managers.
A) Case managers are those who have
				achieved a competency score of 98% or greater for the on-site case reviews done
				by the HSP Ashburn Unit under Section
				686.930(d). The
				case manager shall have full responsibility for the determination of HSP
				eligibility including assessment and implementation of services to be provided.
				The case manager shall develop services with Customer participation that are
				provided in a manner that reflects the Customer's choices, when applicable, and
				address the Customer's strengths, needs and desired goals. Assessments, service
				plans and reassessments completed by case managers may be implemented without
				consultation with the HSP Ashburn Unit.
B) The case manager shall act as a liaison
				with the hospital discharge planner, physician, home health agencies, and other
				medical provider agencies.
C)
				Provisional case managers are those who have not achieved a competency score of
				98% or greater for the on-site case reviews done by the HSP Ashburn Unit, per
				Section 686.930(d).
				Provisional case managers shall submit all developed plans to the HSP Ashburn
				Unit for approval. Approval of the plan will be based on a review to determine
				that: the Determination of Need Assessment on which the plan is developed is
				complete and accurate; the plan meets the needs identified by the assessment;
				the plan does not place the Customer's health and safety at risk; and the plan
				is cost effective compared to comparable institutional care.
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart J - CASE MANAGEMENT SERVICES TO PERSONS WITH AIDS › Section 686.920 - Provider Staffing Requirements, Qualifications, and Training

Current through Register Vol. 48, No. 28, July 12, 2024
a) Each case
				management agency shall designate an individual who will be responsible for the
				administration of the case management program. The designated individual shall
				have or be actively enrolled in a program to obtain:
1) a bachelor's degree in health, human
				services, or a related field;
2)
				licensure as a registered nurse pursuant to the Nurse Practice Act
				[225 ILCS
				65 ]; or
3) at least one year of experience as a home
				health care administrator, medical clinic administrator, or other health
				services administrator.
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart J - CASE MANAGEMENT SERVICES TO PERSONS WITH AIDS › Section 686.930 - Monitoring and Liability of Provider

Current through Register Vol. 48, No. 28, July 12, 2024
a) The HSP Ashburn Unit shall monitor the
				case management agency to assure compliance with this Subpart by:
1) reviewing and approving the assessment
				(Section 686.910(c)).
				The review will be conducted pursuant to the DHS' Home Services Program (89
				Ill. Adm. Code 682), the service plan, and payments for services;
2) reviewing provisional case managers as set
				forth in subsection (d);
3)
				reviewing, on an annual basis, a random sample 10% of the cases handled in the
				preceding 12 months or two cases, whichever is greater;
4) visiting, at least annually, all
				contracting case management agencies.
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart J - CASE MANAGEMENT SERVICES TO PERSONS WITH AIDS › Section 686.940 - Provider Compliance Requirements

Current through Register Vol. 48, No. 28, July 12, 2024
In order to participate in the DHS-DRS program to provide
				  services to persons with HIV/AIDS, the provider agrees to meet the following
				  minimum requirements that shall be reviewed by DHS annually for
				  compliance.
a) Organization and
				Administration: The provider shall make available, upon request, its articles
				of incorporation, or if an unincorporated association (e.g., partnerships and
				limited partnerships) shall provide a statement of purpose and functions, and
				the names and addresses of its owners, partners, or general partners.
b) Audits: DHS reserves the right to audit
				all records and accounts pertinent to the provision of services and billing at
				any time within five years after the provider stopped providing services under
				the HIV/AIDS waiver.
c) Policies
				and Procedures: The provider shall have written policies approved by its
				governing authority (e.g., Board of Directors) and available for review by
				customers and purchasers of the service. Such policies shall at a minimum
				cover:
1) Service Provided: Policy shall
				designate the type and scope of service provided. When more than one type of
				service is offered, there shall be a clear distinction between each type
				provided.
2) Personnel Policies:
				Policies shall cover salary schedules, hours of work, sick leave, provision for
				handling employee grievances, and requirements for attendance at work
				conferences and training sessions. There shall be written job descriptions
				identifying required qualifications and duties for each title. Policies shall
				also include the Centers for Disease Control and Prevention (CDC)
				recommendations for health care workers for provision of services to persons
				with HIV/AIDS and any requirements within the Illinois Compiled Statutes
				regarding HIV/AIDS, including the AIDS Confidentiality Act [410 ILCS
				305 ].
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart K - CASE MANAGEMENT SERVICES TO PERSONS WITH BRAIN INJURIES › Section 686.1000 - Program Overview

Current through Register Vol. 48, No. 28, July 12, 2024
The Department of Human Services (DHS) shall enter into
				  agreements with community-based organizations to provide case management to
				  persons diagnosed with brain injuries who are eligible for services provided by
				  the Medicaid Waiver for Persons with a Brain Injury. For geographic areas in
				  Illinois in which case management agencies are not located, case management
				  shall be provided by DHS Home Services counselors.
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart K - CASE MANAGEMENT SERVICES TO PERSONS WITH BRAIN INJURIES › Section 686.1010 - Case Management Provider Responsibilities

Current through Register Vol. 48, No. 28, July 12, 2024
a) Case Managers
1) The Case Manager shall receive referrals
				from hospitals, other health providers, and other State and local
				agencies.
2) The Case Manager shall
				have responsibility for the implementation of services to be provided. The
				services, developed by the HSP Counselor with Customer participation, shall be
				provided in a manner that reflects the Customer's choice, when applicable, and
				shall address his/her strengths, needs and desired goals.
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart K - CASE MANAGEMENT SERVICES TO PERSONS WITH BRAIN INJURIES › Section 686.1020 - Case Manager Staffing Requirements, Qualifications and Training

Current through Register Vol. 48, No. 28, July 12, 2024
a) Every agency
				providing case management services shall designate an individual who has
				overall responsibility for the administration of case management
				services.
b) A Case Manager shall
				meet one of the following qualifications:
1)
				a Registered Nurse, licensed pursuant to the Illinois Nursing Act of 1987 [225
				ILCS 65 ];
2) a Certified or
				Licensed Social Worker, certified or licensed pursuant to the Illinois Clinical
				Social Work and Social Work Practice Act [225 ILCS 20 ];
3) a Social Worker with a minimum of a
				Bachelor's degree in social work, social sciences or counseling. A Bachelor's
				of Social Work or a Master's of Social Work from a school accredited by any
				organization nationally recognized for the accreditation of schools of social
				work is preferred;
4) a Vocational
				Specialist holding a certification in Rehabilitation Counseling or a minimum of
				3 years working with people with disabilities;
5) Licensed Clinical Professional Counselor
				(LCPC), licensed pursuant to the Professional Counselor and Clinical
				Professional Counselor Licensing Act of 1998 [225 ILCS 107 ];
6) Licensed Professional Counselor (LPC),
				licensed pursuant to the Professional Counselor and Clinical Professional
				Counselor Licensing Act [225 ILCS 107];
7) Certified Case Manager (CCM) with
				certification in case management from an appropriate certifying
				organization.
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart K - CASE MANAGEMENT SERVICES TO PERSONS WITH BRAIN INJURIES › Section 686.1025 - Provisional Case Manager

Current through Register Vol. 48, No. 28, July 12, 2024
a) There
				shall be two levels of case management staff: Provisional Case Manager and Case
				Manager. A Provisional Case Manager is one who has not achieved a competency
				score of 98% or greater on the case reviews done by the Home Services Program
				(HSP) administrative staff per Section
				686.1030(d).
				Assessments, service plans and reassessments completed by a Case Manager may be
				implemented without consultation with the HSP administrative staff. Provisional
				Case Managers shall submit all developed plans to HSP for approval. Approval of
				the plan will be based on a review to determine that: the DON assessment on
				which the plan is developed is complete and accurate; the plan meets the needs
				identified by the assessment; and the plan is cost effective compared with
				comparable institutional care.
b)
				All Provisional Case Managers will work toward meeting Case Manager standards
				within six months after receiving the HSP Case Manager Training. Case Manager
				status will be granted when six case file reviews attain a competency score of
				98-100% using the review process described in this subsection (b).
1) The HSP administrative staff will review
				three case files within three months from the end date of the Case Manager
				Training. The Case Manager will be present and have the Case Manager Training
				Manual.
2) The HSP staff will
				review each case using the HSP case file review quality assurance
				form.
3) Using the Case Manager
				Training Manual, HSP staff will discuss each deficiency with the Case
				Manager.
4) A corrective action
				plan will be developed by HSP staff for the Case Manager to resolve all
				deficiencies in the case file.
5)
				The Case Manager will implement the corrective action plan and complete all
				items prior to the next review of the case files.
6) HSP staff will review all files noted in
				the corrective action plan for compliance with case management
				practices.
7) The above process
				will continue until the cases reviewed for the Case Manager meet a 98-100%
				compliance score on six case file reviews.
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart K - CASE MANAGEMENT SERVICES TO PERSONS WITH BRAIN INJURIES › Section 686.1030 - Monitoring and Liability

Current through Register Vol. 48, No. 28, July 12, 2024
a)
				The HSP staff shall monitor the Case Manager to assure compliance with this
				Subpart by:
1) reviewing Provisional Case
				Managers as set forth in subsection (d);
2) reviewing, on an annual basis, a random
				sample of 10% of the cases handled in the preceding 12 months or two cases,
				whichever is greater; and
3)
				visiting, at least annually, all contracting case management
				agencies.
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart K - CASE MANAGEMENT SERVICES TO PERSONS WITH BRAIN INJURIES › Section 686.1040 - Provider Compliance Requirements

Current through Register Vol. 48, No. 28, July 12, 2024
In order to participate in the DHS program for providing
				  services to persons with brain injuries, the provider of case management
				  services agrees to meet the following minimum requirements, which shall be
				  reviewed by DHS annually for compliance.
a) Organization and Administration: The
				agency providing case management services shall make available, upon request,
				its articles of incorporation, or if an unincorporated association, it shall
				provide a statement of purpose and functions and the names and addresses of its
				owners, partners or general partners.
b) Audits: DHS reserves the right to audit
				all records and accounts pertinent to the Agreement at anytime within five
				years after the final completion date of the Agreement.
c) Policies and Procedures: The provider of
				case management services shall have written policies approved by its governing
				authority and available for review by customers and purchasers of the service.
				Such policies shall at a minimum cover:
1)
				Services Provided: the type and scope of services provided. When more than one
				type of service is offered, there shall be a clear distinction between each
				type of service.
2) Personnel
				Policies: salary schedules, hours of work, sick leave, provision for handling
				employee grievances and requirements for attendance at work conferences and
				training sessions. There shall be written job descriptions identifying required
				qualifications and duties for each title.
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart L - BEHAVIORAL SERVICES FOR PERSONS WITH BRAIN INJURIES › Section 686.1100 - Behavioral Services Provider Requirements

Current through Register Vol. 48, No. 28, July 12, 2024
HSP shall use Behavioral Service Providers that are licensed
				  under the Illinois Clinical Psychologist Licensing Act [225 ILCS 15 ], the
				  Illinois Professional Counselor and Clinical Professional Counselor Licensing
				  Act [225 ILCS 107 ], or the Illinois Clinical Social Work and Social Work
				  Practice Act [225 ILCS 20 ].
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart L - BEHAVIORAL SERVICES FOR PERSONS WITH BRAIN INJURIES › Section 686.1110 - Rate of Payment for Behavioral Services

Current through Register Vol. 48, No. 28, July 12, 2024
HSP shall pay Behavioral Service Providers at rates
				  established per 89 Ill. Adm. Code 545, "Ratemaking".
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart M - DAY HABILITATION SERVICES FOR PERSONS WITH BRAIN INJURIES › Section 686.1200 - Day Habilitation Services Provider Requirements

Current through Register Vol. 48, No. 28, July 12, 2024
a) All Habilitation Service Agency providers
				(hereafter referred to as providers) who provide services to Customers of the
				DHS-DRS HSP shall have habilitation services accredited by an appropriate
				accrediting organization or shall be certified by DHS according to the criteria
				set forth in this Subpart.
1) DHS shall apply
				its criteria to certify a provider that provides HSP approved services as
				identified on a Customer's service plan, when the provider has not yet received
				national accreditation.
2) DHS
				certification shall be granted for two years, after which time the provider
				must be accredited for Brain Injury Habilitation Services in accordance with
				subsection (b).
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart M - DAY HABILITATION SERVICES FOR PERSONS WITH BRAIN INJURIES › Section 686.1210 - Rate of Payment for Day Habilitation Services

Current through Register Vol. 48, No. 28, July 12, 2024
HSP shall pay Day Habilitation Providers the rate established
				  per 59 Ill. Adm. Code 120, "Medicaid Home and Community-Based Services Waiver
				  Program for Individuals with Developmental Disabilities."
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart M - DAY HABILITATION SERVICES FOR PERSONS WITH BRAIN INJURIES › Section 686.1220 - Certification of Day Habilitation Agency Providers

Current through Register Vol. 48, No. 28, July 12, 2024
a) With the submission of an application to
				HSP, a provider described in Section
				686.1200(a)(1)
				shall be evaluated by representatives of DHS.
b) The provider service program shall be in
				operation for a period of one year prior to application.
c) DHS shall apply the standards set forth in
				Sections 686.1230 and 686.1240 to the provider.
d) DHS shall contact the provider to arrange
				the evaluation date and time that is convenient for all parties, provide
				written confirmation of that date and time, and explain the on-site evaluation
				procedure.
e) During the evaluation
				process, the DHS representative may review case records, program descriptions
				and documents, and may interview staff and Customers to ensure that standards
				are being met.
f) DHS shall hold an
				exit interview with the provider. The interview shall identify areas in which
				the provider does and does not comply with Sections 686.1230 and
				686.1240.
g) A written report of
				the results of the certification evaluation shall be sent to the provider
				within 30 calendar days. The results may indicate that remediation is needed to
				address noncompliance with Sections 686.1230 and 686.1240.
1) If remediation is indicated, the provider
				shall submit a corrective action plan (CAP) to DHS within 30 calendar days
				after receipt of the report. The CAP shall identify how the provider will
				comply with areas of Sections 686.1230 and 686.1240 in which the provider was
				found noncompliant. The CAP shall include time frames for the remediation.
A) Upon acceptance of the CAP, DHS shall
				notify the provider of the decision to certify the program and services offered
				by the provider for two years if compliance with the standards are
				met.
B) If the provider fails to
				submit a CAP and/or is unable to institute a plan satisfactorily in compliance
				with the standards of Sections 686.1230 and 686.1240, DHS shall notify the
				provider in writing of the decision not to certify the provider.
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart M - DAY HABILITATION SERVICES FOR PERSONS WITH BRAIN INJURIES › Section 686.1230 - Provider Standards

Current through Register Vol. 48, No. 28, July 12, 2024
a) The
				provider must be a legally constituted agency or organization, or an entity
				operated by a state or political subdivision of a state under an appropriate
				federal, state or local statute.
b)
				The provider's governing body shall:
1)
				establish in writing the organization's mission, policies, and necessary
				financial support;
2) employ a
				full-time Director and delegate to that person the authority and responsibility
				for the management of the provider agency in accordance with established
				policies;
3) meet with its
				executive committee and Director at least quarterly;
4) review and approve the provider agency
				budget and the independent, certified audit annually, and the income and
				expense reports at least quarterly;
5) identify a designated staff member or
				group that shall be responsible for making admission decisions;
6) include written policy that safeguards
				against possible conflicts of interest between its members and the operation of
				the provider agency as part of its constitution or bylaws; and
7) provide documentation of current liability
				insurance to protect assets and to ensure compensation for staff, individuals
				with disabilities, volunteers, and the public, in the event compensation would
				be required for occurrences for which the provider agency is liable.
Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 686 - PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT › Subpart M - DAY HABILITATION SERVICES FOR PERSONS WITH BRAIN INJURIES › Section 686.1240 - Program and Service Requirements

Current through Register Vol. 48, No. 28, July 12, 2024
a) When HSP refers a Customer to a provider
				for services, the provider shall notify HSP, in writing, of the disposition of
				the referral within 15 calendar days after receipt of the referral. This
				notification shall include the expected date after admission and any pertinent
				information regarding the Customer's entry into the program.
b) All Customers referred for services shall
				receive a personal interview that includes an explanation of why the individual
				was referred, service opportunities available to the individual, and the right
				to appeal services under 89 Ill. Adm. Code 510.
c) Customers on waiting lists shall be
				contacted monthly, apprised of their status, and given sufficient information
				to decide whether to remain on the waiting list or seek services
				elsewhere.
d) There shall be
				clearly written entrance and exit criteria for each service offered by the
				agency.
e) Customer case records
				shall be kept secure, confidential, and available only to authorized personnel.
				Customers referred for services shall be notified in writing of their
				acceptance or non-acceptance into the program.
f) Assessment methods, techniques, and work
				sites shall be relevant to the Customer's needs.
g) Each Customer served by the provider shall
				receive a Brain Injury Habilitation Assessment and participate in the
				provider's development of his/her Habilitation Plan.
1) Each Customer shall be provided goal and
				service options that assist him/her in choosing a habilitation goal.
2) Each Customer shall be enabled to choose
				his/her habilitation goals and services and express his/her degree of
				satisfaction with the results achieved.
3) A written report or narrative of the Brain
				Injury Habilitation Assessment shall include:
A) background information regarding the
				person;
B) interpersonal/personal
				observations made by agency staff;
C) a life skills appraisal of the
				person;
D) a recommended
				habilitation goal;
E) recommended
				objectives and services to attain the stated habilitation goal; and
F) a summary of the conference or staffing
				conducted, including Customer comments.
4) The Habilitation Plan shall identify:
A) a habilitation goal;
B) understandable, measurable objectives to
				achieve the habilitation goal;
C)
				services needed to meet the objectives;
D) time frames to achieve the goal and
				objectives;
E) measures to assess
				the outcome of objectives, including review dates; and
F) the persons responsible for implementing
				the plan.
5) All persons
				involved in the plan development shall receive a copy of the service plan
				within five State working days after the plan's development.