Illinois Administrative Code › Title 89 - SOCIAL SERVICES › Part 240 - COMMUNITY CARE PROGRAM › Subpart D - APPEALS › Section 240.400 - Appeals and Fair Hearings

Current through Register Vol. 48, No. 28, July 12, 2024
a) Any
				participant who requests or receives CCP services of any kind has the right to
				appeal a decision, action or inaction of the Department, a CCU or a provider.
				If the decision, action or inaction is based on automatic, non-discretionary
				changes in eligibility, rates or benefits required by federal or State statute
				or regulation, that adversely affect some or all participants, the appeal will
				be automatically denied and the participant will not be afforded a hearing. The
				participant/authorized representative shall be informed by the CCU of his/her
				right to appeal at the time the participant/authorized representative is
				notified of the action taken. The participant shall be given an explanation of
				the right to appeal at the time of the initial home visit at which the action
				is taken and upon request. A copy of the rights and responsibilities of
				participants who request services under CCP and an explanation of the right to
				appeal shall be provided in written format during the initial home visit for
				determination of eligibility and upon request.
b) It shall be the responsibility of each
				participant/authorized representative to advise the Department of his/her
				intent to appeal.
c) The effective
				date of the appeal is the date a participant/authorized representative
				indicates to the Department the intent to appeal either by telephone or in
				writing.
d) If the Department is
				advised of the intent to appeal either by letter or by telephone, the
				Department shall, within 2 work days, send to the appellant a Notice of Appeal
				to Department on Aging form to be completed and signed by the
				appellant/authorized representative.
e) The written notice of appeal must be filed
				with the Department on a Notice of Appeal to Department on Aging form and shall
				be completed and executed by the appellant/authorized representative and
				returned to the Department.
f) The
				executed Notice of Appeal to Department on Aging form must be submitted to the
				Department at its main office in Springfield.
g) No later than 10 work days after the date
				of receipt of Notice of Appeal to Department on Aging form, the Department
				shall send written acknowledgment of receipt to the appellant/authorized
				representative and to all other parties to the appeal.
h) The written Notice of Appeal to Department
				on Aging shall include the following:
1) the
				name, address and telephone number of the participant filing the appeal, or on
				whose behalf the appeal is filed; and
2) the name, address and telephone number of
				the authorized representative, if any, filing the appeal on behalf of the
				participant;
3) the specific action
				being appealed, including the date of notice advising the
				participant/authorized representative of the action appealed and the effective
				date of that action; and
4) the
				name of the CCU, as indicated on the notice of the action being
				appealed.