Section 220.100  Confidentiality and Disclosure of Information

 

a)         No information concerning an older person or obtained from an older person by the Department, area agency on aging, or a provider of services under this rule shall be disclosed by the Department, area agency on aging or provider of services in any form that will identify the particular older person without the informed consent of the older person or his or her legal representative unless the disclosure is required by court order, 45 CFR 74.24 (1984) or for other program monitoring by authorized Federal or State monitoring agencies.

 

b)         Lists of older persons compiled in relation to the provision of Information and Referral services funded under this rule shall be used solely for the purpose of providing services, and only with the informed consent of each individual on such list.

 

Section 220.200  Client Cooperation

 

a)         Clients must cooperate:

 

1)         In the determination of eligibility;

 

2)         With Department programs (quality control and compliance audits) conducted for the purpose of acquisition or verification of information upon which eligibility or level of care may depend;

 

3)         In applying for all benefits which support the cost of in-home care for which they may qualify and to avail themselves of such benefits at the earliest possible date.

 

b)         Clients are required to avail themselves of all potential resources that may reduce the cost of in-home care to the Department.

 

c)         When eligibility cannot be established or level of care determined because the client is unwilling or fails to provide essential information or to consent to verification (if requested) the client is ineligible.

 

d)         Refusal to cooperate means that the household is able to cooperate but clearly demonstrates that it will not take action that it can take, and that is required to complete an eligibility determination.  If the household has merely failed to cooperate, rather than refused to cooperate, the application will not be denied or benefits terminated.

 

Section 220.300  Referral Requirements

 

The client shall have the right to receive information about programs and services of the Illinois Department on Aging or the area agency on aging. The client also shall have the right to be referred to other service agencies and/or departments (public and private) for appropriate programs and services.  If the client is an applicant for or recipient of Community Care services under Title XX of the Social Security Act (45 CFR 204) or a recipient of in-home health care under Title III of the Older Americans Act (45 CFR 1321), the client has the responsibility to accept a referral to a source of potential medical or service assistance.

 

Section 220.400  Other Resources Supporting the Cost of In-Home Care Services

 

a)         The Department may require individuals to apply for or obtain available benefits or resources which would support the costs of in-home care services.  Where such benefits or resources would be available upon payment of a fee, the Department may elect to pay such fees so long as the costs of the fee to the Department would be less than the cost of the associated benefits the individual would derive.

 

b)         Other available benefits or resources may include but are not limited to:

 

1)         Voluntary or in-kind services

 

2)         Insurance programs

 

3)         Services funded under Title XVIII of the Social Security Act (42 CFR 405)

 

4)         Local programs not under direct programmatic responsibility of the State of Illinois

 

5)         Services funded under Title XIX of the Social Security Act (42 CFR 440).

 

Section 220.500  Appeals and Fair Hearings (Repealed)

 

(Source:  Repealed at 45 Ill. Reg. 10769, effective August 10, 2021)

 

Section 220.501  Initiation of Appeal Process (Repealed)

 

(Source:  Repealed at 45 Ill. Reg. 10769, effective August 10, 2021)

 

Section 220.502  Request for Hearing or Appeal (Repealed)

 

(Source:  Repealed at 45 Ill. Reg. 10769, effective August 10, 2021)

 

Section 220.503  Place of Filing (Repealed)

 

(Source:  Repealed at 45 Ill. Reg. 10769, effective August 10, 2021)

 

Section 220.504  Responsibility of Department or Area Agency on Aging (Repealed)

 

(Source:  Repealed at 45 Ill. Reg. 10769, effective August 10, 2021)

 

Section 220.505  Informal Review (Repealed)

 

(Source:  Repealed at 45 Ill. Reg. 10769, effective August 10, 2021)

 

Section 220.506  Hearing Officer (Repealed)

 

(Source:  Repealed at 45 Ill. Reg. 10769, effective August 10, 2021)

 

Section 220.507  Notice of Hearing (Repealed)

 

(Source:  Repealed at 45 Ill. Reg. 10769, effective August 10, 2021)

 

Section 220.508  Representation of Appellant (Repealed)

 

(Source:  Repealed at 45 Ill. Reg. 10769, effective August 10, 2021)

 

Section 220.509  Appellant Participation in Hearing (Repealed)

 

(Source:  Repealed at 45 Ill. Reg. 10769, effective August 10, 2021)

 

Section 220.510  Amendment of Appeal (Repealed)

 

(Source:  Repealed at 45 Ill. Reg. 10769, effective August 10, 2021)

 

Section 220.511  Consolidation of Appeals (Repealed)

 

(Source:  Repealed at 45 Ill. Reg. 10769, effective August 10, 2021)

 

Section 220.512  Postponement of Hearing (Repealed)

 

(Source:  Repealed at 45 Ill. Reg. 10769, effective August 10, 2021)

 

Section 220.513  Withdrawal of Appeal (Repealed)

 

(Source:  Repealed at 45 Ill. Reg. 10769, effective August 10, 2021)

 

Section 220.514  Evidentiary Requirements (Repealed)

 

(Source:  Repealed at 45 Ill. Reg. 10769, effective August 10, 2021)

 

Section 220.515  Closing of Hearing Record (Repealed)

 

(Source:  Repealed at 45 Ill. Reg. 10769, effective August 10, 2021)

 

Section 220.516  Dismissal of Appeals (Repealed)

 

(Source:  Repealed at 45 Ill. Reg. 10769, effective August 10, 2021)

 

Section 220.517  Transcript (Repealed)

 

(Source:  Repealed at 45 Ill. Reg. 10769, effective August 10, 2021)

 

Section 220.518  Decision (Repealed)

 

(Source:  Repealed at 45 Ill. Reg. 10769, effective August 10, 2021)

 

Section 220.519  Notice of Decision to Appellant (Repealed)

 

(Source:  Repealed at 45 Ill. Reg. 10769, effective August 10, 2021)

 

Section 220.520  Public Review (Repealed)

 

(Source:  Repealed at 45 Ill. Reg. 10769, effective August 10, 2021)

 

Section 220.600  Case Coordination Unit Minimum Standards

 

a)         To be designated as a Case Coordination Unit (CCU) for a specific geographic area, as identified by the Area Agency on Aging (AAA) in a specified planning and service area, an agency shall enter into a contract or grant with the AAA to provide Title III (Older Americans Act (42 USC 3001)) case management services pursuant to 89 Ill. Adm. Code 230 (Subpart G) and with the Department to provide Community Care Program (CCP) case management services pursuant to 89 Ill. Adm. Code 240.260 and 240.1400 et seq.

 

1)         The agency shall be a free-standing, single purpose agency, or shall be part of a multi-purpose agency. A multi-purpose agency shall have a separate, clearly definable organizational unit functioning as the CCU.

 

A)        An AAA shall not be designated a CCU except in an emergency situation as specified in Section 220.655(e).

 

B)        A CCP provider may not serve as a CCU in the same contract service area except in temporary situations as specified in 89 Ill. Adm. Code 240.1400(f).

 

C)        No organization having any other conflict of interest in the performance of case management service activities shall serve as a CCU.  Conflict of interest means any entity or individual uses an official position for private gain (other than salary), gives preferential treatment to any entity or individual in the conduct of official duties because of personal interest, impedes or adversely affects governmental efficiency or economy because of personal interest, fails to act impartially in the conduct of official duties because of personal interest, or engages in conduct that could adversely affect the confidence of the public in the integrity of the Department on Aging and its programs.  The term also means that the circumstances are such that the Department might reasonably conclude that an entity's or individual's judgment could be influenced by the nature of the circumstances.

 

2)         The designation of CCUs shall be accomplished by the AAA and the Department as described in Sections 220.610 through 220.645 of this Part.

 

3)         The designated CCU must be in compliance with Older Americans Act (42 USC 3001) requirements.

 

4)         Only one designated CCU shall have jurisdiction in a particular geographic area.

 

b)         Case management service is defined as assistance either in the form of access or care coordination in circumstances where the older persons and/or their caregivers are experiencing diminished functioning capacities, personal conditions or other characteristics which require the provision of service by formal service providers.  Activities of case management include assessing needs, developing case plans, authorizing services, arranging services, coordinating the provision of services among formal service providers and informal sources of support, follow-up and reassessment, as required.

 

c)         An individual AAA may establish additional requirements than those specified in subsections (e) through (k) relative to any contract/grant for case management services provided in its respective planning and service area. The AAA shall arrange for funding of such additional requirements.  Such additional requirements shall bear no additional cost to the Department or to recipients of services.

 

d)         An individual AAA may require a CCU to provide additional funded Older Americans Act (42 USC 3001) or General Revenue Fund services that are directly related to case management as defined in subsection (b).

 

e)         Case management service activities shall minimally include (as specified in 89 Ill. Adm. Code 230.250(i)(1) and 240.1420):

 

1)         Intake:  Older persons who are potentially in need of case management services shall be screened.

 

2)         Needs Assessment:  A face-to-face assessment/reassessment shall be conducted for all potentially eligible or current Title III case management clients and CCP applicants/clients.

 

3)         Case Plan Development:  A written goal-oriented case plan shall be prepared for all individuals determined to be in need of case management services.

 

4)         Case Plan Implementation:  A referral of the client shall be made to appropriate formal and informal resources.

 

5)         Follow-up:  Contact to ensure that service has been implemented for the client.

 

f)         The CCU shall minimally:

 

1)         Coordinate services with the following types of organizations in the contractual area:

 

A)        Information and Assistance and Outreach Providers

 

B)        Nursing Facilities

 

C)        Health Care Providers (including all hospitals in the geographic area)

 

D)        Social Service Providers

 

E)        Public Assistance/Financial Assistance Organizations

 

F)         Elder Abuse and Ombudsman Provider Agencies

 

2)         Coordinate services to individual clients and shall, at a minimum, include a process for handling information requests, referrals, and follow-up activities.  The process must be clearly defined in written policy and procedures.

 

3)         Establish and follow procedures, which must be retained on file, to assure that each client has an assigned case manager to contact, including back-up procedures for assigning a substitute case manager, who meets the minimum requirements specified in Section 220.605 of this Part and in 89 Ill. Adm. Code 240.1440, in the absence of the assigned case manager.

 

4)         Establish and follow procedures, which must be retained on file to assure maintenance of and safeguard the use of and disclosure of information relating to applicants and clients as required by Federal or State laws, rules and regulations and the requirements specified in Section 220.100 of this Part and in 89 Ill. Adm. Code 240.340.

 

5)         Present service options and information about available providers to each client and/or client's authorized representative in an objective manner.

 

6)         Establish and follow a written procedure for coordinating the CCU intake system with the Title III Information and Assistance and Outreach providers.

 

7)         Arrange services to non-English speaking and hearing impaired applicants and/or clients.

 

8)         Have a TTY or assist the applicant and/or client in using the Illinois Relay Center to accommodate the hearing and/or speech impaired.

 

9)         Comply with the Illinois Human Rights Act [775 ILCS 5]; the Equal Employment Opportunity Act of 1974, as amended (Title VII of the U.S. Civil Rights Act of 1964, as amended (42 USC 2000e et seq.)); Section 504 of the Rehabilitation Act of 1973 (29 USC 790 et seq.); the Immigration Reform and Control Act of 1986 (8 USC 1101 et seq.); and the Americans With Disabilities Act of 1990 (42 USC 12101 et seq.).

 

10)         Perform service activities and responsibilities for which a contract/grant is in effect.

 

11)         Establish personnel policies, job descriptions, training requirements and wages for each job category in accordance with all applicable State and Federal rules and requirements and Department procedures. Personnel policies shall include hours of work, benefits, and promotion and evaluation criteria.  To be considered a full-time employee of the CCU, for the purpose of defining Full Time Equivalent (FTE) ratio commitments in the CCU proposal, the FTE employee must work a minimum of 35 hours per week, excluding holidays observed by the CCU.

 

12)         Assure each individual employed by the CCU having face-to-face contact with clients in the client's residence, in the hospital and/or nursing facility shall be free from communicable disease.

 

g)         The CCU shall be located to provide accessibility to older persons and their families and other organizations providing services to the elderly in the agency's jurisdiction.

 

h)         The CCU shall be open at least 7 hours per day, Monday through Friday, excluding holidays observed by the CCU.

 

i)          Any satellite offices operated by the CCU shall comply with all rules and regulations, as set forth in this Part and 89 Ill. Adm. Code 230 and 240.

 

j)          The CCU shall maintain books, records, documents and other evidence of accounting procedures and practices which sufficiently and properly reflect all direct and indirect costs of any nature expended in performance of the contracts and/or grants. These records shall be subject at all reasonable times to inspection, review, and/or audit as specified in 89 Ill. Adm. Code 230 and 240.

 

k)         The CCU shall provide for financial audits in accordance with requirements specified in 89 Ill. Adm. Code 230.360 and 89 Ill. Adm. Code 240.1420.

 

l)          The CCU shall comply with all applicable Federal, State and local laws, rules, regulations and ordinances as well as all specified requirements as set forth in this Part and in 89 Ill. Adm. Code 230 and 240.

 

m)        All program records, reports, and related information and documentation, including files of terminated clients, which are generated in support of a contract/grant between the CCU and the Department/AAA shall be maintained by the CCU for a minimum of three years after the completion of the contract/grant.  If any litigation, claim or audit is started prior to the expiration of the three year period, the records shall be retained until all litigation, claims or audit findings involving the affected records, information or documentation has been resolved.

 

n)         Each CCU shall carry general liability insurance in the single limit minimum amount of $100,000 per occurrence. The policies or current letters documenting all insurance coverage shall be available in the CCU files.

 

o)         CCUs shall not subcontract for the direct provision of case management services unless prior written approval has been obtained from the Department and the AAA, as appropriate.

 

p)         CCUs are expressly prohibited from assigning either their contract with the Department or their contract/grant with the AAA.

 

q)         All records, case notes or other information maintained on persons served under the contract shall be confidential and shall be protected by the CCU from unauthorized disclosure pursuant to Section 220.100.

 

(Source:  Amended at 26 Ill. Reg. 9652, effective July 1, 2002)

 

Section 220.605  Case Management Staff Requirements and Qualifications

 

The agency shall have sufficient staff to perform all activities and to fulfill all responsibilities outlined in 89 Ill. Adm. Code 230.Subpart G and 89 Ill. Adm. Code 240.Subpart N for which a contract/grant is in effect.

 

a)         Case Management Supervisor

 

1)         Case management supervisor activities shall include:

 

A)        consultation on case management activities as needed to provide proper supervision;

 

B)        documented provision of training on Illinois Department on Aging and Area Agency on Aging policies, procedures and case management techniques, including those specified in 89 Ill. Adm. Code 240.1440; and

 

C)        annual written performance evaluation of case managers for whom they serve as supervisor.

 

2)         Case management supervisor minimum qualifications shall:

 

A)        Both:

 

i)          be an RN, or have a BSN, or have a BA/BS degree in health or social sciences, social work, or health service administration; and

 

ii)         have at least two years experience in health or human services. This experience shall include one year of supervisory experience or program experience, which is defined as assessment, provision, and/or authorization of formal services for the elderly; or

 

B)        be waived for persons hired/serving in this capacity prior to December 13, 1991.

 

b)         Case Manager

 

1)         Case manager activities shall include:

 

A)        administration of the appropriate intake form, including a comprehensive needs assessment;

 

B)        development of a case plan;

 

C)        making appropriate referrals and responding to applicant/client requests;

 

D)        authorization of services; and

 

E)        maintaining case records, including documentation of follow-up, reassessment, and termination.

 

2)         Case manager minimum qualifications shall:

 

A)        be an RN, or a BSN, or have a BA/BS degree in social science, social work or related field.  One year of program experience, which is defined as assessment, provision, and/or authorization of formal services for the elderly, may replace one year of college education up to and including four years of experience replacing a baccalaureate degree; or

 

B)        be a LPN with one year of program experience which is defined as assessment of and provision of formal services for the elderly and/or authorizing service provision; or

 

C)        be waived for persons hired/serving in this capacity prior to December 13, 1991.

 

c)         Case management supervisors and case managers shall meet all training requirements as specified in 89 Ill. Adm. Code 240.1440.

 

d)         The agency may utilize case aides, operating under the direction of the case manager, with supervision provided by the case management supervisor, to assist with specified back-up case management activities, including collateral visits, intake/referrals, program information and paperwork verifications.

 

1)         Case aides shall be trained by the case manager and/or the case management supervisor.

 

2)         Case aides shall not perform assessments, develop case plans, or authorize services.

 

3)         The case manager shall retain responsibility for all case aide activities related to case management.

 

4)         The agency shall ensure that activities assigned to the individual case aide do not exceed that case aide's level of education, experience and training.

 

(Source:  Amended at 22 Ill. Reg. 3426, effective February 1, 1998)

 

Section 220.610  Case Coordination Unit Procurement

 

a)         Although the Department is not required to competitively bid purchase of care, which includes case management services, in order to maximize competition in procurement, case management services shall be procured through use of the Request for Proposal (RFP) process whenever possible.

 

1)         The RFP process is a form of invitation to bid which the Department and the AAA shall use to obtain case management services to be provided by a Case Coordination Unit (CCU).

 

2)         The RFP documents shall determine applicant interest in providing case management services in the opened geographic areas, explain the purpose for submittal of a proposal, outline the scope of the work, and solicit proposals from agencies for the funding of case management services to be provided by CCUs for the Department's Community Care Program and for the AAA.

 

3)         If current case management service providers are in good standing and are the only respondents to the RFP process, the current case management service providers may submit noncompetitive renewal proposals, in order to retain current contractual service areas.

 

4)         Good standing is defined as no imposition of contract action, as outlined in Section 240.1665, within two years from the date the selected geographic area is opened. Areas served by case management service providers who are not in good standing shall be opened for competitive procurement.

 

b)         Case management services shall be procured by use of the following procurement cycle:

 

1)         A county/service area will be opened in accordance with Sections 220.610 through 220.645 of this Part, at least once every six years, unless the Department, for purposes of administration, finds it necessary to suspend the procurement cycle.  Such suspension shall also apply to emergency contracts executed under Section 220.655 of this Part.

 

2)         The Department/AAA shall each offer a contract/grant for a one year period, with the option to extend the contract/grant for a maximum of five additional one year periods for a total of six years.  Thus, a contractor may be issued a new contract/grant for a six year period.

 

3)         Contractors will be notified of any change in the reimbursement amount that occurs during the period of the contract/grant.

 

c)         All CCU procurement actions shall be advertised in accordance with procedures issued by the Department.

 

d)         The AAA shall ensure that current contractors whose service areas are open for solicitation are notified of the RFP process.

 

(Source:  Amended at 26 Ill. Reg. 9652, effective July 1, 2002)

 

Section 220.615  Procurement Cycle  (Repealed)

 

(Source:  Repealed at 22 Ill. Reg. 3426, effective February 1, 1998)

 

Section 220.620  Definition of Case Coordination Unit Request For Proposal (Repealed)

 

(Source:  Repealed at 22 Ill. Reg. 3426, effective February 1, 1998)

 

Section 220.625  Issuance of Case Coordination Unit Proposal and Guidelines (Repealed)

 

(Source:  Repealed at 22 Ill. Reg. 3426, effective February 1, 1998)

 

Section 220.630  Content of Case Coordination Unit Request For Proposal Documents

 

a)         A standard CCU Proposal, with instructions, and Guidelines shall be utilized by a AAA conducting a solicitation, or by the Department in the event that a particular AAA is unwilling or unable to conduct the procurement. Prior to the beginning of the procurement cycle, the standard CCU Proposal and Guidelines shall be developed jointly by the Department and AAAs, and shall be utilized by all AAAs.

 

b)         The CCU Request for Proposal package shall include:

 

1)         Proposal, which shall consist of the questions and required attachments to be completed by the applicant and returned to the AAA or the Department, as appropriate, for consideration and scoring.  Proposal criteria shall include:

 

A)        Experience in service provision, and

 

B)        Commitments to meet or exceed Community Care Program and/or Title III minimum service requirements for:

 

i)          Program management

 

ii)         Service delivery

 

iii)        Client issues

 

iv)        Staffing, and

 

v)         Training.

 

2)         Guidelines, which shall contain necessary information to enable a prospective CCU to prepare a proposal.

 

c)         Point values shall be assigned to each proposal criterion specified in subsection (b)(1) above.  Points shall be awarded based upon the amount and type of applicant experience in service provision and the type and number of commitments to exceed minimum service requirements made by the applicant.

 

(Source:  Amended at 22 Ill. Reg. 3426, effective February 1, 1998)

 

Section 220.635  Review of Case Coordination Unit Proposals

 

a)         In order to determine if an applicant shall be recommended for designation, the AAA and the Department shall separately review and evaluate the complete CCU proposal in accordance with Department review procedures.

 

1)         All proposals shall be considered as submitted and may not be amended, corrected or revised except when determined appropriate by the AAA or the Department.

 

2)         A proposal which does not respond to all requirements in the CCU Proposal and Guidelines shall be deemed incomplete and shall not be considered by the Department or AAA.

 

3)         A proposal which fails to meet minimum requirements contained in 89 Ill. Adm. Code 220, 230 and/or 240 shall be rejected.

 

4)         The Director of the Department reserves the right to reject any informality of a proposal when, in the Director's opinion, the best interests of the State will be served by such action.

 

5)         Review of the CCU proposal shall identity the final score of each proposal.

 

b)         The AAA will forward the originally submitted proposals, the score sheets and the AAA's written recommendation for designation (refer to Section 220.640 of this Part) to the Department.

 

c)         The Department will review the AAA's process and recommendation for designation.

 

(Source:  Amended at 22 Ill. Reg. 3426, effective February 1, 1998)

 

Section 220.640  Recommendations for Case Coordination Unit Designation

 

a)         The AAA shall make recommendation(s) for designation to the Department.

 

b)         If the Department agrees with the AAA recommendation(s), a joint recommendation for designation shall be made to the Director.

 

c)         In the event the Department and AAA recommendations are not in agreement, the Department will meet with the AAA to discuss the differences and attempt to reach a joint recommendation.

 

1)         If a joint recommendation is reached, the recommendation will be forwarded to the Director.

 

2)         If a joint recommendation is not reached, the differences will be forwarded to the Director for a final designation decision.  If a joint recommendation is not reached after the Department and the AAA meet, the Director will be provided with the review of the recommendation rationale of both the AAA and the Department.  The Director will, on the basis of this review, render a final designation decision.  Following the Director's decision, designation will be made pursuant to Section 220.645 of this Part.

 

d)         If, after review of the proposals submitted, the Department and the AAA agree that no applicant qualifies for designation, or if no proposals are received for a geographic area in response to the Request for Proposal process, the Department and the AAA shall secure CCU services through any means of selection likely to result in a contract/grant and shall issue a contract/grant for these services.

 

(Source:  Amended at 22 Ill. Reg. 3426, effective February 1, 1998)

 

Section 220.645  Designation of Case Coordination Units and Award of Contracts/Grants

 

a)         The Director of the Department shall represent and act for the State in all matters pertaining to the Request for Proposal (RFP) process and to contracts awarded as a result of that process.  The Director shall receive the recommendations from the AAA and the Department and has the ultimate decisionmaking authority for designation of CCUs and award of Department contracts.

 

b)         When a CCU designation is made:

 

1)         the Department and AAA shall notify each applicant, in writing, of the success or failure of the applicant to be jointly designated as a CCU in accordance with Department procedures; and

 

2)         after resolution of any objections to the designation decisions (refer to Section 220.650 of this Part), all agencies jointly designated as CCUs shall be offered a contract from the Department and a contract or grant, as appropriate, from the AAA.  The successful proposal shall be an integral part of the contract/grant awarded.

 

c)         A designated CCU shall be held accountable for all statements made in the CCU proposal, as well as any amendments made to a contract/grant, until such time as the contract/grant is terminated or a renewal proposal is submitted and the CCU has been awarded a new contract/grant.

 

(Source:  Amended at 26 Ill. Reg. 9652, effective July 1, 2002)

 

Section 220.650  Objection to Case Coordination Unit Designation Decision

 

a)         Upon receipt of the written notification of designation decision, the applicant may object to the decision.  The Department shall provide information on the objection process with the written notification.

 

1)         An objection regarding a designation decision must be in writing and received by the Director at the Department's Springfield office within ten calendar days from the date of the objecting agency's receipt of the designation decision.

 

2)         Upon receipt of an objection, the Department shall immediately notify the applicable AAA.  The objection will be processed in accordance with Department procedures and a recommendation will be forwarded to the Director.

 

3)         If the objection is not received in the time specified, the objection will be denied and the award will be made based upon the Director's original designation decision.

 

4)         The Department may request additional details from the objecting agency and from the AAA at any time. Failure of the objecting agency to supply information requested by the Department will be cause for dismissal of the objection.

 

b)         A contract/grant shall not be awarded until after the objection is resolved, unless the Department determines that:

 

1)         The services to be procured are urgently required and cannot be delayed until the objection is resolved; or

 

2)         A prompt award will otherwise be advantageous to the State.

 

c)         The designation decision shall not be considered final until an objection decision is issued by the Director.

 

1)         The Director shall issue a response in writing to the objecting agency which shall be sent by certified mail, return receipt requested.

 

2)         A copy of the Director's decision shall be provided to the appropriate AAA.

 

3)         The decision of the Director is final.

 

(Source:  Amended at 22 Ill. Reg. 3426, effective February 1, 1998)

 

Section 220.655  Replacement of a Case Coordination Unit

 

a)         A contract between the Department and a CCU or a contract/grant between the AAA and the CCU may be terminated prior to the regular procurement cycle due to:

 

1)         the CCU exercising its termination rights as specified in the contract/grant, or

 

2)         the CCU failing to perform in accordance with applicable provisions of 89 Ill. Adm. Code 220, 230 and/or 240, or other provisions of either the Department or AAA contract/grant.

 

b)         A contract/grant may be terminated by either the Department or the AAA. Both the Department and the AAA shall abide by the decision to terminate. When the termination decision is made by either the Department or the AAA, the contract/grant shall be concurrently terminated by both the Department and the AAA.

 

c)         In the event of termination of a CCU contract/grant in accordance with subsection (a)(1) or (a)(2), the AAA shall review the proposals submitted during the previous Request for Proposal (RFP) submittal in the solicited area.

 

1)         If the second ranked viable applicant from that previous RFP submittal is acceptable to the AAA and the Department, the AAA and the Department shall recommend to the Director that a replacement contract/grant be offered to the applicant.

 

2)         If the AAA and/or the Department determines that proposals from the previous RFP submittal do not yield an acceptable agency/organization for designation as the CCU, or if there was no second applicant, the AAA shall procure the needed CCU in accordance with the procurement process contained in Sections 220.610 through 220.650 of this Part.  If the AAA notifies the Department that it elects not to take the lead in procuring the needed CCU, the Department shall take the lead and shall keep the AAA apprised at all stages of the procurement/designation process.

 

d)         If time does not permit the use of the procurement process specified in Sections 220.610 through 220.650 of this Part, the Department/AAA shall issue a replacement contract/grant through any means of selection likely to result in a contract.  This action is indicated under the following circumstances:

 

1)         Service is immediately needed to:

 

A)        prevent interruption of services to current clients or

 

B)        protect clients or clients' health, safety or welfare.

 

2)         Only one CCU is reasonably capable or willing to perform, per the Department/AAA assessment of viable alternate applicants.

 

e)         In the event that no replacement contract/grant can be awarded, the Department shall request that the AAA perform the CCU function on an emergency basis. If an AAA serves as a CCU, an Area Plan direct service waiver shall be submitted to the Department, as specified in 89 Ill. Adm. Code 230.130(f).

 

f)         A replacement contract/grant shall be effective until the solicited area is opened by the AAA for the next regularly scheduled procurement.  (Refer to Section 220.610 of this Part.)

 

(Source:  Amended at 22 Ill. Reg. 3426, effective February 1, 1998)

 

Section 220.660  Performance Reviews of Case Coordination Units

 

a)         Determination of the extent of CCU adherence to the agency's proposal/contract/grant and any applicable amendments shall be made by the Department and the AAA through separate review processes.

 

b)         The reviews conducted by the AAA shall not duplicate, in content, the reviews conducted by the Department.

 

c)         The AAA's review instrument shall address requirements as contained in the contract/grant with each CCU and in the applicable provisions of this Part and 89 Ill. Adm. Code 230, including, at a minimum, staffing requirements and qualifications, and adherence to the minimum standards contained in Section 220.600 of this Part.

 

d)         The Department's review instrument shall address requirements as contained in the contract with each CCU and in the applicable provisions of this Part and 89 Ill. Adm. Code 240.

 

e)         The Department and AAA shall have the authority to conduct a review of a CCU agency at any time during the course of the CCU's contract or grant period, as appropriate, for the purpose of protecting the health, safety and welfare of the clients and ensuring CCU adherence to Department rules, and Department and AAA policies and procedures.  The Department or the AAA shall notify the other party of any violations which could lead to contract sanctions or termination.

 

(Source:  Amended at 22 Ill. Reg. 3426, effective February 1, 1998)

 

Section 220.665  Case Coordination Unit Compliance (Repealed)

 

(Source:  Repealed at 22 Ill. Reg. 3426, effective February 1, 1998)

 

Section 220.670  Sanctions for Case Coordination Unit Failure to Comply with Case Management Contract/Grant

 

Department or AAA sanctions which may be imposed upon any CCU failing to comply with applicable Federal, State and local laws or regulations, AAA standards and requirements and Department rules and/or other contract requirements (which include the statements contained in the CCU's Proposal) include:  

 

a)         suspension of some or all payments;,

 

b)         mandatory training or technical assistance;

 

c)         requiring a limited financial audit;

 

d)         suspension (AAA action only);

 

e)         prohibition of specified staff from serving CCP and/or Title III clients;

 

f)         refusing to accept a proposal from a provider in one or more areas opened for procurement;

 

g)         termination of contract/grant; and/or

 

h)         taking any other action which the Director or AAA determines to be appropriate to the non-compliance circumstances.

 

(Source:  Amended at 22 Ill. Reg. 3426, effective February 1, 1998)

 

Section 220.675  Sanction Notification and Case Coordination Unit Right to Appeal

 

a)         The Department shall provide prior notification to the applicable AAA, or the AAA shall provide prior notification to the Department, of any sanctions being taken against a CCU.

 

b)         The CCU shall be advised by the Department or AAA, as appropriate, (with a copy provided to the other) of any sanction(s) being taken.  Notification to the CCU shall be sent registered mail, return receipt requested.

 

c)         If the CCU receives notification of termination of contract/grant, the CCU may appeal the action and request that the Department review of the appeal be conducted either face-to-face or through a paperwork review of the relevant documentation.

 

d)         If the CCU receives notification of any sanction other than termination, the CCU may appeal the action and request that the Department review of the appeal be conducted through a paperwork review of the relevant documentation.

 

e)         All appeal requests must be made in accordance with Department appeal procedures which shall be included with the sanction notification.

 

f)         The Director shall review the recommended written report of the appeal and the recommendation and make a final administrative decision to either sustain the appeal of the CCU and reinstate the CCU contract/grant or uphold the action of the Department and AAA to terminate the contract/grant.

 

1)         Written notification of the final administrative decision shall be provided to the CCU by registered mail, return receipt requested, with a copy provided to the appropriate AAA.

 

2)         The decision of the Director is final.

 

(Source:  Added at 22 Ill. Reg. 3426, effective February 1, 1998)

 

Section 220.APPENDIX A   Names and Addresses of Area Agencies on Aging by Planning and Service Area  (Repealed)

 

(Source:  Repealed at 22 Ill. Reg. 3426, effective February 1, 1998)