Section 132.65  Organizational Requirements

a)         The provider shall operate in a manner consistent with all applicable State laws and federal regulations, and adopted procedures.

b)         A provider shall have written operating policies and procedures that detail and explain the operation of programs and the delivery of services, including a description of staff decision-making authority.

c)         A provider shall have proof of insurance against professional and physical liabilities.

d)        A provider shall ensure the availability of staff or consultants capable of using languages or methods of communication used by Medicaid-eligible clients served by the provider.

e)         The provider shall have an active system of program evaluation.

1)         This system shall monitor quantitative characteristics such as caseload information and qualitative characteristics such as client satisfaction.

2)         The evaluation system shall include mechanisms for producing evaluation reports that describe the outcome of monitoring activities and provide for the use of the results to improve the program.

f)         The provider shall have an active system for determining compliance with all client record requirements of this Part.

1)         The provider shall maintain policies describing the methods for performing client record compliance audits.  Audits shall be performed by persons not involved in providing services to the clients whose records are reviewed;

2)         The provider shall maintain procedures describing the method for selecting cases for client record compliance audits.  Procedures shall include methods for ensuring a review of 10 percent of the clients served under this Part annually; and

3)         Client record compliance audits shall verify each client record's compliance with requirements included in Sections 132.100, 132.142, 132.145(b), 132.148, 132.150 and 132.165.

(Source:  Amended at 36 Ill. Reg. 18582, effective December 13, 2012)