Section 240.260  Case Management Service

Case management service is defined as the provision of a needs assessment and service coordination by Case Coordination Units (CCUs) to assist an older person to gain access to and receive needed services.

a)         Service Components

            Specific components of case management service include the following:

1)         Review of all inquiries to determine if application for Community Care Program (CCP) services is desired, and maintenance of an application request log.

2)         Distribution, and assistance with completion of Community Care Program applications.

3)         Performance of determinations/redeterminations of eligibility, including a needs assessment, plan of care development, and authorization of CCP services.

4)         Availability to receive client inquiries and requests, by telephone or in person, and respond to such inquiries and requests.

5)         Nursing facility prescreenings, see Section 240.1010 of this Part.

6)         Department of Human Services OBRA-1 (Level I ID Screen).

7)         Provide referrals to other needed services.

8)         Implementation of services and client transfers.

9)         Authorization of all actions related to the disposition of CCP services as required by CCP rules 240.100 through 240.2050 of this Part.

b)         Unit of Service

            Several different types of assessments constitute a case management unit of service for which reimbursement is made.

1)         Completion of one initial eligibility determination for Community Care Program services constitutes one unit.

2)         Completion of one required continuous eligibility redetermination of Community Care Program eligibility constitutes one unit.  A redetermination shall be completed at least annually.

3)         Completion of one face-to-face prescreening of an applicant constitutes one unit.

4)         Completion of one Department of Public Aid Interagency Certification of Screening Results form, following prescreening by hospital discharge staff constitutes one unit.

5)         Availability to receive client inquiries and requests, by telephone or in person, and to respond to such inquiries and requests for each active client per month constitutes one unit.

(Source:  Amended at 23 Ill. Reg. 5642, effective May 1, 1999)