Section 240.410  When the Appeal May Be Filed

a)         The right to appeal must be exercised within 60 calendar days from the date the notice of the action being appealed was sent to the applicant/client advising the action being taken by the Case Coordination Unit (CCU) such as:

1)         the date the notice was sent by a CCU of a decision on an application; or

2)         the date the notice was sent by a CCU or the Department of a reduction or termination of Community Care Program (CCP) services; or

3)         the date the notice was sent by a CCU or the Department of denial of a request or other action which aggrieves the applicant/client, when that denial or action was other than an application decision or a decision to reduce or terminate services.

b)         If a notice of appeal is filed after the 60 calendar day time period, the right to appeal is not affected.  However, the final administrative decision of the Department will not be favorable to the appellant if it is determined that the 60 calendar day time period applies to the situation and has expired.

c)         The 60 calendar day time limitation does not apply when:

1)         a CCU or the Department fails to send the required written notification of the action taken which is being appealed; or

2)         a CCU or the Department fails to allow 15 calendar days from the date of the notice to the effective date of the action appealed; or

3)         a CCU, provider or the Department fails to take any action on a specific request made by an applicant/client within 15 calendar days from the date of request as required in Section 240.1520 of this Part; or

4)         a CCU, provider or the Department denies a request without informing the applicant/client in writing within 15 calendar days from the date of request as required in Section 240.1520 of this Part; or

5)         a CCU or provider failed to advise the applicant/client of the right to appeal; or

6)         a CCU or provider has violated CCP rules.

d)         If an applicant/client/authorized representative advised the Department by telephone of his/her intent to appeal and subsequently files a written appeal with the Department, the date of the documented telephoned intent shall be the date of filing of the appeal.

e)         If the intent to appeal by or on behalf of a client is filed within ten calendar days from the date of the notice of adverse action (refer to Section 240.160 of this Part) and is followed by a written appeal as requested by the Department, Community Care Program services shall be continued at the level in effect prior to the notice of adverse action until the final decision in the appeal is reached.  The client/authorized representative and all other interested parties to the appeal shall be notified in writing by the Department of the continuation of the client's services at the previous level. If the Department determines that the health, safety or welfare of the provider/direct service worker shall be jeopardized if service is continued (refer to Section 240.350 of this Part), the client's right to continued service may be denied until the appeal decision is reached.

f)          Services shall not be continued during the appeal process for an individual receiving interim services.  Those individuals receiving interim services have not received full eligibility for the Community Care Program, have applicant status only, and are presumed eligible until a full determination of eligibility has been completed.

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