Section 240.730  Plan of Care

a)         Services are to be offered to each applicant/ client who meets the minimum required scores on the Community Care Program (CCP) Determination of Need form required by Sections 240.720 or 240.725; who meets all other eligibility requirements; for whom an adequate plan of care has been developed; and whose service costs are within the allowable maximums.

b)         If a plan of care cannot be developed that adequately meets the applicant's/client's needs within the allowable maximums for cost of service, Community Care Program services shall be denied or services terminated, as appropriate to the case.

c)         Each applicant/client must be advised by the Case Coordination Unit (CCU) of his/her right to refuse the offered services, to choose to enter a long-term care facility or to choose neither.

d)         Services which the applicant/client has been determined to need by the CCU are not actually to be provided until the Physician/Nurse Practitioner/Registered Nurse/Christian Science Practitioner agrees that the plan of care is adequate (meets the applicant/client's determined needs) to protect the health and safety of the applicant/client. It shall be the responsibility of the applicant/client to provide the endorsement from the applicant's/client's Physician/Nurse Practitioner/Registered Nurse/Christian Science Practitioner.

e)         The allowable monthly cost for services provided to an eligible individual and paid for through the Community Care Program cannot exceed the maximum monthly cost as determined by the score attained on the CCP Determination of Need which is determined by the CCU based on current, full and complete information on the specific needs of the individual.

(Source:  Amended at 13 Ill. Reg. 11193, effective July 1, 1989)