Section 240.1130  Participant Transfers – Care Coordination Unit to Care Coordination Unit

a)         A CCP participant may transfer from 1 CCU service area to another CCU service area with continuous eligibility pending a redetermination of eligibility by the receiving CCU.  The transfer may be requested by the Department, a CCU, or the participant/authorized representative verbally or in writing.

b)         A reason for transfer from CCU to CCU shall be a geographic change in the participant's residence.

c)         The effective date of transfer shall be within 15 calendar days after the date of the Participant Agreement − Person-Centered Plan of Care and services shall be initiated by the receiving vendor without service interruption.

d)         To implement the transfer, the transferring CCU, within 5 work days after the date of a request or notice of need to transfer, or 5 work days prior to the effective date of transfer, whichever provides the most notification to the receiving CCU, shall:

1)         notify the receiving CCU of the impending transfer and the desired date of transfer;

2)         forward to the receiving CCU the original case record of the transferring participant; and

3)         forward the Participant Agreement − Person-Centered Plan of Care to the participant/authorized representative and a copy to the transferring vendor.

e)         The receiving CCU shall:

1)         Upon receipt of the participant's case record, advise the participant/authorized representative as to the vendors in the CCU's area that are authorized, and appropriate, to provide the participant's service needs in accordance with the participant's person-centered plan of care.  The participant shall advise the CCU as to his/her selection and the CCU shall complete a new Participant Agreement and Consent Form − Person-Centered Plan of Care.

2)         Forward to the participant/authorized representative a new completed Participant Agreement and Consent Form – Person-Centered Plan of Care for signature.

3)         Upon receipt of the signed Participant Agreement and Consent Form – Person-Centered Plan of Care, establishing the effective date of the transfer.

4)         Forward:

A)        the Participant Agreement − Person-Centered Plan of Care to the participant/authorized representative;

B)        a copy of the Participant Agreement − Person-Centered Plan of Care and the old Participant Agreement – Person-Centered Plan of Care and a copy of the applicable pages of the comprehensive assessment to the receiving vendor on the same day the Participant Agreement − Person-Centered Plan of Care is sent to the participant/authorized representative.

5)         Upon receipt of the vendor's signature on the new Participant Agreement – Person-Centered Plan of Care, a copy of the executed Participant Agreement – Person-Centered Plan of Care is to be placed in CCU's participant file and a copy shall be forwarded to the participant/authorized representative.

f)         If any delay in any of the time frames established by this Section is caused by the documented action or inaction of the participant/authorized representative, time frames shall be extended by the number of days of delay.

g)         The receiving CCU shall perform an initial determination of eligibility of the participant and develop a new person-centered plan of care within 30 calendar days after the date of receipt of the case record.

(Source:  Amended at 42 Ill. Reg. 20653, effective January 1, 2019)