Section 240.1580  Standards for Alternative Providers

a)         In the event that Community Care Program (CCP) services are not provided to an eligible applicant within the time limit specified in Section 240.910 of this Part, the eligible applicant may arrange to receive CCP homemaker services from an individual or a home care agency of the eligible applicant's choice 15 calendar days from the date of the notice of eligibility. The Case Coordination Unit (CCU) shall approve the applicant's choice of individual or home care agency for homemaker services to be provided.

b)         If there is an interruption of services provided to a client due to the failure of a contractual provider to provide such services, the CCU shall assist the client in locating an individual or home care agency.

c)         The Department shall authorize the individual or home care agency and shall guarantee a minimum of 15 calendar days of service provided by such alternative provider, if at the request of the alternative provider. A home care agency whose previously held CCP contract was terminated for cause shall not be authorized as an alternative provider.

d)         The Department shall make payment on a monthly basis for such services at the rate which would have been paid an individual provider, if an individual is selected by the eligible applicant/client; or at the usual and customary rate of the home care agency/provider chosen by the eligible applicant/client to provide this service, if a home care agency is selected by the eligible applicant/client.

e)         Payment shall continue in accordance with subsection (c) above, and only until such time as the Department's contractual provider initiates provision of CCP services to the client, at which time service by the alternative provider shall be immediately terminated. The CCU shall verbally notify the alternative provider and the client of the date upon which service shall be initiated by the Department's contractual provider.

f)         Request for payment for services rendered by an individual alternative provider shall be submitted to the Department by the individual providing the service.

g)         Payment for services rendered by a home care agency of the eligible applicant's/client's choice shall be made by the Department following submittal by the agency and processing by the Department of billing forms provided to the agency by the Department.

h)         Payment shall be authorized in compliance with the State Prompt Payments Act [30 ILCS 540].

i)          The Department shall be liable for its share of the cost of CCP services, as determined in accordance with Sections 240.855 and 240.870 of this Part.

j)          The payment for the monthly expense for care incurred by the client for CCP alternative provider services shall be the responsibility of the client as set forth in Section 240.875 of this Part.

(Source:  Amended at 23 Ill. Reg. 2496, effective February 1, 1999)