Section 520.10  Timing of the Authorization

The authorization for services must be made either prior to or simultaneously with the purchase of services.

(Source:  Amended at 25 Ill. Reg. 8758, effective July 2, 2001)

Section 520.20  Issuance of Authorizations

Prior to the purchase of any service on the customer's Individualized Plan for Employment (IPE) (89 Ill. Adm. Code 572) or Service Plan (89 Ill. Adm. Code 684), a written authorization must be made to the vendor.  If the written authorization would unreasonably delay services to the customer, a verbal authorization to the vendor may be made, with a written authorization immediately following.

(Source:  Amended at 34 Ill. Reg. 10157, effective June 29, 2010)

Section 520.30  Standards for the Issuance of Authorizations

In order for an authorization to be issued, the services must:

a)         be essential to obtaining necessary diagnostic information, determining eligibility, or achieving the objectives listed in the IPE or Service Plan;

b)         when so required, be from a qualified vendor as specified in 89 Ill. Adm. Code:  Chapter IV, Subchapter b (Vocational Rehabilitation) and Subchapter d (Home Services Program);

c)         be consistent with the Department of Human Services' (DHS) set rate of payments, exceptions being:

1)         Services that are available from only one service provider;

2)         Services for vocational rehabilitation customers that are above set rates but still less expensive than the purchase of the same service at the set rate because of the need for support services, i.e., increased costs (89 Ill. Adm. Code 590.650) and transportation (89 Ill. Adm. Code 590.600); and

3)         Services for which set rates have not been established.  In these cases, services will be authorized based upon best value, by comparative analysis of cost and quality of similar services.

(Source:  Amended at 34 Ill. Reg. 10157, effective June 29, 2010)

Section 520.100  Authorization for Purchased Services

a)         In authorizing purchased services, it should be remembered that under Section 50-13 of the Illinois Procurement Code [30 ILCS 500/50-13] DHS cannot pay for services from some State employees, even if provided on their own time, without the granting of an exemption.  If a proposed authorization is with a State employee, the DHS-DRS supervisor shall submit the proposed authorization to the Department of Central Management Services (CMS) for review in compliance with Subpart P of 44 Ill. Adm. Code 1 (Standard Procedures – Ethics).

b)         Unless specified in subsection (c), amounts authorized for purchased services shall constitute total charges and payment in full for those services.  For vocational rehabilitation customers, such amounts shall be less comparable benefits (89 Ill. Adm. Code 567).  Providers shall not charge customers with fees or portions of fees for services authorized by DHS-DRS.

c)         Customer financial participation (89 Ill. Adm. Code 562.40) and customer informed choice (89 Ill. Adm. Code 557.20) may result in additional cost to the vocational rehabilitation customer.

(Source:  Amended at 34 Ill. Reg. 10157, effective June 29, 2010)