TITLE 59: MENTAL HEALTH
CHAPTER I: DEPARTMENT OF HUMAN SERVICES
PART 115 STANDARDS AND LICENSURE REQUIREMENTS FOR COMMUNITY-INTEGRATED LIVING ARRANGEMENTS
SECTION 115.215 CRITERIA FOR TERMINATION OF INDIVIDUALS


 

Section 115.215  Criteria for termination of individuals

 

a)         The community support team shall consider recommending termination of services to an individual only if:

 

1)         The medical needs of the individual cannot be met by the CILA program; or

 

2)         The behavior of an individual places the individual or others in serious danger; or

 

3)         The individual is to be transferred to a program offered by another agency and the transfer has been agreed upon by the individual, the individual's guardian, the transferring agency and the receiving agency; or

 

4)         The individual no longer benefits from CILA services.

 

b)         Termination of services shall occur only if the termination recommendation has been approved by the Department.  For individuals enrolled in the Department's Medicaid DD Waiver, termination of services is subject to review according to 59 Ill. Adm. Code 120.

 

c)         Absenses

 

1)         Whenever individuals are required to be absent from a living arrangement for an extended period of time, an agency shall not consider termination of services unless the absence has been at least 60 days in duration and it is documented that the absence is expected to continue indefinitely.  The Department reserves the right to terminate payment within the 60 days during which the individual is absent when it is clear that the individual will be unable to return to the CILA.

 

2)         If an individual is to be away from his or her residence for an extended time period and the intent is that he or she will return to the residence, the licensed agency shall contact the Department in writing to request authorization for the absence.  A request for extension of the absence must be submitted to the Department at the end of 30 consecutive days and after 60 consecutive days.  If the absence exceeds 90 consecutive days in duration, funding for CILA services for the individual will cease.  Prior to the end of 30 consecutive days and again, prior to the end of  60 consecutive days, the agency shall receive approval from the Department for funding of a continued absence.  The request shall be documented and forwarded to the attention of the Department for approval.  The Department shall respond to each request within 14 days.  Continued funding past 30 days will be determined according to Department guidelines and will consider, but not be limited to, the following:

 

A)        Services being provided to the individual by the agency during the absence;

 

B)        The continued likelihood of the individual being able to return to the site; and

 

C)        Continuing funding available to the agency to support the site.

 

(Source:  Amended at 23 Ill. Reg. 9791, effective August 13, 1999)