Section 240.270  Alternative Provider

a)         An alternative provider is defined as an individual or an agency selected by the participant, assisted by the CCU and authorized by the Department to provide CCP services to a participant only if the following criteria are met:

1)         a contractual provider has failed to provide the services as required by the person-centered plan of care; and

2)         there is no contractual provider available to provide the services as required by the person-centered plan of care.

b)         Alternative providers may be supervised by the participant or agency providing the services, as required by the person-centered plan of care.  The service components and hours of service to be provided, as required by the person-centered plan of care, shall conform to the service components as defined in Section 240.210.

c)         The appropriate CCU shall be responsible for monitoring of alternative provider services.

d)         An alternative provider shall be authorized by the Department prior to provision of services to the participant.

e)         Unit of Service

1)         One unit of alternative in-home service is 1 hour of direct service provided to the participant while in the participant's home, while providing transportation/escort to the participant to medical facilities, or while performing essential errands/shopping or conducting essential participant business with or on behalf of the participant.

2)         For services that the provider was unable to provide due to either the participant's absence without prior provider notification or refusal to admit the worker into the home to provide service (see Section 240.350), 1 unit of documented in-home service per occurrence will be reimbursed to the alternative in-home provider to a maximum of 2 units per participant per State fiscal year.

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