AUTHORITY: Implementing Sections 15, 34 and 34.1 of the Mental Health and Developmental Disabilities Administrative Act [20 ILCS 1705/15, 34 and 34.1] and the Community Services Act [405 ILCS 30] and authorized by Section 5-104 of the Mental Health and Developmental Disabilities Code [405 ILCS 5/5-104] and Section 5 of the Mental Health and Developmental Disabilities Administrative Act [20 ILCS 1705/5].

SOURCE: Emergency rule adopted and codified at 6 Ill. Reg. 9361, effective July 21, 1982, for a maximum of 150 days; emergency expired December 19, 1982; adopted at 7 Ill. Reg. 1788, effective February 2, 1983; amended at 7 Ill. Reg. 9304, effective July 27, 1983; amended at 10 Ill. Reg. 10572, effective June 1, 1986; amended at 10 Ill. Reg. 10568, effective September 1, 1986; emergency amendment at 16 Ill. Reg. 2643, effective February 1, 1992, for a maximum of 150 days; emergency expired on June 30, 1992; amended at 17 Ill. Reg. 10282, effective July 1, 1993; amended at 21 Ill. Reg. 8282, effective June 25, 1997; recodified from the Department of Mental Health and Developmental Disabilities to the Department of Human Services at 21 Ill. Reg. 9321; emergency amendment at 22 Ill. Reg. 12176, effective June 24, 1998, for a maximum of 150 days; emergency expired November 20, 1998; amended at 22 Ill. Reg. 22390, effective December 8, 1998; emergency amendment at 24 Ill. Reg. 9263; effective June 14, 2000, for a maximum of 150 days; emergency expired November 10, 2000; amended at 24 Ill. Reg. 18160, effective November 30, 2000.

SUBPART A: SYSTEM DESIGN

 

Section 103.10  Purpose

 

In accordance with the Community Services Act [405 ILCS 30], this Part establishes the Department's policies and procedures which are necessary to fund community agencies and programs which are eligible to receive grant-in-aid funding.

 

(Source:  Amended at 17 Ill. Reg. 10282, effective July 1, 1993)

 

Section 103.11  Definitions

 

For the purpose of this Part, the following terms are defined:

 

            "Accreditation." A process establishing that a program complies with nationally recognized standards of care as set by one of the following:

 

            1997 Hospital Accreditation Standards (Joint Commission on Accreditation of Healthcare Organizations (JCAHO), One Renaissance Boulevard, Oakbrook Terrace, Illinois 60181, 1996);

 

            1997 Standards for Behavioral Health Care (Joint Commission on Accreditation of Healthcare Organizations (JCAHO), One Renaissance Boulevard, Oakbrook Terrace, Illinois 60181, 1996);

 

            1996 Comprehensive Accreditation Manual for Health Care Networks (Joint Commission on Accreditation of Healthcare Organizations (JCAHO), One Renaissance Boulevard, Oakbrook Terrace, Illinois 60181, 1996);

 

            Council on Accreditation 1997 Standards for Behavioral Health Care Services and Community Support and Education Services (Council on Accreditation of Services for Families and Children (COA), 120 Wall Street, 11th Floor, New York, New York 10005, 1996);

 

            Outcome Based Performance Measures (The Council, 100 West Road, Suite 406, Towson, Maryland 21204, 1993);

 

            Standards Manual and Interpretive Guidelines for Behavioral Health (Commission on Accreditation of Rehabilitation Facilities (CARF), 4891 East Grant Road, Tucson, Arizona 85711, 1996);

 

            Standards Manual and Interpretive Guidelines for Employment and Community Support Services (Commission on Accreditation of Rehabilitation Facilities (CARF), 4891 East Grant Road, Tucson, Arizona 85711, 1996); or

 

            Education Standards (National Accreditation Council for Agencies Serving the Blind and Visually Handicapped, 15 West 65th Street, New York, New York 10023, 1994).

 

            "Agency plan." A part of the grant agreement which identifies the services to be provided, the target population and the geographic areas to be served. It identifies how the services will be financed and through what budget items and funding sources.

 

            "Authorized agency representative."  The administrative head of an agency appointed by the agency's governing body with overall responsibility for fiscal and programmatic management.

 

            "Code."  The Mental Health and Developmental Disabilities Code [405 ILCS 5].

 

            "Community agency" or "agency." Local government or not-for-profit corporation under contract with the Department to provide services.

 

            "Confidentiality Act."  The Mental Health and Developmental Disabilities Confidentiality Act [740 ILCS 110].

 

            "Control."  For a not-for-profit corporation, control is indicated if current members of the governing body (or staff) of the agency comprise 50 percent or more of the governing body of the controlled entity or the governing body of the agency can select 50 percent or more of the controlled entity, or any combination of seats and selection that results in influencing 50 percent or more of the seats of the controlled entity.  For a for-profit corporation, control is indicated if the agency owns or controls, by options or trust, 50 percent or more of the voting stock of the corporation, or has control over the selection of over 50 percent of the governing body of the for-profit corporation, or the hiring of its management.  For a partnership, control is being a general partner in a limited partnership, or being a partner with more than 50 percent of the invested equity in a general partnership.  For a sole proprietorship, control exists if the proprietor is a full or part-time employee of the grantee.

 

            "Controlled entity." Any corporation, partnership or sole proprietorship that is controlled by the agency's governing body.

 

            "Day mode." An administrative designation quantifying service activities which are delivered during any substantial and regularly scheduled portion of a specific 24-hour time period.

 

            "Days." Calendar days unless otherwise specified.

 

            "Department."  The Department of Human Services.

 

            "Deemed status."  If an agency has been accredited by an approved accrediting body as identified in the definition of "accreditation" in this Section, the Department shall deem the agency to be in compliance with specific Sections of this Part.  Deemed status, however, may be nullified by a finding by the Department that the agency is in substantial non-compliance with one or more of the designated Sections.

 

            "Event mode."  An administrative designation quantifying service activities which are delivered in short, time-limited segments.

 

            "Fair market value."  The prevailing rate at which similar business is contracted in the agency's community, including the following specific criteria:

 

            Fair market rent means up to plus 10 percent from the average of two estimates of appropriate rental costs from two local appraisers, which the agency is responsible for securing.  If the appropriate rental cost is unclear, the Department and the agency shall establish a fair and appropriate fee.

 

            Fair market fees for personnel means, whenever possible, the like prevailing rates in the community on a per day or per hour basis.

 

            "Geographic service area."  A geographic division for the purpose of providing locally-operated networks of services.  The Department's programs are funded through a structure of service areas.

 

            "Governing body."  The policy-making authority of an agency which establishes policies concerning the agency's operation and the welfare of individuals; provides for the agency's administration by appointing an authorized agency representative to implement its policies, and exercises general oversight of the agency's operation, its fiscal affairs and programmatic content to implement the agency's mission.

 

            "Grant agreement."  When fully executed, the obligating instrument providing the basis for Departmental financial participation in grant-in-aid programs, and which formalizes the contractual relationship between the Department and the agency indicating the amount of Department funds which will be paid to the agency for the provision of services as described in the grant agreement and the agency plan.

 

            "Individual" or "individuals."  A person or persons who receives or receive mental health or developmental disability services.

 

            "Lapse."  Grant funds not expensed at the expiration of the grant agreement, due to allowable expenses not meeting revenue for Department grant funds awarded, by program.

 

            "Lapse notice."  A notification that the Department has determined potential lapsed funds, when the Department revenue by program exceeds allowable expense, by Department-funded program.

 

            "Linkage."  Person-to-person contact to assure that the supports and services needed by the individual and specified in the individual services plan are obtained.  The qualified mental retardation professional, qualified mental health professional or staff under their supervision shall be responsible for assuring linkage.

 

            "Medicaid."  Medical assistance issued by the Illinois Department of Public Aid under the provisions of Title XIX of the Social Security Act (42 U.S.C.A. 1396 et seq. (1996)), for eligible recipients including Aid to the Aged, Blind and Disabled (AABD), Temporary Assistance to Needy Families (TANF), Medical Assistance No Grant (MANG), Refugee Repatriate Program (RRP) recipients, as well as Title XIX eligible Department of Children and Family Services (DCFS) wards.

 

            "Network of services."  A network which is developed and maintained by service providers, community residents (including consumers and consumer representatives), mental health authorities and the Department (including State-operated facilities), and which is planned, organized and coordinated for the delivery of mental disabilities services.  Such a network will emphasize continuity, accessibility, appropriateness and comprehensiveness.

 

            "Operating fund."  A term inclusive of funds an agency may have in its accounting records, except those in a capital fund(s).

 

            "Performance indicator."  A qualitative and/or quantitative measure that can be included: in the assessment of how well the mental health and developmental disabilities service system is functioning; in evaluating both outcomes and system processes; and in assessing all levels of the system, including the system as a whole, the geographic service area, the agency, the State-operated facility, and the individual receiving mental health or developmental disabilities services.

 

            "Preliminary evaluation."  The use of a system to evaluate the physical, social, developmental, behavioral and psychosocial aspects of an individual.

 

            "Redistribution."  A change in the distribution of the agency's total award between two or more individual program awards, involving an intra-agency transfer of funds; therefore, the increases to individual programs are always balanced by the decreases to other programs, but not changing the agency total.

 

            "Reduction."  A decrease in the level of funding to a program currently receiving grant funds as well as a decrease to the agency total.

 

            "Residential mode."  An administrative designation quantifying service activities which are delivered in a specified living environment.

 

            "Secretary."  The Secretary of the Department of Human Services or his or her designee.

 

            "Services" or "mental health or developmental disability services." Any treatment  or habilitation events or products as contracted for through the grant agreement and as specified in the agency plan.

 

            "Supplemental."  For a program currently receiving grant funds, a supplemental represents an increase to both the individual program award and the agency total.  For a new program, a supplemental represents both the addition of a specific program award, and an increase to the agency total.

 

            "Umbrella agencies."  Those organizations which have overall legal, administrative, planning, and funding responsibility for delivery of services in more than one geographic service area.

 

(Source:  Amended at 21 Ill. Reg. 8282, effective June 25, 1997)

 

Section 103.15  Incorporation by reference

 

Any rules of any agency of the United States or of a nationally-recognized organization or association that are incorporated by reference in this Part are incorporated as of the date specified and do not include any later amendments or editions.

 

(Source:  Added at 17 Ill. Reg. 10282, effective July 1, 1993)

 

Section 103.20  Geographic service area

 

Agency plans shall be developed, presented, and reviewed in the context of the needs and resources within the geographic service area(s) to be served.  The objectives stated in the plan shall be integrated into the development of the objectives of a community-based delivery system which is serving individuals through services or a network of services.

 

a)         The agency shall define and describe the specific geographic area to be served by each program.  Agencies are required to provide services in the grant-funded programs, up to the program's capacity and capability, for individuals in the target group who need such services.

 

b)         All persons requesting services from any Department-funded agency shall receive a preliminary evaluation and be provided with immediate crisis intervention, if needed, regardless of their home area.  The agency receiving the request for services shall, if funded for these services, provide the services.  If the agency is not funded to provide these services, an immediate referral shall be made to an agency nearby which is funded to provide such services.  The agency receiving the referral shall, then, provide the services as requested. Pursuant to the individual's consent in accordance with the Confidentiality Act, linkage to the individual's home area must be undertaken with an agency most suitable for responding to the individual's treatment and training needs.

 

c)         Agencies receiving federal Community Mental Health Services (CMHS) Block Grant funds (42 U.S.C.A. 300x et seq. (1996), Subpart I and III, Part B, Title XIX, Public Health Services Act, 45 CFR 96 (1996)) through State financing shall assure that individuals admitted to Department facilities are screened and determined appropriate for that level of care or provide other treatment alternatives within the local community.

 

(Source:  Amended at 17 Ill. Reg. 10282, effective July 1, 1993)

 

Section 103.25  Agency governance (Repealed)

 

(Source:  Repealed at 24 Ill. Reg. 18160, effective November 30, 2000)

 

Section 103.30   Conflict of interest (Repealed)

 

(Source:  Repealed at 24 Ill. Reg. 18160, effective November 30, 2000)

 

Section 103.40  Community operation of programs (Repealed)

 

(Source:  Repealed at 17 Ill. Reg. 10282, effective July 1, 1993)

 

Section 103.50  General program requirements

 

Agencies funded by the Department shall meet the following general program requirements for all funded services:

 

a)         Service setting

            Services shall be provided in the setting most appropriate to the needs of the individual.  This may include the individual's home, the agency, or the community.  All settings shall be used innovatively in order to reach the target populations.

 

b)         Recordkeeping

 

1)         Cumulative case records including an individualized service plan shall be maintained for each person.

 

2)         The individualized service plan shall state the goals for each individual.  The individual shall be afforded the opportunity and encouraged to participate in goal/objective selection.  Goals/objectives shall include timeframes specified by the agency's professional staff, in consultation with the individual and relevant collaterals.

 

"Individualized service plan", as used herein, refers to and is equivalent to "individual treatment plan" and "individual habilitation plan".

 

c)         Behavior management and human rights review

            Each agency is required to establish or ensure a process for the periodic review of behavior intervention and human rights issues involved in the individual's treatment and/or habilitation.  Agencies required to have behavior intervention and human rights review policies and procedures under licensure or certification standards shall continue to comply with those standards.

 

d)         Abuse and neglect

            Each agency shall have and use a process for reporting and handling instances of abuse and neglect in accordance with applicable standards, regulations and laws.

 

e)         Admission to programming

 

1)         Grant agencies shall not discriminate in the admission to and provision of needed services to individuals on the basis of race, color, sex, religion, national origin, ancestry, or disability.

 

2)         Admission policies and procedures shall be set forth in writing and be available for review.

 

f)         Compliance with life safety standards and requirements

            All program facilities shall be in compliance with applicable State licensure requirements and local ordinances with regard to fire, building, zoning, sanitation, health, and safety requirements.

 

g)         Personnel requirements

 

1)         A licensed physician (MD or DO) shall assume medical and legal responsibility for medical services offered in any program, including prescription of medications.

 

2)         All services shall be provided by appropriately trained staff, operating under the supervision of qualified clinical professionals.

 

h)         Mandated services

 

1)         Mandated services shall be provided according to the requirements as stated in the Department's rules at 59 Ill. Adm. Code 125, Recipient Discharge/Linkage/Aftercare.

 

2)         The Department shall monitor the provision of mandated follow-up monitoring services as outlined in 59 Ill. Adm. Code 125.

 

i)          Utilization review

            Utilization review is the ongoing review of services delivered, their intensity and their duration, to determine adherence to generally accepted guidelines or standards regarding the individual's assessment, eligibility for service and appropriateness of services rendered.  Agencies shall engage in a utilization review process for all program services.

 

j)          Compliance with 89 Ill. Adm. Code 509

            Each agency shall comply with the Department of Human Services Fiscal/Administrative Recordkeeping and Requirements (89 Ill. Adm. Code 509).

 

(Source:  Amended at 24 Ill. Reg. 18160, effective November 30, 2000)

 

Section 103.60   Fiscal management (Repealed)

 

(Source:  Repealed at 24 Ill. Reg. 18160, effective November 30, 2000)

 

Section 103.65  Programs eligible for grants

 

a)         Mental health services

            The following services, and others that may not be listed herein, are eligible for State support in whole, or in part, by the Department for the provision of community-based mental health services for eligible clients.

 

1)         Outpatient mental health services;

 

2)         Screening, assessment and support services (SASS);

 

3)         Community integrated living arrangements (CILA);

 

4)         Day mental health services; or

 

5)         Residential mental health services.

 

b)         Developmental disabilities services

            The following services, and others that may not be listed herein, are eligible for State support in whole, or in part, by the Department for the provision of community-based developmental disabilities services for eligible clients.

 

1)         Diagnosis and evaluation;

 

2)         Client and family support;

 

3)         Epilepsy services;

 

4)         Developmental training;

 

5)         Vocational development;

 

6)         Early intervention;

 

7)         Regular work;

 

8)         Supported employment;

 

9)         Community integrated living arrangements (CILA);

 

10)         Case coordination;

 

11)         Pre-admission screening;

 

12)         Group day respite services;

 

13)         Limited use programs;

 

A)        Dental services;

 

B)        Leisure time services;

 

C)        Additional support for residential respite services;

 

D)        Demonstration projects;

 

E)        Program start-up;

 

F)         Administration; or

 

G)        Transportation.

 

(Source:  Amended at 17 Ill. Reg. 10282, effective July 1, 1993)

 

Section 103.70  Special organizational structures

 

a)         Comprehensive community mental health centers

 

1)         As a part of the Public Health Services Act, Title XIX, Part B (42 U.S.C.A. 300x (1996)) the CMHS Block Grant funds services provided to persons with mental illness by comprehensive community mental health centers.

 

2)         Comprehensive community mental health centers receiving CMHS funds shall provide specialized outpatient services, 24-hour a day emergency care, day treatment or other partial hospitalization, screening to determine the appropriateness of admissions to State mental health facilities and consultation and education services. Agencies receiving block grant funds shall also provide services to individuals residing in a defined geographic area, with special attention to persons with severe and persistent mental illness, regardless of ability to pay, current or past health condition, or any other factor.  These services shall be available and accessible promptly and in a manner which preserves human dignity and assures continuity and high quality care.

 

3)         CMHS Block Grant funds shall not be used to: provide inpatient services; purchase or improve land, purchase, construct or permanently improve (other than minor remodeling) any building or other facility, or purchase major medical equipment; satisfy any requirements for the expenditures of non-federal funds as a condition for the receipt of federal funds; provide financial assistance to any entity other than a public or nonprofit private entity; or make cash payments to intended individuals.

 

b)         Community mental health (708) boards

 

1)         As required by the Community Mental Health Act [405 ILCS 20], community mental health boards (708) shall develop and submit a comprehensive plan for mental health and developmental disabilities programs in their geographic area by October 1 of each year for the ensuing 12-month and 3-year periods. Such plans shall be submitted annually for the ensuing 12 months to the Department.

 

2)         When there is more than one 708 board within the geographic service area, the Department encourages the development of a single plan and a single delivery system for the entire geographic service area.

 

3)         Pursuant to Section 3e(h) of the Community Mental Health Act, the Department will not make grant awards without consideration to the review and comments submitted by the 708 boards.

 

4)         Programs operated by a 708 board are eligible for grant funding for no more than two fiscal years and must fully meet the requirements of this Part.

 

5)         The Department will not participate in the costs of a 708 board which are attributable to the administration of local funds, duties and responsibilities. However, the Department may participate in the administrative costs of a 708 board which are directly attributable to the cost of administering Departmental duties and responsibilities.

 

6)         Authorized agency representatives  and staff of agencies funded by both 708 boards and the Department may not serve concurrently as a member or as staff of the 708 board.  Individual exceptions to this provision must be justified in writing and require the written approval of the Secretary. Reasons for exceptions may include but are not necessarily limited to rural areas with limited numbers of mental health professionals.

 

c)         Public health departments

 

1)         County, multiple county, and municipal public health departments established by either referendum or resolution have the option to provide mental health and developmental disabilities services (see the Department of Public Health's rules at 77 Ill. Adm. Code 615 (Local Health Departments Program Standards Code)). Those public health departments which opt to provide these services are eligible agencies for grant funds, whether they provide services directly or by contract with existing providers of services (either within or outside the geographic service area).

 

2)         Administrative costs of non-Department funded programs within a public health department are not eligible for funding by the Department.

 

3)         A mental health and developmental disabilities services advisory committee must be appointed by the health department board.

 

4)         Department-funded local health departments shall be in compliance with 77 Ill. Adm. Code 615.

 

d)         Umbrella agencies

            A plan for providing community input  to the operation of units of the umbrella agency shall be developed for use by the umbrella agency.  This plan shall be available for review by Department staff.

 

(Source:  Amended at 17 Ill. Reg. 10282, effective July 1, 1993)

 

Section 103.80  Monitoring and evaluation

 

The agency shall agree to participate in a monitoring and evaluation system as described in the grant agreement.

 

a)         Evaluation methodologies

            Agencies shall develop evaluation methodologies that address the issues of the effective and efficient use of program resources; for example, quality assurance, utilization review, and professional services review organization. The agency shall also provide documentation of the implementation of these evaluation methodologies and demonstrate how the information gained through evaluation efforts is used in the planning process.  The Department shall review and provide consultation in this evaluation effort.

 

b)         Monitoring

            Monitoring is the review of the agency's compliance with contractual obligations, applicable administrative rules and legislation and insuring that Departmental funds are spent appropriately for services as specified in the grant agreement.  Monitoring may include desk review and site review of agency performance.

 

c)         Performance indicators

            Performance indicators shall be established for each agency as a part of the annual grant negotiation process.  Performance indicator data shall be routinely distributed to the agency as part of the monitoring process. Previous data on performance indicators shall be included in this distribution to allow for analysis of change in functioning over time.

 

(Source:  Amended at 17 Ill. Reg. 10282, effective July 1, 1993)

SUBPART B: OPERATIONAL PROCEDURES

 

Section 103.90   Fiscal requirements (Repealed)

 

(Source:  Repealed at 24 Ill. Reg. 18160, effective November 30, 2000)

 

Section 103.95  Grant negotiation process

 

A number of factors enter into the grant negotiation process, including, but not limited to:

 

a)         A review of program expenses for the budget year and the past year;

 

b)         Whether the agency provided the level of services budgeted for in prior years;

 

c)         Number of individuals to be served;

 

d)         Characteristics of individuals to be served (such as, disability or severity);

 

e)         Cost per unit of service;

 

f)         Other funding sources (such as, other State agencies, local governmental units, third party payors or individual fees);

 

g)         Services proposed to be funded versus those outlined in the Department's annual plan;

 

h)         The agency's current financial status;

 

i)          The agency's ability to meet its own established goals;

 

j)          Impact of recent Department audit findings or independent audit report conditions on the agency's operation;

 

k)         Maintenance of effort needs; and

 

l)          Performance indicators.

 

(Source:  Added at 17 Ill. Reg. 10282, effective July 1, 1993)

 

Section 103.100   Accounting requirements (Repealed)

 

(Source:  Repealed at 24 Ill. Reg. 18160, effective November 30, 2000)

 

Section 103.110   Allowable/non-allowable expenses (Repealed)

 

(Source:  Repealed at 24 Ill. Reg. 18160, effective November 30, 2000)

 

Section 103.120   Audits

 

a)         Each agency receiving a grant from the Department shall have an annual independent audit as of the close of its fiscal year. This audit shall be performed in accordance with Section 89 Ill. Adm. Code 507.

 

(Source:  Amended at 22 Ill. Reg. 22390, effective December 8, 1998)

 

Section 103.130   Department review and hearing process

 

In order to assure that agencies have input and recourse to fiscal and programmatic decisions which directly affect them, a Department review and hearing process is established and available to each Department-funded agency:

 

a)         Grant award re-evaluation process

 

1)         An agency may request a review of the following decisions of the Department concerning an award of funds:

 

A)        Differences or changes in the elements considered in the funding negotiations with the Department as specified in Section 103.90; or

 

B)        Decisions which countermand previous commitments made to the agency.

 

2)         The request shall be submitted in writing to the associate director of the appropriate program division within 45 days after the date of an executed or amended grant agreement and shall include the basis for the request.

 

3)         Program division staff shall review the request and may request the agency to submit additional material.  The program division staff shall render a written decision with 45 days after the date of the receipt of the request or of the additional material.  The decision shall be mailed to the agency within 15 days after the completion of the review.

 

4)         Program division staff may meet with the agency representatives for purposes of clarifying issues, seeking additional information, or attempting to resolve the matter.

 

b)         Grant award hearing process

 

1)         Agencies may submit a written request to the Department for a formal hearing only when resolution of the issues specified in subsection (a) of this Section is not in accordance with this Part.

 

2)         A hearing may be requested by an agency not later than 30 days after the postmark date of the letter from the Department's program divisions informing the agency of the outcome of the review.  The written request for a formal hearing must state specifically how the outcome was not in accordance with this Part.

 

3)         Notice of hearing proceedings shall be in accordance with Section 10-25 of the Illinois Administrative Procedure Act [5 ILCS 100/10-25].

 

4)         The hearing shall be conducted by a Department hearing committee, appointed by the Secretary, and composed of an agency representative selected from a roster of authorized agency representatives and who is not objectionable to the appealing agency, the associate director for the applicable program division or his or her designee(s) and the Associate Director of Administrative Services or his or her designee, who shall chair the committee.

 

A)        At the hearing, Department staff shall present written and oral evidence concerning the Department's decision.  The agency may then present written or oral evidence.

 

B)        The Department shall have the burden of proving that its decision was made in accordance with this Part.

 

C)        The hearing officer shall uphold the Department's decision if he or she finds that the decision was supported by substantial evidence.  Substantial evidence is such evidence as a reasonable person can accept as adequate to support a conclusion.

 

5)         The hearing shall be held not later than 45 days after receipt of the agency's request.

 

6)         The finding(s) and decision of the hearing committee shall be made not later than 10 working days following the conclusion of the hearing proceedings and shall be sent to the agency via certified mail.

 

c)         Secretary's review

 

1)         If the agency is not satisfied with the committee's decision, it may request a review of the decision by the Secretary or his or her designee.  Such request shall be made in writing to the Secretary within 20 days after receipt of the decision.

 

2)         After receiving the request for review, the Secretary or his or her designee shall review the committee's decision and copies of all documents considered at the hearing.  Within 20 working days after receipt of the request for review, the Secretary or his or her designee shall issue a written decision upholding, revising or modifying the committee's decision.  Copies of the decision shall be sent to the Department and the agency.

 

3)         The Secretary's or designee's decision shall constitute a final administrative decision, which is appealable in accordance with the Administrative Review Law [735 ILCS 5/Art. III].

 

d)         Grant issue resolution process – for adjustments during the year.

 

1)         Issues other than those directly related to the annual grant award process and not an exception to this Part are to be resolved within the Department's existing program division structure.

 

2)         An agency may request a review related to a specific issue once an impasse has been reached in its negotiations with that program division level of the Department to which it relates on a regular basis.

 

3)         If the program division and the agency are unable to resolve the issue, the agency may submit a written request to the Secretary for review.  The agency shall send a copy of this request to the relevant program division.  The Secretary shall not act on a review request unless the program division review process previously described has been exhausted.

 

e)         The Department and the agency shall comply with all timeframes for submission of information, response to submission of information, notice, review or hearing as outlined in this Section regarding audits.  The agency may appeal the Department's failure to respond to timelines as outlined in this Section.

 

(Source:  Amended at 17 Ill. Reg. 10282, effective July 1, 1993)

 

Section 103.140  Budget application (Repealed)

 

(Source:  Repealed at 17 Ill. Reg. 10282, effective July 1, 1993)

 

Section 103.150  Agency plan

 

a)         The agency shall submit an agency continuation application prior to the beginning of the fiscal year.  The purpose of the continuation application is to provide documentation of service and service contracting in order to permit continuation of grant payment into the new fiscal year.  A complete agency plan shall be submitted after the beginning of the fiscal year.

 

b)         All agencies are required to submit their data on forms prescribed by the Department.

 

c)         Hereafter, in this Section and other Sections of this Part, " agency plan" shall refer to the currently approved program service and funding plan.

 

d)         The agency plan when fully executed as part of the grant agreement, serves as the formal statement of mutual expectations between the Department and the agency regarding contracted levels of service, costs and funding levels. The agency plan is a combination service plan and budget. It identifies what services will be provided, to what target group and the geographical area to be served. In addition, it identifies how the services will be financed, and through what budget items and funding sources. It becomes formalized documentation of the agreement between the Department and the agency through mutual execution of the grant agreement.

 

e)         An agency not funded by the Department or whose funding has been canceled pursuant to Section 103.190(e) shall submit verification of status as a not-for-profit organization, a complete agency plan on forms prescribed by the Department and shall execute a signed grant agreement prior to commencement of funding.

 

(Source:  Amended at 17 Ill. Reg. 10282, effective July 1, 1993)

 

Section 103.160  Grant agreement and addenda

 

a)         Definition of grant agreement

            When fully executed, the grant agreement is the obligating instrument providing the basis for the Departmental financial participation in grant-in-aid programs, and which formalizes the contractual relationship between the Department and the agency, indicating the amount of Department funds which will be paid to the agency for the provision of services as described in the grant agreement and the agency plan.

 

b)         Contents of grant agreement

            The grant agreement shall specify the general services to be provided, the general terms and conditions of the agreement and may specify additional terms and conditions for specific services provided by the agency.

 

c)         Preparation responsibilities

            The Department is responsible for preparing the grant agreement, designating the appropriate addenda, and forwarding it to the agency. The agency shall sign the grant agreement and return it to the Department. The Department agent's signature shall be affixed thereby approving the grant agreement. An approved and executed copy shall be returned to the agency.

 

d)         Provisions of the grant agreement

            Provisions, as referenced in the grant agreement when applicable, and as described below become part of the grant agreement.

 

1)         Non-discrimination

 

A)        The agency agrees to comply with Title VI of the Civil Rights Act of 1964 (42 U.S.C.A. 2000d (1996)) and all requirements imposed by or pursuant to the regulation of the U.S. Department of Health and Human Services (45 CFR 80 (1996)) issued pursuant to that Title, to the end that, in accordance with Title VI of that Act and the regulation, no person in the United States shall, on the grounds of sex, race, color, or national origin be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any program or activity for which the grantee receives federal or State financial assistance from the grantor. Grantee hereby gives assurance that it will immediately take any measures necessary to effectuate this grant agreement.

 

B)        The agency agrees to comply with Title VII of the Civil Rights Act of 1964 (42 U.S.C.A. 2000e (1996)) and not discriminate in the hiring or employment of staff on the basis of race, color, national origin, age, disability or sex.

 

C)        The agency agrees to comply with the Americans With Disabilities Act of 1990 (42 U.S.C. 12101-12213 (1996) and 47 U.S.C. 225 and 611 (1996)) and all requirements imposed by or pursuant to the regulations of the U.S. Department of Health and Human Services issued pursuant to that statute, to the end that no otherwise qualified individual shall be discriminated against on the basis of handicap in the provision of services.

 

2)         Drug-free workplace

            The agency agrees to comply with the Drug-Free Workplace Act [30 ILCS 580].  Agency employees are prohibited from the unlawful manufacture, dispensing, possession or use of a controlled substance or alcohol in the workplace while performing their duties.

 

3)         Mandated follow-up monitoring services

 

A)        The agency shall comply with Section 15  of the Mental Health and Developmental Disabilities Administrative Act and the Department's rules at 59 Ill. Adm. Code 125 (Recipient Discharge/Linkage/Aftercare), which requires mandatory follow-up monitoring services to individuals placed in licensed nursing homes, sheltered care homes and homes for the aged in accordance with the Nursing Home Care Act [210 ILCS 45], and this Part.

 

B)        The agency shall comply with the provisions of 59 Ill. Adm. Code 101.80 (Conflict of interest) in relation to its activities with licensed long-term care facilities. In essence, no employee of the agency shall serve as an employee or consultant either paid or unpaid to any licensed facility in the State of Illinois. Additionally, the agency itself shall not be in a financial relationship with a licensed facility in such a way which results in, or appears to result in, a conflict of interest with its monitoring functions under the grant. This shall include, at the very least, a situation where the agency is purchasing or receiving services from the same facility it monitors under this grant. The Secretary may issue approvals for exceptions which have been requested in writing to this subsection under circumstances including but not necessarily limited to those where the only developmental disabilities or mental health expertise available in a rural area is part of a current grant or of a governmental agency.

 

C)        The Department shall monitor the agency's performance of the mandated follow-up monitoring function and maintain final responsibility for the provision of this service if the grant agreement is violated.

 

4)         Adjustments addendum

            This addendum is used for corrections, a redistribution, a supplemental award or a reduction in award.

 

(Source:  Amended at 17 Ill. Reg. 10282, effective July 1, 1993)

 

Section 103.165  Accreditation (Repealed)

 

(Source:  Repealed at 24 Ill. Reg. 18160, effective November 30, 2000)

 

Section 103.170  Agency plan compliance

 

a)         The principles and procedures in subsections (c) through (e) of this Section do not replace any of the Departmental accountability standards and procedures currently in effect; rather, they are intended to clarify responsibilities for assuring compliance with all Departmental policy as it relates to the agency plan.

 

b)         Principles

 

1)         All agencies are accountable for the performance levels specified in their agency plans.  Variances between the agency plan and an agency's actual performance as submitted to the reporting system shall be reviewed by the Department staff.  Services shall be reported as event mode, day mode, residential mode services or other mutually negotiated measurements. An agency must be able to explain these variances to the Department's request.

 

2)         The analysis of financial and statistical variances is not, in itself, an exercise in quality assessment. Variances are principally quantitative measures which should be used as an administrative guide in reviewing program performance.

 

3)         The delivery of human services is not always predictably quantifiable in precise terms; variances, therefore, are not always meaningful measures.

 

4)         All negative variances of 15% or greater in contracted units of service (direct service staff hours, direct service individual (client) hours, and days of care) shall be reviewed.  Documentation shall be provided to the Department by the agency identifying the variance, the reason for the variance and action which the agency shall take to correct the variance.

 

5)         The variance levels described in subsection (b) (4) of this Section are not intended to define an acceptable level of service but serve only as a "management flag" identifying the point beyond which formal documentation is required for Department review.

 

6)         In applying these principles, it is important for the mutual expectations between the Department and the agency to be clearly established and for discussions regarding these expectations to be ongoing.

 

c)         Procedures for Department review

 

1)         During the grant year, events occur that may result in variations between the agency plan and the agency's actual performance, either statistically or financially. These variances in performance may be either temporary or permanent.

 

A)        A temporary variance is a difference between the agency plan and actual performance that is caused by a short-lived event or circumstance that will not adversely impact a program's ability to perform as outlined in the agency plan, except in the short term.  Best estimates of the program's future financial and service activity would indicate the correctness of staying with the current agency plan rather than changing it to meet the unusual and temporary circumstances.  In other words, the causes of temporary variance are, by their nature, not sufficient reason to change the approved agency plan.

 

B)        A permanent variance is a difference between the agency plan and actual performance that is caused by an event or circumstances that significantly alter expectations about the future financial or service activity in terms of a program's ability to perform as outlined in the approved agency plan.  The causes of a permanent variance are such that a new agency plan will have to be negotiated between the agency and the Department.

 

2)         It is the Department's responsibility to exercise a review function for all funded agencies assuring accountability for the service levels and costs established in all agency plans.  To effectively perform this role, all statistical and financial variances from agency plans shall be reviewed semiannually (at a minimum).  In addition, the Department may schedule site visits to agencies as part of this review process.

 

d)         Identifying statistical variances

 

1)         As administrative guide in conducting reviews, Department staff will focus on the following measures which are based on service projections included in the agency plan. These measures indicate the total units of service delivered by a program:

 

A)        Either direct service staff hours, direct service individual (client) hours or total program participant hours, or as appropriate, total individual days of service.

 

B)        For all programs with a variance in one of the above measures, written explanations are required if the variance exceeds minus 15%. For any variance identified in this manner, documentation is required at least semiannually. (Explanations, however, must addresses the variance for each month within the period.)

 

2)         Variances requiring documentation

            Those statistical variances which require documentation are identified in reports generated from the Department's reporting system.  Variances will be determined according to the service modality of the program.

 

e)         Audits

            Documentation of variances and the records of renegotiated agency plans form the basis for any after-the-fact review of an agency's relationship with the Department.

 

(Source:  Amended at 17 Ill. Reg. 10282, effective July 1, 1993)

 

Section 103.180  Prerequisites for disbursement of funds

 

a)         Agencies are required to submit a continuation application for the forthcoming year prior to commencement of the fiscal year, within timeframes as established by and using forms prescribed by the Department.

 

b)         Agencies are further required to submit a full agency plan for the Department's review and approval within timeframes as established by and using forms prescribed by the Department.

 

(Source:  Amended at 17 Ill. Reg. 10282, effective July 1, 1993)

 

Section 103.190  Interruption of disbursement and grant cancellation (Repealed)

 

(Source:  Repealed at 24 Ill. Reg. 18160, effective November 30, 2000)

 

Section 103.200  Revenue/expense reports (Repealed)

 

(Source:  Repealed at 17 Ill. Reg. 10282, effective July 1, 1993)

 

Section 103.210  Reallocation

 

Reallocation of funds

Agencies may transfer funds between programs within the agency plan guidelines distributed by the Department.  Agencies desiring to reallocate funds in excess of agency plan guidelines must request this reallocation in writing prior to the expiration of the grant agreement.  Authorization to transfer these funds within the agency plan guidelines distributed by the Department will be allowable, with justification, unless the Department indicates to the contrary within 30 days after notification.  The agency must request this reallocation by registered mail prior to the end of the fiscal year.

 

(Source:  Amended at 24 Ill. Reg. 18160, effective November 30, 2000)