Section 115.214  Individuals Requiring Additional Services and Support

There are occasions when an individual receiving CILA services requires additional services and support as a result of changes in medical or behavioral health.  Examples include, but are not limited to, a gradual deterioration of health and/or behavioral stability or a more recent acute medical condition and/or sudden intense behavioral episodes.  The CILA agency must take reasonable and appropriate action to address and stabilize the individual's situation for the health and safety of the individual and/or others.

a)         When an individual receiving CILA services requires additional services and support, the CILA agency's Provider Support Team shall be convened.  The CILA agency's designated QIDP shall:

1)         Convene a meeting including, but not limited to, the individual, the individual's guardian, the Provider Support Team, relevant staff as determined by the QIDP (e.g., CILA agency administrative leadership staff, as necessary), and a representative of the ISC agency.

2)         The team will consider the current system of services and supports, including the use of internal CILA agency resources, external consultants, and the effectiveness of the current Personal Plan, Implementation Strategy, and other service planning documents.  The CILA provider must notify the ISC agency when changes to the Personal Plan are needed.

A)        If not in place and indicated by the situation, a behavioral support strategy will be developed to outline the plan of action.  If there is a current behavior support plan, it will be reviewed and revised as necessary.

B)        If complex medical conditions are a concern, the team will review the current Personal Plan and Implementation Strategy to ensure needed medical services and supports are in place.

C)        The team will determine whether the CILA agency will request additional staff resources or other supports from DDD.

D)        The team will determine whether to request technical assistance, training, short-term residential stabilization supports, or other necessary consultation from the Division.

E)        Should the team request additional staff resources or other supports as described in subsection (a)(2)(C) – (D), the Department will respond to the request as soon as possible but no later than ten business days following receipt of the request.

b)         The steps outlined in subsection (a) must be followed by a CILA agency prior to termination of its services (see Section 115.215), except as specified in 59 Ill. Adm. Code 120.110(i).

c)         Following the team meeting described in subsection (a)(1), it is expected that, after additional staff resources and consultations have been implemented, at least 30 calendar days will be invested in determining the effectiveness of the behavior support plan or medical services, including any relevant revisions, as well as the benefit of any additional staff resources and consultations, before recommending termination of the CILA agency's services.  The 30 calendar days do not include absences from the CILA for necessary medical or behavior-related services.

(Source:  Added at 47 Ill. Reg. 8485, effective May 31, 2023)