Section 220.600  Case Coordination Unit Minimum Standards

 

a)         To be designated as a Case Coordination Unit (CCU) for a specific geographic area, as identified by the Area Agency on Aging (AAA) in a specified planning and service area, an agency shall enter into a contract or grant with the AAA to provide Title III (Older Americans Act (42 USC 3001)) case management services pursuant to 89 Ill. Adm. Code 230 (Subpart G) and with the Department to provide Community Care Program (CCP) case management services pursuant to 89 Ill. Adm. Code 240.260 and 240.1400 et seq.

 

1)         The agency shall be a free-standing, single purpose agency, or shall be part of a multi-purpose agency. A multi-purpose agency shall have a separate, clearly definable organizational unit functioning as the CCU.

 

A)        An AAA shall not be designated a CCU except in an emergency situation as specified in Section 220.655(e).

 

B)        A CCP provider may not serve as a CCU in the same contract service area except in temporary situations as specified in 89 Ill. Adm. Code 240.1400(f).

 

C)        No organization having any other conflict of interest in the performance of case management service activities shall serve as a CCU.  Conflict of interest means any entity or individual uses an official position for private gain (other than salary), gives preferential treatment to any entity or individual in the conduct of official duties because of personal interest, impedes or adversely affects governmental efficiency or economy because of personal interest, fails to act impartially in the conduct of official duties because of personal interest, or engages in conduct that could adversely affect the confidence of the public in the integrity of the Department on Aging and its programs.  The term also means that the circumstances are such that the Department might reasonably conclude that an entity's or individual's judgment could be influenced by the nature of the circumstances.

 

2)         The designation of CCUs shall be accomplished by the AAA and the Department as described in Sections 220.610 through 220.645 of this Part.

 

3)         The designated CCU must be in compliance with Older Americans Act (42 USC 3001) requirements.

 

4)         Only one designated CCU shall have jurisdiction in a particular geographic area.

 

b)         Case management service is defined as assistance either in the form of access or care coordination in circumstances where the older persons and/or their caregivers are experiencing diminished functioning capacities, personal conditions or other characteristics which require the provision of service by formal service providers.  Activities of case management include assessing needs, developing case plans, authorizing services, arranging services, coordinating the provision of services among formal service providers and informal sources of support, follow-up and reassessment, as required.

 

c)         An individual AAA may establish additional requirements than those specified in subsections (e) through (k) relative to any contract/grant for case management services provided in its respective planning and service area. The AAA shall arrange for funding of such additional requirements.  Such additional requirements shall bear no additional cost to the Department or to recipients of services.

 

d)         An individual AAA may require a CCU to provide additional funded Older Americans Act (42 USC 3001) or General Revenue Fund services that are directly related to case management as defined in subsection (b).

 

e)         Case management service activities shall minimally include (as specified in 89 Ill. Adm. Code 230.250(i)(1) and 240.1420):

 

1)         Intake:  Older persons who are potentially in need of case management services shall be screened.

 

2)         Needs Assessment:  A face-to-face assessment/reassessment shall be conducted for all potentially eligible or current Title III case management clients and CCP applicants/clients.

 

3)         Case Plan Development:  A written goal-oriented case plan shall be prepared for all individuals determined to be in need of case management services.

 

4)         Case Plan Implementation:  A referral of the client shall be made to appropriate formal and informal resources.

 

5)         Follow-up:  Contact to ensure that service has been implemented for the client.

 

f)         The CCU shall minimally:

 

1)         Coordinate services with the following types of organizations in the contractual area:

 

A)        Information and Assistance and Outreach Providers

 

B)        Nursing Facilities

 

C)        Health Care Providers (including all hospitals in the geographic area)

 

D)        Social Service Providers

 

E)        Public Assistance/Financial Assistance Organizations

 

F)         Elder Abuse and Ombudsman Provider Agencies

 

2)         Coordinate services to individual clients and shall, at a minimum, include a process for handling information requests, referrals, and follow-up activities.  The process must be clearly defined in written policy and procedures.

 

3)         Establish and follow procedures, which must be retained on file, to assure that each client has an assigned case manager to contact, including back-up procedures for assigning a substitute case manager, who meets the minimum requirements specified in Section 220.605 of this Part and in 89 Ill. Adm. Code 240.1440, in the absence of the assigned case manager.

 

4)         Establish and follow procedures, which must be retained on file to assure maintenance of and safeguard the use of and disclosure of information relating to applicants and clients as required by Federal or State laws, rules and regulations and the requirements specified in Section 220.100 of this Part and in 89 Ill. Adm. Code 240.340.

 

5)         Present service options and information about available providers to each client and/or client's authorized representative in an objective manner.

 

6)         Establish and follow a written procedure for coordinating the CCU intake system with the Title III Information and Assistance and Outreach providers.

 

7)         Arrange services to non-English speaking and hearing impaired applicants and/or clients.

 

8)         Have a TTY or assist the applicant and/or client in using the Illinois Relay Center to accommodate the hearing and/or speech impaired.

 

9)         Comply with the Illinois Human Rights Act [775 ILCS 5]; the Equal Employment Opportunity Act of 1974, as amended (Title VII of the U.S. Civil Rights Act of 1964, as amended (42 USC 2000e et seq.)); Section 504 of the Rehabilitation Act of 1973 (29 USC 790 et seq.); the Immigration Reform and Control Act of 1986 (8 USC 1101 et seq.); and the Americans With Disabilities Act of 1990 (42 USC 12101 et seq.).

 

10)         Perform service activities and responsibilities for which a contract/grant is in effect.

 

11)         Establish personnel policies, job descriptions, training requirements and wages for each job category in accordance with all applicable State and Federal rules and requirements and Department procedures. Personnel policies shall include hours of work, benefits, and promotion and evaluation criteria.  To be considered a full-time employee of the CCU, for the purpose of defining Full Time Equivalent (FTE) ratio commitments in the CCU proposal, the FTE employee must work a minimum of 35 hours per week, excluding holidays observed by the CCU.

 

12)         Assure each individual employed by the CCU having face-to-face contact with clients in the client's residence, in the hospital and/or nursing facility shall be free from communicable disease.

 

g)         The CCU shall be located to provide accessibility to older persons and their families and other organizations providing services to the elderly in the agency's jurisdiction.

 

h)         The CCU shall be open at least 7 hours per day, Monday through Friday, excluding holidays observed by the CCU.

 

i)          Any satellite offices operated by the CCU shall comply with all rules and regulations, as set forth in this Part and 89 Ill. Adm. Code 230 and 240.

 

j)          The CCU shall maintain books, records, documents and other evidence of accounting procedures and practices which sufficiently and properly reflect all direct and indirect costs of any nature expended in performance of the contracts and/or grants. These records shall be subject at all reasonable times to inspection, review, and/or audit as specified in 89 Ill. Adm. Code 230 and 240.

 

k)         The CCU shall provide for financial audits in accordance with requirements specified in 89 Ill. Adm. Code 230.360 and 89 Ill. Adm. Code 240.1420.

 

l)          The CCU shall comply with all applicable Federal, State and local laws, rules, regulations and ordinances as well as all specified requirements as set forth in this Part and in 89 Ill. Adm. Code 230 and 240.

 

m)        All program records, reports, and related information and documentation, including files of terminated clients, which are generated in support of a contract/grant between the CCU and the Department/AAA shall be maintained by the CCU for a minimum of three years after the completion of the contract/grant.  If any litigation, claim or audit is started prior to the expiration of the three year period, the records shall be retained until all litigation, claims or audit findings involving the affected records, information or documentation has been resolved.

 

n)         Each CCU shall carry general liability insurance in the single limit minimum amount of $100,000 per occurrence. The policies or current letters documenting all insurance coverage shall be available in the CCU files.

 

o)         CCUs shall not subcontract for the direct provision of case management services unless prior written approval has been obtained from the Department and the AAA, as appropriate.

 

p)         CCUs are expressly prohibited from assigning either their contract with the Department or their contract/grant with the AAA.

 

q)         All records, case notes or other information maintained on persons served under the contract shall be confidential and shall be protected by the CCU from unauthorized disclosure pursuant to Section 220.100.

 

(Source:  Amended at 26 Ill. Reg. 9652, effective July 1, 2002)