Department of Human Services
Division of Developmental Disabilities
Information Bulletin DD.10.002

Closure of an ICF/DD

11-19-2010

Purpose 

The Division of Developmental Disabilities (DDD) established procedures for emergency closure of an Intermediate Care Facility for Persons with Developmental Disabilities (ICF/DD) in order to ensure a safe and smooth transition of persons to alternative residential services or in-home support services. The Division will work in partnership with the Illinois Department of Healthcare and Family Services and Illinois Department of Public Health during an emergency ICF/DD closure to:

  1. To achieve a smooth and consistent emergency ICF/DD closure process.
  2. To assure that persons are afforded choice of alternative services during an emergency ICF/DD closure.
  3. To assure that persons are transitioned to alternative residential or in-home support services in a smooth and efficient manner that fosters the least amount of disruption to their daily schedules and services.

Definition

  1. Bureau of Accreditation, Licensure, and Certification (BALC)
  2. Bureau of Community Reimbursement (BCR)
  3. Closure Team: Court-appointed Receiver Representative, DPH, DDD, and PAS/ISC/ISSA agency.
  4. Community Integrated Living Arrangement (CILA)
  5. Developmental Training (DT)
  6. Division of Developmental Disabilities (DDD)
  7. Home-Based Support Services (HBS)
  8. Illinois Department of Healthcare and Family Services (DHFS)
  9. Illinois Department of Human Services (DHS)
  10. Illinois Department of Public Health (DPH)
  11. Independent Service Coordination (ISC)
  12. Individual Service & Support Advocacy (ISSA)
  13. Individual Service Plan (ISP)
  14. Interdisciplinary Team (IDT)
  15. Intermediate Care Facility for Persons with Developmental Disabilities (ICF/DD)
  16. Long Term Care Unit (LTC) - within the Bureau of Community Reimbursement, Division of Developmental Disability
  17. Pre-Admission Screening (PAS) agent or Independent Service Coordination agency (ISC)

Process and Procedure

The Emergency ICF/DD Closure policy and procedures provide supplementary guidance in addition to the requirements set forth in Illinois Administrative Code Title 77, Chapter 1, Subchapter c, Part 350, Section 350.270 as it relates to the emergency closure of an ICF/DD. An ICF/DD emergency closure can be the result of decertification or licensure issues, bankruptcy, and/or foreclosure. An ICF/DD that changes ownership is covered under Illinois Administrative Code Title 77, Chapter 1, Subchapter c, Part 350, Section 350.150 a-j. This policy and procedures does not address a planned ICF/DD closure.

  1. The Illinois Department of Public Health (DPH), with input from the Division of Developmental Disabilities (DDD) within the Illinois Department of Human Services (DHS), will secure a court-appointed receiver for the emergency closure of the ICF/DD [See Rule 350.270 g)]. For information regarding the Court-appointed Receiver qualifications, refer to Rule 350.270 f). The time frame for the emergency full closure will be set by the Court and IDPH.
  2. The closing ICF/DD will secure written approval from the IDPH, with input from the Director of DDD, regarding the content of its closure notice to the individuals, guardians, and family members prior to dissemination.
  3. The closing ICF/DD will send the official closure notice to persons, guardians, family members, DHS/DDD, DHFS, DPH, and local PAS/ISC agency upon Court order of Receiver appointment.
  4. The closing ICF/DD will send official correspondence to DHS/DDD, DHFS, and DPH that includes the following:
    • date and time the closing ICF/DD will cease operations
    • list of persons per ICF/DD site (if more then one ICF/DD is closing within the organization)
    • address and phone number of each individual's residence
    • name and phone number of contact person during closure
  5. The DPH-contracted monitoring entity will conduct on-site monitoring of the closing ICF/DD as directed by DPH, with input from DHS/DDD. For additional information regarding the DPH-contracted entity's on-site monitoring duties, refer to Rule 350.270 a-c). For information regarding the DPH-contracted entity's qualification(s), refer to Rule 350.270 b).
  6. The Closure Team will schedule and conduct regular meetings to develop and update the ICF/DD closure work plan. The Closure Team will include, at a minimum, representatives from DHS/DDD, DPH, local PAS/ISC agency, and court-appointed receiver. The DPH-contracted monitoring entity may participate in these meetings.

    The DHS/DDD Network Facilitator will be responsible for scheduling and facilitating the regular closure meetings, updating the closure work plan, and maintaining a file of such reports.

  7. The court-appointed receiver of the closing ICF/DD will request from IDPH authorized expenditures from funds appropriated if incoming payments from the operation of the closing ICF/DD are less than the costs incurred by the receiver. For additional information regarding this, refer to Rule 350.270 h).
  8. The local PAS/ISC/ISSA agency will secure release of information for completion of the DHS/DDD-PAS Level II process to determine each person's eligibility for all alternative residential and in-home support services.
  9. The local PAS/ISC/ISSA agency will present to the person, guardian, and family all alternative residential and/or in-home support service options that the person is eligible to receive after completion of DHS/DDD PAS Level II. If a person chooses to transition to an alternative ICF/DD, the DHS/DDD-PAS Level II is not necessary.
  10. The person, guardian, and family will explore all alternative residential or in-home support service options.
  11. The local PAS/ISC/ISSA agency will arrange on-site visits to alternative residential settings for the person, guardian, and family. The local PAS/ISC/ISSA agency will encourage the person, guardian and family to explore in-home support services and/or conduct on-site visits to all potential day programs and alternative residential options. The individual will also be encouraged by the local PAS/ISC/ISSA agency to participate in the potential residential provider's day and evening events (e.g., dinner visits and cook-outs), along with short-term and/or extended overnight visits.
  12. The person and/or guardian will render a final decision regarding alternative residential services. If a CILA or HBS is chosen, proceed to items m - r and items t - u listed below. If an alternative ICF/DD is chosen, proceed to items r - w listed below.
  13. The receiving CILA and sending PAS/ISC agency will coordinate the gathering of required information for the CILA funding packet. If the individual has chosen HBS, the sending PAS/ISC agency along with the individual will gather the necessary information for the HBS funding packet.
  14. The sending PAS/ISC agency will send the CILA or HBS funding packet to DDD Network Facilitator for review and processing.
  15. The DHS/DDD Network Facilitator will forward the complete CILA or HBS funding packet to BCR for processing of an award letter and enter required information into DDD internal tracking system.
  16. The DHS/DDD Bureau of Community Reimbursement (BCR) will generate and send an authorized CILA or HBS award letter to the individual and guardian, receiving CILA or HBS provider, and sending and receiving PAS/ISC agencies.
  17. The sending PAS/ISC/ISSA agency will notify the receiving PAS/ISC/ISSA agency of persons who transition to a new residential location within its service area.
  18. The court-appointed Receiver of the closing ICF/DD will arrange for transportation of the persons to his/her alternative residential setting or family home. The court-appointed Receiver of the closing ICF/DD will also assure that all personal belongings and records/files of the persons are transported to the alternative residential setting or to the sending PAS/ISC/ISSA agency for persons who chose to return home with family, on a temporary basis, until a permanent setting is arranged.
  19. The receiving ICF/DD will notify the local Family Community Resource Center, within the Division of Human Capital Development, of persons who transition to the receiving ICF/DD.
  20. The receiving residential provider will invite all IDT members and will schedule and convene the IDT within the designated time frame, as directed by applicable rule. The HBS Service Facilitator will be responsible for scheduling and convening the members of the IDT for persons who choose in-home HBS.
  21. The sending and receiving PAS/ISC/ISSA agency will conduct mandatory face-to-face on-site visits for the first month and quarterly ISSA visits thereafter for persons who transition to Waiver-funded services (See PAS and Waiver Manuals). For persons who make the transition to another alternative ICF/DD, the receiving PAS/ISC/ISSA agency will ensure monthly contact with the person, guardian, family members, and receiving ICF/DD.
  22. The closing ICF/DD receiver will send final closure notification on last date of operation to DHS/DDD, DPH, and DHFS.
  23. The closing ICF/DD will disenroll the individuals with the current DT provider by submitting to the HFS/DDD Form IL444-2768. The receiving ICF/DD will re-enroll persons with the new DT provider by submitting to DHS/DDD IL444-2768 (N-2-00) - Enrollment/Disenrollment Form (pdf). This form and directions are located on the DHS/DDD website.