From: Theodora Binion, Director
Division of Alcoholism and Substance Abuse
OFF-SITE EXCEPTION - NEW PROCEDURE
This is notification of the new procedure to request off-site exceptions. In order to receive an exception for off-site services, a licensed organization must submit to DASA a written request and a completed Off-Site Exception Form at least 30 days prior to the anticipated provision of such services. An Off-Site Exception Form must be completed for each location requesting an exception.
Once approved, a revised DARTS file with a unit and program number for each off-site location will be sent to your agency to allow off-site service reporting. This will allow DASA staff to track where and what off-site services are being provided.
Attached is a copy of the policy, form and instructions for completion. The Off-Site Exception Form will be posted on DASA's Web page.
If your agency will be billing Medicaid from an off-site location, this location is required to enroll with the Illinois Department of Healthcare and Family Services if the following criteria apply:
- the off-site location is owned or leased by the agency or;
- the off-site location has managing and/or assigned staff at the location or;
- patients need to travel to the off-site location to receive services rather than agency staff going to them.
Providers must comply with all of the provisions in Section 2060.203 Off-Site Delivery of Services.
Please send questions to DHS.DASAHelp@Illinois.gov.
Forms
IL444-4364 - Off-Site Exception Request (pdf) - (N-12-12)
IL444-4364 AP - Off-Site Exception Approval Policy (pdf) - (N-12-12)
IL444-4364 INST - Off-Site Exception Request Form Instructions (pdf) - (N-12-12)