Service Termination Authorization Request (STAR) Form & Process

Helping Families. Supporting Communities. Empowering Individuals.
Illinois Department of Human Services
Division of Developmental Disabilities
Information Bulletin
DD.16.72

Service Termination Authorization Request (STAR) Form and Process
January, 2016

Policy

This Information Bulletin serves as replacement policy and procedure for the language as stated in the CILA User Guide, Cost Center Definitions, and Reimbursement Levels (Revised January, 2002) and the April 4, 2003, Memo to the Field regarding New Bed Hold Extension Request Form

The following pertains to Community Integrated Living Arrangement (CILA), Home-Based Service (HBS) and Purchase of Services (POS) service provider, Independent Service Coordination (ISC) agents and division staff. The reader can also access information in the Division of Developmental Disabilities (DDD) Program Manual and the Waiver Manual found on the DDD website related to bed hold and terminations. This Information Bulletin is also related to Information Bulletin DD.16.071 entitled Bed Hold Request Form and Process.

Process and Procedures

The Service Termination Authorization Request Form (STAR) (IL462-2028) is applicable to all individuals receiving services funded through the Division of Developmental Disabilities including Community Integrated Living Arrangements (CILA), Purchase of Services (POS), Home Based Supports (HBS) and/or Developmental Training only.

  1. The Service Termination Approval Request Form (STAR) (IL462-2028) should be filled out by the service provider no later than five (5) business days after the individual leaves or ceases receiving services from the service provider.
  2. The STAR form is completed and forwarded by the service provider to the appropriate ISC agency which represents the area in which the individual resided or was served. The ISC agency in turn signs the STAR form and forwards it to the appropriate Regions staff within the DDD.

    See the Service Termination Approval Request (IL462-2028).

  3. When an individual, guardian or personal representative files an appeal of their termination from Waiver services, the individual cannot be terminated until a final decision of the appeal is rendered, or the appeal has been withdrawn. If the ISC agent receives a STAR form for an individual who is appealing their termination of services, then the ISC agent should return the STAR form to the service provider. The reader can also refer to the Illinois Administrative Code 120.110 Section i. for more detailed information.
  4. When a CILA service provider wants consideration for payment for any day past the individual's last day present in a CILA residential setting, a Bed Hold Extension Request form (IL462-2027) with two (2) required supporting documentation statements MUST be attached to the individual's STAR form. The DDD shall consider approval of up to 60 days of bed hold for an individual enrolled in CILA services when a complete bed hold request is received with a STAR form.
  5. Any individual terminating from service provider "A" and going to service provider "B" or to another DHS funded program (e.g. POS to HBS, HBS to CILA, etc.) will have their termination date set as the last day the individual "went to bed" for the previous program or slept in the residential setting. In this circumstance the individual's last day present (partial day) is not the date of termination. The receiving service provider or program is eligible for payment of services on the day the individual begins services.
  6. The individual's date of termination will not be later than the individual's last day present when:
    1. The service provider initiates the termination from the provider's program; or,
    2. The individual is discharged directly or indirectly to a State Operated Developmental Center (SODC) or a State Operated Mental Health Center (SOMH); or,
    3. The individual or individual's guardian, if applicable, is appealing the individual's termination initiated by the service provider; or,
    4. The individual's physician stipulates the individual is unable to return to services; or,
    5. The individual or the individual's guardian, if applicable, makes a choice that the individual will not return to services with the current service provider; or,
    6. The individual's date of death.
  7. Upon the DDD's processing and data entry of a STAR form the termination date will not be changed to a later date unless there was an error on the part of the DDD or ISC agency.
  8. The attached Flowchart (pdf) should assist service providers determine an individual's correct termination date.
  9. DDD staff will compare dates reported on the STAR form with actual billing submitted by the service provider as well as other documentation available through the Illinois Department of Healthcare and Family Services (IDHFS).
  10. The division reserves the right to modify any date reported on the STAR form when it does not match official service reporting by the service provider or information obtained through the IDHFS.

The information provided by the Division of Developmental Disabilities within the Illinois Department of Human Services is intended for the use and convenience of interested individuals. The information contained herein should not be considered a substitute for the appropriate official statutes, rules, regulations, or the advice of legal counsel.

Effective Date

While this procedure has been a long standing and is a current Department practice, this is effective immediately with the release of this Information Bulletin.