Rehabilitation Services CSA Attachment D

Helping Families. Supporting Communities. Empowering Individuals.

Table of Contents

I. Introduction

II. Applicable Rules

III. Program Services

IV. Program Plan and Deliverables

V. Payment

VI. Eligibility Criteria

VII. Reporting Requirements

VIII. Special Conditions

I. Introduction

This document serves as an attachment to the Department of Human Services (DHS) Uniform Grant Agreement and sets forth supplemental contractual obligations between the Provider and Department. The Attachment provides contractual requirements beyond those in the Agreement and is intended to clarify programmatic areas of the Division of Rehabilitation Services including, but not limited to, services covered under the Department of Healthcare and Family Services Waiver Program Provider Agreement For Participation in the Illinois Medical Assistance Program (HFS 1413-A).

II. Applicable Rules

Provider must comply with all applicable federal, state and local rules and statutes including, but not limited to, the following:

STATE STATUTES

20 ILCS 2405/ Disabled Persons Rehabilitation Act.

20 ILCS 2407/ Disabilities Services Act of 2003.

20 ILCS 2410/ Bureau for the Blind Act.

30 ILCS 708/ Grant Accountability and Transparency Act

30 ILCS 705/ Illinois Grant Funds Recovery Act

305 ILCS 5/5-5f(g) Save Medicaid Access and Resources Together (SMART) Act

FEDERAL STATUTE

Public Law 113-128 Workforce Innovation and Opportunity Act

Sections 704 and 722, Chapter 1 of Title VII-CILs Program, Rehabilitation Act of 1973, as amended

Public Law 108-364 - Assistive Technology Act of 2004; Assistive Technology Act of 1998

GENERAL DIVISION RULES

PART 505 CONFIDENTIALITY OF INFORMATION

PART 510 APPEALS AND HEARINGS

PART 511 GRANTS AND GRANT FUNDS RECOVERY

PART 515 ADVISORY COUNCILS

PART 520 AUTHORIZATIONS

PART 521 PROGRAM DEFINITIONS

PART 525 GRANTS AND CONTRACTS

PART 527 RECOVERY OF MISSPENT FUNDS

PART 545 RATEMAKING

PART 546 PUBLIC USE OF DHS-ORS FACILITIES

INDEPENDENT LIVING & OTHER PROGRAMS

Federal Regulations

Code of Federal Regulation

Title 34, Part 364 - State Independent Living Services Program and Centers for Independent Living Program: General Provisions

Section 364.1 to Section 364.59

http://www.ecfr.gov/cgi-bin/retrieveECFR?gp=&SID=e69ccfd3ea0363efda853207c4fbb75c&r=PART&n=34y2.1.1.1.9

Code of Federal Regulation

Title 34, Part 365 - State Independent Living Services

Section 365.1 to Section 365.31

http://www.ecfr.gov/cgi-bin/retrieveECFR?gp=&SID=e69ccfd3ea0363efda853207c4fbb75c&r=PART&n=34y2.1.1.1.10

Code of Federal Regulation

Title 34, Part 366 - Centers for Independent Living

Section 366.1 to Section 366.63

http://www.ecfr.gov/cgi-bin/retrieveECFR?gp=&SID=e69ccfd3ea0363efda853207c4fbb75c&r=PART&n=34y2.1.1.1.11

Code of Federal Regulation

Title 34, Part 370 -Independent Living Services for Older Individuals who are Blind

Section 367.1 to Section 367.42

http://www.ecfr.gov/cgi-bin/retrieveECFR?gp=&SID=e69ccfd3ea0363efda853207c4fbb75c&r=PART&n=34y2.1.1.1.12

Code of Federal Regulation

Title 34, Part 367 -Client Assistance Program

Section 370.1 to Section 370.48

http://www.ecfr.gov/cgi-bin/text-idx?SID=e0158f55d7abbdb0c3c4e5232646adb5&mc=true&tpl=/ecfrbrowse/Title34/34cfr370_main_02.tpl

Code of Federal Regulation

Title 34, Part 84 - Governmentwide Requirements for Drug-Free Workplace (Financial Assistance)

Section 84.100 to Section 84.670

http://www.ecfr.gov/cgi-bin/text-idx?rgn=div5&node=34:1.1.1.1.29

Code of Federal Regulations

Title 2, Part 200 - Uniform Administrative Requirements, Cost Principles, and Audit Requirments for Federal Awards

Section 200.1 to Section 200.520

http://www.ecfr.gov/cgi-bin/text-idx?tpl=/ecfrbrowse/Title02/2cfr200_main_02.tpl

State Rules

PART 886 CENTERS FOR INDEPENDENT LIVING

PART 890 TELECOMMUNICATION DEVICES FOR THE HEARING IMPAIRED

HOME SERVICES PROGRAM

Federal Regulations

Code of Federal Regulation

Title 42, Part 441- Services: Requirements and Limits Applicable to Specific Services

Subpart G

http://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&SID=e69ccfd3ea0363efda853207c4fbb75c&ty=HTML&h=L&n=42y4.0.1.1.10&r=PART

State Rules

PART 676 PROGRAM DESCRIPTION

PART 677 CUSTOMER RIGHTS AND RESPONSIBILITIES

PART 679 DETERMINATION OF NEED (DON) AND RESULTING SERVICE COST MAXIMUMS (SCMs)

PART 681 PRESCREENING

PART 682 ELIGIBILITY

PART 684 SERVICE PLANNING AND PROVISION

PART 686 PROVIDER REQUIREMENTS, TYPE SERVICES, AND RATES OF PAYMENT

PART 688 ILLINOIS LONG-TERM CARE PARTNERSHIP PROGRAM

III. Program Services

a. Home Services Program (HSP) - A Medicaid Waiver Program offering individuals with disabilities who are at risk of premature or unnecessary institutionalization the alternative of in-home care when the cost of such care does not exceed the cost of a nursing facility. Services include, but are not limited to Individual Provider, Agency Home Health, Homemaker, Home Delivered Meals, Electronic Home Response, Assistive Equipment, Environmental Modification, and Respite.

1. Agency Services - Support services meeting the definitions and requirements set forth at 89 Ill. Admin. Code 676.40 and 686 covered under the Department of Healthcare and Family Services Waiver Program Provider Agreement For Participation in the Illinois Medical Assistance Program (HFS 1413-A).

Agencies that provide services on behalf of the Home Services Program are serving in the capacity as an agent of the State and are therefore required to appear, testify and provide any information related to customer appeals or hearings.

1. Adult Day Care Services:

Adult Day Care Service - $9.02/hour

Adult Day Care Transportation - $8.30/trip

2. Case Management:

Case Management - $138.10/month

Case Management Assessment - $110.48

Case Management Reassessment - $55.24

Case Management Transportation Services - 0.575/mile

Case Associate - AIDS - Reassessment - $110.48

3. Community Care Unit-Nursing Home Pre-screening:

CCU Pre-Screen - $89.53

CCU Face to Face with Translation - $114.95

4. Emergency Home Response:

Installation Service - $30.00

Electronic Home Response Service - $28.00/month

5. Homemaker Services:

Homemaker Services $17.14/hour

  1. Personal Assistant Referral &Training - Provides PA referral and training, customer PA management training, and related services to increase the independence and quality of life of Home Service Program customers.
  2. Community Reintegration - Provides services and support to individuals to transition from nursing home facilities to their own residences within the community.

b. Independent Living Services - Through independent living services, DRS funds a network of Centers for Independent Living (CILs) statewide that provides accessible programs and services designed to help all people with disabilities live more independently. All CILs, which are nonprofit, community-based organizations operated by and for individuals with disabilities, provide core services: advocacy, peer counseling, skills training, information and referral and transition services. Transition services include facilitating transition from nursing homes to Home and Community-Based Services in the community, activities to prevent individuals from entering institutions and youth transition services.

c. Independent Living Services for Older Individuals who are Blind: Funding for community agencies to provide specialized support services to individuals age 55 or older whose severe visual impairment makes competitive employment difficult to obtain but for whom independent living skills are feasible.

d. Assistive Technology - Supports State efforts to improve the provision of assistive technology to individuals with disabilities of all ages through comprehensive, statewide programs that are consumer responsive. The State Grant for Assistive Technology Program makes assistive technology devices and services more available and accessible to individuals with disabilities and their families

IV. Program Plan and Deliverables

A. Provider Service and Funding Plan: The Provider agrees to provide services and deliverables as stated in the program plan, as well as execute service and budget forms provided by the Division of Rehabilitation Services (DRS) and submit completed forms to DRS within time frames specified. Failure to submit the required service and budget forms and obtain DRS approval may result in suspension of payments and/or loss of contract.

V. Payment

Payment and Billing Information: Reference DRS Program Manuals for all payment and billing information. All manuals are available by contacting the Provider's DRS Project Officer

A. Type of Payment

1. Fixed Rate - A program for which the payments are made on the basis of a rate, unit cost or allowable cost incurred and is based on a statement or bill as required by the Department. Payments made as a fee-for-service are not subject to the Illinois Grants Funds Recovery Act (30 ILCS 705/1 et. seq.).

2. Expenditure-Driven Program - A program for which payments are made based on an expenditure report from the provider reflecting the actual expenditures incurred for the costs associated with carrying out the specified requirements in the Contractual Agreement. Expenses are subject to restrictions for allowability or non-allowability due to the nature of the program.

B. Payments made to the Provider are based upon services, deliverables/milestones, performances measures and standards as specified in the Uniform Grant Agreement. Billings, with substantial documentation, are submitted by the Provider upon completion of service. The Provider must accurately complete and submit billings in a timely manner. The Provider understands that incorrect billings or portions of billings may not be processed in the current monthly cycle and may be returned to the Provider for correction.

C. The Provider must submit accurate reports (service or cost, as specified by the Department). Payments may be suspended if reports are not received in the proper format or timely as specified in the Program Manuals.

VI. Eligibility Criteria

A. Eligible and Target Populations

  1. Home Services Program (HSP): The HSP helps individuals with severe disabilities that need assistance with daily living activities in their homes. The program serves individuals with a wide variety of disabilities including AIDS, physical disabilities, and Brain Injury (BI). To be eligible for HSP, an individual must meet eligibility criteria as stated in 89 Ill.Adm.Code Part 682.
  2. Independent Living (IL) Services - Individuals with a severe physical, mental, cognitive, or sensory impairment whose ability to function independently in the family or community or whose ability to obtain, maintain, or advance in employment is substantially limited and for whom the delivery of IL services will improve the ability to function, continue functioning, or move toward functioning independently in the family or community or to continue in employment
  1. Independent Living Services for Older Individuals Who are Blind: Specialized programs for individuals with visual impairments aged 55 or older whose severe visual impairment makes competitive employment extremely difficult to obtain but for whom independent living goals are feasible.
  2. Assistive Technology: Individual of any age, race, or ethnicity- who has a disability; and who is or would be enabled by an assistive technology device or an assistive technology service to minimize deterioration in functioning, to maintain a level of functioning, or to achieve a greater level of functioning in any major life activity.

VII. Reporting Requirements

Requirements may vary depending upon the type of program. Reference DRS Program Manuals for program specific Reporting and Monitoring Requirements. All manuals are available by contacting the Provider's DRS Project Officer.

VIII. Special Conditions

A. Background Checks: Health Care Worker Background Check Act - The Provider certifies that it is in compliance with all requirements and regulations issued pursuant to the Health Care Worker Background Check Act (225 ILCS 46). The Health Care Worker Background Check Act applies to all individuals employed or retained by a health care employer as home health care aides, nurse aides, personal care assistants, private duty nurse aides, day training personnel, or an individual working in any similar health-related occupation where he or she provides direct care. (225 ILCS 46/10). It is the responsibility of the provider to determine if this act applies to the provider.

B. Nurse Aide Registry: The Provider shall not employ an individual in any capacity until the Provider has inquired of the Department of Public Health as to information in the Nurse Aide Registry concerning the individual. If the Registry reflects the existence or contains information that substantiates a finding of physical or sexual abuse or egregious neglect against an applicant, the Provider shall not employ him or her in any capacity.

C. Abuse and Neglect: Providers are mandated reporters. If the person is enrolled in a program or lives in a setting funded, licensed or certified by DHS or lives in a private home, call the Adult Protective Services Hotline 1-866-800-1409 (Voice) 1-888-206-1327 (TTY) or if the person with disabilities is enrolled in a program or lives in a setting funded, licensed or certified by Department of Public Health (DPH) (e.g. a nursing home), and the abuse/neglect occurs when service is being provided, call the DPH Nursing Home Hotline: 1-800-252-2893.

D. Mandatory Meetings and Training: DRS may designate any meeting or training it deems necessary as mandatory for Provider attendance. Providers will be given notification of such meetings or trainings via registered mail. Such meetings or trainings will be offered free of charge. Providers must support their own travel, per diem and lodging expenses. Reasonable accommodations will be made upon request 14 days prior to the meeting or training.

E. Data: The Provider must provide DRS with any and all data as specified in specific Program Manuals as well as other applicable rules. Data will be submitted in a timely manner in a format prescribed by DRS.

F. Monitoring: Reference DRS Program Manuals for monitoring requirements. All manuals are available by contacting the Provider's DRS Project Officer.

G. Funding Reserve: Reductions in Amounts Payable: The amount(s) payable, or estimated amount(s) payable, to vendor/provider under the agreement and this attachment may be subject to a reduction as necessary or advisable, based upon actual or projected budgetary considerations, at the sole discretion of the Illinois Department of Human Services.

H. Providers providing services to individuals who are Deaf, Hard of Hearing or DeafBlind must adhere to the following:

Sign Language Interpreter Services: Interpreters must be appropriately licensed in accordance with the Interpreter for the Deaf Act of 2007. A Listing of Licensed interpreters can be found at http://www.illinois.gov/idhhc/licensure/Pages/DirectoryHome.aspx. Proficiency Levels indicating License requirements for various environments can be found at http://www.ilga.gov/commission/jcar/admincode/068/068015150000900R.html

Telecommunication Services: When appropriate, Providers will use Telecommunication Relay Services when communicating with Deaf, Hard of Hearing or DeafBlind people. Dial 711 and you will be connected to a TRS operator. Give the operator the number of the person you are calling. This communication takes place via text. Others use Video Relay Services (VRS) which utilizes a sign language interpreter to call people who use Video Phones. Callers dial the 10-digit video phone number and are automatically connected to a communication assistant who will interpret the conversation.

Other Communication Services: Other appropriate methods of communication must be used as requested by the customer and may include: CART (Communication Access Realtime Translation (CART) or an Assistive Listening Device (ALD).

I. Other special conditions may be added at the discretion of the Division of Rehabilitation Services.