January 4, 2010 - Memo to Providers

TO: Licensed or Certified Community Provider Agencies

FROM: Cathy Cumpston, BALC

DATE: January 4, 2010

RE:Recent discussions and changes

I continue to write this quarterly memo to provide information about changes in interpretations and requirements or about long-standing, unchanged practices that remain unclear. I hope it helps you in your efforts to comply with licensure and certification requirements. Please direct any comments or questions to me at (217) 557-9282 or Cathy Cumpston.

Please Remember: Health Care Worker Background Check Act Waivers

The Illinois Department of Public Health is now the state agency responsible for reviewing all requests for waivers under the Health Care Worker Background Check Act. Information and application form are available at www.idph.state.il.us/nar/.

National Accreditation

Although national accreditation is not currently required (or, as was done for FY10 by DMH, suspended), if BALC is to conduct a "deemed status" survey, we must have the accreditation information in our files. Therefore, if your agency plans to continue accreditation, please assure that you have sent or send us the accreditation report that indicates the expiration of the accreditation. If we do not receive this information, we will conduct a "non-deemed status" survey.

New Provider Activity

Since January 2008, the following providers have been licensed to provide CILA services:

Assertive Mission, Inc.Brooke Hill Management, Inc.

Community Integrated Living, Inc.Countryside Association

CuBBull, Inc.Family Association Plus, Inc.

Golden Community Living CenterGolden Pond Homecare, Inc.

New Life ResidenceNu-Care, Inc.

Soledad Social Services Corp. Village Inn of Cobden, Inc.

Wabash Area Vocational Enterprises

During the same period of time, seven (7) CILA applications that were submitted were denied licensure (35% denied).

Since January 2008, the following providers have been certified to provide DT services:

CAM Legal and Social ServicesCognitive Counseling Center

Foundation for Autism ServicesProgressive Housing

Southwest Disabilities Services and Supports

During the same period of time, two (2) DT applications that were submitted were denied certification (29% denied).

Rule 132 Documentation Clarification

Recently, a question cam to the Medicaid Rule 132 Group regarding documentation requirements for services for which reimbursement is claimed (section 132.100i). It is important that all claims submitted be documented according to this section.

Section 132.100i)6) requires that there be a client's response to the "clinical interventions and progress toward attainment of the goals in the ITP." Because Rule 132 does not further define "clinical interventions," the following clarification is being made: "clinical interventions" means services included in 132.150.

Therefore, while there must be a note for each instance of claiming for services listed in 132.148 (evaluation and planning) and 132.165 (case management) that includes all parts of 132.100i) 1) - 6), we would not expect to see the client's response to the clinical interventions and progress toward attainment of the goals in the ITP for those services.