Emergency Closure of an ICF/DD

Illinois Department of Human Services
Division of Developmental Disabilities
Information Bulletin
DD.15.054
Emergency Closure of an ICF/DD
April, 2015

Purpose

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

  • Achieve a smooth and consistent emergency ICF/DD closure process. 
  • Ensure that persons are afforded choice of alternative services during an emergency ICF/DD closure.
  • Ensure that persons are transitioned to alternative residential or in-home support services in a safe, person-centered, and efficient manner that fosters the least amount of disruption to their daily schedules and services.

Definition of Acronyms

  1. Bureau of Community Reimbursement (BCR) 
  2. Bureau of Transitional Services (BTS) 
  3. Closure Team will include court-appointed receiver representative (if applicable), DPH, DHS/DDD and local ISC agency
  4. Community Integrated Living Arrangement (CILA) 
  5. Division of Developmental Disabilities (DDD) 
  6. Home-Based Support Services (HBS) 
  7. Illinois Department of Healthcare and Family Services (IDHFS) 
  8. Illinois Department of Human Services (IDHS) 
  9. Illinois Department of Public Health (IDPH)
  10. Independent Service Coordination (ISC) 
  11. Individual Service Plan (ISP) 
  12. Interdisciplinary Team (IDT) 
  13. Intermediate Care Facility for Persons with Developmental Disabilities (ICF/DD) 
  14. Long Term Care Unit (LTC), Bureau of Community Reimbursement
  15. Pre-Admission Screening (PAS) Level II

Process and Procedures

The Emergency ICF/DD Closure Informational Bulletin provides 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 Informational Bulletin does not address a planned ICF/DD closure.

  1. The Illinois Department of Public Health (IDPH), with input from IDHS's DDD will secure a court-appointed receiver for the emergency closure of the ICF/DD (See Rule 350.270), if deemed necessary. 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 IDPH with input from the Director of DDD regarding the content of its closure notice to the persons, guardians, and family members prior to dissemination. 
  3. The closing ICF/DD will send the official closure notice to persons, guardians, family members, IDHS/DDD, IDHFS, IDPH, and local ISC agency upon court order of receiver appointment. 
  4. The closing ICF/DD will send official correspondence to IDHS/DDD, HFS, and IDPH that includes the following:
    • Date and time the closing ICF/DD will cease operations.
    • List of persons per ICF/DD site (if more than one ICF/DD is closing within the organization).
    • Address and phone number of each individual's residence.
    • Name and phone number of ICF/DD contact person during closure. 
  5. The IDPH-contracted monitoring entity will conduct on-site monitoring of the closing ICF/DD as directed by IDPH with input from IDHS/DDD. For additional information regarding the IDPH-contracted entity's on-site monitoring duties refer to Rule 350.270 a-c). For information regarding the IDPH-contracted entity's qualification(s) refer to Rule 350.270 b). 
  6. The ISC agency will inform the persons, guardians, and family of its role and available resources throughout the emergency ICF/DD closure process. 
  7. The DDD/BTS Representative will notify other entities within IDHS of the ICF/DD's closure activities. 
  8. The ICF/DD 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 IDPH, DDD/BTS Representative, local ISC agency, and (if applicable) court-appointed receiver. The IDPH-contracted monitoring entity may participate in these meetings. 
  9. The DDD/BTS representative will be responsible for scheduling and facilitating the closure work group meetings, updating the closure work plan, and maintaining a file of all related reports. 
  10. 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. 
  11. A Pre-Admission Screening (PAS) Level II will not be completed for individuals who transition from the closing ICF/DD to another ICF/DD or a Medicaid Waiver service such as CILA or HBS (See PreAdmission Screening Manual for further guidance).
  12. The local ISC agency will present to the person, guardian, and family all alternative residential or in-home support service options that the person is eligible to receive. 
  13. The local ISC agency will ensure that releases of information are secured from the individual or guardian. 
  14. The person, guardian, and family will explore all alternative residential or in-home support service options. 
  15. The local ISC agency will arrange on-site visits to alternative residential settings for the person, guardian, and family, if the time frame for closure permits. The local ISC agency will encourage the person, guardian, and family to explore in-home support services and conduct on-site visits to all potential day programs and/or alternative residential options, if the time frame for closure permits. The individual will also be encouraged by the local ISC 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. 
  16. The person and/or guardian will render a final decision regarding alternative residential or in-home support services. 
  17. If the person or guardian has chosen CILA services, the receiving CILA and assigned ISC agency will coordinate the gathering of required information for the CILA funding packet. If needed, DDD will issue a Pre-Award letter (PAL) for CILA services; thereby allowing the person to transition to Medicaid Waiver services immediately. If the person or guardian has chosen HBS, the sending ISC agency along with the guardian will gather the necessary information for submission of a HBS funding packet. If an ICF/DD is selected, the individual will transition per the processes of the receiving ICF/DD. 
  18. The sending ISC agency will send the CILA or HBS funding packet to DDD/BTS Representative for further processing. 
  19. The DDD/BTS representative will review and forward complete and thorough CILA or HBS funding packet to BCR for processing of an award letter. 
  20. The 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 ISC agencies. 
  21. The sending ISC agency will notify the receiving ISC agency of persons who transition to a new residential location within its service area. 
  22. The court-appointed receiver of the closing ICF/DD will arrange for transportation of the person 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 a copy of the person's records/files are transported to the alternative residential setting or to the sending ISC agency for a person who chose to return home with family, on a temporary basis, until permanent services are arranged. 
  23. 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. 
  24. The HBS Service Facilitator will be responsible for scheduling and convening the members of the IDT for persons who choose HBS. 
  25. The assigned ISC agency will conduct mandatory face-to-face on-site visits with the individual who transitions to Medicaid Waiver-funded services. 
  26. The closing ICF/DD court-appointed receiver will send final closure notification on last date of operation to IDPH, IDHS/DDD, and IDHFS. 
  27. The closing ICF/DD will dis-enroll the individuals with the current DT provider by submitting to the IDHS Enrollment/Disenrollment Form (IL444-2768). For individuals who transition to another ICF/DD, the receiving ICF/DD will re-enroll persons with the new DT provider by submitting to DDD the Enrollment/Disenrollment Form (IL444-2768). The instructions are also on this form.

ISC Items to take to ICF/DD for Emergency Closure

For smaller ISC agencies, they may need to reach out to other ISC agencies and DDD for assistance.

A copy of this checklist and any listed item noted will be sent with the individual to the new provider agency, and a copy of the checklist/information will also stay with the sending Independent Service Coordination (ISC) agency. Initial each item when secured or note as N/A if not applicable.

______ Stapler/paper clips/pens

______ Portable Copier and/or Scanner (or the ability to fax, scan, or email items)

______ Copy Paper

______ Referral forms

______ Blank releases

______ Large Garbage bags (to use for bags for individuals who do not have suitcases)

______ Labels

______ List of providers statewide with emergency contacts-vacancy list

______ List of other ISC agencies with contact information

______ Cell phones and/or laptop computers

______ Copies of Emergency Closure Checklist of Needed Information of Individuals

Personal Information Needed

______ Family contact information

______ Copy of guardianship papers and guardian contact information

______ Copies of Assessments/Evaluations and Contact Information:

  • ______ Physical/physician contact information
  • ______ Dental/dentist contact information
  • ______ Vision/physician contact information
  • ______ Hearing/physician contact information
  • ______ Speech/Communication/therapist contact information
  • ______ PT/therapist contact information
  • ______ OT/therapist contact information
  • ______ Physician orders and physician contact information, if different from above
  • ______ Most recent diet orders
  • ______ MARS
  • ______ Most recent ISP (also IEP if children)
  • ______ Behavioral program and therapist/counselor contact information
  • ______ Most recent ICAP
  • ______ Psychological evaluation(s) and Psychologist/Counselor contact information
  • ______ Psychiatric information and Psychiatrist contact information

______ Daily schedule and day program provider contact information

______ Social security card (copy if original unavailable)

______ ID or driver's license (copy if original unavailable)

______ Medicaid /Medicare/private insurance card (copy if original not available)

______ LINK card (copy if original not available)

______ Birth certificate (copy if original not available)

______ Prepaid burial information

______ Bank/financial statements, including savings account/checkbook information

Personal Treatment/Medical Items Needed

______ All remaining medications (List here and send with person)

______ Special dietary foods/supplements (List here and send with person)

______ Adaptive equipment (List here and send with person)

______ Communication devices (List here and send with person)

______ Specialized medical equipment (List here and send with person)

Personal Inventory Items Needed

______ Personal money on hand (List amount and send with person)

______ Copy of the agency's most recent personal inventory checklist

______ Personal furniture (List and send with person) 

______ Recreational equipment (List and send with person)

______ Electronics (List and send with person)

______ Personal care items (List and send with person)

______ Personal bedding (List and send with person)

______ Room decorations (List and send with person)

______ Clothing, including stored out-of-season clothing (List and send with person)

______ Suitcase and/or other bags (List and send with person)