Ill. Admin. Code tit. 89, § 240.950 - Reasons for Termination

a) A participant shall be terminated from CCP for one or more of the reasons identified in this Section:

1) participant is deceased;

2) participant has been institutionalized or is otherwise not available for services for more than 60 calendar days;

3) participant's condition has improved and there is no longer a need for CCP services as measured by the CCP DON to determine need for long-term services and supports;

4) participant cannot be located;

5) participant/authorized representative has requested termination of services;

6) participant/authorized representative refuses transfer to a different provider/CCU and the current provider/CCU cannot provide services needed by the participant;

7) participant/authorized representative has failed to cooperate with the Department/CCU/provider as required and as specified in Section 240.350;

8) participant no longer meets citizenship requirements;

9) participant no longer meets residency requirements;

10) the CCU determines that an adequate person-centered plan of care cannot be developed that meets the participant's determined needs under Section 240.715.

11) the total value of a participant's non-exempt assets has increased and exceeds $17,500;

12) participant/authorized representative failed to report the transfer of non-exempt assets within the past 60 months for the purpose of obtaining CCP services;

13) participant/authorized representative has failed to report or refused to provide documentation of changes in circumstances, as required by Section 240.360;

14) participant/authorized representative refuses to sign a Participant Agreement - Person-centered Plan of Care;

15) participant refuses to sign the Participant Agreement and Consent Form in accordance with Section 240.330;

16) participant/authorized representative refuses to apply for and, if eligible, enroll in medical assistance under Article V of the Public Aid Code, as required by Section 240.865;

17) participant/authorized representative threatened violence or committed actual violence against a Department representative/CCU/provider as specified in Section 240.355; or

18) participant has been convicted of fraud or an OIG investigation has determined that fraud has occurred.

b) A participant cannot be terminated for attempting to exercise or exercising their right to appeal an action by the CCU or provider.

Notes

Ill. Admin. Code tit. 89, § 240.950

Amended at 35 Ill. Reg. 8919, effective June 2, 2011

Amended at 42 Ill. Reg. 20653, effective 1/1/2019 Amended at 48 Ill. Reg. 11053, effective 7/16/2024