License Application

Section 115 Section 115.410  License Application a)         Forms 1)         Agencies must fulfill new provider requirements for prospective CILA providers within one of year of requesting a licensure application.  Upon verification of eligibility, agencies can obtain an application by contacting: The Bureau of Accreditation, Licensure and Certification Department of Human Services DHS.BALC@illinois.gov 2)         The application shall require prospective CILA agencies to certify that individuals being served and the programs and services to be provided in CILAs comply with Section 4 of the Community-Integrated Living Arrangements Licensure and Certification Act, the Mental Health and Developmental Disabilities Confidentiality Act, and this Part. Agencies that will be providing CILA services for individuals in the DDD Medicaid HCBS Waiver shall ensure: A)        Services to be provided comply with 59 Ill. Adm. Code 120 and 42 CFR 441.301(c)(1) through (c)(4), which specifies Person-Centered Planning and Settings requirements for individuals receiving Medicaid HCBS Waiver Services; B)        Settings are not the type of settings described in 42 CFR 441.301(c)(5)(v); and C)        CILAs that will be provider-owned or controlled also meet the additional conditions set forth in 42 CFR 441.301(c)(4)(vi)(A) through (E). 3)         The application shall request information including, but not limited to: A)        The CILA agency, the type of business organization (per 805 ILCS 5 through 415), the names of all owners, partners, and stockholders; B)        The individuals being served or to be served in the CILAs supervised by the agency, including their disabilities and diagnoses, any special needs such as visual or hearing impairments or mobility issues, the kind of supervision received, and whether individuals are in living arrangements owned or leased by the agency; C)        The living arrangements used as CILA sites, including site addresses and telephone numbers; D)        Policies and procedures of the agency; and E)        Organizational chart, staffing patterns, and staff qualifications for the agency. 4)         The authorized agency representative shall sign and date the application forms. b)         Fees The Department shall charge a non-refundable licensure and renewal fee as provided by Section 4(d) of the Community-Integrated Living Arrangements Licensure and Certification Act. c)         Renewal On Department notification, each licensed agency shall submit a signed and dated renewal application at least 120 days prior to expiration of the license. d)         Change in Ownership The agency will notify BALC and DDD within 60 business days of any change of ownership including the type of business organization (see 805 ILCS 5 through 415), the names of all owners, partners, and/or stockholders. e)         CILA agencies must be operational within 18 months or the Department will consider the licensure process abandoned.  Any future licensure application by the provider will be considered a new application.