59 Ill. Adm. Code 120.65
Conflict of interest-free case management
Section 120.65 Conflict of interest-free case management
a) The
Department shall contract ISC agencies to provide conflict of interest-free
case management, as described in 42 CFR 441.301(c)(1)(vi).
b) Case
management shall include, but not be limited to:
1) Determination
of eligibility. In accordance with Section 120.140, the Department has the
responsibility to oversee the accuracy, quality, and appropriateness of
functions provided by ISC agencies and reserves the right to review and approve
or reject determinations of eligibility made by ISC agencies.
2) Development
and annual update of the Personal Plan as described in 42 CFR 441.301(c)(1)(vi)
and Section 120.160(b).
3) Enrolling
and maintaining Individuals in PUNS.
4) Ensuring
the provision of informed choice of all services (including State Plan,
entitlement services, unpaid, and natural supports) and providers.
5) Collaboration
with service providers to ensure Individual's health, safety, welfare,
well-being, and satisfaction with services funded by DDD, and as such,
addressing problems related to outcomes and quality.
6) Supporting
Individuals, including but not limited to, advocacy, exercising rights, and
securing and maintaining services.
c) Conflict
of interest occurs when the entity providing case management is:
1) A
provider agency or a person who has an interest in, or who is employed by, a
provider.
2) A
person who is related by blood or marriage to the Individual or to any paid
caregiver of the Individual.
3) A
person who is financially responsible for the Individual.
4) A
person who is empowered to make financial or health-related decisions for the Individual.