Eligibility Determination Process

Section 141.205  Eligibility Determination Process a)         The Department will implement a standardized, assessment-based process for identifying individuals eligible to receive CMH-HCBS that includes the following: 1)         An individual seeking community-based mental health services must first have an Integrated Assessment and Treatment Plan (IATP) completed by a qualified provider of their choice. IATP providers shall be required to upload IATP data into the Department's statewide IATP data system. 2)         The Department shall apply a standardized stratification methodology against IATP data to identify individuals who meet the eligibility criteria outlined in Section 141.200. The stratification methodology shall: A)        Utilize information from the individual's IATP to determine whether the individual meets the criteria outlined in Sections 141.200(d) and 141.200(e); and B)        Be published and maintained on the Department's website. b)         Individuals seeking CMH-HCBS, or their parent, legal guardian, or authorized representative as appropriate, may also submit a request for an eligibility determination along with a copy of the individual's completed IATP to the Department or its designee. 1)         The Department or its designee will review complete requests for eligibility determination based upon the criteria found in Section 141.200 to determine whether the request is approved or denied within 30 days after the date the completed request for eligibility determination is received by the Department. 2)         The Department shall issue a written notice of disposition of the request for eligibility determination, consistent with 89 Ill. Adm. Code 102.70. c)         The Department shall issue written notice to individuals or their parent, legal guardian or authorized representative, when applicable, regarding the individual's eligibility to receive CMH-HCBS within 15 days after the individual is determined eligible. d)         Individuals determined eligible for CMH-HCBS shall be authorized to receive services for a period of 6 calendar months beginning on the first day of the calendar month following the eligibility determination.