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Illinois Case Management Service Provider Policy Manual

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The Illinois Case Management Service Provider Policy Manual establishes a comprehensive framework for agencies delivering case management services to individuals with disabilities, older adults, or other vulnerable populations. These services are designed to coordinate care, connect clients to community resources, and ensure access to necessary supports for maintaining independence and well-being. This manual aligns with the Illinois Administrative Code (Title 89, Part 240), Medicaid Home and Community-Based Services (HCBS) Waiver regulations (42 CFR 441.301), and the Illinois Department on Aging (IDoA) Community Care Program (CCP) standards, ensuring compliance with state and federal requirements.
The manual provides detailed guidance for implementing case management services under programs administered by the Illinois Department of Healthcare and Family Services (IDHFS), the Illinois Department of Human Services Division of Rehabilitation Services (IDHS-DRS), and IDoA. 
Key areas covered include:
  • Eligibility and Service Access: Policies outline eligibility criteria for individuals who are Medicaid-eligible or enrolled in HCBS Waiver programs, requiring assistance with accessing services or coordinating care. 
  • Service Delivery Standards: Case management services include needs assessment, service planning, resource coordination, advocacy, monitoring of service effectiveness, and periodic reassessment of client needs.
  • Individualized Service Plans: Person-centered service plans that address each client’s unique needs, preferences, and goals for independence and community integration.
  • Staff Qualifications and Training: Training requirements for Case managers established by IDHS-DRS or IDoA, including instruction on Medicaid policies, client rights, cultural competency, person-centered planning, and crisis intervention strategies.
  • Client Rights: Policies ensure that individuals receiving case management services are treated with dignity and respect while maintaining autonomy over their care decisions.
  • Health and Safety: Guidelines emphasize monitoring client safety during service delivery, including identifying risks in living environments and responding to emergencies or changes in health status.
  • Funding and Reimbursement: The manual includes information on Medicaid reimbursement processes for case management services, reporting obligations for providers, and documentation requirements for compliance.
  • Quality Assurance: Implementation of quality improvement measurements on monitoring service effectiveness, client satisfaction, and adherence to regulatory standards.
  • Coordination with Other Services: Policies encourage collaboration between case management providers and other service providers such as homemaker agencies, personal assistance services agencies, adaptive equipment suppliers, housing authorities, or healthcare professionals.
This manual serves as an essential resource for providers delivering case management services in Illinois.
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