Section 240.1130  Participant Transfers – Care Coordination Unit to Care Coordination Unit

a)         A CCP participant may transfer from one CCU service area to another CCU service area with continuous eligibility pending a redetermination of eligibility by the receiving CCU.  The transfer may be requested by the Department, a CCU, or the participant/authorized representative verbally or in writing.

b)         A reason for transfer from CCU to CCU shall be a geographic change in the participant's residence.

c)         The effective date of transfer shall be within 15 calendar days after the date of the Participant Agreement − Person-Centered Plan of Care and services shall be initiated by the receiving provider without service interruption.

d)         To implement the transfer, the transferring CCU, within five work days after the date of a request or notice of need to transfer, or five work days prior to the effective date of transfer, whichever provides the most notification to the receiving CCU, shall:

1)         notify the receiving CCU of the impending transfer and the desired date of transfer;

2)         forward to the receiving CCU the original case record of the transferring participant; and

3)         forward the Participant Agreement − Person-Centered Plan of Care to the participant/authorized representative and a copy to the transferring provider.

e)         The receiving CCU shall:

1)         Upon receipt of the participant's case record, advise the participant/authorized representative as to the providers in the CCU's area that are authorized, and appropriate, to provide the participant's service needs in accordance with the participant's person-centered plan of care.  The participant shall advise the CCU as to their selection and the CCU shall complete a new Participant Agreement and Consent Form − Person-Centered Plan of Care.

2)         Forward to the participant/authorized representative a new completed Participant Agreement and Consent Form – Person-Centered Plan of Care for signature.

3)         Upon receipt of the signed Participant Agreement and Consent Form – Person-Centered Plan of Care, establishing the effective date of the transfer.

4)         Forward:

A)        the Participant Agreement − Person-Centered Plan of Care to the participant/authorized representative;

B)        a copy of the Participant Agreement − Person-Centered Plan of Care and the old Participant Agreement – Person-Centered Plan of Care and a copy of the applicable pages of the comprehensive assessment to the receiving provider on the same day the Participant Agreement − Person-Centered Plan of Care is sent to the participant/authorized representative.

5)         Upon receipt of the provider's signature on the new Participant Agreement – Person-Centered Plan of Care, a copy of the executed Participant Agreement – Person-Centered Plan of Care is to be placed in CCU's participant file and a copy shall be forwarded to the participant/authorized representative.

f)         If any delay in any of the time frames established by this Section is caused by the documented action or inaction of the participant/authorized representative, time frames shall be extended by the number of days of delay.

g)         The receiving CCU shall perform an initial determination of eligibility of the participant and develop a new person-centered plan of care within 30 calendar days after the date of receipt of the case record.

(Source:  Amended at 48 Ill. Reg. 11053, effective July 16, 2024)