a) A CCU shall have specified staff to carry out the following functions:
- 1) care coordination; and
- 2) supervision of care coordinators.
- b) Care coordination supervisor qualifications shall be as specified in 89 Ill. Adm. Code 220.605(a)(2).
- c) Care coordination qualifications shall be as specified in 89 Ill. Adm. Code 220.605(b)(2).
d) Care coordinator activities and responsibilities shall, at a minimum, include:
- 1) administration of the DON;
- 2) development of a Participant Agreement – Person-Centered Plan of Care;
- 3) performance and/or approval of Choices for Care screening;
- 4) performance of HFS Level I Screen;
- 5) authorization of CCP services; and
- 6) attendance at appeal hearings.
e) Required activities that may be performed by a care coordinator or other CCU staff include:
- 1) screening of inquiries;
- 2) arranging for service implementation in accordance with each specific Participant Agreement – Person-Centered Plan of Care;
- 3) completing required billing activities with the Department;
- 4) reviewing and correcting required billing activities with the Department;
- 5) assisting providers with Vendor Request for Payment (VRFP) rejects;
- 6) timely provision of documents requested by the Department for participant appeals or other Departmental matters;
- 7) implementing case transfers; and
- 8) assisting with completion and submission of participant Medicaid applications.
(Source: Amended at 48 Ill. Reg. 11053, effective July 16, 2024)