Section 230.520  Eligibility Criteria

The following eligibility criteria must be met in order to receive services provided through Title III-D:  

a)         individuals must be 60 years of age or older;

b)         special consideration shall be given to individuals in greatest economic need, with particular attention to low-income (at or below the poverty threshold defined in Section 230.45(b)) minority individuals (however, means testing may not be used for any service under this Subpart);

c)         the individual shall have a demonstrated need for the specified service, taking into consideration the ability of the individual to perform basic (e.g., eating, bathing, grooming, dressing, transfer (in/out of bed), inside home, toileting, bladder continence, and bowel continence) activities of daily living, instrumental (e.g., managing money, shopping, telephoning, preparing meals, laundry, housework, outside home, medication management, routine health, special health, and being alone) activities of daily living, and the availability and adequacy of support (i.e., informal and/or environmental) received from other sources in relation to the need for such services (refer to 89 Ill. Adm. Code 240.715, Need For Long Term Care).  The demonstration of need for the specified service will be defined by utilizing:  

1)         the Community Care Program Determination of Need point score, the basis for which is established in 89 Ill. Adm. Code 240.715; or

2)         an area agency on aging devised process for assessment of case management services for which the area agency on aging has received approval from the Department prior to its implementation.  An area agency's process shall be approved by the Department if it contains the following assurances:  

A)        a standardized initial intake tool shall be utilized in determining each applicant's need for case management services considering those factors specified in subsection (c) above;

B)        an in-home assessment must be conducted for all case management clients, utilizing the standardized assessment tool, to evaluate the functional, financial, and environmental conditions of the client and to identify service needs;

C)        an in-home reassessment of the client's condition and needs must be conducted at least annually, and when there is a significant change in a client's status or circumstances (e.g., hospitalization, loss of caregiver); and

D)        in the provision of case management services, all activities shall be carried out in a timely manner and as early as practical depending upon the client's particular situation.

(Source:  Added at 13 Ill. Reg. 3054, effective March 1, 1989)