Section 686.1010  Case Management Provider Responsibilities

a)         Case Managers

1)         The Case Manager shall receive referrals from hospitals, other health providers, and other State and local agencies.

2)         The Case Manager shall have responsibility for the implementation of services to be provided.  The services, developed by the HSP Counselor with Customer participation, shall be provided in a manner that reflects the Customer's choice, when applicable, and shall address his/her strengths, needs and desired goals.

b)         The Case Manager shall provide the following services:

1)         networking/coordination/brokering services (i.e., referring and assisting the Customer in obtaining other agencies' services);

2)         counseling and advocacy;

3)         contacting the Customer a minimum of one time per month;

4)         maintaining and updating Customer records; and

5)         monitoring the cost effectiveness of the service plan (89 Ill. Adm. Code 679.50).

c)         Service Plan

1)         The person-centered service plan will be retained during the time the case is opened and for five years after closure, unless an audit exception has occurred. In the case of an audit exception, the service plan will be retained until the audit exception has been resolved.  Copies of the service plan will be maintained in the Case Manager's location and the HSP office.  Closed cases will be retained in the HSP Central Office.

2)         If implementation of services is delayed beyond required time limits in subsection (c), the Case Manager must inform the HSP administration and assist the Customer in obtaining another provider.

d)         Records of contact with Customer will be entered and maintained by the Case Manager in the Customer's confidential case record.  All contacts, oral or written, with or on behalf of a Customer shall be documented in a confidential case record.  The Case Manager is responsible for obtaining consents for the release of information as necessary and when required by regulation (89 Ill. Adm. Code 505) and the Health Insurance Portability and Accountability Act (42 USC 1320(d) et seq.).

(Source:  Amended at 43 Ill. Reg. 2133, effective January 24, 2019)