Section 641.15  Certification/Re-certification

a)         A Center may be certified and re-certified by the Department as set forth in this Part.

b)         Center Certification

1)         A sponsoring agency's request for certification shall be in writing and submitted to the Illinois Department of Public Health.

2)         Applicants for certification will be accepted from programs or parent organizations of programs that have a history of providing comprehensive school health services.

3)         Applicants shall submit evidence that they are in compliance with all applicable Department audit requirements as specified in 89 Ill. Adm. Code 507.

4)         Prior to certification, the Department shall conduct an on-site inspection.

5)         Based upon the on-site inspection, the Department will certify the program if the Department determines that:

A)        the applicant has proven that it meets the standards as set forth in this Part;

B)        the sponsoring agency operating the program is fiscally sound and responsible;

C)        the program management is experienced in business and in the delivery of comprehensive school health services.

6)         The Department shall notify the sponsoring agency of certification or denial of certification within 60 calendar days.

A)        Approval of Certification

If the Department certifies the program, it shall include the HFS Medicaid enrollment forms with the letter of certification.

B)        Denial of Certification

If the Department is not able to certify the program based on the criteria outlined in this Part, the Department shall notify the applicant in writing, describing those deficiencies that will result in a denial of the certification.  The applicant has 60 days after receipt of the notice to correct the deficiencies and supply the new information to the Department.  If the new information indicates that the program meets the criteria of this Part, the Department shall certify the applicant.  If the program continues to fail to meet the requirements of this Part, the Department shall deny the application for certification.  If certification is denied, the applicant may appeal the Department's decision and request a hearing pursuant to 89 Ill. Adm. Code 508 (Administrative Hearings).

7)         Certification shall be effective on the date of approval by the Department and shall remain in effect for two years provided the Center continues to meet the requirements outlined in this Part. Upon certification, the Center may deliver services to Medicaid recipients that will be reimbursable after the applicant completes the HFS Medicaid enrollment procedure.  The Center is responsible for complying with all Medicaid policies (89 Ill. Adm. Code 140).  Should a Center's ownership change, a new certification must be obtained within 60 days.

8)         Re-certification

A)        To be eligible for re-certification, a Center shall be in compliance with all provisions of this Part.

B)        To be eligible for re-certification, a Center that receives funding from the Department shall be in compliance with all applicable Department audit requirements specified in 89 Ill. Adm. Code 507.

C)        The Department shall review all documents and the results of the last inspection and shall re-certify based on the standards set forth in this Part.

9)         Denial of Re-certification

If the Department is not able to re-certify the Center based on its review and inspection, the Department shall notify the applicant in writing, describing those deficiencies that will result in a denial of re-certification. The applicant has 45 calendar days after receipt of the notice to correct the deficiencies and supply the new information to the Department.  If the new information indicates that the Center meets the criteria of this Part, the Department shall re-certify the Center.  If the Center continues to fail to meet the requirements of this Part, the Department shall deny the application for re-certification and shall notify the applicant in writing, giving the reasons for the denial.  The provider may appeal the Department's decision and request a hearing pursuant to 77 Ill. Adm. Code 100 (Practice and Procedure in Administrative Hearings).

(Source:  Added at 24 Ill. Reg. 14435, effective September 13, 2000)