1.Program Definition and Services
Case Management Services in Illinois assist individuals in accessing needed medical, social, educational, and other services. Services include:
- Assessing client's situation and needs
- Developing goals and action plans with clients
- Facilitating access to community resources
- Coordinating and monitoring services
- Regular meetings to evaluate progress
- Providing emergency crisis services when necessary
2. Regulations
The program is governed by:
- Illinois Administrative Code Title 77, Part 630 (Maternal and Child Health Services Code)
- Illinois Administrative Code Title 89, Chapter IV, Subchapter d (Home Services Program)
- Health Care Worker Background Check Act [225 ILCS 46]
3. Licensing or Certification
Providers must be certified as a Case Management Agency by the Illinois Department of Public Health or approved by the Department of Human Services
4. Responsible State Agency
The Illinois Department of Healthcare and Family Services (HFS) and the Department of Human Services (IDHS) oversee Case Management Services programs.
5. Application Process
Providers must:
- Apply for certification as a Case Management Agency with IDPH or IDHS
- Enter into a written agreement with the Department or its designee
- Enroll as a Medicaid provider with HFS if applicable
6. Required Documentation
Providers must submit:
- Proof of staff qualifications and licensure
- Comprehensive written job descriptions for key positions
- Policies and procedures for case management services
- Documentation of ability to provide services in various settings
- Proof of adequate and confidential participant records system
7. Timeline for Approval
The exact timeline for approval is not specified. Providers should contact IDPH or IDHS for more detailed information on the approval process and expected timeframes.
8. Pre-Application Process
There is no specific pre-application process mentioned. However, potential providers should ensure they meet all eligibility requirements before applying.
9. Pre-Application Training
No specific pre-application training is mentioned. However, case managers must meet specific qualifications and receive ongoing training.
10. Additional Notes
- Case managers must receive at least 12 hours of relevant in-service training annually.
- Each case manager should have no more than 30 customers, with potential for incremental increases based on demonstrated competence.
- As of March 3, 2025, providers must adhere to the most recent guidelines for service delivery and documentation set by HFS and IDHS.
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