Current through Register Vol. 48, No. 52, December 27, 2024
a) A CILA is a
residence where an individual with developmental disabilities may reside and
receive services and supports coordinated by a licensed CILA agency as outlined
in their Personal Plan and Implementation Strategy. The individual or guardian
actively participates in choosing CILA services and in choosing a home from
among those available to the general public and/or housing owned or controlled
by a CILA agency.
b) CILA agencies
shall comply with Person-Centered Planning requirements outlined in
42 CFR
441.301(c)(1) through
(c)(3); 59 Ill. Adm. Code 120; Section
115.230; the provider agreement;
and attachments to the provider agreement.
c) CILAs shall comply with
42 CFR
441.301(c)(4), which
specifies settings requirements for individuals receiving services through the
Medicaid HCBS Waiver. CILA settings shall have all of the following qualities,
and other qualities as determined to be appropriate, based on the needs of the
individual as indicated in their Personal Plan. A CILA setting and/or services
shall:
1) Be integrated in, and support full
access of individuals receiving Medicaid HCBS to, the greater community,
including opportunities to:
A) engage in
community life to the extent chosen by the individual;
B) control personal resources; and
C) receive services in the community to the
same degree of access as individuals not receiving Medicaid HCBS;
2) Ensure an individual's rights
of privacy, dignity, and respect;
3) Ensure freedom from coercion and restraint
(except as specified in Section
115.245);
4) Optimize, but not regiment, individual
initiative, autonomy, and independence in making life choices, including but
not limited to, daily activities, physical environment, and with whom to
interact; and
5) Facilitate
individual choice, with the assistance of an ISC agency, regarding services and
supports and who provides them.
d) A provider-owned or controlled living
arrangement shall also meet the following additional conditions:
1) Be a specific physical place that can be
owned, rented, or occupied under a legally enforceable agreement, as determined
by the Department and by the individual receiving services. The individual
shall have, at a minimum, the same responsibilities and protections from
eviction that tenants have under the landlord/tenant law of the State, county,
city, or other designated entity. For settings in which landlord/tenant laws do
not apply, the State must ensure that a lease, residency agreement or other
form of written agreement, as determined by the Department, will be in place
for each HCBS participant, and that the document provides protections that
address eviction processes and appeals comparable to those provided under the
jurisdiction's landlord tenant law.
2) Each individual shall have privacy in
their living arrangement:
A) Entrance doors
shall be lockable by the individual, with only the individual and appropriate
staff having keys to doors.
B)
Individuals sharing living arrangements shall have a choice of roommates in
that setting.
C) Individuals shall
have the freedom to furnish and decorate their living arrangements within the
lease or other agreement.
3) Individuals shall have the freedom and
support to control their own schedules and activities and have access to food
at any time.
4) Individuals shall
be able to have visitors of their choosing at any time.
5) The setting shall be physically accessible
to the individual. All communal areas must meet standards set forth by the
Americans with Disabilities Act (ADA) and other federal, State, or municipal
regulations. CILA providers must ensure sites are certified and have capacity
for individuals who use wheelchairs or other mobility devices before offering
placement. The capacity for individuals who use wheelchairs or other mobility
devices is indicated in the certification letter given to each CILA provider by
the Department for every site.
6)
Any modification of the additional conditions under subsections (d)(1) through
(5) must be supported by a specific assessed need and justified in the Personal
Plan. The Personal Plan shall:
A) Identify a
specific and individualized assessed need.
B) Document the positive interventions and
supports used prior to any modifications to the Personal Plan.
C) Document less intrusive methods of meeting
the need that have been tried but did not work.
D) Include a clear description of the
condition that is directly proportionate to the specific assessed
need.
E) Include regular collection
and review of data to measure the ongoing effectiveness of the
modification.
F) Include
established time limits for periodic reviews to determine if the modification
is still necessary or can be terminated.
G) Include the informed consent of the
individual and guardian.
H) Include
an assurance that interventions and supports will cause no harm to the
individual.
e) CILA services are intended to promote the
safety, well-being, and involvement of the individual in community
life.
f) CILA providers:
1) Shall thoroughly assess the needs of the
individual to determine if the provider's CILA setting and services are
appropriate. No otherwise qualified individual shall be denied placement in a
CILA solely on the basis of their diagnosis.
2) Shall assess their ability to serve
individuals and shall not deny placement unless and until the provider has
worked with the Division to explore all possible options and
alternatives.
3) Must provide
reasonable accommodations or modifications for individuals who reside in the
CILA home and require such accommodations or modifications. Providers should
access all available resources, including but not limited to, home
modifications available in the DD Adult waiver and community
resources.
g) Based on
their needs, individuals shall receive supervision and supportive services
which may range from continuous to intermittent. A CILA setting shall promote
maximum independence, choice-making, access to the community and skill building
for each individual as indicated in their Personal Plan.
h) The CILA agency shall request in writing
to the Department for approval to change the staffing model from the one funded
and in use (e.g., from 24-hour-shift staff to host family home, or from
24-hour-shift staff to intermittent supports), for a person receiving CILA
service. The Department shall review and act upon the request within 15 working
days. The Department shall make its decision based on the needs of the
individuals receiving services and the ability of the proposed staffing model
to equally provide for their needs.
i) Once accepted for service by a CILA
agency, termination of services may only occur pursuant to Section
115.215.
