Illinois Administrative Code
Title 89 - SOCIAL SERVICES
Part 240 - COMMUNITY CARE PROGRAM
Subpart E - REQUEST FOR SERVICES
Section 240.540 - Statement to be Included on Participant Agreement and Consent Form

The following statement shall be included on the Participant Agreement and Consent Form:

NOTICE

I understand that a decision regarding my eligibility for Community Care services must be made within 30 calendar days after the date of this completed form (address). I must be notified in writing of the decision within 15 calendar days after it is made, and I will receive services, if I am eligible, within 15 calendar days after the notice of eligibility is mailed to me. However, any delay I cause in failing to provide information requested by the Department on Aging will extend these time limits.